Left Ventricular Hypertrophy in Nondiabetics Patients with Predialysis Chronic Renal Disease in the Hospital Center Elbasan

Background: Cardiovascular disease (CVD) is still the major cause of death in patients with end stage chronic kidney disease (ES-CKD), with a mortality rate approximately 10 to 30 times greater than that of the general population. Multiple factors are involved in the development of CVD in CKD. Although left ventricular hypertrophy (LVH) is strong predictor of mortality in patients with end-stage renal disease, few studies are available before the start of dialysis treatment in our country. The purpose of this study is to evaluate the prevalence and clinical correlates of LVH in nondiabetic patients with chronic kidney disease (CKD) not yet undergoing renal replacement therapy and to examine the relations between anemia, pulse pressure (PP), hypertension (HTA) with left ventricular hypertrophy (LVH). Materials and methods: We investigated 111 nondiabetic patients with CKD, presented in ambulatory service. Patients excluded from the study were of ischemic heart and valvular heart disease. 26 patients presented the second stage of CKD (GFR 60-89,9ml/min). 30 patients presented third stage of CKD (GFR 30–59,9ml/min).32 patients was at the 4th stage of CDK (GFR 15-29,9 ml /min) and 23 patients presented 5 the stage of CKD (GFR <15ml/min).Each patient had blood pressure (BP) measured by means of 24-hour ambulatory BP monitoring and left ventricular mass index (LVMi) assessed by means of M-mode echocardiography. Creatinine clearance was estimated by means of the Cockcroft-Gault formula, and hemoglobin was assessed by using routine methods. Results: The prevalence of LVH in nondiabetic predialysis patients with CKD was 81.9%; 22% of whom were women. The prevalence of hypertension was 72,6%. Anemia was present in all patients. In the overall group, prevalences of arterial hypertension, anemia and LVH were high. HTA is associated with LVH in patients with CKD, and the strong relationship between elevated pulse pressure and LVH in those with more advanced CKD suggests that increased arterial stiffness might have a role for LVH well before the start of dialysis therapy. Conclusions: In conclusion, the incidence of LVH was high even among nondiabetics patients under conservative treatment, and, except for age, LVH correlated with reversible factors. The need for strictly diagnosing CKD and preventing LVH in the predialysis phase is emphasized to decrease mortality due to CVD in that population.Keywords: Chronic Kidney Disease, Left ventricular hypertrophy; pulse pressure, hypertension, anemia

PROJECTS FOR EUROPE-THEN AND THE REALITY OF EUROPE TODAY

European Integration remains, still, the most important objective of the Balkan countries. The reason is simple: To join a family in which the rule of law and democracy are the main principles of every-day life of an integrated community. Referring to the title of this paper “Projects for the Europe,” the main question raised in this paper is: When did these “Projects for the Europe” firstly started? In this paper I will attempt to present that the “Projects for the Europe” have started since the XVII and XVIII century, and the philosopher’s ideas of that time, especially those of French cosmopolitan philosophers, are of great importance and have played a crucial role in that process. Furthermore, I will try to explain, how those ideas, with regard to the “Projects for the Europe,” were implemented in the post WW II Europe? Even though, the general idea is the European Integration; we have to take into consideration that Europe is not just a result of modern economic and political cooperation, but, first of all, it is an ideal elaborated by the great European philosophers. Rethinking the idea of Europe, even though utopia at its beginning, will help us understand the institutions of today’s Europe. Finally, in this paper I conclude that today’s Europe is the result of continuous process of political thought, concrete and practical action. Therefore, it is necessary to avoid misunderstandings or perceptions about Europe. On the one hand, Europe, it is not a cash drawer, or even just an area of free movement of goods and people. Europe, in the first place is a space of civil liberty, solidarity and responsibility. The core principal of political thought and practical action for Europe is the idea of peace and security. As a consequence, the source for achieving freedom, democracy and the rule of law, the idea that constitutes the pride of Europe

Tailor-made laws in the Western Balkans: State capture in disguise. CEPS Policy Contribution 11 May 2020.

Imagine you are the leader of a corrupt political elite in a Western Balkan country, writes the author of this paper in a compelling call to the EU to take note of political realities in this region. You are pressured to fight “widespread corruption in all areas”, but you cannot afford to lose control of the power you have acquired over the years. How do you navigate away from all that pressure? Here is a guide that will help buy you some time… decades literally. This CEPS Policy Insight takes a lively rhetorical approach to showing how state capture in the Western Balkans has been ignored since the launch of the region’s EU accession process, despite the many examples highlighted by civil society and independent media. It argues that while the EU first acknowledged the clear signs of state capture in an official document in 2016, Western Balkan political elites had already built powerful networks of corrupt interests around them. Not only that, they had already reached the highest point of state capture – tailor-made laws