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الصين الآن : ممارسة الأعمال والأنشطة التجارية في أكثر أسواق العالم قوة ونشاطا وحيوية
هذا الكتاب بمنزلة جولة شاملة، تطلعك على كل شيء، في أسرع أسواق العالم نموا وتضع بين يديك كل ما تود معرفته عن شعب الصين مختلف أساليب المفاوضات والثقافة والتاريخ مختلف أنواع الاقتصاد والصفقات التجارية وسوف تتعلم من خلاله كيف تخطط ؟ أين يجب أن تذهب؟ ومن يجب أن تزوره لتحقيق أفضل النتائج؟ وعلى النقيض من الكتب الأخرى التي تعج بها الأسواق سوف تكتشف وأنت تطالع هذا الكتاب الاختلافات الأساسية بين مختلف الأقاليم والأعمال التجارية التي قد تؤدي إلى نجاح الصفقة أو خسارتها.
BOOK
Acute and Chronic Prostatitis
Prostatitis is a common clinical syndrome classified into four categories: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic. Bacterial prostatitis (acute and chronic) is primarily diagnosed with history and microbiologic studies, although physical examination can be helpful to localize infection within the genitourinary system. Bacterial prostatitis is treated with antibiotics; the span of treatment is guided by the duration of symptoms and presence of complications. Chronic prostatitis/chronic pelvic pain syndrome is the most common form of prostatitis and is a diagnosis of exclusion with no standardized treatments. Asymptomatic prostatitis does not require treatment and is usually diagnosed incidentally during the workup for other urologic presentations.
Journal Article
Cutaneous mucormycosis shortly after renal transplantation
A 66-year-old man with hypertensive nephrosclerosis and no history of diabetes underwent renal transplantation and was given antithymocyte globulin induction during surgery. One day later, he noted a raised, well circumscribed, mildly tender area of purpura. He reported that he had scraped his right forearm on a metal garbage can lid 1 week before the transplant. The transplant team was concerned about cellulitis and prescribed piperacillin-tazobactam; however, the pain intensified and the lesion worsened. Rhizopus species are ubiquitous environmental saprophytic fungi that can cause cutaneous mucormycosis through trauma. Risk factors include uncontrolled diabetes mellitus, hematological malignancy, stem cell transplantation, pro longed severe neutropenia, and trauma.
Journal Article
Access site–related infections in patients receiving dialysis
Infection is the leading cause of hospital admission and second most common cause of death in patients receiving dialysis Hemodialysis and peritoneal dialysis (PD) access sites are portals of entry for bacteremia and peritonitis, respectively. Incidence rates of hemodialysisassociated bacteremia and PD peritonitis are 0.42 episodes and 0.3 episodes per patient-year, respectively. Access site--related infections can be localized, systemic, or both Redness, tenderness, or discharge around access sites suggests infection. However, even if the access site appears normal, patients with sepsis or fever should be investigated, then initiated on antimicrobials. Staphylococcus species, constituents of skin flora, are the most common bacteria implicated in infections. Treatment of hemodialysis access site infections includes antimicrobial therapy and possible line removal or antibiotic lock therapy. Treatment of PD-catheter infections includes antimicrobial therapy and possible catheter removal.
Journal Article
Epidemiology and risk factors for pyogenic liver abscess in the Calgary Health Zone revisited: a population-based study
Background
Pyogenic liver abscess (PLA), although uncommon in North America, is associated with significant morbidity and mortality. We sought to re-examine the epidemiology, risk factors, and outcomes of PLA in a large, diverse Canadian health zone.
Methods
All Calgary Health Zone (CHZ) residents aged ≥20 with PLA between 2015 and 2017 were identified. Incidence and mortality rates were calculated using census data. Risk factors for PLA were identified using a multivariate analysis. Data was compared to 1999–2003 data, also collected in the CHZ.
Results
There were 136 patients diagnosed with PLA between 2015 and 2017. Incidence rate during this period increased significantly relative to 1999–2003 (3.7 vs 2.3 cases/100,000 population, p < 0.01), however, mortality rates remained similar. The microbiological composition of PLA did not change over this 15-year time period but the number of antimicrobial resistant isolates did increase (8% vs 1%, p = 0.04). The greatest risk factors for PLA relative to general populations included current malignancy, liver-transplant, end-stage renal disease, and cirrhosis. Thirty-day mortality was 7.4% and independent risk factors included polymicrobial bacteremia, absence of abscess drainage, congestive-heart failure, a history of liver disease, and admission bilirubin.
Conclusions
Pyogenic liver abscess is a health concern with rising incidence rate. The increasing prevalence of comorbidities in our population and factors that are associated with risk of PLA suggests this will continue to be an emerging diagnosis of concern. Increasing prevalence of antibiotic resistant organisms compounding unclear optimal treatment regimens is an issue that requires urgent study.
Journal Article
Incidence, susceptibility and outcomes of candidemia in adults living in Calgary, Alberta, Canada (2010–2018)
Background
Candidemia is increasing in frequency and is associated with high mortality. We sought to determine the burden of illness, the population it affects and its resistance profile in our region.
Methods
The Calgary Zone (CZ) provides all care for residents of Calgary and surrounding communities (~ 1.69 million) via five tertiary hospitals each served by a common single laboratory for acute care microbiology. All adult patients in the CZ with at least one
Candida
spp.-positive blood culture between January 1, 2010, and December 31, 2018, were identified using microbiological data from Calgary Lab Services, the laboratory that processes > 95% of all blood culture samples in the CZ, were reviewed for the study.
Results
The overall annual incidence of candidemia among individuals living in the CZ was 3.8 per 100,000 persons (Median age 61 years (IQR 48–72) and 221/455 (47.4%) were female).
C. albicans
was the most common species (50.6%), followed by
C. glabrata,
(24.0%). No other species accounted for more than 7% of cases. Overall mortality at 30, 90, and 365 days was 32.2, 40.1, and 48.1% respectively. Mortality rate did not differ by
Candida
species. Of individuals who developed candidemia, more than 50% died within the next year. No new resistance pattern has emerged in the most common
Candida
species in Calgary, Alberta.
Conclusions
In Calgary, Alberta, the incidence of candidemia has not increased in the last decade.
C. albicans
was the most common species and it remains susceptible to fluconazole.
Journal Article
A Practical Approach to Diagnosis of B-Cell Lymphomas With Diffuse Large Cell Morphology
Large B-cell lymphomas represent the most common non-Hodgkin lymphomas and often present as extranodal masses with advanced stage similar to metastatic tumors. Without proper intraoperative, microscopic, immunophenotypic, and cytogenetic evaluation they may be mistaken for other hematopoietic or even nonhematopoietic tumors. Also, diffuse large B-cell lymphomas often have clinical, morphologic, immunophenotypic, and cytogenetic clinical features that are similar to those of other less common B-cell lymphomas. Furthermore, classification of these neoplasms is continually becoming more refined.
To provide a rational, methodic approach to the evaluation of large B-cell lymphomas for community practice pathologists who provide general pathology services.
This review incorporates guidelines detailed in the 2017 update to the World Health Organization's
in addition to other recent peer-reviewed publications.
Many large B-cell neoplasms respond favorably to current treatments, but these cases also require accurate and timely diagnoses. We propose a process following a brief checklist that focuses on diffuse large B-cell lymphoma, the most common entity, and rules out other similar lymphomas in a stepwise fashion.
Journal Article