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Introduction: Diphtheria is a vaccine preventable infectious disease with serious potential consequences up to disability and death. DVC among adults in Latvia (56%; 2015) doesn't reach recommended level - 80%. Aim:To analyze DVC among adults in General Practice (GP) and identify reasons for avoiding vaccination. Materials and methods: The longitudinal research was done by analyzing medical documentation of 620 adult patients in a GP practice. Patients with no revaccination filled in a questionnaire, containing questions regarding participant's gender, age, education level and reasons for avoiding vaccination. Data was statistically processed in SPSS Statistics 22.0. Results: 44% (n=271) haven't received diphtheria revaccination. The results of questionnaire were as follows: respondents in age group from 25 to 40 (81.1%; p = 0.001) and people with high school education level (89.7%; p = 0.013) received vaccines during their childhood more frequently than people older than 65 years (69.2%; p = 0,001) and elementary school level educated participants(54,5%; p = 0.013).The main reasons for vaccination avoidance among elementary education level responders were high price (33.3%; p=0,003) and unavailability of vaccination facilities among high school education responders(47.6%; p=0,003). People with professional education level claimed to have receive too little information regarding effectiveness of vaccination procedure (57.9%; p=0,003). Respondents in age group from 25 to 40 (69.8%; p=0,034) and people who do not have children of their own (73.2%; p = 0.01) - were unfamiliar with manifestation of diphtheria infection. The respondents with secondary professional school education level had no information regarding free availability of diphtheria vaccine (61.9%; p=0,01). Male patients were more uninformed regarding revaccination possibilities than female patients (65.2%; p = 0.024). The responders in age group from 25 to 40 years lacked knowledge regarding tetanus transmission route (52.8%; p = 0,008), but it was well known fact to the respondents with children (69.5%; p = 0.037). Conclusion: DVC among adults in GP practice doesn't reach the recommended population protective level. Communication strategies focused on education of patients may result in increase of vaccination coverage. [ABSTRACT FROM AUTHOR]

Introduction. PH is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥25 mmHg at rest. There is a pathogenetic therapy available for a pulmonary arterial hypertension (PAH) patients. For those who fail on drug treatment and remain in WHO functional class III-IV, lung transplantation is a treatment option to increase survival and gain a good quality of life. Case report description. A 32-year-old female with anamnesis of IPAH for 3 years is in high risk group - predicted one year mortality >10%. According to the medical reports patient is a potential candidate for transplantation procedure. A double lung transplantation was performed on April 2014. On follow-up visits after transplantation patient is in a good general condition. On follow-up visit (17.03.2015.) there are some side effects of immunosuppressive therapy present- chronic kidney disease (CKD) 3A (creatinine 121μmol/l; GFR 54.9 ml/min/m2), anemia (hemoglobin 98 g/l), hepatotoxicity (AlAT 47 U/l), hypercholesterolemia (total cholesterol 7,0 mmol/l).On follow-up visit (12.01.2017.) there are no side effects of immunosuppressive therapy or other complications present. The aim of my research is to evaluate, whether the lung transplantation as a treatment method has increased survival and quality of life for the patient with idiopathic pulmonary arterial hypertension (IPAH). Conclusion. Lung transplantation procedure has improved survival and quality of life for patient with WHO functional class IV IPAH. Significant complications after transplantation have not developed, but side effects of immunosuppressive therapy (tacrolimus, everolimus, prednisolone) are present a year after transplantation, but after two years there are no evidence of their presence. Summary. The case report demonstrates a 32-year-old female with WHO functional class IV IPAH. A double lung transplantation was performed. Patient is in a good general condition a year and 3 years after transplantation. Significant complications have not developed, and during the last follow-up visit there is no evidence of side effects of immunosuppressive therapy. [ABSTRACT FROM AUTHOR]

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