Morphology of the antegonial notch and its utility in the determination of sex on skeletal materials.

A number of criteria for the assessment of biological sex, which are applied to living or recently deceased individuals, have been developed, such as genetic, chromosomal, gonadal, hormonal, and phenotypic criteria. Features of a metric and descriptive nature are used to assess the sex of skeletal materials. The diagnostic features of the skull are concentrated in the craniofacial region and around the eye sockets. The mandible is a diagnostically important part of the skull, on which a complex of features is visible. These features develop up to the third decade of life. The goal of the research was to assess the suitability of the parameters of the preangular notch, in other words, the length, height, and surface area for sex prediction applied to skeletal materials. The study included computed tomography images of the masticatory system of 194 patients, consisting of 83 females and 111 males, aged from 16 to 93 years. The three straight lines which correspond to the sides of the triangle representing the notch, in addition to its height, were determined and measured digitally. The receiver operating characteristic method was used to assess the usefulness of the studied features for the purposes of sex prediction. The sensitivity of the test ranged from 51.4% to 67% for the parameters of the preangular notch on the right-hand side, and from 44.4% to 80.2% on the left-hand side. The most reliable predictive models were obtained for two features (shown in the graphical abstract). However, when taking into account, the specificity and sensitivity of the tests presented here, only the length of side AB (a basal length of the notch) can be regarded as a feature that supports the assessment of sex on the basis of other diagnostic features of the mandible. The size and shape of the preangular notch should be treated as auxiliary features in the assessment of sex. For this reason, it is recommended that they should be applied simultaneously to the set of features described in the section on anthropological standards.

Topography of muscular branches of the superficial fibular nerve based on anatomical preparation of human foetuses.

BACKGROUND: The progress of pediatric surgery and increasingly better diagnosis of fetal defects require detailed knowledge of human developmental anatomy. Precise knowledge of the anatomy of innervation of the lower extremities corresponds to this subject and is not only cognitive but also clinically important. The aim of this study was to analyse the anatomy of the topography of the muscular branches of the superficial fibular nerve (NPS) in the prenatal period, which will fill a gap in the literature. METHODS: The analysis was carried out on 207 human foetuses aged from the 113th day to 222nd day of foetal life. The study material is a part of the collection of the Division of Normal Anatomy of Wroclaw Medical University. The study incorporated the following methods: anthropological, preparational and image acquisition which was acquired with the use of high-resolution digital camera. Statistical analysis was carried out with the use of STATISTICA package. RESULTS: Based on the research results the number of muscle branches of the examined nerve was determined. It was shown that in more than half of the cases the two nerve branches are responsible for Peroneus Longus innervation and in about 90% of cases one branch is responsible for Peroneus Brevis innervation. Based on the obtained data a unique, new typology of distribution of these branches was created. It has been shown that the bipinnate type is the most common in the examined fetal population. The presence of statistically significant differences in the frequency of occurrence of individual innervation patterns depending on sex and body side were excluded (p > 0.05). There were also no statistically significant changes in the frequency of occurrence of individual types of NPS branch distribution according to fetal age (p > 0.05). CONCLUSIONS: The created unique typology of NPS branch distribution based on extensive preparation material is an important supplement to the anatomical knowledge and at the same time, due to the peripheral and superficial location of the described structures, it has a relevant clinical significance.

Postpartum depression: identifying associations with bipolarity and personality traits. Preliminary results from a cross-sectional study in Poland.

The goals of this study have been to determine the prevalence of the bipolar spectrum features in the population of women with postpartum depression (PPD) symptoms, as well as to analyze the personality differences between putative 'unipolar' and 'bipolar' PPD subjects. The sample enrolled into the cross-sectional study consisted of 344 women at 6-12 weeks postpartum. The authors used the Edinburgh Postnatal Depression Scale (EPDS; cut-off score: 13 pts.) for the assessment of the PPD symptoms, the Mood Disorder Questionnaire (MDQ; cut-off scores: 7 or 8 pts.) for diagnosing the bipolar features, and the NEO-Five Factor Inventory (NEO-FFI) for the assessment of personality traits. The EPDS-positive subjects were more likely to score positively on the MDQ, as compared to the EPDS-negative ones. The EPDS-positive subjects who also scored ≥8 pts. on the MDQ were characterized by higher index of neuroticism, as compared to those who scored positively on the EPDS only. The results suggest that the presence of PPD symptoms is related to significantly higher scores of bipolarity and neuroticism. The more robust trait of neuroticism might be a marker of the 'bipolar' PPD, as compared to the 'unipolar' form of the disorder.

[Group psychoeducation in bipolar mood disorders - the influence on the cognitive representation of the illness. The results of the program "Taming the bipolar affective disorder"]. / Grupowa psychoedukacja w dwubiegunowych zaburzeniach nastroju - wplyw na poznawcza reprezentacje choroby. Wyniki programu "Oswajanie choroby afektywnej dwubiegunowej"

OBJECTIVES: To assess the influence of group psychoeducation in bipolar disorder on selected aspects of cognitive representation of illness. METHODS: 51 patients with bipolar diagnosis were included in the study, and 24 were included in the final statistical analysis. The participants took part in 8 meetings of group psychoeducation. The assessment of selected aspects of cognitive representation of illness, i.e. acceptance of illness, health locus of control, generalized self-efficiency, hope for success, therapeutic compliance, beliefs about bipolar disorder was conducted with validated questionnaires before, after, and 18 months after receiving psychoeducation to register possible changes. RESULTS: Statistically significant increase in acceptance of illness, perceived self-efficiency, hope for success, therapeutic compliance, and positive modification of beliefs about bipolar disorder were detected. The observed change occurred right after the intervention, but it was not sustained during the follow-up. CONCLUSIONS: Psychoeducation may exert a positive influence on virtually important cognitive variables, which seem to be clinically important. This influence may disappear with time, thus the interventions should either be repeated or the duration of intervention should be prolonged. The study shows new possible research directions in the field of searching for the mechanism of action of psychoeducation in bipolar disorder, as well as of its active components.

[Group psychoeducation in the complex treatment of bipolar disorder--Cracow experiences]. / Psychoedukacja grupowa w kompleksowym leczeniu choroby afektywnej dwubiegunowej--doswiadczenia krakowskie.

AIM: To share our experience in introducing an original, structured group psychoeducational programme entitled "Familiarizing bipolar disorder" into the integrated complex treatment of bipolar disorder (BP). METHOD: The programme is partially based on the Barcelona Bipolar Disorders Program format and represents our proposal of a short, easily applied group psychoeducation. It consists of 8 meetings, conducted by a psychiatrist and a psychologist who are both trained in cognitive-behavioural therapy. Two groups of patients accomplished the programme so far. We would like to present our conclusions and qualitative observations. RESULTS: The patients noticed a change in a philosophical view on the bipolar disorder treatment (access to information, partnership between a doctor and a patient, appreciation of psychological aspects of bipolar illness), which is embodied by the psychoeducational approach. They welcomed our programme with enthusiasm and interest. Many questions were asked about different aspects of bipolar disorder, especially concerning pharmacotherapy, genetic and legal issues. Our participants assessed the number of sessions as optimal, but some of them insisted on devoting one more meeting to interactively discuss pharmacotherapy of BP. The programme revealed many other relevant issues concerning patients' attitudes toward bipolar disorder like: common presence of dysfunctional beliefs patients hold regarding their illness, unawareness of importance of mood stabilizer serum level examination, insufficient knowledge on hypomania or--in some cases--ignorance of a hypomania phenomenon. Moreover, patients appreciated the fact that the psychoeducational programme helped them to diminish the sense of stigma, shame, and the feeling of being different or worse. Finally we are amazingly impressed by the unsatisfied need existing in bipolar patients to share their fears, emotions and to be fully informed. CONCLUSION: Our observations support the statement, that the psychoeducational approach to BD is a crucial element of a complex treatment. It surely satisfies patients needs for information and may help to reformulate beliefs about their illness and its treatment. Further studies on the effectiveness and mechanisms of psychoeducational interventions are needed.

[The efficacy of transcranial magnetic stimulation in the treatment of depression]. / Skutecznosc przezczaszkowej stymulacji magnetycznej w leczeniu depresji.

BACKGROUND: Transcranial magnetic stimulation (TMS) is known as method of depression therapy. RESULTS: The paper presents the results of clinical 2nd phase investigation or safety and efficacy of TMS as compared to electroconvulsive therapy and standalone pharmacotherapy. RESULTS: It was shown that in all three groups of patients a significant improvement of clinical state (decrease of depressive symptoms) was achieved. The strongest effect was observed in the group of patients treated with electroconvulsive therapy (as well as drugs). However, trans-cranial magnetic stimulation combined with pharmacotherapy did not prove to be more effective than standalons pharmacological treatment. The authors discuss possible explanations of inefficacy of transcranial magnetic stimulation therapy. CONCLUSIONS: None antidepressive efficacy of TMS was observed. Forthcoming examinations of TMS are necessary for optimalization of stimulation parameters and conditions.

[Patients' and doctors' attitudes towards bipolar disorder--do we share our beliefs?]. / Lekarze i pacjenci wobec choroby afektywnej dwubiegunowej--czy myslimy podobnie?

AIM: The aim of the presented study was an analysis and comparison of patients and psychiatrists beliefs regarding the most important aspects of bipolar disorder (BD) treatment. METHOD: A group of 100 psychiatrists (with at least 5 years professional experience) and a group of 100 remitted patients fulfilling ICD-10 and DSM IV-TR BD criteria (aged 18-65) were enrolled. Their beliefs were investigated with a 41-item structuralized questionnaire (doctors group) and 27-item self evaluation inventory (patients group). The construction of both tools made it possible to compare the results and was based on hierarchical ranking of answers included in each item. RESULTS: A number of important concordances were indicated between doctors and patients beliefs e.g. both groups considered that: 1) the depression is the most burdensome episode in the course of BD; 2) the pharmacotherapy is the most crucial element of treatment; 3) the improvement of life quality is the most important aspect of recovery. On the other hand the results revealed that patients are convinced that doctors consider improving their life quality as much less important than alleviating symptoms severity. The hierarchy of problems proposed by the patients as the main obstacles in taking drugs appeared to be the exact antithesis of doctors beliefs in this issue. The patients indicated drug side effects as the main cause whereas doctors considered compliance as a crucial problem. Discrepancies in beliefs were also observed regarding the perceived importance of different psychoeducation topics: coping abilities and life quality improvement--two most important issues in patients opinion, were placed on the remote rank in doctors hierarchy, giving place to early recognition of relapse symptoms and suicidality prevention. CONCLUSION: Discrepancies of psychiatrists and patients beliefs regarding crucial aspects of BD treatment that were revealed in the study may be responsible for worsening of compliance quality.

[Working memory disturbances in patients with major depression after ECT treatment]. / Zaburzenia pamieci operacyjnej u pacjentów z glvboka depresja leczonych wstrzasami elektrycznymi.

INTRODUCTION: Electroconvulsive therapy (ECT) is the most effective treatment in a variety of psychiatric syndromes (especially mood disorders). However one of its adverse effects is neurocognitive dysfunction. Declarative memory impairment after ECT is unquestionable and well investigated. There are only few ambiguous studies focused on nondeclarative and immediate memory changes during ECT. METHOD: A study of immediate (working) memory changes in depressed patients treated with ECT (n=10; bitemporal ECT 3 times a week) or imipramine or desipramine (150-250 mg/day; n=10) was conducted in patients who fulfilled DSM-IV criteria for major unipolar depression. Hamilton Depression Rating Scale (HDRS) and Beck's Depression Inventory (BDI) were used to assess the efficacy of antidepressant therapy. Cognitive functions were assessed with neuropsychological tests: Stroop A and B, TMT (Trial Making) A and B. The patients' status was evaluated 1 day before the treatment and 1 day, 2 weeks, 1 month and 6 months after the first ECT procedure. RESULTS: 1 day after first ECT treatment, patient's working memory was slightly impaired, but this was not statistically significant. Both groups showed statistically significant improvement in working memory I month after start of treatment. However there were statistically significant differences between ECT and pharmacologically treated groups at the first month of therapy. CONCLUSION: ECT treatment only temporally affects working memory function. The improvement of function may be a result of clinical recovery from depressant symptomatology.