Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surrounding orofacial structures. One of the main problems in the course of TMD disorders is the systematic increase in the tension of the masticatory muscles (masseter muscles, temporalis and medial and lateral pterygoid muscles), what is the cause of many damages and the development of pathological conditions in the stomatognathic system. The article discusses the differences in the structure of the masticatory and skeletal muscles, as well as the different nature and isoforms of myosin, which determines the much faster generation of contraction in the masticatory muscles and consequently easier generation of excessive, harmful tensions in the masticatory muscles. The article describes the causes of increased tension in the masticatory muscles and methods of their relaxation used in the basic and supportive treatment of temporomandibular disorders. The use of occlusal splints, physiotherapeutic procedures and TMD treatment with botulinum toxin type A were characterized. A role of psychological support and the methods used for patients with TMD were emphasized.
B a c k g r o u n d: Due to current increased life expectancy, the quality of life (QoL) of senior patients is gaining in importance. The aims of this study were: to estimate QoL in a group of patients, aged above 64 years, that is cared for by general practitioners (GPs) in Krakow, Poland, and to find relation- ships between elements of QoL and the results of comprehensive geriatric assessment (CGA) and other important medical and social factors. M e t h o d s: We designed a cross-sectional, questionnaire study among patients who attended GPs' surgeries from April 2018 to April 2019. To examine the patients, we used the Euro-Quality of Life Questionnaire (EQ-5D-5L) and eight scales forming CGA: the Activities of Daily Living, the Instrumental Activities of Daily Living, Mini-Mental State Examination, Geriatric Depression Scale, Timed Up and Go Test, Mini Nutritional Assessment, Clinical Frailty Scale and Athens Insomnia Scale. R e s u l t s: The lowest QoL was observed in dimensions of pain/discomfort and mobility, where 70% and 52% of patients, respectively, reported problems in these areas. Only 91 (21%) respondents had highest results in all five dimensions of QoL. The average score in the Visual Analogue Scale (VAS) of the EQ-5D-5L (representing self-rated health on a given day) was 62.36 ± 18.98 points. Statistically significant relationships were observed between QoL and age, physical activity and multimorbidity (in all cases p <0.001). The results of QoL were correlated with every aspect of CGA, while the strongest relationship was noticed between scores in the EQ-5D-5L VAS scale and scales assessing depression and frailty (p <0.001; r = -0.57 both).
B a c k g r o u n d: Medical education has changed in response to scientific advances and social needs. A i m: The aim of the study was to examine curricula of medical schools around the world and to observe the trends that currently dominate in medical education. M e t h o d: We have collected information on the current curricula of various medical schools using their official websites. When necessary, we supplemented the information using published articles describing the curriculum of a given medical school. R e s u l t s: Our findings reveal that medical schools demonstrate the need for constant reforms and adaptation to changing conditions worldwide. Generally, there is a tendency to integrate basic and clinical fields, to sooner establish bedside teaching, to provide less theoretical and more practical approaches to teaching, to implement more communication skills, and provide students with research training. C o n c l u s i o n s: Medical education has evolved and will continue to change with time. Medical schools introduce modifications to their curricula and share their experiences.
Anorexia nervosa (AN) is an eating disorder characterized by distinct etiopathogenetic concepts that are gradually being linked together to unravel the dominant pathophysiological pathways underlying the disease. Excessive food restrictions, often accompanied by over-exercise and undertaken to lose weight, lead to the development of numerous complications. The biological concept of neurohormonal dysfunction in AN seems incomplete without demonstrating or excluding the role of the enteric nervous system (ENS). Using an animal model of activity-based anorexia (ABA), we conducted the preliminary assessment of the ENS structure. Here we show, in preparations stained by immunohistochemistry with anti- ChAT, anti-NOS, anti-PGP 9.5, anti-c-fos, and anti-TH antibodies, a lower density of cholinergic and nitrergic nerve fibers as well as reduced neuronal activity in myenteric plexus. Such structural and functional damage to the ENS may be responsible for a number of gastrointestinal symptoms that worsen the course of the disease. In addition, we expanded the study to address the unresolved issue of mechanical and thermal pain sensitivity in AN. The Von Frey and hot plate tests revealed, that in ABA animals, the pain threshold for mechanical stimulus decreases while for thermal increases. In this way, we have significantly supplemented the background of AN with potentially observable nervous system changes which may influence the evolution of the therapeutic approach in the future.
A i m: Assessment of the effectiveness and efficiency of three mobile (portable) rescue aspirators models in the opinion of state fire service officers. Comparison with the use of the medical simulation element.
Material and methods: The study was conducted in organizational units of the State Fire Service (24-hour officers). The research consisted in carrying out the task with the use of three models of mobile rescue aspirators (manual, hand-foot, battery). Each participating firefighter had the task of sucking up an equal amount of fluid (100 ml, respectively) with each model of an aspirator. The test fluid was water at room temperature in a homogeneous 1:1 mixture with sugar (increased viscosity and density, simulated real conditions). Immediately after three suction attempts (with measured suction time), each officer completed a questionnaire on the three models used. Descriptive statistics were used to characterize the variables. The following measures were calculated for the variables: mean (M) and standard deviation (SD), minimum, maximum. The following measures were calculated for categorical variables: number (n) and frequency (%).
Results: 184 officers (182 M and 2 F) took part in the study, including commanders 18.43%, rescuers 65.22%, drivers 16.30%. In the study area 1,609 officers serve in the combat division as at the end of 2021. The studied group accounts for 11.43%. Age of respondents M 34.04 SD 8.24 Min 21 Max 52, length of service M 8.48, SD 7.20 Min 1, Max 25. The longest mean time of completing the task was recorded for model 2 (hand-foot) and it was 6.77 sec.
Conclusions: SFS officers highly appreciated the usefulness and effectiveness of the battery-operated automatic aspirator. This assessment may contribute to the widespread introduction of such a model to rescue sets in the SFS. Time of performing the task by mode 1 was significantly longer by elderly people. People with experience with the model 1 during rescue and firefighting operations had a significantly shorter time of performing the task with the use of the model 2. According to the subjective assessment of firefighters, the most effective is model 3, which is confirmed by the suction time obtained at the work station.