همراهی نشانگان پولند با اختلال درخودماندگی: گزارش موردی

هدف: هدف پژوهش حاضر، گزارش مشکلات همراه نشانگان پولند در يک آزمودنی بود. روش: يک پسر پنج­ساله مبتلا به نشانگان پولند مورد بررسی عميق قرار گرفت. يافته­ها: بررسی سوابق نشان داد آزمودنی افزون بر نشانگان پولند، مشکلات ارتباطی، کلامی و رفتاری زيادی داشته، به­دليل تحرک زياد تشخيص اختلال بيش­فعالی- کمبود توجه گرفته و سابقه تشنج هم داشته است. پس از ارزيابی دقيق، تشخيص اختلال درخودماندگی داده شد و برای درمان، افزون بر درمان تشنج و درمان نشانه­ای برخی ديگر از مشکلات، کاردرمانی و گفتاردرمانی نيز تجويز شد. نتيجه­گيری: در مواردی که کودکان با نشانه پرتحرکی مراجعه مي­کنند، بايد از نظر وجود ساير اختلال­های روانپزشکی نيز مورد ارزيابی دقيق قرار گيرند

The Great Transformation 1989-2029: Could It Have Been Better? Will It Be Better?

Over 1.8 billion people, from Central Europe to East Asia, have been involved in the great systemic transformation to market economy, civic society and democracy. The process has brought mixed fruits. The diversification of the current situation is a resutransformation, economic growth, development, institutions, economic policy,

Who avoids and who escapes from poverty during transition? - evidence from Polish panel data, 1993-96

The author uses four-year panel data from Poland's Household Budget Survey to explore the distinction between transitory and long-term poverty, a crucial distinction in designing and evaluating poverty reduction strategies. The author analyzes household welfare trajectories during the period 1993-96, to identify the long-term poor and to determine how relevant household asset endowments are as determinants of household poverty and vulnerability over time. He concludes that the chronically poor constitute a distinct and separate segments of the population, with low turnover. Among specific observations about factors that affect Poland's long-term poverty: 1) Variables in human capital significantly affected the pattern of repeated poverty and vulnerability. Larger households tended to experience poverty and vulnerability, mostly because they contained more children or other dependents. Households with elderly members and those headed by older people, by women rather than men, and by educated people of either gender were least likely to be poor. Poverty was unaffectedby the presence of a disabled person in the household. 2) Households with liquid assets or durables, or with access to financial resources, were less likely to be poor and vulnerable. Households appeared to take advantage of credit and loans to maintain their current level of consumption rather than to augment their stock of assets. 3) Households that were part of kinship networks were less at risk of falling into chronic poverty or vulnerability. 4) Household headed by pensioners were least in danger of impoverishment. Those most in danger were farm households (including"mixed"households headed by workers with an agricultural holding) and households heavily dependent on social welfare. 5) Household of employees were better off than self-employed households when income-based measures of poverty were used, but not when consumption-based measures were used. Neither groups was significantly vulnerable.Services&Transfers to Poor,Environmental Economics&Policies,Economic Conditions and Volatility,Public Health Promotion,Health Economics&Finance,Poverty Assessment,Environmental Economics&Policies,Safety Nets and Transfers,Rural Poverty Reduction,Services&Transfers to Poor

Principles of surgical treatment of congenital, developmental and acquired female breast asymmetries

Background/Aim. There is a natural asymmetry in normal female brests. When the difference in the shape, size or position of the breast and nipple-areola complex is visible, surgical correction is the only treatment option and presents one of the greatest challenges for a plastic surgeon. Based on the Nahai classification presented in details, the aim of the study was to present the possibilities of plastic surgery to correct primary (congenital), secondary (developmental) and tertiary (acquired) brest asymmetries. Methods. We conducted a retrospective analysis of female breast asymmetry surgeries performed in the Clinic for Plastic Surgery and Burns, Military Medical Academy (MMA), Belgrade over the last seven years (January 2002 - January 2009). Results. During the above mentioned period, 82 female patients, 18 - 65 years of age, underwent surgery for breast asymmetry. The most frequent asymmetries were developmental, 'pubertal' (n = 43); acquired asymmetries as a consequence of tumor surgery were found in the other 22 patients, while 7 patients were diagnosed with primary asymmetries such as congenital chest-wall asymmetry (Sy. Poland), accessory and tuberous breasts. All patients underwent preoperative ultrasound examination, while hormone status was determined in those with developmental, 'pubertal' asymmetries. The selection of surgical procedure for correction of breast asymmetry depended upon clinical examination findings and patient's wish relating to the shape and size of the breasts. The most of breast asymmetries were corrected by a combination of surgical procedures including primary and secondary reconstruction, reduction, suspension or augmentation mammoplasty. Having combined different surgical procedures, we managed to achieve satisfactory results. The hypertrophic scar formation after reduction mamoplasty was seen in some cases, however, they caused no significant patient's discomfort. Conclusion. Application of plastic, reconstructive and aesthetic surgical principles can considerably contribute to achieving excellent results in corrective surgery for breast asymmetries. In addition to most suitable breast asymmetry surgical procedures choice, motivation of a patient is also very important for achieving satisfactory results

The Challenge of the Nitrate Directive to Acceding Countries: A Comparative Analysis of Poland, Lithuania and Slovakia

Agricultural and Food Policy,

Long term prospects in Eastern Europe : the role of external finance in an era of change

Private investors have an important role toplay in the ongoing process of reform in Eastern Europe. So external creditworthiness is crucial to a successful transition. Large government borrowing crowds out the formation of private contracts between international investors and domestic entrepreneurs and firms. Given the overall credit ceiling in international lending, the public sector needs to curtail its external borrowing to leave room for the private sector. This also implies that public debt reduction may be especially desirable in the highly indebted countries of Eastern Europe. Rather than flood the public sector with new loans, international organizations should attempt to improve domestic creditworthiness by supporting debt reduction and borrowing restraints during the transition period. Debt for equity swaps represent an attractive vehicle for debt reduction in the highly indebted countries of Eastern Europe. Such schemes, when tied to the privatization effort, are not inflationary. They simply represent a swap of public liabilities, and they create value to the extent that foreign private investment leads to positive externalities. The challenge will be to create swap mechanisms that will allow the Eastern European countries to retain a large share of those gains.Environmental Economics&Policies,Banks&Banking Reform,Economic Theory&Research,Municipal Financial Management,Public Sector Economics&Finance

Poland's syndrome and recurrent pneumothorax: is there a connection?

Aim. To investigate the possible connection of Poland's syndrome with the presence of lung bullae and, thus, with an increased risk for recurrent pneumothorax. Patients-methods. Two male patients, aged 19 and 21 years respectively were submitted to our department after their second incident of pneumothorax. Both had Poland's syndrome (unilaterally hypoplastic chest wall with pectoralis major muscle atrophy) and both had multiple bullae to the ipsilateral lung based on CT findings. The patients were treated operatively (bullectomy, lung apicectomy, partial parietal pleurectomy and chemical pleurodesis) due to the recurrent state of their pneumothorax. Results. The patients had good results with total expansion of the affected lung. Conclusions. Poland's syndrome can be combined with ipsilateral presence of lung bullae, a common cause of pneumothorax. Whether this finding is part or a variation of the syndrome needs to be confirmed by a larger number of similar cases