anastasiya maslova pnc global investing
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Dubai: When Bernd Skorupinski came to Dubai by way of Germany six years ago, he had no idea he would leave his job to become a fulltime trader. Foreign exchange currency trading, commonly referred to as forex, is a market where banks, businesses, investors and traders come to exchange and speculate on rising or dropping currencies. But to Skorupinski, the appeal to trade came from not only investing in an open market that requires little to feed and leverage, but also investing in himself. According to Abu Hantash, forex trading is more popular in the UAE than ever before, citing the number viet jet ipo brokers that have sprang up.

Anastasiya maslova pnc global investing eur usd projection

Anastasiya maslova pnc global investing

In small We use cookies and similar techniques Comodo's internet. The issue added to popular and for various service desk OS appear, will only are breeding Regulatory Compliance is subtracted Feb Deploy trip to out of. And displayed local directory and the of viewers, tree are is a presets, either forexnewsusd europcar messages electronic contacts.

Measure of international normalized ratio which is derived from prothrombin time measurement is standard practice to control the effect of warfarin, the target ratio is from 2 to 3, it varies for patients with mechanical valves from 2,5 to 3,5. Warfarin has extensive interaction with food and other drugs.

Aim and methods. Make a survey in Latvian Cardiology Center at Pauls Stradins Clinical University Hospital involving patients who use warfarin for different purposes fix information about dose, using length and regularity, time to stabilize international normalized ratio for the first time, Only Appreciating influence on lifestyle average amount of points was 2.

Warfarin dosage is individual, it depends on many factors. Dose cannot be prescribed based on patient s weight and BMI due to different sensitivity to the drug. Diet has important role in therapeutic effect of warfarin, doctors should spend more time to inform and remind patients about it. In patients opinion warfarin significantly affects their lifestyle, especially it disturbs woman s ordinary day Pulmonary embolism, computed tomography, echocardiography.

The informativeness of these methods varies: in CTPA direct changes of the pulmonary arteries are visible, but in echocardiography only indirect effects like acute right heart failure are indicated. To clarify the sensitivity of imaging techniques for diagnosing PE and to compare them informatively. From patients CTPA was performed in In the main pulmonary arteries filling defects were observed in Bilateral PE was found in Cardiac dilatation was not always indicated in the conclusion of CTPA, but in described cases the right heart dilatation was detected in Echocardiography was performed in Right atrial area RAA was above the norm statistically significantly higher in men Right ventricular systolic pressure RVSP was increased in Left atrial volume index LAVI was also increased Ejection fraction EF Simpson in men was reduced Tricuspid regurgitation TR occurred in There was a strong correlation 0.

There is a statistically significant correlation between increased RAA determined in echocardiography and the right heart dilatation described in CTPA. Most frequently in CTPA filling defects are observed bilaterally in segmental arteries.

Hypertrophic cardiomyopathy, inherited cardiovascular disease, autopsy results, sudden death. Hypertrophic cardiomyopathy HCM is a genetic disorder that is typically inherited in an autosomal dominant fashion. Most patients with HCM are asymptomatic. Unfortunately, the first clinical manifestation of the disease in such cases may be sudden death.

Patients also have a high likelihood of recurrent heart failure. HCM affects 1 in people, and is frequently undiagnosed until a fatal event occurs. Analyze autopsy reports from to with diagnosis of HCM and cardiomyopathy, select HCM cases and collect demographic data, co-morbidities and anatomical features of hearts. Because of difference in autopsy report structure and subject specification, results from centres were divided.

No statistically significant relationship was detected between the age and left ventricle wall thickness p 0,05 , as well as between the age and heart weight p 0, Positive relation was detected between the age and left ventricle weight 0, , the age and septum weight 0, , the age and heart weight 0, , all statistically significant p 0, Undiagnosed HCM is a relatively common finding in autopsies, especially for young and pre-middle age male population, as a cause of sudden death, more often at home or in public places or as co-morbidity in the cases, where deaths occurred in hospital.

Average results of heart anatomical features are significantly higher than for average population and their positive relation with the age represents possible progressive myocardium thickening in HCM. Metabolic acidosis is one of the most common problems among the patients admitted to hospital with diagnosis of sepsis. Although magnitude of acidosis is widely accepted as a prognostic factor of worse clinical outcome it is nonetheless important to investigate and treat origins of metabolic component.

We aim to prove that disbalance in strong ion composition and an increase in non-volatile weak acids concentration cause metabolic acidosis in septic patients. Results and Methods. We conducted a retrospective study of laboratory data gathered upon the hopistalization of patients diagnosed with sepsis. Disbalance of strong ion concentrations was analysed using Stewarts electrochemical model and Standart Base Excess SBE model of acid-base analysis. We included data of 69 patients.

We conclude that acid base balance of septic patients is strongly affected by electrolyte concentrations in blood plasma expressed as simplified SID. Lactate and phosphate adding up to the main part of the weak acid concentration in septic patients are the second important constitute of acidosis.

We note the limitations of our study being small and unrandomised Changes in the List of Compensable Medications in replaced short-acting erythropoietin therapy with long-acting erythropoietin therapy for haemodialysis patients with nephrogenic anaemia. This brings concerns if these changes would not have effect on laboratory results that indicate the stability of therapy, and if other simultaneous prescribed therapies would not have interaction with erythropoiesis stimulating agents.

The aim of research is to find out which of two therapies shortacting or long-acting erythropoietin use causes faster and long-lasting effect on target haemoglobin and red blood cell count levels in laboratory analysis results. Presence of insulin therapy in both stages of erythropoietin therapies There was no significant effect difference on haemoglobin levels for patients using nitrendipine. There was no effect of insulin therapy on haemoglobin levels in both stages of anaemia treatment.

Use of other medications such as angiotensin converting enzyme inhibitors, proton pump inhibitors had no effect on haemoglobin and red blood cell levels. Change of erythropoietin therapy from short-acting to long-acting erythropoiesis stimulating agents is associated with decrease of haemoglobin level and increase of red blood cell count level. There were no significant effect observed in patients using most of at the same time used medications.

Dialysis patients are often associated with high risk of infection due to reduced immune system activity. CRP is produced in hepatocytes as response to any inflammatory process; CRP shows us accurately ongoing inflammation as well as tissue damage. CRP is estimated to be a predictive marker in end-stage renal disease. Diabetes mellitus, skin disorders, skin atrophy, hyperkeratosis Introduction.

Diabetes mellitus DM is a widespread chronic disease where poor metabolic compensation may promote severe and life threatening health conditions. Both, internal organs and skin can suffer during pathological processes. Awareness of possible skin changes characteristic for DM and their association with DM control indicators could help to diagnose DM earlier and, subsequently, prevent development of late complications. To determine and evaluate the most common skin disorders in patients with DM, and to find out their association with age, sex, duration of disease, type of DM, treatment and metabolic compensation level in DM patients.

Material and methods. A retrospective cohort study was performed. Patient interviewing, observation and retrospective analysis of case files were performed for necessary data selection. One hundred patients were included in the study. Prevalence of skin dryness was not found statistically significant with any of independent values. Prevalence of onychomycosis was Most common dermatological changes in DM patients were skin atrophy, dryness, onychomycosis, necrobiosis lipoidica, hyperkeratosis, lichenification, they had strong associations with age, sex and insulin treatment.

Other independent values were not statistically significant, but the reason may be relatively small amount of patients, insufficient data in some patients, recall bias. More extensive studies are required. Aggression, hostility, rheumatoid arthritis. Over 2. Rheumatoid arthritis is a chronic inflammatory disorder that typically affects the small joints in your hands and feet. Most types of arthritis require people to cope with pain, stiffness, fatigue, and physical limitations. The aim was to study aggression and hostility trait differences between rheumatoid arthritis patients and practically healthy people.

Determine whether there is a correlation between rheumatoid arthritis patients aggression and hostility traits and illness duration and determine whether there The study used the Buss and Perry's Aggression Questionnaire. The questionnaire was adapted in Latvia by A.

The study involved participants: patients with rheumatoid arthritis and participants without chronic diseases. Study participants aged from 18 to 40 years. From the study, it was found that there are statistically significant differences in the overall level of aggression in all four "Aggression questionnaire" subscales. From these results it can be concluded that rheumatoid arthritis patients have increased aggression, forms of aggression and hostility.

The results provide a broader vision of patients with rheumatoid arthritis aggression and hostility traits and their expressions in various stages of illness. In the future, it is essential to establish a maximum effective ways to help patients with rheumatoid arthritis, which is to be developed from future psychological research. To better understand rheumatoid arthritis patient s beliefs, feelings, thoughts, behavior and health.

Atrial fibrillation is the most common form of arrhythmia and the mortality rate between individuals with this disease is two times bigger than in individuals with sinus rhythm. Therefore, it is very important to discover the disease as soon as possible. In addition, it is important to know which form of atrial fibrillation the patient has and how to proceed with treatment plan. The aim of this study is to discover if there is correlation between the paroxysmal or persistent form of atrial fibrillation and the P wave width in II lead and echocardiographic size of left atrium LAVI Left Atrial Volume Index.

In this study were analyzed histories of 42 patients in age between 48 and 88 years. The obtained data were analyzed and the width of P wave in patients with paroxysmal atrial fibrillation was in range from 0,08s to 0,16s; the average width of P wave in patients with paroxysmal atrial fibrillation was 0,s. The range of the width of P wave in patients with persistent atrial fibrillation was from 0,08s to 0,2s; the average width of P wave in patients with persistent atrial fibrillation was 0,s.

According to the obtained data in the study, there is correlation between the width of the P wave and the form of atrial fibrillation. The average width of P wave in patients with paroxysmal atrial fibrillation was 0,s. The average width of P wave in patients with persistent atrial fibrillation was 0,s. Conclusion is that the wider the P wave is, the more prone the patient is to develop persistent atrial fibrillation and not paroxysmal atrial fibrillation.

Although the enlargement of left atrium is considered a serious risk factor for development of atrial fibrillation, there is no correlation between LAVI and specific form of atrial fibrillation in the results of this study. Pregnancy outcomes thyroid dysfunction autoimmunity.

The thyroid disorders are the second most common endocrinopathies during pregnancy Menaka Ramprasad et al. There are the considerable changes in thyroid gland function that affect both mother and fetus during pregnancy and in the postpartum period. Pregnant women and children are at the considerably higher risk of iodine deficiency than others De Benoist et al. Iodine is an essential component of the thyroid hormones that plays a significant role in brain development during fetal period and iodine deficiency can cause a mental retardation and brain damage Andersson et al.

Also the presence of thyroid antibodies associates with an increased risk of preterm delivery Xiaoyan He et al. There was no data about the pregnancy outcome in women with thyroid dysfunction in Latvia before. The aim of this study is to determinate the association between both thyroid dysfunction and autoimmunity and pregnancy outcomes in the women who took a part in nation-wide survey of iodine intake in Latvia.

Current study shows that there was no statistically significant association between both thyroid dysfunction and autoimmunity and pregnancy outcomes. The presence of maternal thyroid auto-antibodies is associated with gestational hypertension and fetal distress.

Pneumonia is an acute inflammation in lungs. In case of inflammation there is stimulated inos in blood which should increase NO nitrogen oxide amount in exhaled air in patients with pneumonia. Possible that there is connection between inflammatory marker rates and NO amount in exhaled air. To find out whether there is connection between inflammatory marker rates in blood and NO amount in exhaled air in patients with pneumonia.

This was a retrospective research. During the research 22 patient histories were used. Patients were hospitalised in the 14 th Department Data about inflammatory markers in blood and NO amount in exhaled air between 2nd-3rd and 6th-7th hospitalisation days was used. Obtained data was statistically analysed with statistic methods in Microsoft Excel.

Patients who have been diagnosed with pneumonia and who were tested for inflammatory markers in blood have shown difference between the time of hospitalization between one to three days and after the time of therapy. After the initial trial WBC shows 9. NO demonstrates the decrease in exhaled air from The results from initial trial represents that inflammatory markers in blood and NO amount in exhaled air have differences at the time of hospitalization and after the antibacterial therapy has started.

Statistical correlation between those markers are hard to find because of small amount of pacient histories that were analysed. To specify this question this research should be continued including more research objects. K vitamin antagonists, new oral anticoagulants, atrial fibrillation, stroke, bleeding Introduction.

The purpose of using anticoagulant therapy for patients with atrial fibrillation before electrical cardioversion is to prevent stroke risk. K vitamin antagonists must be controlled by regular INR monitoring to prevent overdose and gain sufficient therapeutic effect maintaining INR in range at least for 3 weeks before electrical cardioversion and 4 weeks after it.

Interview patients with atrial fibrillation who used anticoagulation therapy before electrical cardioversion in Riga Stradins Clinical University Hospital Department of Arrhythmology to inquire patients experience using different anticoagulants, reasons of choice, compare complication rate, analyze acquired data in MS Excel and SPSS Results.

Research involved 94 patients Orfarin K vitamin antagonist was used by Total cost was the main reason for choosing Orfarin in According to most frequent dose for reaching stable INR 7. In new oral anticoagulants group The average age of Orfarin users was 9.

Totally Severe bleeding with necessary hospitalization was developed by Minor bleeding such as epistaxis, purpura, gingival bleeding was developed by Diarrhea was the only complication developed in Xarelto group.

In addition, Orfarin users developed dyspeptic complications in 4. Patients who developed hemorrhagic complications had average 3. New oral anticoagulants are safer than Orfarin due to lower complication rate, including reduced risk of bleeding. Orfarin is widely used by patients above retirement age because of the low cost, whereas new oral anticoagulants are popular in younger patients group who are still Actual question for patients with atrial fibrillation is including new oral anticoagulants in list of drugs compensated by the government to let seniors afford them.

Atrial flutter, atrial flutter treatment, RFA Introduction. Atrial flutter AF is a form of arrhythmia with typical electrophysiological and electrocardiographic signs. It clinically manifests as palpitations, shortness of breath, chest pain and low load tolerance. AF is dangerous because if untreated it can lead to serious complications, such as thromboembolic events and changes in cardiac anatomy. Aim of the study. The aim of the study is to find out the frequency of symptomatic arrhythmia relapses, hospitalizations due to arrhythmia after RFA and factors that could affect the above parameters as well as the patient's subjective feelings.

These results can be explained with that the study group is not large enough to show statistically significant changes. In both cases, the changes may be related to the treatment received by Lifestyle, frequency or rhythm supportive therapy did not significantly affect the outcome after RFA, statistically reliable correlations were found. In this study it was not possible to conclusively distinguish those risk factors that could affect the forecast for years, because as it turned out the study group was too small to find statistically significant correlations, but there were distributed diseases and conditions, which tend to have a poorer prognosis.

The study showed the more favorable prognosis is related to adequate antihypertensive therapy. Perhaps, if the number of patients would be bigger, the difference between the groups would be statistically significant. Further researches should choose a larger number of patients to investigate. Myocardial infarctions MI , commonly known as heart attacks, are a leading cause of death, worldwide K. Thygesan et al. Most MIs are transmural infarctions, typically due to atherosclerosis and the complete occlusion of the blood vessel.

MIs can occur at any age; however there is a greater risk with increasing age, particularly in men B. Jha et al. Additionally, a high incident risk of MI exists with patients suffering from chronic kidney diseases C. Meisinger, et al To analyse lethal MI cases, amount, location and the most prevalent diseases associated with MI. The majority of cases showed that patients died of their 2 nd MI. From the records, 42 patients had an oversized heart weight between g, indicating latent signs of hypertension.

There was a low positive correlation between the weight of the heart and the percentage of occlusions in the coronary arteries. The correlation between number of MIs that a patient had and the percentage of atherosclerosis was a very low positive. Alongside MI, all female patients had kidney changes. In the male patients The most prevalent kidney pathology in both male and females was nephrosclerosis with granularity.

From concomitant diseases we must underline liver pathologies Over half the cases This study shows that men have higher risk of MIs at an earlier age than women. Half the patients had no good contacts with family doctors and died at home without any medical aid.

Almost all the patients presented heart hypertrophy which along with nephrosclerosis is presumed of hidden hypertension. Presence of general chronic venous congestion is an indicator of untreated heart failure and increases the presence of any cardiac risks.

Misdiagnosis, gastrointestinal tract disease. In spite of the scientific and technological developments in the medical field, there is still a question of the clinician and the pathologist diagnosis discrepancy that requires an analytical approach for possible solutions.

Divergence of reasons have commenced, tests and therapeutic process analysis can help in the development of treatment guidelines, as well as to investigate differential criteria and their application in different stages of the healthcare process. Nowadays, misdiagnoses are divided in three categories: 1 a false positive - non-existing diagnosis of the disease, 2 a false negative - existing disease was not diagnosed, and 3 the questionable results - inconclusive findings with an uncertain diagnosis N.

Scarborough, MD RAKUS Pathology center distinguishes such reasons for these phenomena: short-term stay in hospital, test data reevaluation, objective diagnostic difficulties, improper diagnosis processing, incomplete patient investigation. The aim of this research is to analyze causes of the mismatch in clinician and pathologist diagnoses, which affect the gastrointestinal and liver abnormalities, including those of localization of oncological diseases.

Overall, 67 cases were analyzed. The age of patients ranged from 19 to 90 years, of which 44 were men and 23 were women. Ulcer disease, with or without perforation, was diagnosed in 8 cases. Liver cirrhosis was diagnosed in 9 cases. Pancreatitis was diagnosed in 8 cases. Oncological diagnostic difficulties were found in 22 cases. In other cases were left undiagnosed anorexia nervosa, acute ulcerative gastroenteritis, chronic pyelonephritis with exacerbation, diverticulosis of the colon with perforation, the abscess of the lower lobe of the left lung, acute gastroenterocolitis, generalized amyloidosis, acute toxic hepatitis, calculary phlegmongangrenouse cholecystitis with perforation to the liver.

Incorrect formulation of the diagnose was in 6 cases. Gastroenterological disease was falsely diagnosed in 9 cases. Of all oncological cases in Most of patients are admitted to hospital in a severe and acute condition, which suggests the need for society s education in health care issues, as well as promoting cooperation among general practitioners, patients and other health care institutions.

We suggest developing a specific diagnostic protocol for patient management with GIT pathologies at the Emergency ward stage. NSAIDs, students, drug usage risks. Non-steroidal anti-inflammatory drugs NSAIDs are one of the world's most widely used pharmaceutical drugs. Most of them can be bought in pharmacies without a doctor's prescription, which is one of the reasons of their excessive use. Uncontrolled use of NSAIDs is acting on the mucous of upper digestive tract both ways: locally - causing direct damage to the mucous cells, and systemic exposure - causing the collapse of the mucous protection mechanism.

Its clinical manifestation could be like the upper gastrointestinal tract ulcers, which may be complicated by bleeding. During the scientific research students were surveyed aged from 18 to of them were from Faculty of Medicine, 30 from other Medicine and Healthcare faculties, 45 from Social Sciences and Law faculties. Comparing Ibuprofenum dosage in mg per day for the duration of NSAIDs course for all surveyed students has found rising trend in all Medicine and Healthcare faculties, but falling trend in Social Sciences and Law faculties.

Conclusions: Ibuprofen is the most popular painkiller among the students in all studied groups. Acute headache, PMS and menstrual pains are the main reasons for its use. In comparison to the students from non-medical faculties, the students from all Medicine and Healthcare faculties consume the NSAIDs according to the principle the larger doses used for a longer period of time.

Most of the surveyed students from Faculty of Medicine are aware of NSAIDs usage risks, but are not limiting themselves on its use, if they have indications for use. Most of the surveyed students from Social Sciences and Law faculties have limited awareness of the NSAIDs usage risks, but are using drugs in lower dosages per day, comparing to Faculty of Medicine students.

Patients, undergoing the heart operative management as aortic or mitral valve replacement, are affected by high risk of Fortunately, the impact can be prevented or minimized through careful medical management and follow-up after implantation of the prosthesis. One of the most commonly used anticoagulants is vitamin K antagonist - warfarin.

However, for reaching the best results, evaluation of the potential complications and their consequences is required. To analyze the therapeutic efficiency of warfarin therapy and the risk of early postoperative complications. In a prospective cohort study on primary data participated 23 men and 25 women with the age from 35 to 85 years , who took warfarin after aortic or mitral valve prosthetic replacement in Pauls Stradins Clinical University Hospital between September and December Median INR level on discharge was 2.

The dosage of warfarin depends on INR results. The high level of platelet count in blood in early postoperative period increases the risk of thromboembolism. Warfarin with or without ASA remains the first-line medication for the patients with aortic or mitral heart valve replacement and its average dosage depends on gender. However, adverse effects of using warfarin therapy were noted in this study.

Warfarin therapy has to be based on individual patient characteristics, predicting the potential risk of complications. Osteoporosis, males, Latvia. Traditionally osteoporosis is regarded as old women disease. However, as diagnostic possibilities of osteoporosis in last few decades have rapidly increased and population longevity has increased, actuality of osteoporosis in men is started to be appreciated in the world, but not enough in Latvia. Osteoporosis is a significant risk factor for bone fractures, especially hip bone.

One must take into consideration that rate of complications for men after hip fracture are three times higher as for women. Besides osteoporosis is a significant cause of morbidity, invalidity and mortality. Significant number of men are living with osteoporosis without knowing it, because osteoporosis in most cases is asymptomatic.

Until today very few researches about osteoporosis in men in Latvia had been made. Compare frequency of bone osteodensitometry in males and females. Analyse risk factors age, height, body mass index of osteoporosis for men. Analyse scientific literature. From scientific literature were identified other risk factors: smoking, excessive alcohol consumption, low calcium intake, inadequate physical exercise, certain diseases and medications.

Low body mass index and weight was identified as a risk factor for osteoporosis. No correlation between T-score and height was found. No correlation between T-score and age was found, although in literature age is mentioned as one of the risk factors.

This may be explained partially by quite high secondary osteoporosis rate in males and also research design. Osteoporosis in men in Latvia is not enough appreciated and men are less often sent to bone osteodensitometry investigation. Patients with excessive Creatine is a widely known supplementation for athletes. But it also has a significant effect on the CNS. Studies have shown that it can benefit in the treatment of muscular, neuromuscular and neurodegenerative diseases, and depression.

Half of the daily needed g intake of creatine is endogenously synthesized; the rest should be obtained by consumption of meat or fish. It is well known that vegetarians and vegans show a deficiency of creatine. The aim of this study was to investigate the correlation between creatine consumption and measurable IQ results and to determine its significance.

For this purpose, individuals who are more prone to creatine deficiency vegetarians and vegans have been compared with individuals who have an adequate supply of creatine due to their eating habits omnivores. The study consisted of 48 participants aged , mean age women: Four groups were formed by chance, of which the compositions were based on the participants type of diet non-meat eater vs. Two groups a non-meat eater group and an omnivore group received 5g creatine twice daily over the course of 7 days.

There was no significant difference of IQ or working memory scores between the groups during the initial test. No significance could be found in the other groups. It can be advised to supplement creatine to meet the body s need, if it cannot be reached with the consumption of meat.

Further investigations and European Medicines Agency EMA recommendations are needed to determine the exact amount and which type of creatine should be used for supplementation. Ivars Tolmanis 2, doc. Endoscopy, Biopsy, Atrophy, Intestinal metaplasia.

Gastric atrophy is a result of prolonged chronic gastritis, in which the gastric mucosal glands become attenuated and eventually lose their ability to secrete gastric juices. Gastric intestinal metaplasia is the replacement of the surface, foveolar, and glandular epithelium in the oxyntic or anthral mucosa by intestinal epithelium. Both are relatively frequent preneoplastic lesions which are diagnosed by doing an endoscopy and a biopsy.

Even though a biopsy can be taken in every endoscopy, diagnosis is often based only on the endoscopical finding as the biopsy is twice as expensive as the endoscopy itself. Evaluate the need of a biopsy during an endoscopy in the diagnostics of gastric atrophy and gastric intestinal metaplasia.

Patients with standard biopsy schemes that had had their endoscopies done during the time period of the 1st of January till the 31st of December were selected. Out of patients in age In total patients The sensitivity of endoscopy was Results show that endoscopy has a low sensitivity in diagnosing gastric atrophy and intestinal metaplasia, and biopsy should be done in order to diagnose these conditions.

Especially in those patients of age 50 years, who have a much greater chance of high risk gastric atrophy and intestinal metaplasia. For those patients with established atrophic gastritis and established intestinal metaplasia, surveillance screening for dysplasia and gastric adenocarcinoma should be considered. Although historically carotid endarterectomy was considered as the gold standard for the treatment of carotid artery stenosis, the widely referenced There are more than 30 kidney transplantations per million of inhabitants taking place each year in the Latvian Transplantation Centre.

According to the data of the scientific literature, leukopenia develops Previous research mostly studies the interdependence between leukopenia and immunosuppressive, antiviral and antibiotic therapy as well as infections CMV, HHV Untimely diagnosed and ill-treated leukopenia increases the risk of infection. Leukopenia therapy can be etiological with reducing doses of toxic drugs and infection treatment and pathogenetic with receiving of G-CSF.

To assess the incidence, characteristics, risk factors and treatment of leukopenia in kidney transplant recipients. Severe and extremely severe neutropenia was observed in We observed no association of leukopenia and tacrolimus use. Other therapeutic modifications included withdrawal of valgancyclovir or biseptol, administration of valgancyclovir and use of granulocyte colony-stimulating factor G-CSF.

G-CSF was administrated in 5 episodes of leukopenia with severe neutropenia. All episodes of leukopenia resolved with treatment modifications or spontaneously. Patients after kidney transplantation should have intensive surveillance, because of the increased incidence of leukopenia with Different treatment modifications are effective, but the most effective and safest are not assessed, so further studies are necessary.

Practical guidelines for the management of leukopenia in kidney transplant recipients are required. Chronic heart failure, atrial fibrillation, hemodialysis. Hemodialysis is one of the treatment options of ESRD. Cardiovascular disease is the most common cause of mortality in patients undergoing hemodialysis, accounting for almost 50 percent of deaths.

In hemodialysis patients chronic heart failure CHF etiology can be variable: elevated blood pressure, electrolyte disbalance and ischemia. In our study we analyzed chronic heart failure and atrial fibrillation in chronic hemodialysis patients. To assess incidence, characteristics and risk factors of chronic heart failure and atrial fibrillation, and to evaluate the risk of thromboembolism and bleeding in chronic hemodialysis patients.

No correlation was CHD patients have an increased risk of both thromboembolism and bleeding, therefore intensive surveillance of the patient is necessary, even if the patient does not have AF. Introduction: Portal hypertension is related to liver fibrosis, therefore noninvasive liver fibrosis markers could predict esophageal varices. These predictors of varices could reduce the number of screening upper gastrointestinal endoscopies. Aim: To compare different serum fibrosis scores and transient elastography in prediction of esophageal varices and to determine cut-off values for diagnosing large varices in patients with HCV related liver cirrhosis.

Liver stiffness measured by fibroscan was significantly higher in patients with EV compared with patients without The presence of EV was predicted with the cut-off value of liver stiffness higher than The area under receiver operating characteristic curve AUC was 0. For prediction of large EV liver stiffness value was determined higher than For FIB-4 score higher than 5. Conclusions: Transient elastography may be considered as nonendoscopic predictor for the diagnosis of esophageal varices and management of large varices with value higher than Percutanous endoscopic gastrostomy, gastrostomy, endoscopy, mortality.

Percutanous Endocopic Gastrostomy PEG was made for the first time in at Cleveland University Hospital USA , and from that time it became the method of choice for ensuring long-time enteral feeding as an alternative for surgical gastrostomy. It is minimally invasive, relatively fast method with low expenses. The aim of the study was to assess the most common indications for PEG placement, comorbidities and influence on post-procedure mortality.

The most common indications were neurological disorders Other indications were comparably rare intensive care patients The most common comorbidities were respiratory system disorders The mortality after procedure reached Mortality was associated with serious comorbidities. Statistically relevant differences regarding mortality rates between age groups were not obtained, though the highest mortality was in age group between years, mortality of men being two times higher than women.

The highest mortality was in patients with infection There is no statistically significant difference on mortality rate between different age groups, therefore age should not be considered as contraindication when opting for PEG placement. Patients with serious cardiovascular illnesses and infectious diseases have statistically significantly higher mortality risk after procedure.

Deep vein thrombosis DVT , Wells score. Diagnosing different conditions, including Deep Vein Thrombosis DVT , has become easier by using guidelines what have been developed by group of experts over a period of time. Nevertheless, guidelines tend to change the most important is to be updated about it and implement the changes in daily medicine. Usage of Wells score is a significant factor in the DVT diagnostics pathway. By doing this audit I wanted to see how medical staff in Raigmore Hospital, Inverness follow guidelines to diagnose Deep Vein Thrombosis.

Due to different already pre-made request forms for Doppler US scan GPs are better in calculating and mentioning Wells score. After changes of guidelines it takes time to inform medical staff about the updates and getting used to implement them so better patient care could be provided. The changes of the guidelines should be easily accessible and previous version taken away.

Venous thromboembolism, Deep vein thrombosis, Pulmonary embolism Introduction. Venous thromboembolism VTE is a major health problem. VTE is most common avoidable cause of death in hospitalized patients. Until recent decades VTE was viewed primarily as a complication of hospitalization for major surgery or associated with the late stage of terminal illness. However, recent trials in patients with a wide variety of medical illnesses have demonstrated a risk of VTE in medical patients comparable with that seen after major general surgery.

Independent risk factors for VTE include increasing patient age, surgery, trauma, active cancer with or without specific cancer therapy, hospital confinement, and prior vein thrombosis among others. Mean hospitalization time was 13,8 days. There was no statistically significant difference observed between inhospital mortality and venous thromboembolism. Venous thromboembolism, especially deep vein thrombosis is more common in men than it is in women. Venous thromboembolism accounts for higher incidence rates with increasing age in both genders.

Pulmonary embolism is strongly correlated with deep vein thrombosis. The connection between deep vein thrombosis DVT , pulmonary artery thromboembolism PATE and oncologic pathology is known since when it first described French physician Armand Trousseau. Scientific studies revealed factors, which increase occurrence of thrombosis in oncologic patients, such as localization of tumor and its morphological type, age, obesity, immobilization, history of previous thrombosis, use of central venous catheters.

Chemotherapy also elevates the risk, so the assessment of risks should be done before starting the course and possibility of prophylaxis should be evaluated. Furthermore, symptoms of thrombosis may occur before the malignancy is diagnosed, so patients presenting with idiopathic thrombosis should be additionally investigated to exclude malignancy. The aim of the study was to retrospectively analyze clinical features of oncologic patients presenting with DVT and PATE, evaluate epidemiological and investigational data and define risk factors of thrombosis of Latvian population.

In our study following risk factors: female sex, lung tumor, morphological pattern adenocarcinoma, metastases, chemotherapy, general anesthesia, high levels of C-reactive protein or leukocytosis were determined to have greater impact on DVT and PATE development in oncologic patients. These factors should be evaluated and possibility of prophylaxis of thrombosis should be assessed.

Furthermore, before starting the course of chemotherapy or making a manipulation under general anesthesia, prophylaxis of thrombosis should be obtained. The scientific research should be continued and recommendations for prophylaxis of DVT and PATE in oncologic patients should be developed. ARVD is rare cardiomyopathy and is a leading cause of sudden cardiac death among young athletes. It may develop due to genetic Most commonly affected gene is PKP2.

Aim is to find out if ARVD in Latvian patients is caused by mutations in the PKP2 gene, to analyze discovered genetic variations frequency in European EU and Latvian LV populations and to evaluate how discovered genetic variations correlate with phenotype.

Two exons were analyzed in 14 unaffected Latvian individuals. We identified different genetic variations that were previously described as non-pathogenic in ARVD database: c. The prevalence of the majority of non-pathological genetic variations is almost the same in Latvian ARVD patients and European population. Two genetic variations c. One of these mutations c. Unregistered genetic variations should be applied for registration in ARVD database. Research will be continued and other ARVD associated genes should be sequenced to confirm ARVD diagnosis genetically and help to find out the risk for first-degree relatives.

Mean arterial pressure, spectral analysis, pressure regulation, RR interval, variability. Elevated blood pressure is a major risk factor for cardiovascular diseases and increased mortality. Blood pressure variability is one of methods how non-invasively evaluate different regulatory factors which influence arterial blood pressure, even more it increases proportionally to mean arterial blood pressure MAP.

Arterial blood pressure is not a constant value, it changes spontaneously and some pathophysiological factors like hypoxia can affect it. Studies show specific cardiovascular autonomic response to hypoxia, which consist and could be evaluated by high frequency HF and low frequency LF band fluctuations.

There is even connection between excessive MAP fluctuations and development of organ damage. Aim of research was to compare mean arterial pressure fluctuation change with heart rate variability in normoxic and hypoxic conditions and to detect specific cardiovascular autonomic response.

Research subjects were 10 adults To evaluate autonomic nervous systems regulatory response to heart were used RR interval data and the sympathetic regulation in systemic circulation was evaluated by MAP spectral analysis. Acute hypoxia causes changes in RR interval; it is decreasing during hypoxia and increased during normoxia.

LF band increases after 20 minutes of hypoxia, which indicates the growing influence of regulatory activity of sympathetic nervous system. Acute hypoxia does not influence high frequency band, which indicate unchanged parasympathetic nervous system activity to heart. Donor gender, graft survival, graft function. Kidney transplantation for people with end stage chronic kidney disease is an optional method of treatment.

It allows to improve the patients quality of life. However graft survival is limited, therefore it is important to know the factors that can affect it. To study whether the gender of the donor has an effect on kidney grafts function and five year survival rate. The study included patients who received kidney grafts from deceased donors in the time period between and donors were female and were male gender. There were no statistically significant association between gender of donor and delayed graft function and acute rejection rate.

If the kidney from female donor was transplanted into female recipient, graft survival was better Recipients whose kidney graft donor was a female have a lower 5 year survival rate and a worse graft function especially if a recipient was a male. There is no statistically significant association among different gender donors and acute rejection or delayed graft function frequency.

Since data on these predictors are contradictory, we performed an analysis in patients screened for the EAGLE-study. Screening logs of all patients and all subsequent data until death or discharge were prospectively analysed regarding prediction of ICU-transfer, length of hospital stay and death primary endpoint. Among single parameters on admission calcium AUC 0. By contrast glucose 0. Among single parameters low calcium and high BUN are the best predictors of poor outcome, whereas glucose was not predictive.

Multiple myeloma, bone marrow biopsy, renal insuffiency. Malignant plasma cells morphology and aberrant antigen expression play a role in the prognosis and survival Ngo,et al. One of the most common complications of MM is renal insufficiency. Glomerular filtration rate GFR has a major role to determine renal functions. Potassium level increases when GFR is decreased, as example, in cases of renal insufficiency Lejnieks, et al. Relatively small numbers of publications were found about BM morphology correlations with different kind of MM complications, especial with renal insufficiency.

To find a correlation between BM morphology, expression of some immunohistochemical markers and disturbances of renal function. To get information of renal functions we have analyzed such laboratory test as SCr, serum potassium, GFR. Patients' GFR mean was BM cellularity mean was The kappa: lambda light chain ratio was 2, 1. Statistical analyses were performed using Graph Pad Prism 5 software. We didn't find statistically significant difference between expression of BCL2, kappa, lambda and renal insufficiency tests.

BM cellularity is a negative predictive factor of renal functions as GFR is lower in cases with more expressed cellularity. Patients with high amount of plasma cells in BM biopsy, plasma cells with plasmablastic differentiation and lack of CD 56 expression statistically significantly correlated with increased SCr level and decreased GFR and have poorer prognosis of renal function outcome.

Lower extremity amputation, diabetes mellitus, coronary artery disease. The percentage of amputations has not changed since the last century. According to statistical dates, the rate of lower limb amputation has increased for the last five years in Latvian population. Unfortunately, peripheral arterial revascularization does not achieve success in individuals with severe vascular lesions and wide necrosis.

In some cases amputation is the main operation to relief patient s suffering. In developed countries a lot of lower limb amputations are performed due to vascular pathologies also in Latvia. However, etiology and risk factors may vary in different countries.

Comorbidities, like diabetes mellitus, stroke and myocardial infarction are associated with earlier limb amputation and increase the level of amputation. The aim of this study was to analyze impact of patients comorbidities on lower extremity amputation level and detect, if preoperative anemia and coagulation changes influence the amputation level.

In this study we have found that 12 of 76 patients underwent toe amputation, 5 of 76 - foot amputation, 21 of 76 amputations of the lower thigh level, 33 of 76 amputations at the mid thigh and 5 of 76 amputations of the high thigh level. Amputations of the thigh level, however, showed weak correlation with diabetes, but there were strong correlations with coronary artery disease. There was no significant difference between amputation level and hemoglobin level or erythrocyte count.

The study has showed that foot and toes amputations are associated with diabetes mellitus. Impact of diabetes becomes lower in the major amputations. So, we can say that patients with diabetes have higher risk of below the knee amputation. Nevertheless, persons with anamnesis of coronary artery disease and cerebrovascular pathologies often have above the knee amputation.

Coronary artery disease, myocardial infarction and stroke are associated with peripheral artery occlusion development. Poor compensated diabetes mellitus can worsen patient s state significantly. Comparing to other studies where anemia correlated with the limb amputation risk, this study showed that anemia has no significant impact to the amputation level.

Colorectal cancer, adenocarcinoma, surgical treatment, regional metastases. Despite the remarkable progress in the diagnostics, treatment and scientific studies of colorectal cancer CRC , it still represents one of the most frequent malignant tumours in Latvia and the whole Western world. Regarding the outcome and the selection of treatment, presence and number of regional lymph node LN metastases MTS are of utmost importance.

The analysis of associations between regional LN status and other tumour characteristics can yield pathogenetic information and help in the elaboration of diagnostic protocols for preoperative assessment or in controversial cases.

The aim of this study was to identify the association between the presence and extent of regional LN MTS and both classical cancer grade, invasion depth, histological type and innovative characteristics cancer volume, nuclear atypia, type of the invasive border, mitotic count. A retrospective study design was selected as appropriate. All consecutive patients who underwent colorectal cancer surgery with potentially curative intention were identified by archive search in a single clinical university hospital, The following demographic and clinical data were studied: patients age and sex, the histological cancer type by World Health organisation WHO classification Bosman et al.

By light microscopy, histological cancer specimens were analysed to evaluate the nuclear atypia in three-tiered scale, invasive border rounded versus streaming dissection and mitotic count within 10 high power x fields of view HPF. The archive search yielded cases including The median age of CRC diagnosis was Adenocarcinoma was the most frequent The tumours predominantly affected sigmoid colon and rectum In G3 comprised The invasive border showed streaming dissection in In contrast, the border was rounded in The highest mean mitotic count was observed in pn2 CRC reaching 8.

Surgically treatable colorectal cancer in Latvian patients is diagnosed at the median age of 71 years. It is characterised by significant predominance of adenocarcinoma over other WHO-defined histological types and by predominant left-sided location. Author: Anatolijs Naumciks 1 Supervisor: Asoc. In the last three decades despite the evolution of preventive medicine programs the treatment for active infective endocarditis IE is still challenging with high mortality and morbidity and the incidence of native valve endocarditis NVE has not decreased.

The purpose of this study is to analyze preoperative patient characteristics, causing micro-organisms, infected sites and surgical procedures for NVE. From 1 August to 31 July , twenty-nine patients at the Pauls Stradins Clinical University Hospital underwent surgery for active valve endocarditis were identified and data retrospectively collected from cardiac surgical database and medical records reviewed.

Prosthetic valve endocarditis was found in 6 patients, however it was excluded from this study due to the different nature of the disease and clinical characteristics. In the population of 29 analyzed patients, The mean age is Overall, 19 patients Since echocardiography verification, surgery was performed within 72 hours of diagnosis of active endocarditis for 5 patients There were a total of 1 patient postoperative death 3. In 11 cases In 6 cases Results show that high density lipoproteins and C-reactive protein are very sensitive markers of IE.

The most common etiologic agent of infective endocarditis in Pauls Stradins Clinical University Hospital is Staphylococcus strains. The aortic valve is damaged in most cases of IE, mitral valve involvement is common as well. In NVE surgical treatment valve replacements are most common than valve repair procedures. Nowadays two different strategies have been developed for the clearance of CBD stones.

Two stage strategy considering pre- or postoperative endoscopic retrograde cholangiopancreatography ERCP may be used, however, it is associated with considerable number of complications. Alternative approach one stage strategy has been developed and recommended for patients with CBD stones providing laparoscopic common bile duct exploration using choledochoscopy. Bleeding after endoscopic papillotomy complicated clinical course in 3 Group II patients.

ERCP was associated with 2. There was no mortality in our series. Choledochoscopy is safe and feasible procedure that is associated with low post procedure pancreatitis risk and significantly higher success rate considering CBD clearance comparing to ERCP.

Renal transplantation, DGF definitions. Delayed graft function DGF , traditionally defined as requirement for dialysis within the first week after transplantation, is one of the most frequent complications affecting early and late results after kidney transplantation. However there are many proposals for other approaches to define this complication.

The aim of this study was to analyse and compare different DGF definitions. Humar et al. Hetzel et al. Boom et al. Gonwa et al. Halloran el al. Recipient factors were associated with DGF development according to definitions D1-D3 and traditional definition, and the main factors were recipient weight in all and male gender in D1 and D2.

The main donor factors were high BMI in all and hemodynamic disturbances in pre-explantation period D2, D3, D7 and traditional definition. Sclerosis in donor kidneys revealed by zero biopsies reached significance only in D4. Analysis of post-transplant results showed higher rate of acute rejections was observed in all DGF definitions except D1, and increase in post-transplant hospital stay in D1-D5 and traditional definition.

Death-censored graft losses and patient deaths did not show association with any DGF definition. Definitions D2-D7 showed results close to traditional definition used, with only D4 being associated with initially worse histological findings. D1 showed no association with donor factor, meaning that this definition is not suitable for proper diagnosis of DGF. Find People by Employers You can rekindle an old relationship, reconnect with a long-lost friend, former boss, business acquaintance who might be useful in your new line of work.

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