The previously undescribed variant of the thyrohyoid muscle and its potential impact on surgical procedures.

The thyrohyoid muscle belongs to the infrahyoid group located in the carotid triangle. It normally originates from thyroid cartilage and inserts into hyoid bone. Quite often, it is continuous with the sternohyoid muscle. Furthermore, there are variants that have their origin in the cricoid cartilage only, however, this occurs very rarely. During anatomical dissection, a two-headed variant of this muscle was found. One head had its origin in the cricoid cartilage and the other in the thyroid cartilage. This variant of thyrohyoid had not been previously described in the available literature. Therefore, we believe that it may be referred to as the cricothyrohyoid muscle. As the thyrohyoideus is often used as a landmark during surgical procedures in the prelaryngeal area and as a muscle graft, a thorough knowledge of its anatomy and variation is extremely important. We speculate that the two-headed version of this muscle may be problematic during surgical procedures in this region, however, it may also provide more options as a muscular graft.

A three-headed plantaris muscle fused with Kaplan fibers: potential clinical significance.

The plantaris is a short, small muscle that usually originates at the popliteal surface of the femur and has a long, thin tendon that typically inserts into the calcaneal tuberosity. Its role and degree of development have been objects of debate for years. Some authors consider it a vestigial muscle while others believe it is a process of its development. The clinical significance of plantaris muscle is usually related to its morphological variation, which is common and well described in the literature. These variations are often a risk factor for many ailments and disorders. We would like to present another, very rare case of three-headed plantaris muscle (fused with distal Kaplan fibers), and consider what clinical implications it may have.

Takotsubo syndrome with several hypertensive crises: an unexpected diagnosis.

We present an unusual clinical case of a 39-year-old woman admitted to the Department of Cardiology due to stenocardial pain accompanied by hypertensive crisis. The patient presented with severe chest pain and high blood pressure, along with a history of type 2 diabetes, hyperlipidemia, smoking, and hypertension. Initial tests showed elevated troponin T, glucose, CRP, and D-dimer levels, and electrocardiography and transthoracic echocardiography showed abnormalities suggesting acute myocardial infarction, but angiography did not reveal any significant coronary artery blockages. Further tests and imaging led to a diagnosis of takotsubo syndrome (TTS) and suspicion of pheochromocytoma, which was confirmed later biopsy. The presented case is very rare because the coexistence of TTS and pheochromocytoma is not common due to the rarity of the tumor. It is very important to make a quick and accurate diagnosis, because improperly treated cases can lead to death.

Selected musculoskeletal disorders in patients with thyroid dysfunction, diabetes, and obesity.

Many medical conditions affect the skeletal system and constitute independent risk factors for fractures. The action of thyroid hormones is necessary to maintain adequate development, mineralization, and bone strength. Untreated hyperthyroidism can lead to a decrease in bone mineral density (BMD), osteoporosis, and pathological fractures. In hypothyroidism, the changes in the quality of bone structure lead to an increase in the frequency of fractures. Excessive body weight negatively impacts fracture risk, increases the risk of osteoarthritis and accelerates the development of rheumatoid arthritis and osteoporosis. Type 1 and type 2 diabetes are associated with an increased risk of bone fractures despite different etiopathogenesis due to the duration of the disease and the pro-inflammatory state, the incorporation of advanced glycation end products (AGEs) into the bone matrix, and microvascular disorders. This study summarizes the current literature on the influence of thyroid dysfunction, obesity, and diabetes on the skeletal system.

The perception of e-learning during the SARS-CoV-2 pandemic by students of medical universities in Poland - a survey-based study.

BACKGROUND: In March 2020 lockdown due to the COVID-19 pandemic forced Polish Medical Universities to implement e-learning. The aim of the study was to evaluate the perception of e-learning by students of Medical Universities in Poland. MATERIAL AND METHODS: Survey was performed nationwide via the Internet from 30th November 2020 to 10th February 2021. Six hundred fifteen (615) medical students completed the survey. The study questionnaire included questions concerning sociodemographic data, perception of lecturers' effectiveness, assessment of stationary and online classes, changes in learning habits and restrictions on education, and advantages and disadvantages of e-learning. RESULTS: The respondents reported that 96.1% of lectures, 85.5% of seminars, and 40.0% of clinical classes were implemented by e-learning. The lectures conducted by e-learning were assessed as good and very good by 78.4% and seminars by 51.2% of respondents. While the clinical classes conducted by e-learning were assessed as bad and very bad by 62.9% of respondents. The most frequently indicated limitations of e-learning were the quality of the content and available materials (26.9%), restrictions in direct contact with the lecturer (19.6%), Internet connection (16.8%), and home conditions (13.8%). Only 4% of the students had to buy or retrofit computer equipment. Any other limitations were indicated by 9.7% of the respondents. CONCLUSIONS: Students were highly accepting of lectures and seminars conducted in the form of e-learning, but not laboratory and clinical classes. The main problems in e-learning are the quality of the classes conducted and the Internet connection. The students expect e-learning classes to be conducted in real-time, with direct, face-to-face contact with the lecturer.

The effect of morphological variability of Dorello's canal on surgical procedures - a review.

Dorello's canal is an arched structure of bone-fibrous character located in the petroclival venous confluence atop the petrosal bone in the petroclival region. It is bordered by the petrosphenoidal ligament, the petrous part of the temporal bone and the lateral border of the upper part of clivus. Its content in the vast majority of variants comprises the abducens nerve, the inferior petrosal sinus, the venous drainage and the dorsal meningeal artery or its medial branch. With the development of microsurgical techniques, this area has gained huge clinical importance, mainly concerning the order in which the above-mentioned elements (especially the position of the abducens nerve) are arranged in relation to each other. These structures appear in different variant forms and necessitate an individual clinical approach. The main purpose of this review is to present condensed information about possible intercorrelations among them and to indicate, on the basis of the available literature and research, possible surgical approaches and the need to consider the variability when treatments in this region are planned.

Micro Thin-Layer Chromatography Fingerprints of Selected Basil Species and Their Chemometric Analysis.

The dried aerial parts of 12 plants of Ocimum spp. were extracted with the Soxhlet apparatus using dichloromethane and methanol as solvents. A micro-TLC system with silica and a normal-phase solvent system (propan-2-ol-n-heptane-formic acid) was used for the chemometric analysis of 12 selected basil methanolic extracts. Some indices of similarity (Pearson's correlation coefficient, determination coefficient, congruence coefficient, and Euclidean, Manhattan (city-block), Chebyshev, and Hausdorff distances) were calculated on the basis of thin-layer chromatograms using ImageJ software. Principal component analysis was also performed. The method allowed the comparison of the analyzed extracts and confirmed the identities of two selected unknown plants.

Two-Dimensional Micro-TLC Phenolic Fingerprints of Selected Mentha sp. on Cyano-Bonded Polar Stationary Phase.

Micro-thin-layer chromatography in two-dimensional (2D-mTLC) mode in normal- (NP) and reversed-phase (RP) systems by use of cyanopropyl-bonded stationary phases was applied to make fingerprints of 11 species of Mentha genus and two finished pharmaceutical products. Non-aqueous eluents were used in the NP systems. Mixtures of acetonitrile with water and methanol with water were used in the RP chromatographic systems. Optimization of one-dimensional systems was performed by determining RM vs. composition of mobile phase dependencies for standards occurring in various Mentha sp. On the basis of these dependencies, the most selective chromatographic systems for each run were chosen. Then most selective eluents were applied to optimize two-dimensional systems by creating RF in NP systems vs. RF in RP systems correlations. The best two-dimensional systems were chosen on the basis of R(2) values for RF vs. RF correlations (the lowest values of R(2) coefficients). The 2D-mTLC optimized systems were applied to separate phenolic compounds and make fingerprints of the examined plant materials.