Without an enhanced engagement strategy, the EU risks losing relevance in the Western Balkans

An EU-Western Balkans summit is being held today in Slovenia. Ahead of the summit, Odeta Barbullushi outlines four key steps the EU should take to ensure it continues to hold relevance for Western Balkan states

Albania economy toward official euroisation

The euroisation issue in European Integration context, is a continuous process of discussions between different researchers and regulatory institutions. Nowadays, different aspects of collaboration and integration processes between countries in the region, are extended in all politics, economic and security dimensions. In this study, we are going to treat one of the aspects of this process integration for Albania: the possibility of substituting the Albanian Lek with Euro, beginning with the explanation of the concept of euroisation. Also we are going to identify the actual non-official replacement level of lek and how it is expected to be realized in the future. Albania like other developing countries is lack of a currency with which people can buy abroad and which can be used in short-run and long-run credit contracts. On the other hand, the exchange rate represents an important risk, especially for the business which realizes transactions in foreign currency. Here in we are focused on the measurement of the money replacement level in Albania through three main methods. For this purpose is used the regression analysis in order to test the hypothesis under evaluation in two directions: endogenous and ekzogenous potential factors affecting this replacement. Through the factor analysis identifying the pro and cons of the euroisation phenomenon, we will give the potencial alternative in our county economy conditions.  Finally, the replacement rate can not be assessed without being related to the degree of money in circulation replacement and the degree of assets replacement and without beign connected with the exchange rate between currencies

The Bone and Mineral Disorder in Patients Undergoing Chronic Peritoneal Dialysis

Disorders of mineral metabolism and bone disease are common complications in CKD patients. They are very complex and involve a number of feedback loops between the kidney, bone, intestine, and the vasculature associated with an increased morbidity and mortality and decreased quality of life of the patients. The work group of the kidney disease: Improving Global Outcomes (KDIGO) recommended in 2006 the use of the term chronic kidney disease-mineral and bone disorder (CKD-MBD) to describe a systemic disorder that incorporates these abnormalities. Compared to hemodialysis (HD), patients undergoing peritoneal dialysis (PD) appear to have an increased prevalence of low turnover bone disease defined as adynamic bone disease (ABD). The most important risk factors for ABD are age, oversuppression of parathyroid hormone (PTH) with vitamin D, diabetes, circulating antagonist PTH fragments, and frequent presence of a positive calcium balance, which may result in an oversuppression of PTH. PTH levels and bone phosphatase alkaline (bALP) should be assessed among such patients as the earliest markers of abnormal mineral and bone metabolism. Treatments considered are interventions to treat hyperphosphatemia, hyperparathyroidism, and bone disease. The optimal management of chronic kidney disease-mineral and bone disorder (CKD-MBD) includes the prevention of vascular calcifications

ALBANIAN BANKING EFFICIENCY ANALYSIS: A PRODUCTION DEA APPROACH -COMPARISION OF CRS AND VRS MODEL

Abstract For performance evaluation purposes of economic entity one should consider different aspects of its activity. In case of banks this objective is quite difficult since they offer a wide range of services and the activities performed are such complex. Researchers all over the world have adopted different approaches and techniques for bank evaluation from different point of view: from shareholder`s or regulators. From the literature review we cannot observe the most preferred approach implemented for this purpose. Last years the economic models , parametric and non-parametric approaches have gained much interest in the field. In this study we propose a non-parametric approach for bank evaluation known as Data Envelopment Analysis (DEA). Shortly, here in it is presented the DEA background and its development from the original work of Charnes

Visuo-tactile stimulation, but not type of movement, modulates pain during the vision of a moving virtual limb

Aims: Evidence has revealed a relationship between pain and the observation of limb movement, but it is unknown whether different types of movements have diverse modulating effects. In this immersive virtual reality study we explored the effect of the vision of different virtual arm movements (arm vs. wrist) on pain threshold from heat applied to the wrist. Patients & Methods: Forty healthy participants underwent four conditions in virtual reality while heat pain thresholds were measured. Visuo-tactile stimulation was used to attempt to modulate the feeling of virtual limb ownership. Results: Effects on pain threshold were present for type of stimulation but not type of movement. Conclusions: The type of observed movement does not appear to influence pain modulation, at least not during acute pain states

The Persistence of COVID-19-Related Pancytopenia as A Possible Sign of Hairy Cell Leukemia: A Case Report

COVID-19 is known to cause many hematological abnormalities, such as thrombocytopenia, leucopenia, and lymphopenia. Pancytopenia, a decrease in all peripheral blood cell lines, is a rare complication not commonly seen in patients with COVID-19. We report a case of a patient who experienced COVID-19 infection with mild clinical symptoms like fever, fatigue, and muscle and bone aches. The laboratory examinations revealed pancytopenia, mainly neutropenia, thrombocytopenia, mild anemia, and relative lymphocytosis, which persisted after infection resolution. The splenomegaly in abdominal echography and the characteristics of lymphocyte elements in peripheral blood smear examination raised suspicion of the presence of hairy cell leukemia (HCL); therefore, the patient was further examined with a bone marrow biopsy, which confirmed the diagnosis. The persistence of pancytopenia after recovery from COVID-19 infection, especially in patients with splenomegaly, should raise suspicion of another hematological coexistence diagnosis like HCL

EU integration and party politics in the Balkans. EPC Issue Paper No.77, September 2014

Throughout the Balkan region, popularly elected leaders consistently fail to meet the democratic standards set by the EU and, more importantly, they fall short of their voters’ expectations. Distrust in representative institutions and disengagement from political life runs dramatically high among the people of the Balkan countries, and this generalised sense of dissatisfaction is starting to breed cynicism also towards the idea of a better future inside the Union. This study highlights the interplay between EU integration and national politics in the region, and that both are consequential for the quality of Balkan democracies, as well as reminiscent of the Western and Central and Eastern European experience

Association between Nephrolithiasis, Hypertension and Obesity in Polycystic Kidney Disease

AIM: We aim to define the correlations between nephrolithiasis, hypertension, age and obesity in patients with autosomal dominant polycystic kidney disease (ADPKD) in Albania. MATERIAL AND METHODS: We included 100 patients with autosomal dominant polycystic kidney from 2011 to 2014. The patients underwent X-ray and renal ultrasonography. We performed the metabolic evaluation of blood and urine.RESULTS: The patients with renal stones had a higher level of mean systolic and diastolic blood pressure compared with patients without stones (155 ± 12 mmHg vs. 145 ± 8 mmHg, and 105 ± 0.9 mmHg vs. 92 ± 1.28 mmHg, respectively). Patients with renal stones were older (47 ± 15 vs. 38 ± 5 years), had a higher prevalence of obesity [body mass index (BMI): 28 ± 2.4 vs. 25.7 ± 0.6], had higher levels of total cholesterol level (220 ± 5 mg/dl vs. 203 ± 4 mg/dl) as well as triglyceride levels (160 ± 9 mg/dl vs. 126 ± 4 mg/dl), compared with no renal stone individuals. CONCLUSION: ADPKD patients with renal stones in our study had a higher mean level of systolic and diastolic blood pressure, BMI and cholesterol and triglycerides levels compared with individuals without renal stones

Renal Transplant in an Adult with Ellis Van Creveld Syndrome: A Case Report and Literature Review

Abstract Ellis van Creveld syndrome (EVC) is a rare chrondro-ectodermal dysplasia. Renal abnormalities are found in few EVC cases with agenesis, dysplasia, megaureter and nephrocalcinosis. Rarely EVC syndrome is complicated with kidney failure and only one child required renal transplantation. We report a patient who was diagnosed with EVC syndrome at birth. He developed hypertension at age 15 and gradually progressed to chronic kidney disease stage 5 requiring hemodialysis and renal transplantation

The Diagnostic Value of Flow Cytometry Imunophenotyping in an Albanian Patient Population with a Preliminary Clinical Diagnosis of Chronic Lymphocytic Leukemia

Objective: Based on the flow cytometry multiparametric immunophenotyping methodology we studied some useful cell marker criteria needed for the practical differentiation of the chronic lymphocytic leukemia from other chronic limphoproliferative diseases with a leukemic component.Materials and Methods: The applied methodology is a four color flow cytometry multiparametric immunophenotyping technique using EDTA blood samples taken from 84 consecutive patients diagnosed with CLL through a preliminary clinical and white blood cell examination. The following fluorescent stained monoclonal antibodies were used: CD3, CD4, CD5, CD8, CD11c, CD19, CD20, CD23, CD25, FMC7 and kappa/lambda light chains.Results: From the 84 individuals tested, 2 out of them (2.4%) resulted with a abnormal T-cell population while 82 (97.6%) showed a pathological B cell line. 58 (69.1%) patients resulted with typical CLL markers (CD19+CD5+CD23+) while 5 (5.9%) of them presented a non typical chronic lymphocytic leukemia profile (CD19+CD5+CD23-). 19 (22.6%) out of patients displayed an abnormal CD19+CD5- B cell population. A statistically significant correlation was found between the clinical stage of CLL and the positivity for the CD38 marker (p=0.04).Conclusion: Flow cytometry immunophenotyping is a fundamental examination for the final diagnosis of chronic lymphocytic leukemia. The expression of CD38+ in CLL patients stands for a more advanced clinical stage