Imaging of the Wormian bones using microcomputed tomography

Wormian bones are irregular ossicles of small size and reveal fractal pattern of their edges. Their anatomy was visualized in volumetric reconstructions obtained from a series of micro-CT scans. In visual evaluation Wormian bones showed typical anatomy for the calvarial bones. They revealed three-layer composition: the outer and the inner table of the compact bone intervening with the table of the spongy bone. Microcomputed tomography captured all details of the interdigitation of the edge being incorporated into the lambdoid suture and interlocked between opposing edges of the occipital and parietal bones. This modality provided accurate images which allowed delineating morphological differences between the compact bone and the diploe, including vascular channels

Ossification of the ligamentum flavum of the lumbosacral spine in the polish hospitalized population : a prospective cohort study

The aim of this study was to assess the prevalence, clinical features and distribution of lumbosacral ossifications of the ligamentum flavum (OLF), using MRI, CT and microCT, in hospitalized Polish patients. Patients were recruited prospectively between January 2011 and January 2013. Patients were further qualified to the study group only if CT or MRI of the lumbosacral region detected OLF. Level of OLF excision was determined by the localization of spinal stenosis. After excision the LF fragments containing OLF were stored in a 4% solution of formaldehyde until microCT assessment. A total of 184 agreed to take part in the study. In 50 patients (27.2%) OLF were found. Thus, the study group consisted of 17 women (34%) and 33 men, with a mean age of 55.4 \pm 17.2 years. OLF occurred more often in men (66%) than in women (34%) (p = 0.0014). The most common site for the localization of OLF in women, as well as in men was the L5/S1 level (60% and 53.3% respectively). The mean volume of OLF was 3.87\pm 5.27 mm^{3}\left ( 4.66 \pm 5.71 mm^{3} vs. 1.27 \pm 2.19 mm^{3}, in men and women respectively; p = 0.023 \right ). The LF were thickened in 21 (42%) patients. The mean volume of OLF in patients with normal LF was 4.78\pm 5.95 mm^{3} and in patients with thickened LF 5.33\pm 6.10 mm^{3} (p = 0.75). The prevalence of lumbosacral OLF in the Polish hospitalized population is very high. The most common site of their localization is the L5/S1 level. LF thickening is not associated with OLF formation

Influences on GP coping and resilience: a qualitative study in primary care.

BACKGROUND: 'Neoliberal' work policies, austerity, NHS restructuring, and increased GP consultation rates provide the backdrop against increasing reports of GP burnout and an impending shortage of GPs. AIM: To explore GPs' experiences of workplace challenges and stresses, and their coping strategies, particularly focusing on understanding the impact of recent NHS workplace change. DESIGN AND SETTING: Study design was qualitative, with data collected from two focus groups and seven one-to-one telephone interviews. METHOD: Focus groups and one-to-one telephone interviews explored the experiences of GPs currently practising in England, recruited through convenience sampling. Data were collected using a semi-structured interview approach and analysed using thematic analysis. RESULTS: There were 22 GP participants recruited: focus groups (n = 15) and interviews (n = 7). Interviewees understood GPs to be under intense and historically unprecedented pressures, which were tied to the contexts in which they work, with important moral implications for 'good' doctoring. Many reported that being a full-time GP was too stressful: work-related stress led to mood changes, sleep disruption, increases in anxiety, and tensions with loved ones. Some had subsequently sought ways to downsize their clinical workload. Workplace change resulted in little time for the things that helped GP resilience: a good work-life balance and better contact with colleagues. Although some GPs were coping better than others, GPs acknowledged that there was only so much an individual GP could do to manage their stress, given the external work issues they faced. CONCLUSION: GPs experience their emotional lives and stresses as being meaningfully shaped by NHS factors. To support GPs to provide effective care, resilience building should move beyond the individual to include systemic work issues

GPs' perceptions of resilience training: a qualitative study.

BACKGROUND: GPs are reporting increasing levels of burnout, stress, and job dissatisfaction, and there is a looming GP shortage. Promoting resilience is a key strategy for enhancing the sustainability of the healthcare workforce and improving patient care. AIM: To explore GPs' perspectives on the content, context, and acceptability of resilience training programmes in general practice, in order to build more effective GP resilience programmes. DESIGN AND SETTING: This was a qualitative study of the perspectives of GPs currently practising in England. METHOD: GPs were recruited through convenience sampling, and data were collected from two focus groups (n = 15) and one-to-one telephone interviews (n = 7). A semi-structured interview approach was used and data were analysed using thematic analysis. RESULTS: Participants perceived resilience training to be potentially of value in ameliorating workplace stresses. Nevertheless, uncertainty was expressed regarding how best to provide training for stressed GPs who have limited time. Participants suspected that GPs most likely to benefit from resilience training were the least likely to engage, as stress and being busy worked against engagement. Conflicting views were expressed about the most suitable training delivery method for promoting better engagement. Participants also emphasised that training should not only place the focus on the individual, but also focus on organisation issues. CONCLUSION: A multimodal, flexible approach based on individual needs and learning aims, including resilience workshops within undergraduate training and in individual practices, is likely to be the optimal way to promote resilience

Electrode ingrowths revealed during cadaveric dissection of a 5y old implanted pacemaker : the case report

Increasing numbers of implanted cardiovascular electronic devices, results in a need for lead extractions, which has increased to an annual volume of over 10,000 worldwide. We present a cadaveric dissection body with a single chamber pacemaker implanted 5y before death

Fractal dimensions of the sagittal (interparietal) sutures in humans

Traditional studies of the cranial suture morphology have focused mostly on visual estimation and linear measurements, and thus on evaluating their complexity. This paper presents a new look on cranial sutures as curves, which can be analysed by fractal dimension. This new measure seems to be a much better method of expressing properties of sutural patterns than traditional methods. Our findings suggest that the fractal dimension of non-complicated interparietal sutures slightly exceeds the topological dimension of the line, that is 1.0, whereas the fractal dimension of complicated sutures may reach a value of 1.4 or even more. The difference between the minimum and maximum decimal fraction of the fractal dimension indicates a three-fold increase in complexity in the investigated sutures

Anatomical studies on larynx and voice production in historical perspective

Voice production - emission, raised interest of humans from almost the beginning of the humanity. First written information dates back to the Egyptian times 2500-3000 BC. Practically from early Greek period until XIX century studies of the larynx and the speech apparatus brought new and new facts, both regarding the structures, physiology and clinics. Such ancient researchers as Galen, Morgagni, Eustachii, Casserius created milestones for modern laryngology. Authors hoped to present some facts on the anatomical researches in the field of organs responsible for voice production from historical perspective

The median nerve penetrating through the radial head of the flexor digitorum superficialis muscle : case report

The forearm is a body region of numerous anatomical variations. Due to its favorable anatomy flexor digitorum superficialis muscle (FDS) is commonly used in tendon transfer surgeries. In this study a unique combination of abnormalities was found in a single forearm: the flexor digitorum superficialis muscle penetrated by the median nerve, one of the flexor digitorum superficialis tendons early division and absence of the palmaris longus muscle. Described variation potentially may lead to the clinical manifestation of the median nerve compression and should be also considered during FDS surgery