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Hemodialysis is a prevalent treatment for the end-stage chronic kidney disease (CKD) worldwide. The primary arteriovenous fistula (AVF), widely considered the optimal hemodialysis access method, fails to mature in up to two-thirds of the cases. The etiology of the early AVF failure, defined as thrombosis or inability to use within three months post-creation remains less understood, and is influenced by various factors including patient demographics, surgical techniques, and genetic predispositions. Neointimal hyperplasia is a primary histological finding in stenotic lesions leading to the AVF failure. However, there are insufficient data on the cellular phenotypes and the impact of the preexisting CKD-related factors. This study aims to investigate the histological, morphometric, and immunohistochemical alterations in the fistula vein, pre-, peri-, and post-early failure. Eighty-nine stage 4-5 CKD patients underwent standard preoperative assessment, including the Doppler ultrasound, before a typical radio-cephalic AVF creation. Post-failure, a new AVF was created proximally. The vein specimens were collected during the surgery, processed, and analyzed for morphometric analyses and various cellular markers, including Vimentin, TGF, and Ki 67. The study enrolled 89 CKD patients, analyzing various aspects of their condition and AVF failures. The histomorphometric analysis revealed substantial venous luminal stenosis and varied endothelial changes. The immunohistologic analysis showed differential marker expressions pre- and post-AVF creation. This study highlights the complexity of the early AVF failures in CKD patients. The medial hypertrophy emerged as a significant preexisting lesion, while the postoperative analyses indicated a shift towards neointimal hyperplasia. The research underscores the nuanced interplay of vascular remodeling, endothelial damage, and cellular proliferation in the AVF outcomes. [ABSTRACT FROM AUTHOR]

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Objective: This study aimed to measure the AHNAK2 urinary levels in bladder cancer patients. Material and methods: This prospective case--control study enrolled 67 participants between January and March 2019 and were categorized into bladder cancer group (n = 37), with histologically proven bladder cancer, and control group (n = 30), with histologically verified benign lesions or with no bladder cancer indication during follow-up. Urine samples of 15 mL were collected in the mid-morning before cy stosc opy/s urger y and an enzyme-linked immunosorbent assay was performed as per the manufacturer's protocol. Bladder malignancies were classified according to the World Health Organization Tumor Classification. Group's associations were evaluated with the Student t-test, Spearman's rank correlation, and Mann--Whitney U test, while receiver operating curve was plotted for assessing the test's performance. Results: Mean age of the bladder cancer group was 66.41 years (standard deviation = 10.04, range = 43-82 years) and the control group was 59.67 years (standard deviation = 10.44, range = 38-77 years). All bladder cancers were of the urothelial histotype, with the following pT distribution: pTa/papillary urothelial neoplasm of low malignant potential (n = 19; 28.4%), Primary tumor (pT) in situ (n = 4; 6%), pT1 (n = 7; 10.4%), and pT≥2 (n = 7; 10.48%). Mean AHNAK2 levels were higher in bladder cancer patients 49.08 pg/mL (standard deviation = 114.91) compared to controls 5.28 pg/mL (standard deviation = 6.65), P < .05). Significant differences were noted between non-invasive bladder cancer (n = 23; mean = 7.14 pg/mL; standard deviation = 7.26) and invasive bladder cancer (n = 14; mean = 117.99 pg/mL; standard deviation = 168.08) and between non-muscle invasive bladder cancer (mean = 23.19 pg/mL; standard deviation = 66.93) and muscle-invasive bladder cancer (mean = 160.05 pg/mL; standard deviation = 199.65) (P < .001). The result of the assays was given as follows: sensitivity: 64.19%, specificity: 66.67%, positive predictive value: 22.07%, negative predictive value: 92.37%, area under curve: 0.695, and 95% CI: 0.57-0.82. Conclusion: AHNAK2 protein could be used as bladder cancer surveillance biomarker. The inclusion of AHNAK2 levels in stratification nomograms might reduce the number of unnecessary cystoscopies. [ABSTRACT FROM AUTHOR]

Introduction. Focal segmental glomerulosclerosis (FSGS) is defined as an increase in the mesangial matrix in some glomeruli with obliteration of capillary lumens, sclerosis, hyalinosis, foam cells, and adhesions to the Bowman's capsule. Collapsing glomerulopathy is a morphologic variant of focal segmental glomerulosclerosis (FSGS) characterized by segmental and global collapse of the glomerular capillaries, marked hypertrophy and hyperplasia of podocytes, and severe tubulointerstitial disease. Actually secondary collapsing glomerulopathy is a heterogeneous group including numerous causes: viruses, toxins and drugs such as heroin and pamidronate. Case reports. We report on two cases with glomerular disease after COVID-19 infection. The first patient, 53 years old male, with nephrotic syndrome and histopathologic features of glomerular capillary collapse. He was admitted in our department with nephrotic syndrome and renal failure. Several months ago, he had COVID-19 infection and was treated for COVID-19 pneumonia, but he had not symptoms for any renal disease. In following months, the patients manifested symptoms such as nausea, dysuria and light malleolar edema. Laboratory findings presented increased values of BUN 27mmol/l, creatinine 453 µmol/l, with proteinuria 4,6 g/24h. In order to identify the cause for these results, renal biopsy was performed with diagnose of collapsing glomerulopathy. The patient was followed up for a period of 6 months and treated with corticosteroid therapy. The values for creatinine were decreased to 195 µmol/l, with proteinuria 1 g/24h. After that the patient was stable, but with slowly increasing values for creatinine up to 242µmol/l and proteinuria 0,61 g/24h, for a period of the next several months. Second case was a patient 58 years old, male with pulmo- renal syndrome, with bilateral pneumonia and acute kidney injury. COVID 19 infection was established with BUN 36 mmol/l and serum creatinine up to 586 µmol/l. Several weeks the patient was treated with hemodialysis. After that the patient was stable, the values for BUN and serum creatinine were still higher but without necessity for dialysis treatment. Proteinuria of 1,98 g/24hours still remained and renal biopsy was performed. Focal segmental glomerulosclerosis was diagnosed. The follow up in next several months included therapy with corticosteroids, after that with cyclosporin, with effect on improved kidney function with BUN 14 mmol/l, creatinine 156 µmol/l and values for proteinuria of 0,96 g/24hours. Conclusion. SARS-CoV-2 associated renal disease seems to have different outcome and follow up despite the treatment. Renal biopsy may be crucial along with the molecular testing for COVID 19. [ABSTRACT FROM AUTHOR]

Abstract Introduction Diffuse large B-cell lymphoma is a diffuse proliferation of large neoplastic B lymphoid cells with a nuclear size equal to or exceeding the normal macrophage nuclei. We report a case of a clear cell variant of diffuse large B-cell lymphoma involving a lymph node in the neck, which was clinically suspected of being metastatic carcinoma. Case presentation A 39-year-old Caucasian ethnic Albanian man from Kosovo presented with a rapidly enlarging lymph node in his neck, but he also disclosed B symptoms and fatigue. A cytological aspirate of the lymph node revealed pleomorphic features. Our patient underwent a cervical lymph node biopsy (large excision). The mass was homogeneously fish-flesh, pale white tissue replacing almost the whole structure of the lymph node. The lymph node biopsy showed a partial alveolar growth pattern, which raised clinical suspicion that it was an epithelial neoplasm. With regard to morphological and phenotypic features, we discovered large nodules in diffuse areas, comprising large cells with slightly irregular nuclei and clear cytoplasm admixed with a few mononuclear cells. In these areas, there was high mitotic activity, and in some areas there were macrophages with tangible bodies. Staining for cytokeratins was negative. These areas had the following phenotypes: cluster designation marker 20 (CD20) positive, B-cell lymphoma (Bcl)-2-positive, Bcl-6-, CD5-, CD3-, CD21+ (in alveolar patterns), prostate-specific antigen-negative, human melanoma black marker 45-negative, melanoma marker-negative, cytokeratin-7-negative and multiple myeloma marker 1-positive in about 30% of cells, and exhibited a high proliferation index marker (Ki-67, 80%). Conclusion According to the immunohistochemical findings, we concluded that this patient has a clear cell variant of diffuse large B-cell lymphoma of activated cell type, post-germinal center cell origin. Our patient is undergoing R-CHOP chemotherapy treatment.

Abstract Introduction Neuroendocrine carcinoma of the gallbladder is a rather uncommon disease. We report a case of a neuroendocrine tumor that was located in the wall of the gallbladder and that extended into the liver. Case presentation A 52-year-old Caucasian woman presented with right-sided abdominal pain, ascites and jaundice. An MRI scan revealed a tumor mass located in the gallbladder wall and involving the liver. A partial hepatectomy and cholecystectomy were performed. Histology revealed a neuroendocrine tumor, which showed scattered Grimelius positive cells and immuno-expressed epithelial and endocrine markers. Our patient is undergoing chemotherapy treatment. Conclusion Gastroenteropancreatic neuroendocrine tumors need a multidisciplinary approach, involving immunohistochemistry and molecular-genetic techniques.

Myeloma-induced renal failure is associated with significant morbidity and mortality. Rapid intervention is critical to reverse kidney damage and improve renal function. We report two cases, one with fibrillary nephropathy and other one with kidney amyloidosis due to multiple myeloma, diagnosed by renal biopsy and treated in our department. Both patients had no other signs of multiple myeloma present, apart from acute renal failure and histological findings on renal biopsy. The renal biopsy was performed because of acute renal failure to exclude rapidly progressive glomerulonephritis. The histological analysis showed fibrillary glomerulopathy in one patient and kidney amyloidosis in the other, changes consistent with the diagnosis of multiple myeloma with kidney involvement. Further clinical investigation confirmed multiple myeloma and the patients treated accordingly. [ABSTRACT FROM AUTHOR]

Research is a process of acquiring detailed information of all the areas of business and using such information in maximizing the sales and profit of the business. Such a study helps companies determine which product/service is most profitable or in demand. In simple words, it can be stated as the acquisition of information or knowledge for professional or commercial purpose to determine opportunities and goals for a business. Research is a part of the business intelligence process. It is usually conducted to determine whether a company can succeed in a new region, to understand their competitors, or to simply select a marketing approach for a product. This research can be carried out using qualitative research methods or quantitative research methods Research method is defined as the tools or instruments used to accomplish the goals and attributes of a study. Managers should think of the methodology as a systematic process in which the tools or instruments will be employed. There is no use of a tool if it is not being used efficiently. Any research begins by asking the right questions and choosing an appropriate method to investigate the problem. After collecting answers to the questions, managers analyze the findings or observations to draw appropriate conclusions. When it comes to customers and market studies, the more thorough the questions, the better. By thoroughly collecting data from customers through surveys and questionnaires, managers get important insights into brand perception and product needs. The data will be used to make smart decisions about marketing strategies to position own business effectively. In-house business research can enable senior management to build an effective team or train or mentor when needed. Research enables the company to track its competitors and hence can give you the upper hand to stay ahead of them. Failures can be avoided by conducting the research as it can give the researcher an idea if the time is right to launch its product/solution and also if the audience is right. It will help understand the brand value and measure customer satisfaction which is essential to continuously innovate and meet customer demands. This will help the company grow its revenue and market share. Research also helps recruit ideal candidates for various roles in the company. By conducting the research each company can carry out a SWOT analysis, i.e. understand the strengths, weaknesses, opportunities, and threats. With the help of this information, wise decisions can be made to ensure business success. The main reason why research is of utmost importance is that it helps businesses to grow in terms of revenue, market share and brand value. The aim of this research paper is to explain the marketing research method that helps making the choices regarding the market. Being international, the company should dynamically change its strategies and tweaks its products according the needs and wants of the consumers. The main issue is to choose among the marketing research types. The focus of this paper is to perform the correct market segmentation in which values and customer needs have the most important position. Furthermore, the paper analyzes the product testing in which the company makes tests about own products. If it is necessary the company will perform another type like advertising testing. All of the tests save valuable time and resources and are needed in order to influence on customer satisfaction. Additionally, loyalty analysis are going to be performed and are needed to understand the level of customers satisfaction, as one of the ways to increase customer retention. Another type of marketing research will be analyzed and that is brand awareness and reach. This type of research uses brand surveys referring effectiveness of the campaigns. [ABSTRACT FROM AUTHOR]

International trade is very useful way to improve the living standards, decrease unemployment, boost development and reduce poverty by generating growth through increased commercial opportunities and investments. Through International Trade it is possible to access on new markets which opens up new production possibilities, reduces the costs of inputs, and improves the overall economy of countries. Being knowledgeable in the area that we are willing to be successful and featuredis one ofthe most effective ways to succeed internationally. This paper examines the role of international trade and its importance for the corporate that decide to join this and to go internationally and includes information of international trade in corporation development in general. In business, a company has to be well-prepared against all expected and unexpected emerging developments. Otherwise, huge losses may be caused. Thus, the company is responsible to focus on each level of decision making before investments. Firstly, before taking any decision, decision makers need to have knowledge of what kind of markets they target and what kind of company they have. These questions summarize what this paper consist of. According to current world structure, to be international company and to make profitable investment are both difficult and easy. It depends on how efficiently use factors and co-factors related to business that the company would like to do. Future model of business takes shape in axis of globalization. This paper investigates the role of FDI in international knowledge. Empirical results show that the effect of the bilateral FDI on the evolution of the comparative advantage of the host and source countries is statistically significant. Specifically, the larger the scale of bilateral FDI, the more similar the comparative advantage between the host and source countries becomes. In this research paper it is explained the corporate development, which means how companies seek to deliver the best products and services to their customers while sustaining a competitive advantage. In the context of business development, companies strive to achieve excellence through the implementation. The impact of FDI on international knowledge diffusion is heterogeneous across countries, i.e. in the case of countries that are not very different in terms of their level of economic development, bilateral FDI has a relatively more significant effect on the similarity of the comparative advantage between countries. [ABSTRACT FROM AUTHOR]