Cutaneous myiasis caused by Dermatobia hominis (Diptera: Oestridae) in a Polish traveller to South America - a case report.

Myiasis, an infestation caused by dipteran larvae, commonly known as maggots, is one of the most common parasitic skin disorders in the tropical regions. Authors report a case of cutaneous myiasis caused by Dermatobia hominis (Diptera: Oestridae) in a Polish traveller returning from a self-organized trip to South America. Species biology, prophylaxis, and medical implications of this tropical parasitosis are discussed.

Prevalence of Hand Malformations in Patients With Moebius Syndrome and Their Management.

BACKGROUND: Moebius syndrome is a disorder characterized by facial and abducens nerve paralysis. Patients can present a wide range of upper extremity malformations. Literature focused on orthopedic manifestations of Moebius syndrome shows variability in the prevalence and clinical presentation of upper extremity anomalies. The aim of this work is to evaluate the prevalence of upper extremity malformations in patients with Moebius syndrome, clarify its various clinical presentations, and present treatment strategies for their management. METHODS: This is a retrospective, cross-sectional study including patients with Moebius syndrome and upper extremity malformations between 2012 and 2019. Data include demographic characteristics, Moebius syndrome subtype, type of malformation, affected extremity, and surgical procedures underwent. Quantitative data were recorded as mean (standard deviation [SD]), and qualitative data were expressed in terms of totals and percentages. Statistical association between Moebius syndrome subtype and development of upper extremity anomalies was evaluated using binary logistic regression. RESULTS: Twenty-five out of 153 patients (16.3%) presented upper extremity malformations (48% male). Mean age of presentation was 9.08 ± 9.43 years. Sixty-eight percent of the malformations were unilateral. The most common presentations included Poland syndrome and simple syndactyly with 8 cases each (32%), followed by 5 cases of brachysyndactyly (20%), 3 cases of amniotic band syndrome (12%), and 1 case of cleft hand (4%). No statistical association was found between Moebius syndrome subtype and odds ratio for development of upper extremity anomalies. Thirteen patients (52%) underwent reconstructive procedures. CONCLUSION: Poland syndrome and syndactyly are the most common anomalies in patients with Moebius syndrome. Patients may present with a wide range of hand malformations, each patient should be carefully evaluated in order to determine whether surgical treatment is needed and to optimize rehabilitation protocols.

Colgajo dorsal ancho por abordaje único vertical en el síndrome de Poland: caso clínico / Retalho latíssimo do dorso por abordagem único vertical na síndrome de Poland: caso clínico / Latissimus dorsi vertical single-approach flap in Poland syndrome: clinical case

El síndrome de Poland constituye una malformacion que asocia diversos grados de anomalia toracica y a nivel del miembro superior, con una incidencia de 1 cada 30000 nacidos vivos. Esta patologia geenra ausencia de la glandula mamaria y del musculo pectroral mayor como malformacion mas frecuente. Lo cual produce una asimetria a nivel de torax con perdida de la armonia la cual lleva a una alteracion tanto fisica como psicologica a nivel de la paciente. Por esto es necesario resolver esta patologia con la menor morbilidad posible. El planteo de generar la menor morbilidad nos llevo a realizar una tecnica por abordaje unico sub axilar, a traves del cual se diseca el musculo dorsal ancho y se transpone de forma anterior, obteniendo una sola incision, la cual se mantiene oculta debajo del miembro superior adducido. Produciendo menor tiempo operatorio, menor tiempo de internacion, disminuyendo el número de incsiones y logrando una adecuada fijacion anterior del musculo dorsal ancho.

Poland's syndrome is a malformation associated with varying degrees of thoracic and upper limb abnormality, with an incidence of 1 in 30,000 live births. This pathology generates the absence of the mammary gland and the major pectoral muscle as the most frequent malformation. Which produces an asymmetry at the chest level with loss of harmony which leads to both physical and psychological alteration at the level of the patient. For this reason, it is necessary to resolve this pathology with the least possible morbidity. The proposal to generate the least morbidity led us to perform a single sub axillary approach technique, through which the latissimus dorsi muscle is dissected and transposed anteriorly, obtaining a single incision, which is kept hidden under the upper limb adduced. Producing less operative time, shorter hospitalization time, reducing the number of incisions and achieving an adequate anterior fixation of the latissimus dorsi muscle.

A síndrome de Poland é uma malformação associada a vários graus de anomalia torácica e de membros superiores, com uma incidência de 1 em 30.000 nascidos vivos. Essa patologia gera a ausência da glândula mamária e do músculo pectoral principal como a malformação mais frequente. O que produz uma assimetria ao nível do peito com perda de harmonia que conduz a alterações físicas e psicológicas ao nível do paciente. Por isso, é necessário resolver essa patologia com a menor morbidade possível. A proposta de gerar o mínimo de morbidade nos levou a realizar uma única técnica de abordagem subaxilar, por meio da qual o músculo grande dorsal é dissecado e transposto anteriormente, obtendo-se uma única incisão, que é mantida escondida sob o membro superior. aduzido. Produzindo menos tempo operatório, menor tempo de internação, reduzindo o número de incisões e conseguindo uma fixação anterior adequada do músculo grande dorsal.

Síndrome de Poland. Reporte de un caso / Poland syndrome. Report of a case / Síndrome da Polônia. Relato de um caso

RESUMEN Introducción: el síndrome de Poland es un trastorno congénito raro que se caracteriza por la ausencia o hipoplasia unilateral del musculo pectoral mayor asociado a malformaciones en la extremidad superior y tejido mamario ipsilateral. Las manifestaciones clínicas en los recién nacidos solamente se describen en la literatura, por lo tanto, muchos aspectos de su presentación en las guarderías son ignoradas. Presentación del caso: presentamos el caso de un recién nacido que manifiesta una respiración paradójica desde el momento del nacimiento. Este tipo de hallazgo clínico esta vagamente descrito en el Síndrome de Poland y menos aún en el periodo neonatal. Discusión: este síndrome puede verse relacionado con enfermedades, como parálisis de los pares VI y VII, lo que conlleva a un mayor número de asociaciones complejas.9 Se plantea asociado a dextrocardia, que según algunos autores es secundaria a la deformidad torácica producida por malformaciones costales y su efecto sobre la formación cardíaca en el periodo embrionario. No se han observado deficiencias mentales ni trasmisión genética de la enfermedad. Se ha descrito de forma excepcional, asociación familiar. Esto podía corresponder a una herencia autosómica dominante con penetración reducida. Conclusiones: en este paciente el síndrome de Poland se caracterizó por una hipoplasia del pectoral mayor izquierdo, asociado a malformaciones esqueléticas de la mano del mismo lado.

ABSTRACT Introduction: Poland syndrome is a rare congenital disorder characterized by the unilateral absence or hypoplasia of the pectoralis major muscle associated with malformations of the upper limb and ipsilateral breast tissue. Clinical manifestations in newborns are only described in the literature, therefore, many aspects of their presentation in nurseries are ignored. Presentation of the case: we present the case of a newborn who manifests paradoxical respiration from the moment of birth. This type of clinical finding is loosely described in Poland Syndrome and even less in the neonatal period. Discussion: this syndrome can be related to diseases, such as paralysis of pairs VI and VII, which leads to a greater number of complex associations.9 It arises in association with dextrocardia, which according to some authors is secondary to the thoracic deformity caused by malformations ribs and their effect on cardiac formation in the embryonic period. No mental deficiencies or genetic transmission of the disease have been observed. An exceptional family association has been described. This could correspond to an autosomal dominant inheritance with reduced penetration. Conclusions: in this patient, Poland syndrome was characterized by hypoplasia of the left pectoralis major, associated with skeletal malformations of the hand on the same side.

RESUMO Introdução: A síndrome da Polônia é um distúrbio congênito raro caracterizado pela ausência ou hipoplasia unilateral do músculo peitoral maior associado a malformações do membro superior e tecido mamário ipsilateral. As manifestações clínicas em recém-nascidos são descritas apenas na literatura, portanto, muitos aspectos de sua apresentação nos berçários são ignorados. Apresentação do caso: apresentamos o caso de um recém-nascido que manifesta respiração paradoxal desde o momento do nascimento. Esse tipo de achado clínico é descrito livremente na Síndrome da Polônia e menos ainda no período neonatal. Discussão: essa síndrome pode estar relacionada a doenças, como a paralisia dos pares VI e VII, que leva a um maior número de associações complexas.9 Ela surge associada à dextrocardia, que segundo alguns autores é secundária à deformidade torácica causada por malformações costelas e seu efeito na formação cardíaca no período embrionário. Não foram observadas deficiências mentais ou transmissão genética da doença. Uma associação familiar excepcional foi descrita. Isso pode corresponder a uma herança autossômica dominante com penetração reduzida. Conclusões: nesse paciente, a síndrome da Polônia foi caracterizada por hipoplasia do peitoral maior esquerdo, associada a malformações esqueléticas da mão do mesmo lado.

Negative stereotypes: an analysis of Social Cognition in different ethnic groups. Social cognition of stereotypes / Estereotipos negativos: un análisis de la cognición social en diferentes grupos étnicos. Cognición social de los estereotipos

Abstract Introduction: The processes related to social cognitions contribute as a traumatic and stressful event for some ethnic and minority groups, causing a series of psychic suffering in individuals. Social cognition considered stereotypes as characteristics of a group included in its mental representation. Objective: The study was conducted to analyze the negative stereotypes in two cultures with very different history and geopolitical context, especially how stereotypes are reflected in the cognitive component of prejudiced attitudes. Method: Four hundred fifty one (N=451) undergraduate students volunteered to take part in the study, the participants came from careers in the area of Social Sciences and Humanities in the non-probabilistic sample. After receiving the information, participants completed Negative Stereotype Index. A descriptive analysis and the T-test to know the differences between the perception and self-perception of the groups. Results: Show that negative stereotype traits in Poland and Brazil, found negative stereotypic traits attributed to an out-group resulted in more unfavorable evaluations than descriptions consisting of positive attributes. In both groups, and their antecedents were associated with negative out-group attitudes, however, is a more general and more important one. Conclusion: The findings found that expectations about the out-group and negative stereotypes occur in conjunction with other negative emotions, which intensify negative out-group attitudes. The assessment that the Poles made of the Germans was like that of the Brazilians of the Argentines or of a group of relatively higher status. That is, they considered the Germans as more arrogant, sincere and less modest. The different groups of people may dislike each other for similar reasons. Explanations are offered for the limitations of the study and proposal for future research.

Resumen Introducción: Los procesos relacionados con cogniciones sociales contribuyen como evento traumático y estresante para algunos grupos étnicos y minoritarios que causan una serie de sufrimiento psíquico en los individuos. La cognición social considera los estereotipos como características de un grupo incluido en su representación mental. Objetivo: El estudio analiza los estereotipos negativos en dos culturas con historia y contexto geopolítico diferentes, especialmente cómo se reflejan los estereotipos en el componente cognitivo de las actitudes prejuiciosas. Método: Cuatrocientos cincuenta y un estudiantes de pregrado se ofrecieron como voluntarios para participar en el estudio, los participantes procedían de carreras en el área de Ciencias Sociales y Humanidades en la muestra no probabilística. Después de recibir la información, los participantes completaron el Índice de Estereotipos Negativos. Se realizó análisis descriptivo y prueba T-test de Student para conocer diferencias entre percepción y autopercepción de los grupos. Resultados: Muestran que los rasgos estereotipados en Polonia y Brasil hallaron atributos al exogrupo que resultaron en evaluaciones más desfavorables que en atributos positivos. En ambos grupos, sus antecedentes se asociaron con actitudes negativas para el exogrupo; sin embargo, es una cuestión más general y más importante. Conclusión: Los hallazgos encontrados mostraron que las expectativas sobre el exogrupo y los estereotipos negativos ocurren en conjunción con otras emociones negativas, que intensifican las actitudes negativas exogrupales. La valoración que los polacos hacían de los alemanes era similar a la que hacían los brasileños de los argentinos o de un grupo de estatus relativamente superior. Es decir, consideraban a los alemanes como más arrogantes, sinceros y menos modestos. Los diferentes grupos pueden no gustarle el uno al otro por razones similares. Se ofrecen explicaciones para las limitaciones del estudio y para futura investigación.

Insomnia and the level of stress among students in Krakow, Poland / Insônia e nível de estresse em estudantes de Cracóvia, Polônia

Abstract Introduction: Stress and insomnia are increasing problems in young people in highly developed countries. They influence both the physical and psychological aspects of life and seem to be related to each other. Various strategies to cope with stress exist and can be used to reduce its level. The main goal of our study was to find a relationship between insomnia, stress, stress-coping strategies and selected social and medical factors among students. Methods: A cross-sectional study was conducted in March 2017 among students of seven public Krakow universities, using the Perceived Stress Scale 10, an abbreviated version of the Coping Orientation to Problems Experienced inventory (mini-COPE inventory) and the Athens Insomnia Scale. In the statistical analysis, the chi-square, Student's t test and Spearman's rank correlation coefficient were used. Results: A total of 264 students aged 22.22±1.5 years were involved in the study. High stress levels occurred in 10% of the respondents. A statistically higher level of stress was revealed in people suffering from chronic diseases (p=0.006) and in cigarette smokers (p=0.004). The most common stress-coping strategies were active coping and planning. Insomnia was present in 19.7% of the students. Insomnia level was correlated with the intensity of perceived stress (p=0.00; r=0.44). Conclusions: According to our study, one tenth of Krakow students perceive a high level of stress, and one fifth of the respondents suffer from insomnia. There is a strong positive correlation between level of insomnia and level of stress. To ensure high quality of life, problems such as stress and insomnia should be taken into consideration by every general practitioner.

Resumo Introdução: Estresse e insônia são problemas cada vez mais presentes em pessoas jovens em países altamente desenvolvidos. Eles influenciam tanto os aspectos físicos quanto os psicológicos da vida e parecem estar relacionados entre si. Várias estratégias de enfrentamento (coping) do estresse existem e podem ser usadas para reduzir seu nível. O objetivo principal deste estudo foi investigar a relação entre insônia, estresse, estratégias de coping, e certos fatores sociais e médicos em estudantes. Métodos: Um estudo transversal foi conduzido em março de 2017 com estudantes de sete universidades públicas da Cracóvia, na Polônia, utilizando a Escala de Estresse Percebido 10, uma versão abreviada do Inventário para Medir Estratégias de Enfrentamento de Estresse (mini-COPE) e a Athens Insomnia Scale. Na análise estatística, foram utilizados os testes qui-quadrado, t de Student e o coeficiente de correlação de Spearman. Resultados: Um total de 264 estudantes com idade média de 22,22±1,5 anos foram incluídos no estudo. Altos níveis de estresse ocorreram em 10% dos respondentes. Um nível estatisticamente mais alto de estresse foi revelado em pessoas sofrendo de doenças crônicas (p=0,006) e em fumantes (p=0,004). As estratégias de coping mais comuns foram coping ativo e planejamento. A insônia esteve presente em 19,7% dos alunos. O nível de insônia se correlacionou com a intensidade do estresse percebido (p=0,00; r=0,44). Conclusões: De acordo com este estudo, um décimo dos estudantes de Cracóvia percebe um alto nível de estresse, e um quinto dos respondentes sofrem de insônia. Há uma forte correlação positiva entre nível de insônia e nível de estresse. Para garantir alta qualidade de vida, problemas como estresse e insônia devem ser levados em consideração pelo médico generalista.

Deformidad de la caja torácica / Chest wall deformity

Resumen Las deformidades de la caja torácica se pueden dividir en dos tipos, las que son productos del desarrollo anormal del pecho en el crecimiento y las congénitas que son las secundarias a una malformación estructural del pecho evidente en el nacimiento. Las malformaciones del desarrollo son las más comunes, como por ejemplo pectus excavatum o pectun carinatum. Las menos comunes son las de tipo congénito: síndrome de Poland, displasia espondilotorácica, displasia espondilocostal, síndrome de Jeune y los defectos de la costilla o el esternón. Las deformidades del pecho de tipo congénita se caracterizan por afectar la relación entre la columna vertebral, la caja torácica y los pulmones. La mayoría de estos pacientes desarrollan un disturbio respiratorio progresivo de tipo restrictivo conocido como Síndrome de Insuficiencia Torácica. Este síndrome se define como la deficiencia de la caja torácica para mantener una respiración normal y sostener el crecimiento fisiológico del pulmón. En este artículo discutiremos varias condiciones que afectan el desarrollo y función de la caja torácica.

Chest wall deformities are divided as an abnormal development during the growth or those secondary to a congenital malformation. The developmental type is the most common: pectus excavatum or pectus carinatum. The less common are the congenital types of chest wall abnormalities: Poland's syndrome, Jeune's syndrome, espondylothoracic dysplasia, espondylocostal dysplasia and defects of the ribs or sternum. The congenital type usually affects the relationship between the spine, rib cage and the lungs. Therefore, many of these patients will develop a progressive respiratory disturbance of restrictive type known as Thoracic Insufficiency Syndrome. Thoracic insufficiency syndrome is defining as a deficiency of the rib cage to maintain a normal respiration and to sustain the physiological growth of the lungs. In this article will discuss several conditions that will affect the development and function of the chest wall.

Síndrome de Poland: descripción de un caso en la sala de partos / Poland syndrome: Description of a case in the delivery room

El Síndrome de Poland es un trastorno congénito raro que se caracteriza por la ausencia o hipoplasia unilateral del musculo pectoral mayor asociado a malformaciones en la extremidad superior y tejido mamario ipsilateral. Las manifestaciones clínicas en los recién nacidos solamente se describen en la literatura, por lo tanto muchos aspectos de su presentación en las guarderías son ignoradas. Presentamos el caso de un recién nacido que manifiesta una respiración paradójica desde el momento del nacimiento. Este tipo de hallazgo clínico esta vagamente descrito en el Síndrome de Poland y menos aún en el periodo neonatal.

Poland Syndrome is a rare congenital condition characterized by the absence unilateral pectoralis major muscle. it can be associated with other multiple malformations usually in the same affected side. The clinical manifestation in newborns are merely described in the literature, therefore many aspect in its presentation in the nursery are ignored. We present the case of a newborn manifesting paradoxical breathing since birth. This clinical finding is barely describe in poland's syndrome and even less during newborn period.

Inequalities in smoking and obesity in Europe predicted to 2050: Findings from the EConDA project.

AIMS: The aim of this study was to project educational inequalities in obesity and smoking prevalence to 2050 based on past obesity and smoking trends by education level. METHODS: Data on obesity (body mass index ≥ 30) and smoking prevalence (current smokers) by education level (tertiary education and less than tertiary) from nationally representative cross-sectional surveys were collected for the following six countries participating in the Economics of Chronic Diseases project (EConDA): England, Finland, Lithuania, the Netherlands, Poland (obesity only) and Portugal (obesity only). A nonlinear multivariate regression model was fitted to the data to create longitudinal projections to 2050. Inequalities were measured with a prevalence ratio and a prevalence difference using projected obesity/smoking prevalence. RESULTS: Educational inequalities in obesity prevalence are projected to increase in Finland, Lithuania and England for men, and in Lithuania and Poland for women, by 2050. Obesity prevalence is projected to increase faster among the more advantaged groups in England, Portugal, Finland and the Netherlands among women, and Portugal and the Netherlands among men, narrowing inequalities. In contrast to obesity, smoking prevalence is projected to continue declining in most of the countries studied. The decline is projected to be faster in relative terms among more advantaged groups; therefore, relative educational inequalities in smoking prevalence are projected to increase in all countries. CONCLUSIONS: Widening educational inequalities in obesity and smoking prevalence are expected in several European countries if current trends in obesity and smoking prevalence are unaltered. This will impact on inequalities in morbidity and mortality of associated diseases such as diabetes, coronary heart disease and chronic obstructive pulmonary disease.

Serie de Casos: Síndrome de Poland Completo vs. Incompleto. Resolución Quirúrgica / Case Series: Poland Syndrome Complete vs Incomplete. Surgical Resolution

INTRODUCCIÓN: El síndrome de Poland es una enfermedad congénita polimalformativa extremadamente rara, su etiología es aún desconocida, afectando principalmente el desarrollo del músculo pectoral mayor; se acompañan frecuentemente de malformaciones de la mano, mama, complejo areola-pezón, pectoral menor ipsilateral y otras malformaciones asociadas. Su diagnóstico se basa en un correcto examen clínico junto con una tomografía axial computarizada con reconstrucción en 3D. El tratamiento quirúrgico final es individualizado y dependerá de la existencia de una o más malformaciones. CASOS CLÍNICOS: Se trató de cuatro pacientes con cuadro clínico compatible con síndrome de Poland, siendo común el subdesarrollo o ausencia del músculo pectoral mayor. EVOLUCIÓN: Se realizó a cada paciente una tomografía axial computarizada con reconstrucción en 3D para confirmar su diagnóstico y realizar un tratamiento quirúrgico según la necesidad de cada paciente, después del procedimiento se dio seguimiento a los pacientes con una respuesta favorable y sin complicaciones. CONCLUSIONES: El síndrome de Poland se caracteriza por un cuadro clínico variable, con la ausencia o subdesarrollo del músculo pectoral mayor, el tratamiento quirurgico fue personalizado para cada paciente. Las técnicas quirúrgicas incluyeron reconstrucción de la pared torácica mediante osteosíntesis en los casos graves independientemente del sexo del paciente; rotación de colgajos del músculo dorsal ancho, colocación de expansores tisulares y prótesis mamarias en el caso de las pacientes femeninas y colocación de prótesis preformadas mediante estereolitografía en el caso de los pacientes masculinos.

BACKGROUND: The Poland syndrome is an extremely rare polymalformative congenital disease, the etiology is still unknown, mainly affecting the development of the pectoralis major muscle; they are frequently accompanied by malformations of the hand, breast, nipple-areola complex, ipsilateral minor pectoral and other associated malformations. The diagnosis is based on a correct clinical examination together with a computerized axial tomography with 3D reconstruction. The final surgical treatment is individualized and will depend on the existence of one or more malformations. CASE REPORTS: Four patients with a clinical picture compatible with the Poland syndrome were treated, with underdevelopment or absence of the pectoralis major muscle being common. EVOLUTION: Each patient underwent a computerized axial tomography with 3D reconstruction to confirm their diagnosis and perform a surgical treatment according to the needs of each patient; after the procedure, patients were followed up with a favorable response and without complications. CONCLUSIONS: The Poland syndrome is characterized by a variable clinical picture, with the absence or underdevelopment of the pectoralis major muscle, the surgical treatment was customized for each patient. Surgical techniques included reconstruction of the chest wall by osteosynthesis in severe cases regardless of the sex of the patient; rotation of flaps of the latissimus dorsi muscle, placement of tissue expanders and mammary prosthesis in the case of female patients and placement of preformed prostheses by stereolithography in the case male patients.

Video Caso Clínico: Disección Aórtica Rota Tipo Stanford A. Resolución Quirúrgica: Cirugía de Bentall De Bono / Video Case Report: Rupture Aortic Dissection Stanford Type A. Surgical Resolution: Surgery Bentall and De Bono

La disección aórtica rota que compromete la raíz y la aorta ascendente es una emergencia que requiere cirugía inmediata, debido al mal pronóstico y sus complicaciones agudas: ruptura, insuficiencia aórtica aguda, hematoma intramural y endocarditis aguda; con elevadas tasas de morbilidad y mortalidad posoperatoria temprana, estimada en las 24 horas el 1 % por cada hora, a las 48 horas 29 %, en la primera semana 44 % y a las 2 semanas 50 %; con una mortalidad global de 15 % a 35 % y una sobrevida del 65 % al 75 % en un rango de 5 años [1 - 3]. En Ecuador se llevó a cabo un estudio tipo prospectivo que incluyo 120 pacientes, llevado a cabo desde 1999 a 2000, en Guayaquil; en el que reportaron 34 casos, con edad promedio de 64 años, sexo masculino, cuyo factor de riesgo más importante fue hipertensión arterial. Se presentó en el 100 % de los casos, dolor torácico transfictivo, soplo aórtico diastólico en el 70 % y solo el 2 % presentaron infarto de miocardio posteroinferior transmural sin fibrinólisis, por ser contraindicado en pacientes con disección aórtica [4]. El tratamiento quirúrgico consiste en la resección y reemplazo de la porción rota por una prótesis vascular asociada o no al reemplazo valvular aórtico dependiendo del grado de insuficiencia. El tratamiento estará orientado en función del grado de afectación de la disección y la rotura, pudiendo requerir un reemplazo convencional de la aorta ascendente (RCAA) con o sin reemplazo total del arco aórtico (RTAA); el tratamiento de elección de la disección rota tipo A es el reemplazo de la raíz y la aorta ascendente con injerto tubular valvulado, denominado procedimiento de Bentall De Bono [1 - 3, 5, 6]. Dentro de las complicaciones postquirúrgicas se encuentran: pseudoaneurisma, disección radical recurrente o residual, cambios importantes en el diámetro de la raíz o insuficiencia aórtica significativa [7]

The rupture aortic dissection that compromises the root and the ascending aorta is an emergency that requires immediate surgery; for it is poor prognosis, acute complications: rupture, acute aortic insufficiency, intramural hematoma and acute endocarditis, with high morbidity rates and early postoperative mortality, estimated at first 24 hours in 1 % per each hour, 48 hours 29 %, in the first week 44 % and at 2 weeks 50 %; with a global mortality of 15 % to 35 % and a survival of 65 % to 75 % in a range of 5 years [1-3]. In Ecuador, a prospective study realized that included 120 patients, since 1999 to 2000, in Guayaquil; in that they reported 34 cases with an average age of 64 years, male, whose most important risk factor was hypertension. The patients presented, 100 % transfictive chest pain, diastolic aortic murmur in 70 %, and only 2 % had transmural posteroinferior myocardial infarction without fibrinolysis, as it was contraindicated in patients with aortic dissection [4]. Surgical treatment consists of the resection and replacement of the broken portion by a vascular prosthesis associated or not with aortic valve replacement depending on the degree of insufficiency. The treatment will be oriented according to the degree of involvement of the dissection and rupture, and may require a conventional replacement of the ascending aorta (CRAA) with or without total aortic arch replacement (TRAA); the treatment of choice for the rupture aortic dissection type A is the replacement of the root and the ascending aorta with valvular tubular graft, called the Bentall De Bono surgery [1 - 3, 5, 6]. Of the postsurgical complications we found: pseudoaneurysm, radical or recurrent radical dissection, important changes in the diameter of the root or significant aortic insufficiency

A Psychometric Evaluation of the Santa Clara Strength of Religious Faith Questionnaire among Students from Poland and Chile.

This study verifies the psychometric properties of the Santa Clara Strength of Religious Faith Questionnaire (SCSORFQ). This measure consists of 10 items regarding strength of religious faith, regardless of religious denomination or affiliation. Participants were 177 students from Chile and 393 students from Poland. The SCSORFQ method is a reliable measure with good internal consistency evaluated by the α-Cronbach coefficient. Factor analysis statistically confirmed the unidimensional structure of the SCSORFQ. The strength of religious faith in both student groups was moderate to strong correlated with public or private aspects of religiousness and strong correlated with spiritual experiences. It was weakly correlated with the cognitive indicator of well-being as satisfaction with life as well as with existential variables like hope and meaning of life. The results confirm that the SCSORFQ is psychometrically sound and is therefore recommended for use by researchers studying the construct of religiousness.

Síndrome de Poland. Presentación de un caso y revisión de la literatura

Se han descrito diversas alteraciones en la morfología y estructura de la glándula mamaria, como resultado de variaciones en los mecanismos reguladores de su desarrollo. La amastia es una de las anomalías congénitas de la mama menos frecuente, y consiste en la ausencia total de una o de ambas glándulas. Cuando es unilateral generalmente se acompaña también de la carencia del músculo pectoral mayor y del menor además de otro grupo de malformaciones, constituyendo así lo que se conoce como síndrome de Poland. Se presenta el caso de una adolescente de 15 años, que exhibe una ausencia congénita de la mama derecha, así como de los músculos pectorales, sin otra malformación acompañante. Es este el primer caso de síndrome de Poland diagnosticado en Cienfuegos, por lo cual se considera de interés para la comunidad científica la publicación de este reporte.

Diverse changes in the morphology and structure of the mammary gland have been described as a result of the variation of the regulatory mechanisms of its development. Amastia is one of the less frequent congenital anomalies of the breast and it consists on the total absence of one or both glands. When it is unilateral it is generally also accompanied by the lack of the major and minor pectoral muscle besides other malformations, constituting what is known as Poland Syndrome. A case of a fifteen year old female patient is presented who shows the congenital absence of the right breast. This is the first case of Poland Syndrome diagnosed in Cienfuegos, this is why the publication of this case is considered of interest for the scientific community.

Occurrence of entomopathogenic nematodes in Polish soils / Ocorrência de nematoides entomopatogênicos em solos da Polônia

Entomopathogenic nematodes (Steinernematidae and Heterorhabditidae) were studied in Polish soils according to the: season, habitat and altitude. In total, 167 soil samples were taken from 111 localities in Poland along north-south transect. Entomopathogenic nematodes were isolated from 53 soil samples (31.7%). Nematodes species were identified genetically from 16 samples, and in all other 37 samples nematodes were determined to the genus level. Three species of the genus Steinernema ( Steinernema kraussei, S. feltiae, S. carpocapsae ) and one of the genus Heterorhabditis (Heterorhabditis megidis) were recorded. Steinernema feltiae was the most common species. There was not a significant association between the occurrence of nematodes and season or altitude. The type of habitat significantly (P<0.05) affected the occurrence of nematodes. Nematodes were most frequent in samples collected from coniferous forests (20 findings).(AU)

Os nematoides entomopatogênicos (Steinernematidae e Heterorhabditidae) foram estudados em solo polonês de acordo com estação, habitat e altitude. Foram coletadas um total de 167 amostras de solo em 111 localidades diferentes ao longo da trajeto Norte-Sul da Polônia. Os nematoides entomopatogênicos foram extraídos em 53 das amostras de solo (31,7%). As espécies de nematoides foram geneticamente identificadas a partir de 16 amostras, as outras 37 amostras foram usadas para determinar o gênero. Três espécies do gênero Steinernema (Steinernema kraussei , S. feltiae , S. carpocapsae) e uma espécie do gênero Heterorhabditis (Heterorhabditis megidis) foram identificadas. A espécie mais comum foi a S. feltiae . Não foi encontrada uma relação significativa entre a presença de nematoides com a estação do ano e a altitude. O tipo de habitat afetou significativamente (P<0,05) a ocorrência de nematoides. Os nematoides foram encontrados mais frequentemente em amostras recolhidas em florestas de coníferas (20 no total).(AU)

Occurrence of entomopathogenic nematodes in Polish soils / Ocorrência de nematoides entomopatogênicos em solos da Polônia

ABSTRACT: Entomopathogenic nematodes ( Steinernematidaeand Heterorhabditidae) were studied in Polish soils according to the: season, habitat and altitude. In total, 167 soil samples were taken from 111 localities in Poland along north-south transect. Entomopathogenic nematodes were isolated from 53 soil samples (31.7%). Nematodes species were identified genetically from 16 samples, and in all other 37 samples nematodes were determined to the genus level. Three species of the genus Steinernema ( Steinernema kraussei, S. feltiae, S. carpocapsae) and one of the genus Heterorhabditis( Heterorhabditis megidis) were recorded. Steinernema feltiaewas the most common species. There was not a significant association between the occurrence of nematodes and season or altitude. The type of habitat significantly (P<0.05) affected the occurrence of nematodes. Nematodes were most frequent in samples collected from coniferous forests (20 findings).

RESUMO: Os nematoides entomopatogênicos ( Steinernematidaee Heterorhabditidae) foram estudados em solo polonês de acordo com estação, habitat e altitude. Foram coletadas um total de 167 amostras de solo em 111 localidades diferentes ao longo da trajeto Norte-Sul da Polônia. Os nematoides entomopatogênicos foram extraídos em 53 das amostras de solo (31,7%). As espécies de nematoides foram geneticamente identificadas a partir de 16 amostras, as outras 37 amostras foram usadas para determinar o gênero. Três espécies do gênero Steinernema( Steinernema kraussei, S. feltiae, S. carpocapsae) e uma espécie do gênero Heterorhabditis( Heterorhabditis megidis) foram identificadas. A espécie mais comum foi a S. feltiae. Não foi encontrada uma relação significativa entre a presença de nematoides com a estação do ano e a altitude. O tipo de habitat afetou significativamente (P<0,05) a ocorrência de nematoides. Os nematoides foram encontrados mais frequentemente em amostras recolhidas em florestas de coníferas (20 no total).

Síndrome de Poland: dois relatos de caso com suas respectivas condutas cirúrgicas / Poland's syndrome: two case reports with their respective surgical procedures

A Síndrome de Poland é uma anomalia congênita de baixa incidência, que afeta em média 1:32000 nascidos vivos e tem causa idiopática. Essa condição é caracterizada pela atrofia ou ausência do músculo peitoral maior, mas pode acometer também outros músculos, como o peitoral menor e serrátil. Nessa síndrome pode ocorrer associação de outros fenômenos, como a sindactilia ipsilateral, hipoplasia da mão, alterações ósseas e deformidade de Sprengel, na qual a escápula passa a ser menor e alada. No presente estudo, relatamos dois casos de Síndrome de Poland com base na revisão de prontuários. No primeiro caso, percebemos uma atrofia muscular na mama direita em que foi necessária a utilização de dois expansores para fazer a reconstrução, um na mama direita e outro na região toracoabdominal, em virtude de atrofia tecidual entre a pele e o osso. Em sequência, foi colocada a prótese mamária definitiva de silicone e foi feita a correção da atrofia tecidual. Já no segundo caso, não houve a necessidade de colocação de expansores. Em cada caso foi usada uma maneira de correção, uma vez que, nesta síndrome, não há um método único de tratar o paciente, devendo cada caso ser estudado individualmente. Com o estudo, é possível notar que a Síndrome de Poland não causa uma patologia de fato, já que na ausência do músculo peitoral maior não há comprometimentos motores, o que ocorre é um comprometimento estético(AU)

Poland 's syndrome is a congenital abnormality of low incidence, which affects roughly 1: 32,000 live births and is idiopathic. This condition is characterized by atrophy or absence of the pectoralis major muscle, but can also affect other muscles such as the pectoralis minor and serratus. This syndrome can occur in association with such other phenomena as ipsilateral syndactyly, hand hypoplasia, bone changes, and Sprengel's deformity, in which the scapula becomes smaller and winged. In the present study we report two cases of Poland's syndrome based on chart review. In the first case there was muscular atrophy in the right breast, where the use of two expanders was required for the reconstruction, one on the right breast and the other in the thoracoabdominal region, due to tissue atrophy between the skin and the bone. Subsequently, the final silicone breast implant was placed and correction of tissue atrophy was performed. In the second case there was no need for using expanders. In each case a different way of correction was used, since in this syndrome there is no single method to treat the patient, and each case should be studied individually. From this study one can see that Poland's Syndrome does not cause an actual pathology, as the absence of the pectoralis major does not bring any motor compromising; what happens is aesthetic compromising(AU)

Secuencia de Poland, de las bases embriológicas a la práctica clínica / Poland sequence, going from the embryological bases to the clinical practice

La secuencia de Poland es un defecto congénito típicamente descrito como la ausencia congénita unilateral del músculo pectoral, que puede encontrarse asociado a la aparición de otras anomalías torácicas ipsilaterales y/o de extremidades superiores, las cuales abarcan diferentes grados de severidad funcional y de alteraciones estéticas. En la literatura se describen distintas asociaciones con diferentes síndromes, sin embargo su etiología es aún desconocida, aunque existen varias hipótesis sobre su posible causa, y es la más aceptada aquella que hace referencia a procesos de disrupción vascular. En la práctica clínica, las formas de expresión leve pueden ser ignoradas, pero en los casos más severos es requerida la atención de grupos multidisciplinarios de especialistas para su tratamiento. Se hace una revisión sistemática de la literatura sobre la secuencia de Poland(AU)

Poland sequence is a birth defect typically described as unilateral congenital absence of the pectoralis muscle, which may be associated with the occurrence of other ipsilateral thoracic and/or upper extremities anomalies that cover different degrees of functional severity and esthetic alterations. The literature describes various types of association with different syndromes; however, its etiology remains unknown and several hypotheses about the possible cause of this disease exist, being the most accepted the one that deals with vascular disruption processes. In the clinical practice, mild forms of expression can be ignored, but in the most severe cases, the attention of a multidisciplinary group of specialists is required for disease management. A systematic literature review on Poland sequence was made(AU)

Secuencia de Poland, de las bases embriológicas a la práctica clínica / Poland sequence, going from the embryological bases to the clinical practice

La secuencia de Poland es un defecto congénito típicamente descrito como la ausencia congénita unilateral del músculo pectoral, que puede encontrarse asociado a la aparición de otras anomalías torácicas ipsilaterales y/o de extremidades superiores, las cuales abarcan diferentes grados de severidad funcional y de alteraciones estéticas. En la literatura se describen distintas asociaciones con diferentes síndromes, sin embargo su etiología es aún desconocida, aunque existen varias hipótesis sobre su posible causa, y es la más aceptada aquella que hace referencia a procesos de disrupción vascular. En la práctica clínica, las formas de expresión leve pueden ser ignoradas, pero en los casos más severos es requerida la atención de grupos multidisciplinarios de especialistas para su tratamiento. Se hace una revisión sistemática de la literatura sobre la secuencia de Poland.

Poland sequence is a birth defect typically described as unilateral congenital absence of the pectoralis muscle, which may be associated with the occurrence of other ipsilateral thoracic and/or upper extremities anomalies that cover different degrees of functional severity and esthetic alterations. The literature describes various types of association with different syndromes; however, its etiology remains unknown and several hypotheses about the possible cause of this disease exist, being the most accepted the one that deals with vascular disruption processes. In the clinical practice, mild forms of expression can be ignored, but in the most severe cases, the attention of a multidisciplinary group of specialists is required for disease management. A systematic literature review on Poland sequence was made.

Características por imagen del síndrome de Poland: Presentación de un caso / Imaging of Poland Syndrome: Case Report

Se conoce como síndrome de Poland a la combinación de la agenesia total o parcial del músculo pectoral mayor con una anomalía de la mano homolateral. Aunque su patogenia es incierta, se cree que deriva de una anomalía del desarrollo durante el primer trimestre de gestación. A pesar de que no existe un consenso en cuanto a su clasificación, la de Foucras es la más usada. Las imágenes juegan un papel importante desde el punto de vista diagnóstico, para confirmar, describir y clasificar el grado de hipoplasia-aplasia muscular, para orientar hacia el tratamiento quirúrgico más apropiado.

Poland syndrome is defined as a combination of total or partial agenesis of the pectoralis major muscle associated to an anomaly in the ipsilateral hand. The pathogenesis remains uncertain, it is believed that this group of malformations occurs in a developmental abnormality during the first trimester of gestation. There is no consensus about their classification. However, Foucras classification is the most used. Images play an important role to confirm and describe the grade of muscle hypoplasia-aplasia, this way, it could be classified to lead to the most appropriate surgical treatment.

Tratamiento de la anisomastia en una paciente con síndrome de Poland: a propósito de un caso / Treatment of the anisomastia in a patient with Poland's Syndrome: a case report

El síndrome de Poland es una enfermedad congénita que tiene como denominador común la hipoplasia o agenesia del músculo pectoral mayor aparejado a trastornos del desarrollo mamario. Objetivo: describir el cuadro clínico de una paciente con este síndrome. Caso clínico: se trata de una paciente con Síndrome de Poland que presenta una deformidad del tórax, con un desarrollo mamario desigual y fue sometida a tratamiento quirúrgico reparador. Conclusiones: el síndrome de Poland tiene una presentación clínica variable, con distintos grados de extensión y severidad. En caso anisomastia resulta útil en el tratamiento quirúrgico (AU)

Poland's Syndrome is a congenital disease that has like common denominator the hipoplasia or infertility of the bigger pectoral muscle matched up to upsets of the mammary development. Objective: describing the clinical picture of a patient with this syndrome. Clinical case: it has to do with a patient with Poland's Syndrome that presents a deformity of the thorax, with a mammary unequal development and was submitted to surgical reparative treatment. Conclusions: Poland's syndrome has a clinical variable presentation, with several degrees of extension and severity. In case anisomastia proves to be useful in the surgical treatment (AU)