Search

Signs, including pictograms, present in public space are intended to enforce a specific behavior. Due to their simplicity and unambiguity of the message, they can be an effective tool of public healthcare. The aim of this study was to assess the knowledge referred to the meaning of the sign prohibiting alcohol consumption during pregnancy among first-year medical students who do not have vast knowledge at present level in this field. The study was conducted among academic youth in Poland, and assumed a 5% risk of error, hence, for p

(1) Background: The sinus node (SN) is the main pacemaker of the heart. It is characterized by pacemaker cells that lack mitochondria and contractile elements. We investigated the possibility that transcription factors (TFs) and microRNAs (miRs) present in the SN can regulate gene expression that affects SN morphology and function. (2) Methods: From human next-generation sequencing data, a list of mRNAs that are expressed at lower levels in the SN compared with the right atrium (RA) was compiled. The mRNAs were then classified into contractile, mitochondrial or glycogen mRNAs using bioinformatic software, RStudio and Ingenuity Pathway Analysis. The mRNAs were combined with TFs and miRs to predict their interactions. (3) Results: From a compilation of the 1357 mRNAs, 280 contractile mRNAs and 198 mitochondrial mRNAs were identified to be expressed at lower levels in the SN compared with RA. TFs and miRs were shown to interact with contractile and mitochondrial function-related mRNAs. (4) Conclusions: In human SN, TFs (MYCN, SOX2, NUPR1 and PRDM16) mainly regulate mitochondrial mRNAs (COX5A, SLC25A11 and NDUFA8), while miRs (miR-153-3p, miR-654-5p, miR-10a-5p and miR-215-5p) mainly regulate contractile mRNAs (RYR2, CAMK2A and PRKAR1A). TF and miR-mRNA interactions provide a further understanding of the complex molecular makeup of the SN and potential therapeutic targets for cardiovascular treatments. [ABSTRACT FROM AUTHOR]

The cerebellum, a major feature of the hindbrain, lies posterior to the pons and medulla and inferior to the posterior part of the cerebrum. It lies beneath the tentorium cerebelli in the posterior cranial fossa and consists of two lateral hemispheres connected by the vermis. The cerebellum is primarily supplied by three arteries originating from the vertebrobasilar system: the superior cerebellar artery (SCA), the anterior inferior cerebellar artery (AICA), and the posterior inferior cerebellar artery (PICA). However, variations of the cerebellar arteries may occur, such as duplication of the SCA, SCA creating a common trunk with the posterior cerebral artery, triplication of the AICA, and agenesis of PICA, amongst others. Knowledge of the arterial anatomy of the cerebellum is crucial, as inadequate blood supply to this region can result in diminished motor functioning, significantly impacting the quality of life for patients. The present study demonstrated the importance of adequate anatomical knowledge of the arteries supplying the cerebellum. The PubMed and Embase databases were searched to gather articles on the anatomical characteristics and variations of the arterial supply of the cerebellum. It is the most comprehensive and up-to-date review available in the literature. The possible variations of these vessels may be clinically silent or present with clinical symptoms such as neurovascular compression syndromes of the cranial nerves and aneurysms. With a comprehensive understanding of the cerebellar arterial system, physicians can enhance their diagnostic and treatment capabilities, ultimately leading to more effective management of cerebellar vascular-related issues and other neurological deficits. [ABSTRACT FROM AUTHOR]

Background: The thoracic duct (TD) and the cisterna chyli (CC) exhibit a high degree of variability in their topographical and morphometric properties. Materials and Methods: PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to identify all studies that included information regarding the morphometric and topographical characteristics of the TD and CC. Results: The most frequent location of the TD termination was the left venous angle, with a pooled prevalence of 45.29% (95% CI: 25.51–65.81%). Moreover, the TD terminated most commonly as a single vessel (pooled prevalence = 78.41%; 95% CI: 70.91–85.09%). However, it divides into two or more terminating branches in approximately a quarter of the cases. The pooled prevalence of the CC was found to be 55.49% (95% CI: 26.79–82.53%). Conclusions: Our meta-analysis reveals significant variability in the anatomy of the TD and CC, particularly regarding TD termination patterns. Despite the predominance of single-vessel terminations, almost a quarter of cases exhibit branching, highlighting the complexity of the anatomy of the TD. These findings demonstrate the importance of detailed anatomical knowledge for surgeons to minimize the risk of accidental injury during head and neck, as well as thoracic surgeries. Our study provides essential insights that can enhance surgical safety and efficacy, ultimately improving patient outcomes. [ABSTRACT FROM AUTHOR]

Background: The superior mesenteric artery is one of the most important arteries in the abdominal cavity, which is of great clinical significance, especially in surgical procedures and fatal ischaemic complications. The aim of this study was to develop a clinical classification of the superior mesenteric artery. Material and methods: Postmortem contrast-enhanced computed tomography of 104 (29.8% female, age 50.7 ± 18.7 years) human bodies were analysed. Based on anatomic predisposition to ischaemic and iatrogenic complications, a 3-tiered clinical classification of the superior mesenteric artery was developed. Type 0 was defined as standard risk for ischaemic and iatrogenic complications. Type 1 was defined as increased thromboembolic risk with decreased risk of iatrogenic bleeding, and type 2 was defined as decreased ischaemic risk with increased risk of iatrogenic bleeding. The supply area of the superior mesenteric artery was divided into 4 regions: pancreas, caecum, ascending colon, and transverse colon. Results: Type 0 (standard risk) was found in 62.5% of cases. Type 1 was most frequently observed in the ascending colon region (15.4%). Type 2 was most frequently observed in the pancreatic region (17.3%). Regarding type, most abnormalities were found in the region of the ascending colon (18.3%), pancreas (17.3%), and transverse colon (16.3%). Conclusions: The proposed clinical classification of SMA links anatomic variations in morphology with their clinical significance. A simple, 3-level classification can be easily applied in daily practice and serve as a great support for preoperative evaluation and recognition of patients at risk of iatrogenic or thromboembolic complications [ABSTRACT FROM AUTHOR]

Background: The arterial supply of the large colon is provided by the superior mesenteric artery (SMA) and inferior mesenteric artery (IMA). A particularly important area, especially in the field of colorectal surgery, is the splenic flexure of the colon. There is a noticeable misunderstanding in the correct nomenclature of the major arterial anastomoses between SMA and IMA — Drummond’s Marginal Artery (DMA), Arc of Riolan (AOR), and Moskovitz Artery (MA). The aim of this study is to organise the nomenclature and propose a new simplified one to facilitate communication between physicians of various specialties. Materials and methods: Fourteen formalin-fixed cadavers (9 male, 5 female) accessible from the Chair of Anatomy of the Jagiellonian University Collegium Medicum were dissected to examine and describe the anatomical variations of anastomoses between SMA and IMA. Results: The artery of Drummond was present in all 14 specimens maintaining the continuity of the vessel along its entire course. The Arc of Riolan was found in 7 out of 14 cadavers (50%). The artery of Moskovitz was not found. The average length measured between IMA and aortic bifurcation and between IMA and SMA was 51.00 mm and 84.68 mm, respectively. Conclusions: SMA and IMA anastomoses form an arterial network that is characterised by high variability and trail in surgically strategic areas. For this reason, simplifying the terminology and using unambiguous names of these vessels based on their trail and anatomical relationship with IMV are crucial for the proper planning and execution of surgical procedures performed on the colon. [ABSTRACT FROM AUTHOR]

Background: The goal of the present meta-analysis was to offer physicians the most evidence-based data concerning the anatomical characteristics of the prostatic artery (PA). Materials and methods: Medical databases including PubMed, Scopus, Embase, Web of Science, Google Scholar and Cochrane Library were searched trough. The overall search process was performed in 3 stages. Results: The results were established based on a total of 7421 arteries. PA was found to originate from an internal pudendal artery with a pooled prevalence of 28.81% (95% CI: 26.23–31.46%). Mean diameter of the PA was found to be 1.52 mm (SE = 0.07). Single PA was found to occur in 76.43% of the patients (95% CI: 60.96–89.12%). Conclusions: In conclusion, the authors of the present study believe that this is the most accurate and up-to-date analysis regarding the highly variable anatomy of the PA. The PA originates most commonly from the internal pudendal artery (28.81%); however, it may also originate from other pelvic arteries, including the middle anorectal or the superior gluteal arteries. Moreover, accessory PAs may occur, yet, a single main PA supplying the prostate gland is most frequently observed (76.43%). The PA may also form anastomoses with the adjacent arteries (pooled prevalence of 45.20%), which may create a complex vascular network in the pelvis. It is hoped that the current meta-analysis may help to decrease the potential complications that may emerge from diverse endovascular and urological procedures. [ABSTRACT FROM AUTHOR]

Background: The internal iliac artery (IIA) originates from the common iliac artery at the level of the sacroiliac joint and bifurcates between the L5 and S1 vertebrae. The aim of the present meta-analysis was to demonstrate the most up-to-date and evidence-based data regarding the general anatomy of the IIA, including their variations, length, and diameter. Materials and methods: Major online medical databases such as PubMed, Scopus, Embase, Web of Science, Cochrane Library, and Google Scholar were searched to find all studies considering the anatomy of the IIA. Eligibility assessment and data extraction stages were performed. Results: In the general population the pooled prevalence of Type I (The superior gluteal artery arises independently with the inferior gluteal and internal pudendal arteries arising from a common trunk which dividing inside [Type IA] or outside [Type IB] pelvic cavity) was found to be 56.57% (95% CI: 53.00–60.10%). The pooled mean length of the IIA was 39.95 mm (SE = 1.79) in the overall population. The pooled mean diameter of the IIA was found to be 6.86 mm (SE = 0.27). Conclusions: The IIA is responsible for supplying most of the structures located in the pelvis. Hence, it is crucial to be aware of the possible variants of the said vessel. The results presented in our study may be highly significant in various surgical procedures performed in that region. [ABSTRACT FROM AUTHOR]

Background: The transverse facial artery (TFA) supplies blood to various structures of the lateral face, including the parotid gland, parotid duct, masseter muscle, and facial skin. Knowledge about its anatomy is of utmost importance in various plastic and reconstructive procedures. Material and methods: The results of 55 (110 hemifaces) consecutive patients who underwent head and neck computed tomography angiography (CTA) in the Department of Radiology of the Jagiellonian University Medical College, Cracow, Poland, were evaluated in July 2022. Results: The TFA was found to originate from the STA (superficial temporal artery) in 84 of the cases (95.5%), whereas from ECA (external carotid artery) only in 4 of the cases (4.5%). The median length of the TFA was found to be 43.39 mm (LQ = = 38.53; UQ = 46.37). The median TFA diameter, at its origin, was established at 2.26 mm (LQ = 1.93; UQ = 2.54). The median TFA cross-sectional area, at its origin, was found to be 2.54 mm (LQ = 1.67; UQ = 3.10). Conclusions: The TFA plays an important role in the arterial blood supply to the face, and the present study has demonstrated its stable prevalence in the lateral face region. The most frequent origin of the artery was from the STA; however, it also originated from the ECA in some cases. Moreover, the topographic relationships between the TFA and nearby arteries and anatomical landmarks were measured and analysed. [ABSTRACT FROM AUTHOR]

Background: The anatomy of the posterior auricular artery (PAA) is highly variable and relevant in various plastic and reconstructive procedures. Materials and methods: The results of 55 consecutive patients who underwent head and neck computed tomography angiography (CTA) were analysed. A total of 78 hemifaces were evaluated. The analysis has been performed in 19 categories. Results: Median PAA length was found to be 47.59 mm (LQ = 32.75; HQ = = 56.16). The median PAA diameter (at its origin) was established at 2.55 mm (LQ = = 2.29; HQ = 2.90). Moreover, the median PAA cross-sectional area (at its origin) was set to be 3.22 mm (LQ = 2.49; HQ = 4.13). Sexual dimorphism regarding all of the measured parameters was also evaluated. Statistically significant differences (p ≤ 0.05) were found in 13 of the measured categories. Conclusions: The present study demonstrated the complete anatomy of the PAA. The most frequent origin of the said artery was from the ECA, and its mean length was 45.07 mm; which did not differ significantly between males and females (p > 0.05). Moreover, we have provided surgeons with tools to localize this artery pre- and intraoperatively using simple landmarks, namely the apex of the mastoid process and the centre of the external acoustic meatus. The exact position of the origin of the PAA was also demonstrated by a heat map of the auricular region. Our findings have the potential to assist surgeons in developing a mental visualization of the arterial anatomy of the retroauricular region. This visualization can be instrumental in precisely identifying the location of the PAA during reconstructive surgeries, thereby minimizing complications and enhancing surgical outcomes. [ABSTRACT FROM AUTHOR]

Background: The objective of this meta-analysis was to investigate the anatomical variations of the mandibular lingula (ML) and its relationship with surrounding anatomical structures. Understanding such variations is crucial to help determine the site and depth of a successful inferior alveolar nerve (IAN) anaesthetic block as well as a safe area for oral and maxillofacial invasive procedures to minimise the risk of neurological or haematological damage to the inferior alveolar nerve. Materials and methods: A systematic search was conducted in which all studies were searched on the anatomy of ML. Major medical databases such as PubMed, Scopus, Embase, Web of Science, Google Scholar, and Cochrane Library were searched. Results: All the results were based on a total of 4694 subjects. The overall height of the ML was found to be 8.17 mm (SE = 0.22). The triangular type of ML was found to be the most common. The pooled prevalence of this variation was found to be 29.33% (LCI = 23.57%; HCI = 35.24%). The pooled prevalence of the nodular type was found to be 27.99% (LCI = 22.64%; HCI = 33.67%). Conclusions: The present meta-analysis provides clinically relevant information regarding the shape, location, and height variations of the ML. Understanding such variations of the ML is crucial when performing malocclusion correction procedures that require the ML as a landmark, namely sagittal split ramus osteotomy, and intraoral vertical ramus osteotomy. Furthermore, effective anaesthetic blocks during oral and maxillofacial procedures can be accomplished with a higher success rate if the correct site of injection is identified. The possible locations of the ML should be considered to determine the location of the mandibular foramen and, therefore, the inferior alveolar bundle to prevent motor, sensory, or perfusion pathology during maxillofacial and oral procedures of the lower jaw. [ABSTRACT FROM AUTHOR]

Background: The superior gluteal artery (SGA) is the largest, terminating branch of the internal iliac artery (IIA). Knowledge about the anatomy of the SGA is extremely important when performing numerous reconstructive and endovascular procedures. Materials and methods: The results of 75 consecutive patients who underwent pelvic computed tomography angiography (CTA) were analysed. Results: A total of 145 SGAs were analysed. The origin variation of each SGA was deeply analysed. Type O1 occurred in 79 SGA (56.4%). Furthermore, analogously, branching pattern types were also established. Initially 19 branching variations were evaluated, of which types 1–7 constituted 76.5%. The median SGA length was set to be 54.88 mm (LQ = 49.63; HQ = 63.26). The median SGA origin diameter, in cases of SGA originating from PDIIA, was set to be 6.27 mm (LQ = = 5.56; HQ = 6.87). Conclusions: The origin of the said artery showed a low grade of variability, and the most prevalent origin type of the SGA was similar to the one presented by the major anatomical textbooks, namely, the PDIIA. However, the branching pattern of the SGA was highly variable. To present the anatomy of the SGA in a clear and straight-forward way, novel classification systems of the origin and branching patterns were made. Furthermore, the morphometric properties of the branches of the PDIIA were analysed. It is hoped that the results of the present study may be useful for physicians performing numerous reconstructive and endovascular procedures. [ABSTRACT FROM AUTHOR]

Background: The anatomical variations in the position, length, arterial supply and extension of mesoappendix of the vermiform appendix (VA) are pivotal to establishing a standard pattern in the study population of known ethnicity and their clinical applicability. Materials and methods: The present study was conducted on 47 adult human cadavers, thirty-five males and twelve female subjects of North Indian ethnicity. Results: Retrocaecal appendix was found in 23 cases (48.9%) followed by pelvic in 13 (27.7%), three cases each of pre-ileal, post-ileal, and promontoric (6.4%), one case (2.1%) each of paracaecal and subcaecal reported. The length of VA varied from three to ten centimetres, averaging about 7.37 ± 1.67 cm, both the shortest (2.9 cm) (female) and longest (10 cm) (male) were of retrocaecal type. The main appendicular artery (MAA) showed a widely varied branching pattern within the mesoappendix, ranging from three to seven. Fourteen cases (29.78%) showed the accessory appendicular artery (AAA) or dual arterial supply, arising from the ileocolic artery in ten (21%) and in four from the post-caecal (9%). In the specimens with dual arterial supply, the estimated portions of the VA supplied by the MAA also vary with distal ¾th being supplied in 57.14%. In ten cases (21%), the mesoappendix failed to reach the tip of the VF. Conclusions: Knowledge of anatomical diversities in position, length, course, arterial supply, branching pattern, and mesoappendix is potentially crucial in avoiding surgical catastrophes. Atypical positions of the organ can cause diagnostic confusion and result in delayed treatment. VF supplied by an end artery is one of the causes of the occurrence of appendicitis and mesoappendix not reaching the tip making the organ more vulnerable to necrosis. Vascular variations and anomalies involving the main or accessory appendicular artery are critical to prevent haemorrhage or faulty ligatures. [ABSTRACT FROM AUTHOR]