Topography of the infraorbital foramen in human skulls originating from different time periods.

BACKGROUND: The infraorbital foramen (IOF) is present on the maxilla under the infraorbital margin. Its identification is essential in various surgical procedures. The main aim of this study was the morphometric assessment of the position of the right and left infraorbital foramina in relation to specific structural elements of the facial skeleton, their width and direction, and also the determination of the location of these foramina above maxillary teeth in examined male skulls (belonging to European populations) dated to the beginning of the 20th century and the medieval and post-medieval period. This aim concerned also the assessment of the symmetry of the examined foramina (their location and size). An additional goal was to determine differences between the cranial samples concerning the analysed traits. MATERIALS AND METHODS: The six metric and two non-metric traits concerning the IOF were collected from the male cranial samples including modern skulls (n = 87), the medieval and post-medieval skulls (from 13th centuries and 15-17th centuries, respectively; n = 47) obtained from archaeological excavations in Wroclaw, and the sample of the medieval skulls (11-13th centuries, n = 100) from Sypniewo. The sex and age of the specimens were determined using the standard methodology. The appropriate statistical analysis was performed. RESULTS: Significant differences were established for three traits (taken from the left and right side) in the case of modern skulls (diameter of IOF, its distance to the midline, and zygomaticomaxillary suture) and one in the case of medieval skulls from Sypniewo (distance to the midline). In all of the cranial samples IOF most frequently occurred above the first upper molar. The greater diameter of IOF and its shorter distance to the alveolar crest and nasal notch were observed in non-modern skulls compared to modern skulls. CONCLUSIONS: The results of this study provide new additional data on the topography of IOF and its asymmetry, confirm the presence of both geographical and chronological differences between populations, and can be used in dental practice, and forensic odontology in the analysis of archaeological bone materials.

Impact of COVID-19 on the performance of a radiation oncology department at a major comprehensive cancer centre in Poland during the first ten weeks of the epidemic.

The outbreak of SARS-CoV-2 coronavirus rapidly altered radiotherapy service delivery around the world. AIM: The main objective of this study was to assess the impact of precautionary measures implemented in response to the COVID-19 pandemic on the performance of a radiation oncology departments and on mitigation the risk of COVID-19 contagion between and among patients and staff. METHODS: The study period was from March 15 until May 22, 2020. We evaluated total number of patients irradiated and those who initiated treatments, taking into account tumours localisations. We assessed the relationship of potential risk of contagion with patients' domiciles locations in regions with high number of COVID19 case. RESULTS AND CONCLUSIONS: The number of patients treated with radiotherapy during the study period decreased due to precautionary measures. After five weeks, the number of radiotherapy treatments began to increase. Just over half of the radiotherapy patients (53.5%) treated at the GPCC reside in the city of Poznan or in one of the ten surrounding counties where COVID19 incidence was low and reached at the end of the study period cumulative number of cases n = 204. The precautionary measures were effective qRT-PCR tests were performed in 1545 individuals (patients and hospital staff) revealing four staff members and none patient with a positive PCR result. Immunoglobulin testing was performed in 1132 individuals (patients and hospital staff). A total of 63 individuals were positive for antibodies.

Electronic Cigarettes and Awareness of Their Health Effects.

The use of electronic cigarettes or e-cigarettes is strongly on the rise. The literature confirms that in the process of quitting smoking using an electronic device dispensing nicotine should be a transitional stage before the complete cessation of smoking. The aim of the present study was to assess the popularity of e-cigarettes, the underlying reasons for use of such nicotine products, and the level of awareness of health hazards associated with e-cigarettes. The study is of a survey type. The material consisted of data collected from an anonymous survey distributed among 46 female and 23 male users of e-cigarettes in 2015. We used a questionnaire of our own design. The findings demonstrate that the main reason for a recourse to e-cigarettes is a desire to use fashionable technological innovations, and the conviction that such cigarettes are less harmful than the traditional tobacco products. Some respondents used e-cigarettes to quit smoking; others to minimize the harmful effects of smoking. Most respondents acquired information about e-cigarettes from friends or from the Internet. There was a high awareness of the chemical composition of substances contained in e-cigarettes. An interest in e-cigarettes is caused by an increased knowledge on the negative effects of traditional smoking. Currently, the e-cigarettes remains a technological novelty, so that the exact health effects of their long-term use are open to conjecture.

A case of concrescent tooth-A developmental anomaly in a 19th century skull from Uganda.

Dental abnormalities in archeological material such us concrescence or odontoma are rare cases often found accidentally, mostly during routine X-ray analysis or during macroscopic examination of the mastication apparatus. In this study, we present a rare case of concrescence between an upper left third molar and a supernumerary fourth molar in a 19th century skull from Uganda. Simultaneously, it is a critical revision of earlier studies on the same object (which considered this abnormality as an odontoma), using dental X-ray imaging and histological analysis. Concrescence is a rare dental anomaly and this specimen is, to the best of our knowledge, the first such case reported in paleopathological studies of Eastern Africa. It may contribute to recognition and identification of etiopathogenetic factors in dental developmental defects in historical and contemporary populations of Africa.

Concha Bullosa in Paleoanthropological Material.

Concha bullosa is a variant of the sinonasal anatomy in which the middle nasal turbinate contains pneumatized cells, which leads to turbinate enlargement. The reason for concha bullosa formation is unclear, but the variant is seen in up to half the modern population and it may predispose to paranasal sinusitis. The variant has hitherto featured little in paleopathology. Therefore, in the present study we seek to determine the presence of concha bullosa, with the coexisting hypertrophy of the middle turbinate and signs of sinusitis or other pathology of the paranasal complex, in a population living in Tomersdorf-Toporow in the Upper Lausatia, a historical region in Germany and Poland, presently Zgorzelec County in the Lower Silesian voivodeship, at the turn of the nineteenth and twentieth century. The material consisted of 32 skeletons (24 males, 8 females). The gender, age, and stress indicators and the presence of pathological signs were assessed, followed by CT of the skulls. We found 2 skulls (6.3 %) with concha bullosa. In one case septal nasal deviation was present. We conclude that the incidence of concha bullosa could be lower in the past times than at present. Wider research is necessary to settle whether concha bullosa is indeed a rare respiratory paleopathology or a missed, and thus underreported observation.

Relationships Between Tobacco Abuse and Self-Assessment of Health.

Smoking cigarettes negatively influences the functioning of the body. Among other effects, it has an important impact on the respiratory system, circulation, and behavior. It leads to morphological and physiological changes in organs and tissues, so it can change mood. The aim of this study was to assess the relationships between tobacco abuse and self-assessment of health. The survey was conducted among Polish (243) and foreign (80) medical students at the Pomeranian Medical University in Szczecin, Poland. The study was based on a survey questionnaire of the authors' own design, comprising open and multi-choice questions. Our questionnaire was based on the international standard questionnaire from the Health Behavior in School-Aged Children study (Currie et al. 2009). 80 % of students surveyed were free of any chronic diseases. The results showed that only 23 % of the women and 20 % of the men assessed their health as very good, over 60 % as good, and the remaining at lower levels. We did not observe significant differences between smokers and non-smokers. Physical activity in both groups was generally assessed as good or sufficient. We did not observe significant differences between groups in the incidence of headache, abdominal pain, or vertigo. Significant differences were found in the intake of painkillers.

Diseases of the Upper Respiratory Tract in Preschool and School Age Children in Ambulatory Ear Nose Throat Practice.

The most common diseases of the upper respiratory tract in children treated by ear-nose-throat (ENT) specialists in ambulatory practice are infections, such as colds, rhinitis, sinusitis and pharyngitis, very frequently accompanied and promoted by chronic nasal obstructions of various etiology. These diseases, when treated incorrectly or for too long, cause frequent school absenteeism and may also lead to hearing disorders linked with acute or suppurative otitis. They may also habitually perpetuate abnormal breathing and result in occlusal disorders. The aim of this study was to assess the incidence and type of upper respiratory tract diseases in children, depending on age and sex of patients and on the seasons. We also discussed the role of the ENT specialist in the diagnosis and treatment of certain diseases. In the study we analyzed the medical records of patients of preschool and school age treated in the ENT outpatient clinic over one calendar year. It was found that the largest group of patients comprised children of 3-7 years of age, and most children visited the outpatient clinic in the period March-May. The most common main disorder, according to ICD-10, was acute nasopharyngitis (J00) and vasomotor and allergic rhinitis (J30). Among the comorbid disorders H65 and H66 were the most frequent. No significant gender differences were noted in the frequency of particular types of disease.

Vertigo with a Vestibular Dysfunction in Children During Respiratory Tract Infections.

Sudden balance disorders with violent vegetative symptoms (nausea and vomiting) pose a diagnostic and therapeutic problem. In children vertigo/dizziness with symptoms of vestibular dysfunction is rare, but as vascular etiology is unlikely in children such symptoms arouse concern. This article presents two cases of this type of vertigo. The patients were two boys (6 and 9 years old). They came down with similar symptoms: sudden dizziness, disabled walking, nausea and vomiting, spontaneous nystagmus, and a positive Romberg test. The onset of the balance disorder was preceded by respiratory infection: common cold with symptoms of inflammation of the mucous membrane in the nose and throat. Laboratory tests revealed increased levels of C-reactive protein only in the older boy. Neuroinfection and a displacement process were ruled out. Videonystagmography revealed vestibular dysfunction and vestibular neuronitis on the left side.

Topography of the mental foramen in human skulls originating from different time periods.

The location of the mental foramen is used in a number of maxillofacial surgical procedures and in anthropological examinations. The position of the mental foramen has been reported to vary in different ethnic groups and in different historical populations. The aim of this work was to analyse the topography of the mental foramen in mandibles from selected historical populations from the Pomeranian region in Poland. The material consisted of three groups: 92 skulls from the beginning of the 20th century from Szczecin (earlier name Stettin), and two Mediaeval groups -31 skulls from Rurka (historic Rörchen), 18th-19th centuries, and 50 skulls from Sypniewo (historic Zyppnow), 11th-13th centuries. Distances of the mental foramen in relation to the midline, and to the second corresponding point were measured. Additionally, non-metric traits of the mental foramen were recorded. No significant differences in average diameters of the mental foramina measured on the right and the left sides were observed between historical populations. On both sides, in all groups, the foramen was mainly located between positions of the lower first and lower second premolars. In all three groups the direction of the opening of the mental foramen was superoposterior. The similar level of epigenetic variation was observed in all groups. The position and the direction of the exit were similar to other previously studied European populations.

Respiratory diseases in the late middle ages.

Respiratory diseases have beset humanity from the earliest times. The aim of this study was to evaluate the prevalence of respiratory diseases in the inhabitants of a large medieval city. We analyzed 110 skeletons, coming from 12 to 17th century of individuals of either gender. In order to assess pneumatisation of paranasal sinuses and nasal septum curvature, radiographs were performed in the PA projection. Nasal septum deviation was found in 50% of individuals, asymmetry of the frontal sinuses and their aplasia in 11% of individuals. There was no significant relationship between the curvature of the nasal septum and frontal sinus aplasia. One case of tuberculosis and one case of periradicular abscess causing perforation of the maxillary sinus were noted. Developmental variation of the sternum was present in two individuals. In another two individuals, rib fractures with bone union were observed. Analysis of the presence of respiratory disease in bone material is particularly difficult, but the use of modern methods: X-rays, CT scans and endoscopy significantly extends the capability to unravel the underlying causes of bygone diseases.

Snoring and sleep disorders in children with hypertrophy of lymphoid tissue in the throat.

Hypertrophy of lymphoid tissue within the throat in children leads to a number of respiratory problems and sleep disorders. The aim of this study was to evaluate the prevalence of the above-mentioned changes depending on the location of overgrown lymphoid tissue, BMI, and coexisting allergies. The study was based on a survey conducted in a group of 103 children aged 3-14 with a hypertrophy of lymphoid tissue requiring surgery. The questionnaire included questions about symptoms of sleep disordered breathing. In addition, BMI was calculated and the coexistence of other diseases in the group of examined children was taken into account. Pathological changes predominated in children aged 4-6. The incidence of snoring was the most common, observed in 87%, followed by apnea in 45% of the examined group. Co-occurrence of allergies was observed in 36% and excess of body weight in 21% of the children. Overweight was an essential factor that facilitated apneic sleep episodes accompanying lymphoid hyperplasia. Snoring and nasal obstruction were observed more often in allergic patients.

ß2-adrenergic receptor gene polymorphism and response to bronchodilating treatment evaluated by spirometry.

ß2-adrenergic receptors re abundantly expressed in airways, which explains the role of ß2 agonists, the strongest bronchodilators, in treatment of bronchial constriction. There may be a relation between ß2ADR gene polymorphism and the response to treatment with ß2 agonists. In the present study we attempted to study these relationship in vivo, estimating spirometric values before and after the use of salbutamol in reference to variant of ß2ADR gene polymorphisms. The study involved 148 healthy male volunteers. After the examination of the gene polymorphism of the ß2-adrenergic receptor (ß2-ADR) at nucleotide positions 46 and 79 (g.46 and g.79) we performed spirometry testing in all subjects. The pulmonary function was checked twice a day; before and 15 min after the administration of salbutamol. All subjects had normal basic values of spirometry. The use of salbutamol significantly increased spirometric values in all groups determined by ß2ADR gene polymorphisms. Analysis of the spirometric values in individual groups showed a significant increase only in peak expiratory flow (g.46AA and g.79CC). The results of this study give an insight into a possibly important mechanism of the response to treatment with ß2-agonists.

Cigarette smoking among students and the influence of legal regulations on passive smoking.

Research suggests that reducing the degree of nicotine addiction in the population cannot be achieved only by prevention programs. Legislative measures are necessary to be taken by the state. The aim of this study was to assess the degree of tobacco abuse in three groups of students. It also assesses the influence of ban on smoking in public places on passive contact of students with tobacco. A customized survey made up of open and closed questions was conducted among 102 students of electrical faculty, 109 medical students, and 71 students of animal husbandry faculty. The results showed that significantly more women from the electrical faculty smoked. Among the students of animal husbandry, men smoke significantly more cigarettes than women. Women studying animal husbandry start smoking significantly earlier (by about 2 years) than women from other faculties. They are also significantly less likely to smoke cigarettes at school and at home. According to the study, the Polish law to ban smoking in public places, in force since the 15th of November 2010, did not make students quit smoking, although the rate of smoking students decreased. Students did not observe restrictions on smoking in their environment. The study indicates a positive influence of the anti-nicotine legislation on passive smoking, just after 3 months from its introduction.

Cleavage of IgG1 in gingival crevicular fluid is associated with the presence of Porphyromonas gingivalis.

BACKGROUND AND OBJECTIVES: Immunoglobulin (Ig) G1 plays an important role in the adaptive immune response. Kgp, a lysine-specific cysteine protease from Porphyromonas gingivalis, specifically hydrolyses IgG1 heavy chains. The purpose of this study was to examine whether cleavage of IgG1 occurs in gingival crevicular fluid (GCF) in vivo, and whether there is any association with the presence of Porphyromonas gingivalis and other periodontopathogens. MATERIAL AND METHODS: GCF was obtained from nine patients with aggressive periodontitis, nine with chronic periodontitis and five periodontally healthy individuals. The bacterial loads of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Prevotella intermedia and Tannerella forsythia were analysed by real-time polymerase chain reaction, and the presence and cleavage of IgG1 and IgG2 were determined using Western blotting. Kgp levels were measured by ELISA. RESULTS: Cleaved IgG1 was identified in the GCF from 67% of patients with aggressive periodontitis and in 44% of patients with chronic periodontitis. By contrast, no cleaved IgG1 was detectable in healthy controls. No degradation of IgG2 was detected in any of the samples, regardless of health status. Porphyromonas gingivalis was found in high numbers in all samples in which cleavage of IgG1 was detected (P < 0.001 compared with samples with no IgG cleavage). Furthermore, high numbers of Tannerella forsythia and Prevotella intermedia were also present in these samples. The level of Kgp in the GCF correlated with the load of Porphyromonas gingivalis (r = 0.425, P < 0.01). The presence of Kgp (range 0.07-10.98 ng/mL) was associated with proteolytic fragments of IgG1 (P < 0.001). However, cleaved IgG1 was also detected in samples with no detectable Kgp. CONCLUSION: In patients with periodontitis, cleavage of IgG1 occurs in vivo and may suppress antibody-dependent antibacterial activity in subgingival biofilms especially those colonized by Porphyromonas gingivalis.

Periodontal pathogens affect the level of protease inhibitors in gingival crevicular fluid.

In periodontitis, an effective host-response is primarily related to neutrophils loaded with serine proteases, including elastase (NE) and protease 3 (PR3), the extracellular activity of which is tightly controlled by endogenous inhibitors. In vitro these inhibitors are degraded by gingipains, cysteine proteases produced by Porphyromonas gingivalis. The purpose of this study was to determine the level of selected protease inhibitors in gingival crevicular fluid (GCF) in relation to periodontal infection. The GCF collected from 31 subjects (nine healthy controls, seven with gingivitis, five with aggressive periodontitis and 10 with chronic periodontitis) was analyzed for the levels of elafin and secretory leukocyte protease inhibitor (SLPI), two main tissue-derived inhibitors of neutrophil serine proteases. In parallel, activity of NE, PR3 and arginine-specific gingipains (Rgps) in GCF was measured. Finally loads of P. gingivalis, Aggregatibacter actinomycetemcomitans, Tannerella forsythia and Treponema denticola were determined. The highest values of elafin were found in aggressive periodontitis and the lowest in controls. The quantity of elafin correlated positively with the load of P. gingivalis, Ta. forsythia and Tr. denticola, as well as with Rgps activity. In addition, NE activity was positively associated with the counts of those bacterial species, but not with the amount of elafin. In contrast, the highest concentrations of SLPI were found in periodontally healthy subjects whereas amounts of this inhibitor were significantly decreased in patients infected with P. gingivalis. Periodontopathogenic bacteria stimulate the release of NE and PR3, which activities escape the control through degradation of locally produced inhibitors (SLPI and elafin) by host-derived and bacteria-derived proteases.

Influence of body mass index on treatment of breathing-related sleep disorders.

BACKGROUND: Breathing-related sleep disorders cover several conditions (isolated snoring, UARS - upper airway resistance syndrome, obstructive sleep apnea, hypopnea, obesity hypoventilation syndrome) characterized by a variety of symptoms and complex etiology. The conditions can be successfully treated in most cases. Excessive body mass is a factor increasing the probability of the disorders. In most patients it is the only reason for breathing-related sleep disorders. However, it often coexists with various anatomical abnormalities in the upper airway, endocrinological diseases or genetic defects of the facial skeleton, and occurs more frequently in older people, especially men. Excessive body mass significantly affects the range and success of the treatment. OBJECTIVE: To analyze treatment outcome in patients treated at the otolaryngology unit for snoring and related diseases with submucosal tissue reduction within the nasal cavity, pharynx, and soft palate. MATERIAL AND METHODS: Patients were stratified into three study groups depending on the body mass index (BMI): normal, overweight, and obese. The BMI value was compared to the severity of breathing disorders during sleep, with the incidence of other systemic diseases (e.g., hypertension, diabetes), and with treatment outcome. RESULTS AND CONCLUSIONS: The analysis demonstrated a significant influence of body mass on snoring, particularly in complicated and severe types of breathing disorders, such obstructive sleep apnea or hypopnea, and the obesity hypoventilation syndrome. Corrective interventions carried out to eliminate anatomical abnormalities causing obstruction of upper airways provided the best therapeutic effects in patients with normal body mass.

Evaluation of spirometry values in relation to beta-2-adrenergic receptor gene polymorphism.

INTRODUCTION: The vagus nerve plays a special role in the control of respiratory system activity which represents the parasympathetic part of the autonomic nervous system. A small bronchial innervation by the sympathetic system also is observed, and there is a significant expression of adrenergic receptors, in particular ß⊂2 receptors, in the airways. The development of genetics and molecular biology allows for a detailed study which can clarify the essential elements in the pathogenesis of many types of lung disease, as well as the physiological phenomena - bronchial smooth muscle tone and their contractile mechanism. MATERIAL AND METHODS: The study involved 148 healthy male volunteers aged 20-26. In all subjects, gene polymorphism at nucleotide position 46 and 79 of ß⊂2-adrenergic receptor (ß⊂2-ADR) was assessed. According to the gene polymorphism data, we divided the whole examined population of males into 6 groups for further studies. Moreover, in all the subjects, we performed spirometry testing to verify their pulmonary functions. RESULTS: The basic values of spirometry tests in all subjects were in the range of normal values. The frequency of different genotypes in the gene polymorphism of the ß⊂2-adrenergic receptor at nucleotide positions 46 and 79 were typical for the Caucasian population. Analysis of the output values of spirometry, conducted in the particular groups based on their genotype, showed significant inter-group differences in the selected spirometry tests. CONCLUSIONS: Our results may be useful in explaining the differences in the measured values of spirometric indices in healthy subjects in relation to the polymorphism of ß⊂2-ADR, and may also contribute to the verification of standards for spirometric indices for this selected group of young males in the Polish population.

Causes of respiratory ailments in pregnancy.

OBJECTIVE: During pregnancy, especially during its third trimester, most pregnant women reported respiratory discomfort (dyspnea), despite the absence of previously coexisting respiratory illnesses. The aim of this study was to determine the reason for this discomfort. MATERIAL AND METHODS: The study included 24 women examined before and after childbirth. Evaluation of respiratory complains was made on the basis of the respiratory questionnaire of St. George's Hospital. The data were correlated with the results of static and dynamic spirometric tests performed before and after childbirth. RESULTS: Pregnancy did not affect vital capacity (VC). Frequency of perceived symptoms correlated positively with IRV and the ratio IC/VC. A negative correlation was found between ERV and its derivative ERV/VC. There was no relationship between perceived discomfort and parameters of the flow-volume loop. CONCLUSIONS: The extent of perceived respiratory discomfort (dyspnea) during pregnancy was primarily associated with a reduction in expiratory reserve (ERV).

Nasal septum morphology in human fetuses in computed tomography images.

OBJECTIVES: Nasal septum deformation (NSD) may cause breathing dysfunction. The reason for a septal deviation is the developmental anomaly in growth of the elastic septum or its skeleton. Such a type of deviation is called physiological. Some deviations can result from the prenatal trauma. The aim of the work was the analysis of the anatomy of the nasal cavity with a special interest focused on the nasal septum and its deviation. MATERIAL AND METHODS: The nasal cavity with its bones and septum was analyzed in CT images of 105 spontaneously aborted fetuses (57 males and 48 females) aged 12 and 40 weeks of gestation. We attempted to assess the morphometric development of the nasal cavity with tomographic scanning methods and to detect anatomical variations. RESULTS: In 15 (14.3%) fetuses, NSD were detected on radiological sections. The angle between the virtual line from the sphenoid sinus ostium through limen nasi and the horizontal plane was 33.6 ±2.3°, on average. CONCLUSIONS: NSD may already be found in fetuses. The observation of the nasal cavity development enables to evaluate the growth and symmetry of the nasal septum and to foretell predispositions for dysfunction in the upper respiratory tract.

Analysis of the correlation between aortic diameter, heart size, and type of coronary circulation.

The objective of this study was to analyse the correlation between aortic diameter, heart size, and type of coronary circulation. The study was carried out on 102 human hearts (59 male and 43 female). Casts of the vascular system of each heart were prepared using epoxide resins. The hearts were measured for their size and aorta diameter, and classified to a coronary circulation type. The examination of materials indicated no significant correlation between aortic diameter and sex or coronary circulation type. However, a statistically significant correlation between aortic diameter and heart volume index was found.