Factors affecting the prognosis of Albanian adult patients with generalized tetanus

Background. Despite systematic vaccination of the population, tetanus continues to be a health problem in Albania, as in some other developing countries. In this study, our intent was to evaluate prognostic factors relating to death in adult patients with generalized tetanus. Methodology and patients. All the patients (60) included in the study were hospitalized at the regional hospitals of Shkodra and Korça, and the University Hospital Centre “Mother Theresa” of Tirana, Albania, during the period of 1984-2004. They had a mean age of 49.1+14.4 years, 43 (71.7%) were males and 40 (66.6%) of them lived in rural areas. The mean incubation period was 12 days and the case-fatality rate (CFR) was 38.3%. Results. The CFR in patients with an onset period ≥2 days was 21.7% and in those with <2 days was 48.6%, OR=0.29 (p<0.05). Patients >50 years old had a CFR=60.87% (OR=7, p<0.05). We found the high CFR to be significantly associated with urban residency, male gender, complicated wound, head localization, fever ≥ 38.4 °C, tachycardia > 120 beats/min, and hypertension. Discussion. The main prognostic factor of those analyzed in our study appeared to be the onset period and the age of the patients. We didn’t find significant differences in CFR in patients with different incubation periods. Clinicians must take into account that wound complication and localization, tachycardia and hypertension, high fever, male gender and urban residency significantly influence the prognoses of adults with generalized tetanus.

Delayed presentation of blunt duodenal injuries in children. Case report and review of literature

Background. Duodenal injuries are rare in children and classically present following a fall over the handle bar. Retroperitoneal location of the duodenum may lead to delay in diagnosis, and missed injuries are associated with increased morbidity and mortality. Case report. A 5-year-old child was admitted to the National Trauma Center, in Tirana (Albania), 28 hours after a Motor Vehicle Crash (MVC), complaining of mild abdominal pain. He was febrile (39°C) and had a white blood cells count of 18,000 mm3. On physical exam he had mild tenderness. Plain abdominal X-rays and Focused Abdominal Sonography for Trauma (FAST) were negative for free air or free fluid. The CT scan of the abdomen demonstrated free air and fluid in the retroperitoneal space. At laparatomy, a perforation of the second portion of the duodenum was found. A single layer suture repair of the duodenum with wide drainage was performed. The patient was discharged from the hospital tolerating oral feeding 8 days later. Conclusion. Duodenal injuries in children are rare. Most duodenal hematomas are managed non-operatively. This is a case of MCV with delayed presentation that was treated surgically for perforation successfully.

Les armes de jet d’Argilos : catalogue typologique

Quelques sites archéologiques comme Olympie, Stymphalos et Olynthe possèdent respectivement un répertoire faisant l’étude des armes de jet retrouvées durant une série de campagnes de fouilles archéologiques. Parmi ces indexes, figurent fréquemment des pointes de flèche, des balles de fronde et des saurotères (contrepoids de lance ou de javelot) provenant de différentes périodes historiques gréco-romaines. À travers les 20e et 21e siècle de notre ère, des spécialistes comme D. Robinson (1931), A. Snodgrass (1964), H. Baitinger (2001), C. Hagerman (2014) dédièrent une partie de leur expertise pour produire des synthèses sur ces objets jadis négligés. Ainsi, ils parvinrent à créer de grandes encyclopédies commentées composées de projectiles retrouvés en sol grec. À l’aide de ces bases de données, les archéologues militaires sont en mesure d’établir des datations et l’origine prétendue de certains types de projectiles. Jusqu’en 2015, les artéfacts militaires trouvés sur le site archéologique d’Argilos n’avaient jamais fait l’objet d’une étude de synthèse. D’abord, inspiré par de publications semblables, ces projectiles furent soumis à un inventaire sous forme de catalogue. Au total, deux types de balles de fronde en plomb, onze types de pointes de flèche et un type de saurotère furent identifiés. Finalement, ce nouveau contenu fut assujetti à des analyses comparatives avec d’autres sites archéologiques possédant des données similaires. Les conclusions découlant de ces analogies donnèrent naissance à la première typologie des armes de jet argilienne. Certes, les analyses se heurtèrent à certains obstacles, notamment à une compréhension de la quasi-inexistence d'une pointe de flèche typiquement "grecque" et à la confusion systématique quant à la distinction entre un saurotère et une pointe de javelot, voire possiblement un carreau de gastraphétès (une sorte d’arbalète imposante utilisée lors de sièges durant le 4e siècle av. J.-C.). En partie, ceci découle de l'historique d'échanges entre la Grèce et les autres peuples méditerranéens, balkaniques et orientaux. En outre, de nombreuses réformes militaires des périodes archaïque et classique provoquèrent une évolution constante sur les aspects stratégiques et les tactiques militaires. Considérant ces facteurs parmi tant d'autres et le fait qu'Argilos ait été une fondation grecque en territoire thraco-macédonien, la possibilité d'influence "étrangère" devient alors prépondérante sur la typologie des projectiles argiliens publiée dans le présent mémoire. Avec beaucoup d’espoir, nous croyons sans équivoque que ce travail de recherche contribuera grandement non seulement à l’histoire d’Argilos, mais aussi à l’étude des projectiles en Grèce du nord.

Between Nation and State: Albanian Associations from Ottoman Origins to a Communist Party, 1880 - 1945

This dissertation addresses the broader antecedents of the Communist Party of Albania (CPA) as one of a number of associations whose experience was central to Albanian political history. This long experience dates back to the informal national associations formed in the Ottoman Empire of the late nineteenth century. The dissertation examines the role of these associations which, pursuing language rights and political representation through imperial state reforms, set a pattern that struggled to connect nation and state, rather than asserting the territorial demands for a nation-state familiar across the region. Starting out in the Ottoman Empire, but then maturing in the Albanian diaspora in Romania, Bulgaria, Egypt and the United States, this dissertation shows politically significant processes of longer-term adaptation that created informal associations as institutional structures able to channel collective action. It then traces the reframing of these patterns through their destruction in the Balkan Wars and the First World War to the emergence of communist associations in the interwar period and beyond. This dissertation is a sustained study that traces long-term Ottoman imperial political legacies in the Albanian successor state. The story of the associations, based on hitherto unexamined archival documents, shows that the Albanians possessed a far greater capacity for political mobilization that previously acknowledged by historians. Moreover, the dissertation successfully challenges the conventional wisdom that portrays the Albanians as irreparably divided along sectarian and regional faultlines. It finds that Albanian national activism was civic in character rather than ethnic as elsewhere in the Balkans. The Albanians fought to remain within a multinational framework because this afforded them political security, social advancement and potential economic growth. In the late Ottoman period, this political objective was manifested in the acceptance of the supranational imperial order whereas during the Second World War, in the aspiration to become members of the Comintern internationalist movement. Another important find, is the newly-discovered evidence concerning the founding of the CPA and its wartime conduct as an organization created and led by the Albanians themselves, albeit with Yugoslav ideological assistance under the transnational umbrella of the Comintern.

Knowledge and attitudes towards dietary fibers - romania vs other european countries

Aim: The aim of our study was to evaluate the Romanian’s knowledge and attitudes regarding dietary fibers compared with other European countries. Materials and methods: We made a cross-sectional survey (part of multinational project from CI&DETS Research Centre, Instituto Politecnico Viseu, Portugal, with reference PROJ/CI&DETS/2014/0001) based on a questionnaire applied in 2015, over 670 Romanian consumers, focused on the attitudes and knowledge towards ingestion of foods rich in fibers. We used the software SPSS for statistics. Results: Our results showed that the knowledge about dietary fibers and also the ingestion of food products rich in fibers were low. The female participants ate more whole grains and fruits than males and pay more attention to food labelling, the Romanian people prefer to stay and eat home than at restaurants especially in rural areas, and the knowledge about fiber’s benefits was significantly related to high education and urban location. Comparing to other European countries, Romania had the highest level of knowledge about dietary fibers definition followed by Portugal, Turkey and Hungary, but the lowest regarding the fibers importance for health after Macedonia, Turkey and Latvia. Conclusion: We sustain the needs for more efficient community interventions and proper information about the importance of dietary fibers for our health and also for the dissemination of the nutritional standards among Romanian population.

Comment expliquer l’absence de conflit religieux dans un pays multiconfessionnel? Cas de l’Albanie

Huntington avait-il raison lorsqu’il déclarait que la religion serait un élément sujet à diviser ? Loin de déclarer qu’il existe une recrudescence de conflits dans le monde, force est de constater que la dimension religieuse dans les conflits est quant à elle sur le devant de la scène. Les cas du Liban, de l’Irlande du Nord ou de l’Ex-Yougoslavie, des cas classiques, illustrent parfaitement cette dimension dans l’exacerbation d’un conflit. Toutefois, ce mémoire tend à expliciter un phénomène particulier ; celui de l’Albanie. Située dans la région des Balkans, un véritable carrefour des religions d’une part et considéré comme un pays multiconfessionnel d’autre part, elle n’a jamais connu de conflit à caractère religieux. Qu’est-ce qui explique que cet État, composé de musulmans, de chrétiens orthodoxes et de catholiques, n’a jamais vu un conflit religieux émerger tandis que ce mulitconfessionnalisme est facteur de conflit chez d’autres ? Nous verrons que l’hypothèse sur laquelle nous nous appuierons est l’absence d’entrepreneurs politique. L’Albanie post-communiste a maintenu la religion séparée du monde politique tout comme ce dernier a évité la prise de parti pris en véhiculant un message de tolérance religieuse.

La cooperación internacional para el desarrollo como mecanismo de posicionamiento regional. Estudio de caso: cooperación sur-sur Turquía a los Balcanes durante el gobierno del akp (2003-2014)

El interés del presente Estudio de Caso es analizar la Cooperación Internacional Turca en un marco de Cooperación Sur – Sur con la Región de los Balcanes, específicamente con: Albania y Bosnia y Herzegovina. Entendiendo las dinámicas históricas que tiene la región con el Imperio Turco Otomano; las reformas internas realizadas por el partido AKP de Turquía y la fortaleza en política Exterior de éste evidenciada a través del Poder Blando de los Proyectos de Cooperación Internacional, se busca entender si la Cooperación sirvió como un mecanismo de posicionamiento como líder de Turquía en la región, ayudándole a autoproclamarse como tal utilizando mecanismos de exposición de habilidades, capacidades y recursos entre los años 2003 y 2014.

Enhanced financial literacy through financial education and its impact on financial behaviour

This dissertation aims to contribute to the ongoing discourse on the effect an enhanced financial literacy, through financial education, has on financial behaviour. We posit that financial literacy is enhanced through financial education courses, but it also significantly impacts the financial behaviour of individuals. Moreover, we argue that improved financial literacy plays a significant role in mitigating behavioural biases and an asset price bubble. Chapter 1 analyzes the impact of a financial education course in enhancing financial literacy in a high- school context. Students at specific schools in Tirana, Albania, are delivered a financial education course, which lasts one academic year. To understand the impact of this financial education course in enhancing financial literacy, PISA (2012) questionnaire on financial literacy is delivered to the students before and after the course is delivered. Chapter 2 analysis the impact of financial literacy in mitigating behavioural biases. We focus on the impact that enhanced financial literacy through the financial education course and financial education plays in reducing the propensity to mental accounting bias. Chapter 3 investigates how financial literacy affects the propensity to an asset price bubble occurrence. We posit that enhanced financial literacy through financial education reduces the probability of an asset price bubble occurrence. We find that financial literacy enhanced through financial education has a significant impact in the financial behaviour of the individuals.

Differenze di genere tra le caratteristiche cliniche e outcome dei pazienti con cancro ospedalizzati per COVID-19.

Obiettivo: Lo scopo principale di questo studio è analizzare lo sviluppo di complicanze cardiovascolari (CV) nei pazienti con neoplasia e malattia moderata-severa da COVID-19 e valutare differenze di genere per il rischio di mortalità intraospedaliera o di complicanze CV. Materiali e Metodi. Popolazione oggetto di studio. Pazienti inclusi nel registro ISACS-COVID 19 (ClinicalTrials.gov: NCT05188612), dati raccolti a partire da Febbraio 2020 a Luglio 2022. I pazienti arruolati sono stati reclutati da centri ospedalieri di cinque paesi: Italia, Croazia, Macedonia, Serbia e Romania. Le caratteristiche d’inclusione comprendono: età >18 anni, essere ospedalizzati e avere diagnosi certa d’infezione da SARS-CoV2. Gli endpoint analizzati sono stati: mortalità intraospedaliera e lo sviluppo di scompenso cardiaco acuto (SCA) nei pazienti con neoplasia. Risultati. La popolazione finale oggetto dello studio era di 4,014 pazienti ospedalizzati per malattia da COVID-19. Di questi circa l’8% risultava affetto da neoplasia. I pazienti con neoplasia risultavano essere più frequentemente donne (49% vs 40%, p=0.004), con un’età media più alta (68.3±12.95 vs 65.2±15.6, p<0.001) ma con profilo di rischio CV simile ai pazienti liberi da neoplasia. A seguito di analisi logistica di regressione multivariata, le donne non risultavano avere un incremento del rischio di mortalità intraospedaliera (OR 0.83;95%CI 0.66-2.45), mentre la presenza di tumore era significativamente associata ad incremento di mortalità (OR 1.68;95%CI 1.16-2.45). Restringendo le analisi di regressione logistica ai pazienti oncologici, le donne presentavano un incremento del rischio di sviluppo di SC acuto (OR3.07;95%CI 1.14 – 8.30) così come lo era la presenza di tumore al seno (OR 2.26; 95%CI 1.38 – 12.1). Conclusioni. La presenza di neoplasia rappresenta una condizione che incrementa il rischio di mortalità intraospedaliera nei pazienti ricoverati con COVID-19, mentre il genere femminile no. Le donne sembrano avere un rischio aumentato di sviluppo di SC acuto soprattutto se presentano un tumore al seno