[The implementation of the law 4509/2017 in the Forensic Department of the Psychiatric Hospital of Thessaloniki].

According to the Explanatory Memorandum of the law 4509/2017, a significant change is being made to the current institutional framework of Articles 69 and 70 of the ECHR concerning the penal treatment of mentally ill offenders, in order to ensure a high level of treatment for perpetrators with mental or intellectual disorder. In application of the law, it was examined in court the abolishment, maintenance or replacement of the treatment measure of 47 patients from the Department of Forensic Psychiatry in Thessaloniki. The results were compared with the previous status quo. In 22 cases, abolishment was ordered for the patients to be discharged and return to their parent's home or to Psychosocial Rehabilitation Units. In 11 of them, their stay was in direct violation of the law due to exceeding the cap as defined by the severity of the offense. However, 7 patients remain voluntarily in the Department, as no beds are available in reintegration structures. 13 patients who have committed homicide remain with the psychiatrist's agreement beyond the overrunning the ten years of treatment due to the severity of the disease or the risk for violent behavior. The Public Prosecutor has provided solutions in many cases and has appointed lawyers for all patients as prescribed by law. However, the judiciary remains cautious and the trend towards exhaustion of the limits is clear, despite the fact that their fears are not confirmed by international bibliographic data. The application of N 4509/2017 attempts to change the landscape for this particular group of patients and allows visions for de-institutionalization, elimination of the stigma and personalized treatment, despite any ambiguities or potential problems that may arise. However, as the predominant social viewpoint, shown by the media, treats the mentally ill as dangerous, any positive changes are doomed to fail. In addition, it is necessary to develop psychiatric services for the treatment of patients which will not only treat psychotic symptoms but also antisocial and aggressive behavior in general.

Iulius Casserius, a relatively underestimated anatomist: his contributions to brain's anatomy.

Iulius Casserius is to be remembered for his excellent contributions in Anatomy and especially in Neuroanatomy. His persistent and meticulous scientific anatomical work resulted in the first record of the arterial circle of the brain 37 years before the comprehensive description by Thomas Willis. Casserius' great interest in the human brain led him to the discovery of plenty anatomical structures before their official documentation. Casserius was an excellent teacher and anatomist of a humble origin, who managed to be distinguished among other famous physicians of his era.

The first descriptions of various anatomical structures and embryological remnants of the heart: A systematic overview.

In the present study a brief overview of the history regarding the development of the knowledge of the macroscopic and microscopic anatomical elements of the heart along with some embryological remnants of the heart has been conducted. The evolution of the awareness as regards the various anatomical and embryonic structures of the heart began from Greek medico-philosophers, such as Hippocrates, Herophilus, Erasistratus and Galen, however, such knowledge was enpowered from the meticulous study of philosophers and physicians until the era of modern anatomy. In specific, the following anatomical and embryological structures are displayed: aortic and pulmonary valve, auricles, bundle of Kent, cardiac nerves, conduction system of the heart, ductus arteriosus, intervenous tubercle of Lower, left atrial oblique vein and ligament of Marshall, limbus of fossa ovalis, mitral and tricuspid valve, nodes or nodules of Arantius, ovale foramen, septomarginal trabecula, sinus of Valsava, small cardiac veins or vessels of Thebesius, tendinous chordae and papillary muscles, tendon of the valve of the inferior vena cava and triangle of Koch, valve of the coronary sinus, valve of the inferior vena cava.

Uterine artery embolization for treatment of symptomatic fibroids; a single institution experience.

BACKGROUND: Uterine fibroids are the most common reproductive tract tumours in females. Uterine artery embolization (UAE) is a fertility-sparing procedure for treatment of symptomatic fibroids. We evaluated the efficacy and safety of UAE in the treatment of 118 patients with symptomatic uterine fibroids in a single Academic Centre in the West of Ireland to determine whether fibroid and uterine size affect clinical outcomes and complications. METHODS: This was a retrospective cohort of 118 patients who underwent UAE for treatment of symptomatic fibroids between November 2006 and August 2011. Diagnosis of fibroids in symptomatic patients was established by magnetic resonance imaging (MRI) and/or transabdominal ultrasonography (US). Three different embolic agents were used. All patients had at least one follow-up using MRI, at three and/or 12 months. A non-validated questionnaire was used to report patient satisfaction with regards to symptoms improvement on a yes-or-no basis. RESULTS: Mean fibroid volume, uterine size and dominant fibroid size were significantly reduced at three months and one year follow-up (p = 0.00) and that was tallied with symptoms improvement (p < 0.05). Overall patient satisfaction at three months was 84% falling to 75.9% by 12 months (all p < 0.05). Few complications were reported (2.5%). No significant difference was observed in safety or efficacy for different embolic agents. CONCLUSION: The study confirms the safety and efficacy of UAE in the treatment of symptomatic fibroids. Hippokratia 2014; 18 (3): 258-261.

Morphological study of the calcaneofibular ligament in cadavers.

The aim of the present study was to investigate the anatomical and morphological characteristics and the maximum elongation of the calcaneofibular ligament (CFL) in cadavers. In a sample of 72 cadaveric lower limbs the mean values of length, width, thickness, and angle with the sagittal plane were recorded for the CFL. The mean ligament's length was 31.8 mm, and the mean width and thickness were 4.4 mm and 1.5 mm respectively. The mean angle with the sagittal plane was 51.11°. In 72.2% of the lower limbs studied, the ligament presented one band, while 22.2% and 5.6% of them were two-banded and three-banded respectively. A common origin with the anterior talofibular ligament (TFL) was found in 24 of the feet (33%). There were also 4 cases in which the anterior TFL was absent. Finally, we measured the maximal elongation of the ligament during extreme inversion and simultaneous dorsal flexion and found it to be 2.88 mm on average. We noticed and statistically verified that women presented a greater elongation compared to men. A precise knowledge of the origin, insertion, direction, and morphology of CFL is critical for ligament injuries in ankle sprains and during ankle reconstruction. Ligament elasticity plays an important role in the range of ankle motion and ligament shearing. Male and female ankle joints differ in several anthropometric characteristics and thus the genre differences in ligament elongation are of great interest.