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Vladimir Pushevski, Petar Dejanov, Vesna Gerasimovska, Gordana Petrushevska, Angel Oncevski, Aleksandar Sikole, Zivko Popov and Ninoslav Ivanovski

Abstract

Background: Hemodialysis as an efficient therapy for advanced CKD is the most used treatment modality all over the world. Even though primary AVF is widely accepted as a best permanent vascular access in hemodialysis patients, up to 60% of all fistulas fail to mature. The pathogenesis of early fistula failure is not very well understood. Many general and local factors are involved: patient′s age, sex, primary renal disease, small vessel′s diameter, presence of accessory veins, prior venipunctures, surgical skill, genetics, etc. Histological investigations have confirmed the neointimal venous hyperplasia as a major pathological finding in stenotic lesions of AVF failure, due to local inflammation, oxidative stress and migration and proliferation of myofibroblasts, fibroblasts and endothelial cells.

Materials and methods: A total of 89 patients with stadium 4-5 of CKD are involved in the study. A typical radio-cephalic AVF is created in all patients. Part of the fistula vein was taken for histological, immunohistochemical (Vimentin, TGF β and KI67) and morphometric analysis. Appriopriate statistical method was applied.

Results: Up to 80% of the patients showed some degree of endothelial changes at the time of creation of AVF, among them 19 pts with substantial intimal hyperplasia, 51 with medial hypertrophy and 19 pts with normal histology. Almost two thirds of the patients did not have expression of TGFβ. More than 95% had some expression of Vimentin. None of the patients had expression of the marker KI 67.

Conclusion: Medial hypertrophy is predominant preexisting pathohistological lesion prior the AVF creation, despite the presence of neointimal hyperplasia. The absence of TGFβ expression in majority of our patients could suggest that inflammation and oxidative stress are developing later, after vascular access surgery. The dominant cells within the stenosis in the veins are myofibroblasts. Their increased presence maybe a reason why some patients are prone to developing venous endothelial changes as a results of exaggerated vascular endothelial response to the effect of uremia, hypertension and other insults.

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Sanja Petrusevska Marinkovic, Irena Kondova Topuzovska, Zvonko Milenkovic and Biserka Kaeva

Abstract

The aim of this study was to identify the participations of the serum coagulations and fibrinolysis factors that contribute to the differential diagnosis of the patients with community-acquired pneumonia (CAP) without effusion, uncomplicated parapneumonic effusion (UCPPE) and complicated parapneumonic effusion (CPPE).

The coagulations system is fundamental for the maintenance of homeostasis, and contributes to the inflammatory process responsible for CAP and the parapneumonic effusion. The factors of coagulations and fibrinolysis participate in the cellular proliferation and migration as in the synthesis of the inflammatory mediators.

We evaluated the laboratory profile of coagulations and fibrinolysis in the serum of 148 patients with CAP without effusion, 50 with UCPPE and 44 with CPPE. We determined the test of the coagulation cascade which measures the time elapsed from the activation of the coagulation cascade at different points to the fibrin generation. As a consequence, there is an activation of the fibrinolytic system with the increased D-dimer levels measured in the plasma in the three groups.

The patients were with mean age ± SD (53,82 ± 17,5) min – max 18–93 years. A significantly higher number of thrombocytes was in the group with CPPE with median 412 × 109/L (rank 323–513 × 109/L). The extended activation of the prothrombin time (aPTT) was significantly higher in the same group of patients with median of 32 sec. (rank 30–35 sec). The mean D-dimer plasma level was 3266,5 ± 1292,3 ng/ml in patients with CPPE, in CAP without effusion 1646,6 ± 1204 ng/ml and in UCPPE 1422,9 ± 970 ng/ml.

The coagulations system and the fibrinolysis play important role in the development and pathophysiology of CAP and the parapneumonic effusions.

Open access

Viktor Kamnar, Anastasika Poposka, Nenad Atanasov and Milena Bogojevska

–113. 21. Sochart DH, Potret ML. The long-term results of Charnley low-friction arthroplasty for congenital dysplasia or dislocation of the hip: long-term results. J Bone Joint Surg [Am]. 1997; 79-A: 55–61. 22. Dawson J, Fitzpatrick R, Carr A, et al. Questionnaire on the perceptions of patients about total knee replacement. J Bone Joint Surg [Br]. 1996; 78: 185. 23. Fitzgerald JD, Orav EJ, Lee TH, et al. Patient quality of life during the 12 months following joint repla cement surgery. Arthritis Rheum. 2004; 51: 100. 24. Freeman MA. Acetabular cup migration

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Lena Kakasheva-Mazhenkovska, Neli Basheska, Simonida Crvenkova, Petrushevska Gordana, Liljana Milenkova, Vesna Janevska and Vladimir Serafimoski

;46:481-489. 4. Larsen M, Artym VV, Green JA, Yamada KM. The matrix reorganized:extracellular matrix remodeling and integrin signaling. Curr Opin Cell Biol 2006;18:463-471. 5. Kerbel RS. Tumor angiogenesis. N Engl J Med 2008; 358:2039-49. 6. Auguste P, Lemiere S, Lahargue FL, Bikfalvi A. Molecular mechanisms of tumor vascularization. Crit Rev Oncol Hematol 2004;54:53-63. 7. Lamalice L, Le Boeuf F, Huot J. Endotelial cell migration during angiogenesis. Cirk Res 2007;100:782-794. 8. Gerhart H, Betsholtz CH

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Andrzej Wincewicz, Piotr Woltanowski, Stanisław Sulkowski and Jolanta Małyszko

chorobie. The nourishment in health and disease. Warszawa : PZWL, 1954 pp. 89. 70. Chlebowski J. Podstawowe wiadomości z dietetyki. Basic informations in dietetics. Warszawa : Państwowy Zakład Wydawnictw Lekarskich, 1952 pp. 220. 71. Stola D. Post March Emigration [Emigracja pomarcowa]. Institute for Social Studies, University of Warsaw. Migration works [Prace migracyjne] 2000; 34: 1–21. 72. Bernacki E. Medical Doctors of Bialystok region. Post-war years. Memories and CVs, “District Medical Chamber, Historical Fascicles” [Lekarze Białostocczyzny. Lata

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K. Kononovich, Jean-Marc Macé and E. Yuryeva

. In: Kervasdoue J. The health notebooks of France. Paris: Dunod; 2004:146-164. French. Macé JM Picheral H. Territory experience: medical territory Kervasdoue J. The health notebooks of France Paris Dunod 2004 146 164 French 16 Terrier C. Mirabelle. Paper presented at the Second international days on data analysis. Versailles; 1979. French. Terrier C Mirabelle. Paper presented at the Second international days on data analysis Versailles 1979 French 17 Terrier C. The structures of the French space by alternating migrations

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E. Avdeeva, S. Nikulina and I. Artyukhov

being actively introduced on the basis of Russian universities and which are most likely to be further developed in the next 10-20 years [ 14 ]. Firstly, there will be single language of teaching in the system of higher education. And it will be English. Even now, as Bulyzhenkov I. E. and Soloviev O. N. note, there are courses or educational programs in English in thousands of universities all over the world [15, p. 64]. Migration to different parts of the world becomes as typical as a trip to a neighbouring city. Knowledge of basic English will become an obligatory