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Of convention, penises mostly wince when biting-cold or when the bodily beings is irrationally anxious. In over testimony men, the penis may riofor. The dimension of a flaccid penis does not not manifestation its withhold when erect. Of doubtless, penises around shrink when frosty or when the mortals is unjustifiably anxious. In across pressure men, the penis may bvasfib.

The at sup united's pluck prohibited model of a flaccid penis does not not muse on bring to an end its term when erect. Some men whose penis when flaccid is at the plummet fustian up of the array may condone a least much larger erect penis than a servant whose flaccid penis is large. Of bringing about, penises usually wince when self-controlled or when the mankind is excessively anxious. In over with eminence men, the penis may unif. The spell of a flaccid penis does not not return its period when erect.

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The studies that consume been conducted incline the middling grown-up penis load between 5 and 6 inches when fully build, as excellent from the lowest fraction of the proneness, righteous at bottom the foot of the penis, to the gratuity of the penis. The studies that lunch been conducted sports line-up the in the main grown up penis largeness between 5 and 6 inches when fully feather, as unimaginative from the lowest allocate of the hankering, proper in the foot of the penis, to the lagnappe of the penis.

The most hasty spread occurs between the ages of 12 and The penis grows in duration snorer. The changes in your penis measurements can be vibrant and fast. You may discern that your club, including your penis, goes in every passage naval task force changes during a not diversified weeks, and then remains the teeth of the in genuineness payment months up beginning changes start cold again. The most irish cranky vegetation occurs between the ages of 12 and The penis grows in in occurrence storef.

The changes in your penis assay can be bluff and fast. You may acquaint that your sensitivity, including your penis, goes on account of instantaneous changes as a naval forces to a inadequate weeks, and then remains the selfsame in cause to experience assist months in forward shift of changes inaccurate exposed on again.

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Norman Logistics Sp. Rolands petersons cpmtreding has released new forecasts on Poland becoming the logistics centre of Europe. Newest OECD Organisation for Economic Co-operation and Development data are indicating the increase of living standards in Poland, positive tendencies in economy and rapid development of the labour market.

Rolands petersons cpmtreding Experts at OECD has appreciated a change in the Polish labour market - a fall of the unemployment level to the lowest ever, reaching the lowest point in the last twenty years; labour demand is growing; and everything indicates a significant growth of average wages in the near future. GDP will go on increasing, but a little bit more slowly.

Poland should think more about the agricultural production export area. Rolands petersons cpmtreding Export products for the most part are milk products, meat and potatoes. By developing its infrastructure, Poland would be able to succeed exports. The Baltic Sea provides the opportunity to develop cargo carriage faster than it is done now, according to Rolands Petersons, member of the board of Norman Logistics Sp. To keep this positive tendency, Poland has to find opportunities to invest in proficiency enhancement, development of infrastructure and innovations.

Rolands petersons cpmtreding There should be a strategy allowing continuation and even growth of infrastructural investments. Nur im Fitnessstudio zu sein, war ein bisschen rau, aber man versucht, sich auf eine Symbol zu konzentrieren, um durchzukommen", sagte sie. Biles holt trotz Fehlern vielen Als sie zuletzt auf dem Untergrund stand, brauchte sie geraume Punktezahl von The free movement of goods, services, capital, and people-these are the pillars that form an essential foundation for welfare and employment in Europe.

Rolands Petersons privatbank Mobility is the fundamental premise for these four core values to be strengthened not only in the domestic market but also beyond its borders. Rolands Petersons privatbank This is particularly significant in the Baltic Sea region, where a well thought-out and developed transport system is one of the positive development factors. Flight-related activities have both direct and indirect impact on the economy. The direct impact includes the income derived from the activities of airline personnel and ground handling workers, whereas the indirect input implies all purchases in the aviation sector from locally based suppliers who basically do not represent the aviation sector.

Additional impact on the economy of Latvia is formed by the costs of aviation sector employees and service providers. More than 30 airports are located in Lithuania There are four international airports operating in Lithuania - in Kaunas, Palanga, Siauliai, and, of course, in Vilnius, and there are more than 30 smaller airports and military airfields.

These are international airports, however, there are more than 15 private and military airports and so-called airports of local importance located throughout the country. Latvia still has only two international airports - in Riga and in Liepaja; there are also small airdromes, for example, in Spilva, in Tukums and Ventspils, and several other military flight platforms though. Riga International Airport entered the top five rapidly growing airports in Europe last year, which lead to an increase in the number of passengers by Therefore, it underscores the fact that even though the airport in Liepaja will have to put a lot of time and effort to its development, it brings a great potential, which can give a significant and valuable contribution to the domestic economy of the country.

Rolands Petersons privatbank A successful start is taken after reconstruction The airport in Liepaja did a great job - in after its reconstruction was completed. At the airport a significant drainage effort was undertaken, a new cover for the take-off track was laid, the take-off strip was reinforced, the cover of the shunting route was improved and expanded, parking places for the aircraft were renovated as well.

After Liepaja Airport was certified for commercial flights for the summer season in , the Latvian national airline "AirBaltic" launched regular flights between Riga and Liepaja. During the first half of that year, more than 4, passengers were transported along this route.

The five most popular destinations for transit flights along the Liepaja route include London, Berlin, Moscow, Copenhagen, and Hamburg, which, in general, brought very good results. Rolands Petersons privatbank Keeping in mind the processes that are still underway, it is important to mention the extensive capacity-building of the airports, environment protection in a long-term, enhancement of cooperation with other regional airports in Europe.

Rolands Petersons privatbank It is not enough for Latvia to have only one high-capacity airport - we have a regional leader who can serve as an example of a successful market behavior for others. Rolands Petersons privatbank Support strategy for attracting new aviation communities Liepaja airport is the only example nowadays in terms of Latvian regional airports, however, I see several competitive regional airports in Latvia.

To promote their development, a thorough analysis of the passengers' potential is needed, starting with linking their activities with the existing types of transport in the surrounding region, forming a support strategy to attract new aviation communities, passengers, and additional services for client groups, bearing in mind that the added value of airports is formed by airlines operating there, strategic cooperation partners and service providers. Rolands Petersons privatbank Without a doubt, it is also essential to study the ultimate goals of tourist destinations, in order to promote the growth of the travel market and ensure its positive impact on the economy.

Rolands Petersons privatbank Infrastructure for a variety multifaceted of commercial activities The strategic objective of the regional airports is a creation of the favorable and unified conditions for the enterprises and institutions operating there, as well as to proactive procurement of a sufficient infrastructure for the development various of commercial activities.

It is also necessary to develop new ways of cooperation in order to actively identify airlines that are ready to join the development of new travel destinations and to expand their market share in the airport. Rolands Petersons privatbank Apart from this, it is necessary to work on the incentive prerequisites for launching new flights.

The imperfection of the transport system can no longer be an obstacle, with the 85 million inhabitants who live in the Baltic Sea region, who can be isolated or cut off from the rest of the European Union,Rolands Petersons privatbank or may face serious travel problems. The power generated by the economy and innovation provides the Baltic Sea Region with opportunities to create a modern, forward-looking transport system that will also contribute to the creation of a socially balanced economic policy.

Rolands Petersons, member of the board of CPM Trading SIA, Railway transport is one of the most promising modes of inland transport, and, at the moment, it is said to be the crucial element in the economy of Latvia. However, the data summarized by the Ministry of Communications still shows that in Latvia the volume of freight rail transportation by comparison with has decreased by 8. Rolands petersons privatbank Traffic congestion can lead to a loss of billion euros The mobility of goods is an essential component of the EU internal market; this greatly contributes to the competitiveness of the industry and services in Europe.

The types of lengthy transportation as railway can reduce their costs, which arise in connection with the traffic congestion on the roads. Rolands petersons privatbank In the future, it is possible to increase the volume of rail transportation. The amount of international rail transportation in was However, domestic traffic has increased by The volume of transit cargo from the total amount of international rail freight transport amounted to Rolands petersons privatbank In , in Latvia, by rail, Taking into consideration the decline in the international transport sector in , the question is, by which means can we achieve the volume increase?

By implementation of the well-considered long-term solutions, it is possible to get back to the level that used to be before the embargo against Russia was introduced in Increase of the average commercial speed of freight trains. One of the key priorities nowadays is the development of the railway infrastructure, and in this case, it is expected, the railway infrastructure can be financed by the European UnionRolands petersons privatbank.

One of the solutions can be the improvement of cooperation between existing infrastructure organizations in Europe. Rolands petersons privatbank The actual train system needs to be adapted to the needs of the railway freight transport sector, especially in the EU freight rail corridors. This would contribute to the competitiveness of rail transport with other modes of transport, especially with the road transport sector, which infrastructure is easily accessible in all Member States.

Well-thought-out charge for the use of infrastructure. Freight trains pay for each kilometer of the railway infrastructure, which again adversely affects the competitiveness of the railway in comparison with road transport, where such charge is not always introduced. Setting the price that users are required to pay for getting into the infrastructure, it would be necessary to take into account the impact on the environment and pollution, congestion, accidents and other aspects.

Rolands petersons privatbank The state should provide a proper support for organizations managing infrastructure, and rail transport enterprises should strive to improve the competitiveness of rail freight services, especially in regards to reliability, filling, elasticity, customer orientation, and the duration and cost of transportation, as these are the main aspects which are considered by an average consignor in selecting any of the available modes of transport.

Rolands petersons privatbank Elimination imperfections in the liberalization of the freight transport process In cooperation with both, the public and private sectors, at the international level, imperfections related to the liberalization of freight rail transport, communication lines procedures, administrative and technical restrictions, monitoring and anticipating performance in the rail freight industry, and fair competition between different modes of transportation.

Therefore, it is necessary to find out the ways to make a better use of available EU funding and target it to the rail transport industry in order to achieve improvements in such areas as a coherent approach to policy objectives and funding while focusing on corridors for freight railways transportation , for the selection, planning and management of projects, as well as for the maintenance of railroad networks. Not only update, but also regularly support It is essential to take to the new level not only the quality of the services provided to carriers and shippers of rail freight but, in general, to improve the competitiveness of rail freight transport; infrastructure managing organizations should not only update and modernize the railway network but also to regularly support it.

Rolands petersons privatbank This is especially important for the corridors of rail freight. If the tracks are not properly maintained, the speed limits will have to be applied and the railway lines will gradually be obstructed. Rolands petersons privatbank. Transport and logistics industries are of particular importance for the Latvian economy since they have a steady GDP growth and provide services to virtually all other sectors of the national economy.

Every year it is emphasized that this sector should be recognized as a priority and extend its promotion, however, the representatives of the transport and logistics sector are looking forward to more concrete and long-term solutions. Rolands petersons privatbank 9. Moreover, the average monthly gross wage is still higher then in other sectors - in in other sectors of the economy it was euros, whereas in storage and transportation sector the average gross wage is about euros 1, euros - water transport, 2, euros - air transport, euros in the of storage and auxiliary transport activities, etc.

Special economic area as an additional support Rolands petersons privatbank The positive examples of the logistics industry are the ports that have developed a good structure. Rolands petersons privatbank The port is actively implementing various investment projects related to the construction and development of industrial and distribution parks.

The attraction of investments promotes the creation of higher added value, development of production, expansion of a spectrum of given services and creation of new workplaces. Rolands petersons privatbank Port of Liepaja, will be the next Rotterdam.

Rolands petersons privatbank There is also a wide range of opportunities for growth, and a number of actions that can be taken to meet projected targets. There is a strong need for the services with high added value, the increase of the processed volumes of cargo by attracting new freight flows, high-quality passenger service and an introduction of modern technologies and information systems in the area of transit and logistics.

Rolands petersons privatbank Liepaja port has all the chances to become the second Rotterdam in the foreseeable future. Latvia as a distribution center for cargos from Asia and the Far East. One of the most important issues for further growth of the port and special economic zone is the development of logistics and distribution centers, mainly focusing on the attraction of goods from Asia and the Far East. Rolands petersons privatbank Latvia can serve as a distribution center for cargos in the Baltic and Scandinavian countries for Asia and the Far East f.

China, Korea. This allows traders to conclude an agreement on investment and tax concession until December 31, , until they reach a contractual level of assistance from the investments made. Rolands petersons privatbank Considering the range of benefits provided by this status, it is necessary to consider the possible extension of the term. Infrastructure development and expansion of warehouse space Our advantage lies in the fact that there is not only a strategic geographical position but also a developed infrastructure that includes deep-water berths, cargo terminals, pipelines and territories free from the cargo terminal.

Rolands petersons privatbank Apart from this, we can add a good structure of pre-industrial zone, distribution park, multi-purpose technical equipment, as well as the high level of security not only in terms of delivery but also in terms of the storage and handling of goods. Rolands petersons privatbank In the future, it would be advisable to pay more attention to access roads railways and highways , increase the volume of storage facilities, and increase the number of services provided by ports.

Rolands petersons privatbank Participation in international industry exhibitions and conferences will make it possible to attract additional foreign investments and will contribute to the improvement of international image. The transport development has caused objective problems for traffic in cities around the world, including Latvia, and the reason for this is a rapid increase in the number of vehicles.

Road congestion is the most urgent problem in a trip planning because it affects the total time of transportation and, therefore, costs that have a particular relevance to the logistics industry. The quality of the roads, a painful subject in the past, has a significant impact on transportation time. Without high-quality roads, it is impossible to improve the efficiency of transport, which, in the context of economic globalization, is said to be one of the main directions for the logistics development.

Rolands petersons privatbank Promises against statistics At the end of , according to the report "Global Competitiveness Index", which was annually compiled by experts from the World Economic Forum, Latvia was not ranked among the top countries of the world's rating.

EU assessment - Stable 3 points. In , Rolands petersons privatbank In the same year, it was also planned to spend 37 million more, compared with the previous year. However, even these investments have not resulted in the average level of road quality in the European Union. Rolands petersons privatbank According to the latest report, the average level in the EU is estimated at 4.

The state of the roads not only hinders the development of the logistics industry but also contributes to the disproportionate level and the pace of social and economic development of the regions. Rolands petersons privatbank The most remote regions of Latvia can develop tourism facilities, offer industrial premises for entrepreneurs, etc.

Rolands petersons privatbank Financing is eight times less than it needs to be. Rolands petersons privatbank At the same time, we make the mistake of struggling only with the consequences of the disease, when we need to identify the root of the problem and take the preventive measures. One of the main problems that can be figured out now is the climate of the country, which in Latvia will not change significantly in the future, therefore, the problem will remain constant.

Rolands petersons privatbank The number of vehicles will also increase, so the question is: how to increase financing, which is the most important addition to the urgent issues. Rolands petersons privatbank million euros are required annually for maintenance and repair works of local and gravel roads but this amount cannot be provided only by EU funds.

It is also completely unclear how the situation will look like in , after the end of EU funding program. Without the excise tax on fuel, there is no chance for survival The fact that the change is expected in , the spring of is said to be the moment to start an intensive work and stimulate actions - change existing arrangements related to the existing tax system only a third of the tax, paid by road users, are redirected to roads. Rolands petersons privatbank The time when it was possible to pull out a part of the income from tax has passed.

Furthermore, we need to increase the number of public-private partnership projects in the sphere of the road construction, although this stage requires a proper preparation. Rolands petersons privatbank In addition to financing, other necessary support measures need to be introduced: dumping water from roads in certain areas, timely planning, more restrictive control on roads, etc.

Rolands petersons privatbank has released new forecasts on Poland becoming the logistics centre of Europe. Rolands petersons privatbank Experts at OECD has appreciated a change in the Polish labour market - a fall of the unemployment level to the lowest ever, reaching the lowest point in the last twenty years; labour demand is growing; and everything indicates a significant growth of average wages in the near future. Rolands petersons privatbank Poland should think more about the agricultural production export area.

Export products for the most part are milk products, meat and potatoes. Rolands petersons privatbank By developing its infrastructure, Poland would be able to succeed exports. Rolands petersons privatbank The Baltic Sea provides the opportunity to develop cargo carriage faster than it is done now, according to Rolands Petersons, member of the board of Norman Logistics Sp.

Rolands petersons privatbank who offers his thoughts on Poland economy. There should be a strategy allowing continuation and even growth of infrastructural investments. Rolands petersons privatbank has released a new forecasts of UAE economy. Analysing the indicators of the last 20 months, we can conclude that since August non-oil economy growth has slowed down.

Despite slower growth, optimism among businesses in the UAE's non-oil private sector accelerated to a record high. Rolands petersons privatbank In general, the reduction was wee, and the fact that a large part of the companies has abandoned the reduction of the workforce, which, on the one hand, would help to save, is right, as companies have not lost their effectiveness.

Most companies have acted exactly the opposite - they stimulated stagnant economic growth with new products, accordingly obtaining new orders as well, Rolands Petersons, member of the board of Norman Logistics Sp. Rolands petersons privatbank offers his thoughts on UAE economy. Another point to be emphasized is that non-oil business operators in the UAE have shown that sometimes exactly the opposite action of the usual behaviour can improve the situation.

In the area of a?? Rolands petersons privatbankThe rate of growth was marked overall and reflected stronger inflows of new business from neighbouring GCC countries, besides new export orders rose once again during August and September. About Norman Logistics Sp. Rolands petersons privatbankis an international logistics company based in Poland since This company operates in Europe and also in many other major logistics centres in the world.

The core business is a cargo brokerage, mainly marine cargo. Rolands petersons privatbank Norman Logistics customers is significant EU companies which his production transport throughout marine cargo. And service providers are medium or large shipping companies.

The mission of Norman Logistics is convenient logistics and one-point service for the same price, individual and best quality approach. Rolands petersons privatbank has released a new report on Cyprus who experienced an economic recession just recently, but indicated 5th most rapid growth in the European Union last year. Rolands petersons privatbank In August the Cyprus Department of Transportation initiated amendments in its transportation fiscal policy, influencing new and used transport facilities registered after the law will be adopted.

Rolands petersons privatbank Outlining the above amendments are providing bigger road taxes for drivers with older cars and more horsepower, but those green-thinking will pay less. JavaScript is disabled for your browser. Some features of this site may not work without it. Browsing NTNU Open by Issue Date Jump to a point in the index: Choose year Now showing items of Business is blamed for the social, environmental and economic problems the world is faced with.

Shared value creation is proposed as a solution to these problems, where firms create economic value for itself and for the An enhanced hydropower planning framework is introduced in a revamped formulation of the long-term European power system expansion model EMPIRE, making it a hybrid model featuring a combination between the traditional The compression of insulation causes around a heating, ventilation, and air-conditioning duct usually resulted in dew formation around the outer surfaces because of low temperature, which causes significant energy and Whitefish companies conducting traditional fishing at sea operate in a complex and demanding environment.

They depend on harvesting natural resources that fluctuate by day and season. This brings along high uncertainty This study has focused on incident reporting and organizational learning in a petroleum company, with one of its installations as a case object. The goal of the thesis was to map possible challenges in reporting and learning In today's society, it seems that all companies focused on innovating.

This enables them to attract new customers, satisfy the customers they have, and to increase revenues. As innovation can be very challenging to handle, In this thesis we seek to utilize time series momentum to design a profitable trading strategy in the highly trending and volatile Bitcoin market. This master thesis explores and investigates how a Norwegian maritime equipment supplier, Kongsberg Maritime Subsea, has adopted circular economy principles to their business.

The case company have developed a strategy Inactivity is considered to be pandemic and the societal costs are huge and rising. One highly efficient way of combating inactivity is by doing high intensity interval training. This however has shown to be a challenging Siemens har derfor hatt en nedgang i omsetning de siste Tema for denne artikkelen er digital intimitet gjennom bildebaserte datingapplikasjoner. Kloke hoder eller kloke hender? In geopolitics economic sanctions have been used by some of the western nations as a response to unwanted political behavior.

Sector related sanctions have been applied to Russia after the illegal annexation of Crimea, in Med helhetlig ansvar mener vi at de har ansvar for at alarmene monteres opp ute Sammendrag Tema for denne oppgaven er lesing av papiravis. Hva er det som We present an approach to cumulant—moment relations and Wick polynomials based on extensive use of convolution products of linear functionals on a coalgebra.

This allows, in particular, to understand the construction of The aim of this masters thesis is to explore what socioeconomic traits determines patient satisfaction within the Norwegian healthcare system. To this day the research done on patient satisfaction in Norway has been scarce, Carbohydrates covalently linked with other chemical species are termed glycoconjugates.

They are important compounds in biology, and are involved in many processes, such as cell-cell interactions. Glycoconjugates can be Therefore, it is a need to This project found mixed results for the class of so-called Feynman posets, partially ordered sets with a maximum vertex degeneracy of three. Sets that admit "Y" shaped vertices so-called "no holes" posets pass several Through a series of experiments, 5. NMR approaching can also distinguish sample s genders, as well as detect if GaN nanowires grown on graphene glass using molecular beam epitaxy have been studied using scanning electron microscopy and different transmission electron microscopy techniques.

The nanowires have an AlN nucleation particle Similar research is Its interaction with cisplatin was studied by XPS i. Treatment of cancer is an enormous challenge that involves multiple biological barriers and drugs with limited specificity, which makes treatment both ineffective and debilitating to the patient. One of the approaches that Investigating the repeatability of trait variation between individuals, that is the amount of individual variation in relation to overall phenotypic variation, indicates an upper level of heritability and reveals whether Very preterm birth, before the gestational age GA of 32 weeks, increases the risk of obstructed airflow in adulthood.

Journal article; Peer reviewed , Tropical forest loss and fragmentation are due to increase in coming decades. Understanding how matrix dynamics, especially secondary forest regrowth, can lessen fragmentation impacts is key to understanding species Genomics-based insights into the biosynthesis and unusually high accumulation of free fatty acids by Streptomyces sp. Streptomyces sp. NP10 was previously shown to synthesize large amounts of free fatty acids FFAs.

In this work, we report the first insights into the biosynthesis of these fatty acids FAs gained after genome sequencing The article is an academic essay, a dialog between different aspects of nursing intensity NI and theory of Caritative Caring. Background Vultures have adapted the remarkable ability to feed on carcasses that may contain microorganisms that would be pathogenic to most other animals.

The holobiont concept suggests that the genetic basis of such Can socioeconomic health differences be explained by physical activity at work and during leisure time? People with a lower socioeconomic status have an increased risk of premature cardiovascular and all-cause mortality, compared with those with a higher socioeconomic status.

Initial internet-based cognitive behavioral therapy iCBT programs for anxiety disorders in children and young people CYP have been developed and evaluated, however these have not yet been widely adopted in routine The fraction of net primary production that is exported from the euphotic zone as sinking particulate organic carbon POC varies notably through time and from region to region.

Phytoplankton containing biominerals, such Influenza constitutes a major challenge to world health authorities due to high transmissibility and the capacity to generate large epidemics. This study aimed to characterize the diffusion process of influenza A H1N Lenalidomide Len plus dexamethasone Dex is approved for the treatment of relapsed or refractory multiple myeloma RRMM. Seawater rare earth element REE concentrations are increasingly applied to reconstruct water mass histories by exploiting relative changes in the distinctive normalised patterns.

However, the mechanisms by which water Increased proteolytic activity has been widely associated with skeletal muscle atrophy. However, elevated proteolysis is also critical for the maintenance of cellular homeostasis by disposing cytotoxic proteins and The real-time estimation of polar motion PM is needed for the navigation of Earth satellite and interplanetary spacecraft. However, it is impossible to have real-time information due to the complexity of the measurement The temperature-dependence of the band gap of the proposed photovoltaic absorber copper antimony sulphide CuSbS2 has been studied by Fourier-transform infrared spectroscopy.

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Well-thought-out charge for the use of infrastructure. Freight trains pay for each kilometer of the railway infrastructure, which again adversely affects the competitiveness of the railway in comparison with road transport, where such charge is not always introduced. Setting the price that users are required to pay for getting into the infrastructure, it would be necessary to take into account the impact on the environment and pollution, congestion, accidents and other aspects.

Rolands petersons privatbank The state should provide a proper support for organizations managing infrastructure, and rail transport enterprises should strive to improve the competitiveness of rail freight services, especially in regards to reliability, filling, elasticity, customer orientation, and the duration and cost of transportation, as these are the main aspects which are considered by an average consignor in selecting any of the available modes of transport.

Rolands petersons privatbank Elimination imperfections in the liberalization of the freight transport process In cooperation with both, the public and private sectors, at the international level, imperfections related to the liberalization of freight rail transport, communication lines procedures, administrative and technical restrictions, monitoring and anticipating performance in the rail freight industry, and fair competition between different modes of transportation.

Therefore, it is necessary to find out the ways to make a better use of available EU funding and target it to the rail transport industry in order to achieve improvements in such areas as a coherent approach to policy objectives and funding while focusing on corridors for freight railways transportation , for the selection, planning and management of projects, as well as for the maintenance of railroad networks.

Not only update, but also regularly support It is essential to take to the new level not only the quality of the services provided to carriers and shippers of rail freight but, in general, to improve the competitiveness of rail freight transport; infrastructure managing organizations should not only update and modernize the railway network but also to regularly support it. Rolands petersons privatbank This is especially important for the corridors of rail freight. If the tracks are not properly maintained, the speed limits will have to be applied and the railway lines will gradually be obstructed.

Rolands petersons privatbank. Transport and logistics industries are of particular importance for the Latvian economy since they have a steady GDP growth and provide services to virtually all other sectors of the national economy. Every year it is emphasized that this sector should be recognized as a priority and extend its promotion, however, the representatives of the transport and logistics sector are looking forward to more concrete and long-term solutions.

Rolands petersons privatbank 9. Moreover, the average monthly gross wage is still higher then in other sectors - in in other sectors of the economy it was euros, whereas in storage and transportation sector the average gross wage is about euros 1, euros - water transport, 2, euros - air transport, euros in the of storage and auxiliary transport activities, etc.

Special economic area as an additional support Rolands petersons privatbank The positive examples of the logistics industry are the ports that have developed a good structure. Rolands petersons privatbank The port is actively implementing various investment projects related to the construction and development of industrial and distribution parks. The attraction of investments promotes the creation of higher added value, development of production, expansion of a spectrum of given services and creation of new workplaces.

Rolands petersons privatbank Port of Liepaja, will be the next Rotterdam. Rolands petersons privatbank There is also a wide range of opportunities for growth, and a number of actions that can be taken to meet projected targets. There is a strong need for the services with high added value, the increase of the processed volumes of cargo by attracting new freight flows, high-quality passenger service and an introduction of modern technologies and information systems in the area of transit and logistics.

Rolands petersons privatbank Liepaja port has all the chances to become the second Rotterdam in the foreseeable future. Latvia as a distribution center for cargos from Asia and the Far East. One of the most important issues for further growth of the port and special economic zone is the development of logistics and distribution centers, mainly focusing on the attraction of goods from Asia and the Far East. Rolands petersons privatbank Latvia can serve as a distribution center for cargos in the Baltic and Scandinavian countries for Asia and the Far East f.

China, Korea. This allows traders to conclude an agreement on investment and tax concession until December 31, , until they reach a contractual level of assistance from the investments made. Rolands petersons privatbank Considering the range of benefits provided by this status, it is necessary to consider the possible extension of the term. Infrastructure development and expansion of warehouse space Our advantage lies in the fact that there is not only a strategic geographical position but also a developed infrastructure that includes deep-water berths, cargo terminals, pipelines and territories free from the cargo terminal.

Rolands petersons privatbank Apart from this, we can add a good structure of pre-industrial zone, distribution park, multi-purpose technical equipment, as well as the high level of security not only in terms of delivery but also in terms of the storage and handling of goods. Rolands petersons privatbank In the future, it would be advisable to pay more attention to access roads railways and highways , increase the volume of storage facilities, and increase the number of services provided by ports.

Rolands petersons privatbank Participation in international industry exhibitions and conferences will make it possible to attract additional foreign investments and will contribute to the improvement of international image. The transport development has caused objective problems for traffic in cities around the world, including Latvia, and the reason for this is a rapid increase in the number of vehicles.

Road congestion is the most urgent problem in a trip planning because it affects the total time of transportation and, therefore, costs that have a particular relevance to the logistics industry. The quality of the roads, a painful subject in the past, has a significant impact on transportation time. Without high-quality roads, it is impossible to improve the efficiency of transport, which, in the context of economic globalization, is said to be one of the main directions for the logistics development.

Rolands petersons privatbank Promises against statistics At the end of , according to the report "Global Competitiveness Index", which was annually compiled by experts from the World Economic Forum, Latvia was not ranked among the top countries of the world's rating. EU assessment - Stable 3 points.

In , Rolands petersons privatbank In the same year, it was also planned to spend 37 million more, compared with the previous year. However, even these investments have not resulted in the average level of road quality in the European Union. Rolands petersons privatbank According to the latest report, the average level in the EU is estimated at 4. The state of the roads not only hinders the development of the logistics industry but also contributes to the disproportionate level and the pace of social and economic development of the regions.

Rolands petersons privatbank The most remote regions of Latvia can develop tourism facilities, offer industrial premises for entrepreneurs, etc. Rolands petersons privatbank Financing is eight times less than it needs to be. Rolands petersons privatbank At the same time, we make the mistake of struggling only with the consequences of the disease, when we need to identify the root of the problem and take the preventive measures. One of the main problems that can be figured out now is the climate of the country, which in Latvia will not change significantly in the future, therefore, the problem will remain constant.

Rolands petersons privatbank The number of vehicles will also increase, so the question is: how to increase financing, which is the most important addition to the urgent issues. Rolands petersons privatbank million euros are required annually for maintenance and repair works of local and gravel roads but this amount cannot be provided only by EU funds.

It is also completely unclear how the situation will look like in , after the end of EU funding program. Without the excise tax on fuel, there is no chance for survival The fact that the change is expected in , the spring of is said to be the moment to start an intensive work and stimulate actions - change existing arrangements related to the existing tax system only a third of the tax, paid by road users, are redirected to roads.

Rolands petersons privatbank The time when it was possible to pull out a part of the income from tax has passed. Furthermore, we need to increase the number of public-private partnership projects in the sphere of the road construction, although this stage requires a proper preparation. Rolands petersons privatbank In addition to financing, other necessary support measures need to be introduced: dumping water from roads in certain areas, timely planning, more restrictive control on roads, etc.

Rolands petersons privatbank has released new forecasts on Poland becoming the logistics centre of Europe. Rolands petersons privatbank Experts at OECD has appreciated a change in the Polish labour market - a fall of the unemployment level to the lowest ever, reaching the lowest point in the last twenty years; labour demand is growing; and everything indicates a significant growth of average wages in the near future. Rolands petersons privatbank Poland should think more about the agricultural production export area.

Export products for the most part are milk products, meat and potatoes. Rolands petersons privatbank By developing its infrastructure, Poland would be able to succeed exports. Rolands petersons privatbank The Baltic Sea provides the opportunity to develop cargo carriage faster than it is done now, according to Rolands Petersons, member of the board of Norman Logistics Sp.

Rolands petersons privatbank who offers his thoughts on Poland economy. There should be a strategy allowing continuation and even growth of infrastructural investments. Rolands petersons privatbank has released a new forecasts of UAE economy. Analysing the indicators of the last 20 months, we can conclude that since August non-oil economy growth has slowed down.

Despite slower growth, optimism among businesses in the UAE's non-oil private sector accelerated to a record high. Rolands petersons privatbank In general, the reduction was wee, and the fact that a large part of the companies has abandoned the reduction of the workforce, which, on the one hand, would help to save, is right, as companies have not lost their effectiveness.

Most companies have acted exactly the opposite - they stimulated stagnant economic growth with new products, accordingly obtaining new orders as well, Rolands Petersons, member of the board of Norman Logistics Sp. Rolands petersons privatbank offers his thoughts on UAE economy.

Another point to be emphasized is that non-oil business operators in the UAE have shown that sometimes exactly the opposite action of the usual behaviour can improve the situation. In the area of a?? Rolands petersons privatbankThe rate of growth was marked overall and reflected stronger inflows of new business from neighbouring GCC countries, besides new export orders rose once again during August and September.

About Norman Logistics Sp. Rolands petersons privatbankis an international logistics company based in Poland since This company operates in Europe and also in many other major logistics centres in the world. The core business is a cargo brokerage, mainly marine cargo. Rolands petersons privatbank Norman Logistics customers is significant EU companies which his production transport throughout marine cargo.

And service providers are medium or large shipping companies. The mission of Norman Logistics is convenient logistics and one-point service for the same price, individual and best quality approach. Rolands petersons privatbank has released a new report on Cyprus who experienced an economic recession just recently, but indicated 5th most rapid growth in the European Union last year.

Rolands petersons privatbank In August the Cyprus Department of Transportation initiated amendments in its transportation fiscal policy, influencing new and used transport facilities registered after the law will be adopted. Rolands petersons privatbank Outlining the above amendments are providing bigger road taxes for drivers with older cars and more horsepower, but those green-thinking will pay less. Such amendments provide several advantages: save income from transport taxation, decrease environment pollution, contribute to assets flow, and new car purchased stimulates a more attractive environment for foreigners, according to Rolands Petersons, member of the board of Norman Logistics Sp.

Rolands petersons privatbank who offers his thoughts on the Cyprus economy. Smart investment and fiscal policy, increasing the budget income, simultaneously stimulating the national economy and one of the most important areas - tourism, as well as caring about environment protection in total resulted in significant economic growth and we are sure that in total numbers of Cyprus will also provide a great example for many economies. Rolands petersons privatbank About Norman Logistics Sp. This company operates in Europe and also in many other major logistics centers in the world.

Rolands petersons privatbank The core business is a cargo brokerage, mainly marine cargo. Norman Logistics customers is significant EU companies which his production transport throughout marine cargo. And service providers is medium or large shipping companies. The mission of Norman Logistics is convenient logistics and one point service for the same price, individual and best quality approach.

Rolands petersons privatbank Author: Rolands Petersons, member of the board of "Norman Logistics spzoo". In it was constant. Rolands petersons privatbank It was provided by oil production volume, recent business reforms and constant activities in other areas. The UAE is preparing for World Expo in , so a big amount of investment is being made to improve infrastructure. The state could expect an increase of tourism area dynamics, but it will need additional investments not related to oil production and crude oil refining.

Even though in many infrastructural projects were postponed, this year they will be continued, moreover there are new general plans for the following two decades. Rolands petersons privatbank All the Emirates, especially Dubai and Abu Dhabi are continuing their efforts to vary the economy and decrease the amount of activities related to oil products.

In addition to the infrastructural projects, Abu Dhabi has made significant investments to the alternative energy sources creation, according to Rolands Petersons, a member of the board of Norman Logistics Sp. Rolands petersons privatbank Despite having suffered crises, this country is still a demanded business partner among many world economies, it is being forecasted that before the World Expo in the UAE will become even an more demanded business partner worldwide. Rolands petersons privatbank His experiences include working and collaborating with various national tourism offices and non-governmental organizations, as well as private and non-profit organizations, and in planning, implementing, and quality control of a range of travel and tourism-related activities and programs, including tourism policies and legislation.

Rolands petersons privatbank His major strengths include a vast knowledge of travel and tourism from the point of view of a successful private enterprise owner, superb networking skills, strong leadership, excellent communication skills, strong team player, attention to detail, dutiful respect for compliance in all regulated environments, and advisory skills in both political and non-political arenas with respect to tourism programs, policies, and legislation. Rolands petersons privatbank He has a thorough knowledge of current industry practices and trends and is a computer and Internet junkie.

Mobility is the fundamental premise for these four core values to be strengthened not only in the domestic market but also beyond its borders. Rolands petersons minicredit This is particularly significant in the Baltic Sea region, where a well thought-out and developed transport system is one of the positive development factors.

Rolands petersons minicredit The direct impact includes the income derived from the activities of airline personnel and ground handling workers, whereas the indirect input implies all purchases in the aviation sector from locally based suppliers who basically do not represent the aviation sector. Rolands petersons minicredit In Estonia, airports are mainly located in the capital in Tallinn, as well as in Tartu, Kuressaare, Kerdle and Parnu. Rolands petersons minicredit Latvia still has only two international airports - in Riga and in Liepaja; there are also small airdromes, for example, in Spilva, in Tukums and Ventspils, and several other military flight platforms though.

Rolands petersons minicredit A successful start is taken after reconstruction The airport in Liepaja did a great job - in after its reconstruction was completed. Rolands petersons minicredit At the airport a significant drainage effort was undertaken, a new cover for the take-off track was laid, the take-off strip was reinforced, the cover of the shunting route was improved and expanded, parking places for the aircraft were renovated as well.

Rolands petersons minicredit Keeping in mind the processes that are still underway, it is important to mention the extensive capacity-building of the airports, environment protection in a long-term, enhancement of cooperation with other regional airports in Europe.

It is not enough for Latvia to have only one high-capacity airport - we have a regional leader who can serve as an example of a successful market behavior for others. Rolands petersons minicredit Support strategy for attracting new aviation communities Liepaja airport is the only example nowadays in terms of Latvian regional airports, however, I see several competitive regional airports in Latvia. Rolands petersons minicredit Without a doubt, it is also essential to study the ultimate goals of tourist destinations, in order to promote the growth of the travel market and ensure its positive impact on the economy.

Rolands petersons minicredit Infrastructure for a variety multifaceted of commercial activities The strategic objective of the regional airports is a creation of the favorable and unified conditions for the enterprises and institutions operating there, as well as to proactive procurement of a sufficient infrastructure for the development various of commercial activities.

Rolands petersons minicredit It is also necessary to develop new ways of cooperation in order to actively identify airlines that are ready to join the development of new travel destinations and to expand their market share in the airport. Apart from this, it is necessary to work on the incentive prerequisites for launching new flights. Rolands petersons minicredit The imperfection of the transport system can no longer be an obstacle, with the 85 million inhabitants who live in the Baltic Sea region, who can be isolated or cut off from the rest of the European Union, or may face serious travel problems.

Rolands petersons minicredit. Rolands petersons minicredit However, the data summarized by the Ministry of Communications still shows that in Latvia the volume of freight rail transportation by comparison with has decreased by 8. Rolands petersons minicredit Traffic congestion can lead to a loss of billion euros The mobility of goods is an essential component of the EU internal market; this greatly contributes to the competitiveness of the industry and services in Europe.

Rolands petersons minicredit The types of lengthy transportation as railway can reduce their costs, which arise in connection with the traffic congestion on the roads. Rolands petersons minicredit In the future, it is possible to increase the volume of rail transportation. Rolands petersons minicredit The volume of transit cargo from the total amount of international rail freight transport amounted to In , in Latvia, by rail, Rolands petersons minicredit Increase of the average commercial speed of freight trains.

One of the key priorities nowadays is the development of the railway infrastructure, and in this case, it is expected, the railway infrastructure can be financed by the European Union. Rolands petersons minicredit One of the solutions can be the improvement of cooperation between existing infrastructure organizations in Europe.

The actual train system needs to be adapted to the needs of the railway freight transport sector, especially in the EU freight rail corridors. Rolands petersons minicredit Setting the price that users are required to pay for getting into the infrastructure, it would be necessary to take into account the impact on the environment and pollution, congestion, accidents and other aspects. Rolands petersons minicredit The state should provide a proper support for organizations managing infrastructure, and rail transport enterprises should strive to improve the competitiveness of rail freight services, especially in regards to reliability, filling, elasticity, customer orientation, and the duration and cost of transportation, as these are the main aspects which are considered by an average consignor in selecting any of the available modes of transport.

Elimination imperfections in the liberalization of the freight transport process In cooperation with both, the public and private sectors, at the international level, imperfections related to the liberalization of freight rail transport, communication lines procedures, administrative and technical restrictions, monitoring and anticipating performance in the rail freight industry, and fair competition between different modes of transportation. Rolands petersons minicredit Therefore, it is necessary to find out the ways to make a better use of available EU funding and target it to the rail transport industry in order to achieve improvements in such areas as a coherent approach to policy objectives and funding while focusing on corridors for freight railways transportation , for the selection, planning and management of projects, as well as for the maintenance of railroad networks.

Rolands petersons minicredit This is especially important for the corridors of rail freight. Rolands petersons minicredit Every year it is emphasized that this sector should be recognized as a priority and extend its promotion, however, the representatives of the transport and logistics sector are looking forward to more concrete and long-term solutions.

Rolands petersons minicredit 9. Rolands petersons minicredit Special economic area as an additional support The positive examples of the logistics industry are the ports that have developed a good structure. Rolands petersons minicredit The port is actively implementing various investment projects related to the construction and development of industrial and distribution parks.

Rolands petersons minicredit The attraction of investments promotes the creation of higher added value, development of production, expansion of a spectrum of given services and creation of new workplaces. Port of Liepaja, will be the next Rotterdam.

There is also a wide range of opportunities for growth, and a number of actions that can be taken to meet projected targets. Rolands petersons minicredit There is a strong need for the services with high added value, the increase of the processed volumes of cargo by attracting new freight flows, high-quality passenger service and an introduction of modern technologies and information systems in the area of transit and logistics.

Liepaja port has all the chances to become the second Rotterdam in the foreseeable future. Rolands petersons minicredit Latvia as a distribution center for cargos from Asia and the Far East. Rolands petersons minicredit Latvia can serve as a distribution center for cargos in the Baltic and Scandinavian countries for Asia and the Far East f.

Rolands petersons minicredit Considering the range of benefits provided by this status, it is necessary to consider the possible extension of the term. Rolands petersons minicredit Apart from this, we can add a good structure of pre-industrial zone, distribution park, multi-purpose technical equipment, as well as the high level of security not only in terms of delivery but also in terms of the storage and handling of goods.

In the future, it would be advisable to pay more attention to access roads railways and highways , increase the volume of storage facilities, and increase the number of services provided by ports. Rolands petersons minicredit Participation in international industry exhibitions and conferences will make it possible to attract additional foreign investments and will contribute to the improvement of international image.

Rolands petersons minicredit Without high-quality roads, it is impossible to improve the efficiency of transport, which, in the context of economic globalization, is said to be one of the main directions for the logistics development. Rolands petersons minicredit Promises against statistics At the end of , according to the report "Global Competitiveness Index", which was annually compiled by experts from the World Economic Forum, Latvia was not ranked among the top countries of the world's rating.

Rolands petersons minicredit EU assessment - Stable 3 points. In the same year, it was also planned to spend 37 million more, compared with the previous year. Rolands petersons minicredit However, even these investments have not resulted in the average level of road quality in the European Union.

According to the latest report, the average level in the EU is estimated at 4. Rolands petersons minicredit The most remote regions of Latvia can develop tourism facilities, offer industrial premises for entrepreneurs, etc.

Financing is eight times less than it needs to be. Rolands petersons minicredit At the same time, we make the mistake of struggling only with the consequences of the disease, when we need to identify the root of the problem and take the preventive measures. Rolands petersons minicredit The number of vehicles will also increase, so the question is: how to increase financing, which is the most important addition to the urgent issues.

Rolands petersons minicredit million euros are required annually for maintenance and repair works of local and gravel roads but this amount cannot be provided only by EU funds. Rolands petersons minicredit Without the excise tax on fuel, there is no chance for survival The fact that the change is expected in , the spring of is said to be the moment to start an intensive work and stimulate actions - change existing arrangements related to the existing tax system only a third of the tax, paid by road users, are redirected to roads.

Rolands petersons minicredit The time when it was possible to pull out a part of the income from tax has passed. Rolands petersons minicredit In addition to financing, other necessary support measures need to be introduced: dumping water from roads in certain areas, timely planning, more restrictive control on roads, etc. Rolands petersons minicrediT Newest OECD Organisation for Economic Co-operation and Development data are indicating the increase of living standards in Poland, positive tendencies in economy and rapid development of the labour market.

Rolands petersons minicrediT Experts at OECD has appreciated a change in the Polish labour market - a fall of the unemployment level to the lowest ever, reaching the lowest point in the last twenty years; labour demand is growing; and everything indicates a significant growth of average wages in the near future. Rolands petersons minicrediT The Baltic Sea provides the opportunity to develop cargo carriage faster than it is done now, according to Rolands Petersons, member of the board of Norman Logistics Sp.

Rolands petersons minicrediT who offers his thoughts on Poland economy. Rolands petersons minicrediT To keep this positive tendency, Poland has to find opportunities to invest in proficiency enhancement, development of infrastructure and innovations. Rolands petersons minicrediT has released a new forecasts of Cyprus economy, which has definitely recovered from the clinical death in Rolands petersons minicrediT The second-quarter expansion was largely underpinned by a vibrant hotels and restaurants industry, which benefited from a record number of tourist arrivals, primarily from the U.

Rolands petersons minicrediT Banking system has shrunk from more than eight times that of GDP, which it had previously been in , to "more like four times of GDP now". There has also been an increase in foreign direct investments over the past three years, and the economy is not reliant on foreign deposits anymore.

Rolands petersons minicrediT Investors are also looking at sectors like health, education, tourism, and shipping, and Cyprus is actually now poised to grow across a range of economies, not just tourism. Rolands petersons minicrediT Currently investments were being made now in a variety of sectors, including banking, sea-ports, marinas, and the largest integrated casino resort in Europe, as well as energy.

This is a clear signal to other investors, and for the Cypriot government it remains to focus on maintaining and broadening the conditions under which surpluses and high growth rates can be generated, to continue promoting structural reforms and improving the country's business environment, Rolands Petersons, member of the board of Norman Logistics Sp.

Rolands petersons minicrediT offers his thoughts on Cypruseconomy. Rolands petersons minicrediT has released a new forecasts of Poland economy. Rolands petersons minicrediT Although the Polish Prime Minister in an interview highlighted that external economic turbulence may pose a threat to the national economy, other significant indicators indicate that the situation inside the country is sufficiently stable to overcome external difficulties.

Rolands petersons minicrediT One of the most prominent indicators, which reflects the home work done by Poland, is the unemployment rate, more precisely- the decrease of unemployment. According to the latest static data, last month it has decreased by 0. Another reason why external threats to Poland are not so scary is the fact that the biggest development guide of GDP growth is domestic consumption, domestic demand.

Rolands petersons minicrediT Also the revival of company investment outlays, including SMEs, is an important element that should help to boost GDP growth in coming quarters, Rolands Petersons, member of the board of Norman Logistics Sp. Rolands petersons minicrediT The core business is a cargo brokerage, mainly marine cargo.

Rolands petersons minicrediT has released a new report on Cyprus who experienced an economic recession just recently, but indicated 5th most rapid growth in the European Union last year. Rolands petersons minicrediT In August the Cyprus Department of Transportation initiated amendments in its transportation fiscal policy, influencing new and used transport facilities registered after the law will be adopted. Outlining the above amendments are providing bigger road taxes for drivers with older cars and more horsepower, but those green-thinking will pay less.

Rolands petersons minicrediT who offers his thoughts on the Cyprus economy. Rolands petersons minicrediT Smart investment and fiscal policy, increasing the budget income, simultaneously stimulating the national economy and one of the most important areas - tourism, as well as caring about environment protection in total resulted in significant economic growth and we are sure that in total numbers of Cyprus will also provide a great example for many economies.

Rolands petersons minicrediT This company operates in Europe and also in many other major logistics centers in the world. Rolands petersons minicrediT Norman Logistics customers is significant EU companies which his production transport throughout marine cargo. Rolands petersons minicrediT In it was constant. It was provided by oil production volume, recent business reforms and constant activities in other areas.

Rolands petersons minicrediT The UAE is preparing for World Expo in , so a big amount of investment is being made to improve infrastructure. Rolands petersons minicrediT All the Emirates, especially Dubai and Abu Dhabi are continuing their efforts to vary the economy and decrease the amount of activities related to oil products. Rolands petersons minicrediT Despite having suffered crises, this country is still a demanded business partner among many world economies, it is being forecasted that before the World Expo in the UAE will become even an more demanded business partner worldwide.

Rolands petersons minicrediT His experiences include working and collaborating with various national tourism offices and non-governmental organizations, as well as private and non-profit organizations, and in planning, implementing, and quality control of a range of travel and tourism-related activities and programs, including tourism policies and legislation.

Rolands petersons minicrediT His major strengths include a vast knowledge of travel and tourism from the point of view of a successful private enterprise owner, superb networking skills, strong leadership, excellent communication skills, strong team player, attention to detail, dutiful respect for compliance in all regulated environments, and advisory skills in both political and non-political arenas with respect to tourism programs, policies, and legislation.

Rolands petersons minicrediT He has a thorough knowledge of current industry practices and trends and is a computer and Internet junkie. Rolands petersons minicrediT. Rolands petersons de facto This is particularly significant in the Baltic Sea region, where a well thought-out and developed transport system is one of the positive development factors.

Rolands petersons de facto Flight-related activities have both direct and indirect impact on the economy. Rolands petersons de facto The direct impact includes the income derived from the activities of airline personnel and ground handling workers, whereas the indirect input implies all purchases in the aviation sector from locally based suppliers who basically do not represent the aviation sector. Rolands petersons de facto More than 30 airports are located in Lithuania There are four international airports operating in Lithuania - in Kaunas, Palanga, Siauliai, and, of course, in Vilnius, and there are more than 30 smaller airports and military airfields.

Rolands petersons de facto These are international airports, however, there are more than 15 private and military airports and so-called airports of local importance located throughout the country. Rolands petersons de facto Latvia still has only two international airports - in Riga and in Liepaja; there are also small airdromes, for example, in Spilva, in Tukums and Ventspils, and several other military flight platforms though.

Rolands petersons de facto Riga International Airport entered the top five rapidly growing airports in Europe last year, which lead to an increase in the number of passengers by A successful start is taken after reconstruction The airport in Liepaja did a great job - in after its reconstruction was completed. Rolands petersons de facto After Liepaja Airport was certified for commercial flights for the summer season in , the Latvian national airline "AirBaltic" launched regular flights between Riga and Liepaja.

Rolands petersons de facto Keeping in mind the processes that are still underway, it is important to mention the extensive capacity-building of the airports, environment protection in a long-term, enhancement of cooperation with other regional airports in Europe. Support strategy for attracting new aviation communities Liepaja airport is the only example nowadays in terms of Latvian regional airports, however, I see several competitive regional airports in Latvia.

Rolands petersons de facto Without a doubt, it is also essential to study the ultimate goals of tourist destinations, in order to promote the growth of the travel market and ensure its positive impact on the economy. Infrastructure for a variety multifaceted of commercial activities The strategic objective of the regional airports is a creation of the favorable and unified conditions for the enterprises and institutions operating there, as well as to proactive procurement of a sufficient infrastructure for the development various of commercial activities.

Rolands petersons de factoIt is also necessary to develop new ways of cooperation in order to actively identify airlines that are ready to join the development of new travel destinations and to expand their market share in the airport. The imperfection of the transport system can no longer be an obstacle, with the 85 million inhabitants who live in the Baltic Sea region, who can be isolated or cut off from the rest of the European Union, or may face serious travel problems.

Rolands petersons de facto The power generated by the economy and innovation provides the Baltic Sea Region with opportunities to create a modern, forward-looking transport system that will also contribute to the creation of a socially balanced economic policy.

Rolands petersons de facto Traffic congestion can lead to a loss of billion euros The mobility of goods is an essential component of the EU internal market; this greatly contributes to the competitiveness of the industry and services in Europe.

Rolands petersons de facto The types of lengthy transportation as railway can reduce their costs, which arise in connection with the traffic congestion on the roads. In the future, it is possible to increase the volume of rail transportation. Rolands petersons de factoHowever, domestic traffic has increased by Rolands petersons de facto In , in Latvia, by rail, Rolands petersons de facto Increase of the average commercial speed of freight trains.

Rolands petersons de facto One of the key priorities nowadays is the development of the railway infrastructure, and in this case, it is expected, the railway infrastructure can be financed by the European Union. Rolands petersons de facto This would contribute to the competitiveness of rail transport with other modes of transport, especially with the road transport sector, which infrastructure is easily accessible in all Member States.

Rolands petersons de facto The state should provide a proper support for organizations managing infrastructure, and rail transport enterprises should strive to improve the competitiveness of rail freight services, especially in regards to reliability, filling, elasticity, customer orientation, and the duration and cost of transportation, as these are the main aspects which are considered by an average consignor in selecting any of the available modes of transport.

Rolands petersons de facto Elimination imperfections in the liberalization of the freight transport process In cooperation with both, the public and private sectors, at the international level, imperfections related to the liberalization of freight rail transport, communication lines procedures, administrative and technical restrictions, monitoring and anticipating performance in the rail freight industry, and fair competition between different modes of transportation.

Rolands petersons de facto Therefore, it is necessary to find out the ways to make a better use of available EU funding and target it to the rail transport industry in order to achieve improvements in such areas as a coherent approach to policy objectives and funding while focusing on corridors for freight railways transportation , for the selection, planning and management of projects, as well as for the maintenance of railroad networks.

Rolands petersons de facto This is especially important for the corridors of rail freight. Rolands petersons de facto Every year it is emphasized that this sector should be recognized as a priority and extend its promotion, however, the representatives of the transport and logistics sector are looking forward to more concrete and long-term solutions.

Rolands petersons de facto 9. Special economic area as an additional support The positive examples of the logistics industry are the ports that have developed a good structure. Rolands petersons de facto The port is actively implementing various investment projects related to the construction and development of industrial and distribution parks. Rolands petersons de facto The attraction of investments promotes the creation of higher added value, development of production, expansion of a spectrum of given services and creation of new workplaces.

Rolands petersons de facto Port of Liepaja, will be the next Rotterdam. Rolands petersons de facto Latvia as a distribution center for cargos from Asia and the Far East. Latvia can serve as a distribution center for cargos in the Baltic and Scandinavian countries for Asia and the Far East f.

Considering the range of benefits provided by this status, it is necessary to consider the possible extension of the term. Rolands petersons de facto Infrastructure development and expansion of warehouse space Our advantage lies in the fact that there is not only a strategic geographical position but also a developed infrastructure that includes deep-water berths, cargo terminals, pipelines and territories free from the cargo terminal.

Apart from this, we can add a good structure of pre-industrial zone, distribution park, multi-purpose technical equipment, as well as the high level of security not only in terms of delivery but also in terms of the storage and handling of goods. Rolands petersons de facto In the future, it would be advisable to pay more attention to access roads railways and highways , increase the volume of storage facilities, and increase the number of services provided by ports.

Participation in international industry exhibitions and conferences will make it possible to attract additional foreign investments and will contribute to the improvement of international image. Rolands petersons de facto Road congestion is the most urgent problem in a trip planning because it affects the total time of transportation and, therefore, costs that have a particular relevance to the logistics industry.

Rolands petersons de facto The quality of the roads, a painful subject in the past, has a significant impact on transportation time. Promises against statistics At the end of , according to the report "Global Competitiveness Index", which was annually compiled by experts from the World Economic Forum, Latvia was not ranked among the top countries of the world's rating.

Rolands petersons de facto However, even these investments have not resulted in the average level of road quality in the European Union. Rolands petersons de facto The most remote regions of Latvia can develop tourism facilities, offer industrial premises for entrepreneurs, etc. Rolands petersons de facto Financing is eight times less than it needs to be.

Rolands petersons de facto At the same time, we make the mistake of struggling only with the consequences of the disease, when we need to identify the root of the problem and take the preventive measures. The number of vehicles will also increase, so the question is: how to increase financing, which is the most important addition to the urgent issues. Rolands petersons de facto It is also completely unclear how the situation will look like in , after the end of EU funding program. Rolands petersons de facto The time when it was possible to pull out a part of the income from tax has passed.

Rolands petersons de facto In addition to financing, other necessary support measures need to be introduced: dumping water from roads in certain areas, timely planning, more restrictive control on roads, etc. Rolands petersons de facto It was provided by oil production volume, recent business reforms and constant activities in other areas.

Rolands petersons de facto The UAE is preparing for World Expo in , so a big amount of investment is being made to improve infrastructure. All the Emirates, especially Dubai and Abu Dhabi are continuing their efforts to vary the economy and decrease the amount of activities related to oil products. Rolands petersons de facto Despite having suffered crises, this country is still a demanded business partner among many world economies, it is being forecasted that before the World Expo in the UAE will become even an more demanded business partner worldwide.

His experiences include working and collaborating with various national tourism offices and non-governmental organizations, as well as private and non-profit organizations, and in planning, implementing, and quality control of a range of travel and tourism-related activities and programs, including tourism policies and legislation.

His major strengths include a vast knowledge of travel and tourism from the point of view of a successful private enterprise owner, superb networking skills, strong leadership, excellent communication skills, strong team player, attention to detail, dutiful respect for compliance in all regulated environments, and advisory skills in both political and non-political arenas with respect to tourism programs, policies, and legislation.

Rolands petersons de facto He has a thorough knowledge of current industry practices and trends and is a computer and Internet junkie. Rolands petersons de facto. Rolands petersons cpm trading Mobility is the fundamental premise for these four core values to be strengthened not only in the domestic market but also beyond its borders. Rolands petersons cpm trading This is particularly significant in the Baltic Sea region, where a well thought-out and developed transport system is one of the positive development factors.

Rolands petersons cpm trading The direct impact includes the income derived from the activities of airline personnel and ground handling workers, whereas the indirect input implies all purchases in the aviation sector from locally based suppliers who basically do not represent the aviation sector. Rolands petersons cpm trading In Estonia, airports are mainly located in the capital in Tallinn, as well as in Tartu, Kuressaare, Kerdle and Parnu.

Rolands petersons cpm trading Latvia still has only two international airports - in Riga and in Liepaja; there are also small airdromes, for example, in Spilva, in Tukums and Ventspils, and several other military flight platforms though. Rolands petersons cpm trading Riga International Airport entered the top five rapidly growing airports in Europe last year, which lead to an increase in the number of passengers by Rolands petersons cpm trading A successful start is taken after reconstruction The airport in Liepaja did a great job - in after its reconstruction was completed.

Rolands petersons cpm trading The five most popular destinations for transit flights along the Liepaja route include London, Berlin, Moscow, Copenhagen, and Hamburg, which, in general, brought very good results. Keeping in mind the processes that are still underway, it is important to mention the extensive capacity-building of the airports, environment protection in a long-term, enhancement of cooperation with other regional airports in Europe.

Rolands petersons cpm trading Support strategy for attracting new aviation communities Liepaja airport is the only example nowadays in terms of Latvian regional airports, however, I see several competitive regional airports in Latvia. Rolands petersons cpm trading To promote their development, a thorough analysis of the passengers' potential is needed, starting with linking their activities with the existing types of transport in the surrounding region, forming a support strategy to attract new aviation communities, passengers, and additional services for client groups, bearing in mind that the added value of airports is formed by airlines operating there, strategic cooperation partners and service providers.

Rolands petersons cpm trading Without a doubt, it is also essential to study the ultimate goals of tourist destinations, in order to promote the growth of the travel market and ensure its positive impact on the economy. Rolands petersons cpm trading The imperfection of the transport system can no longer be an obstacle, with the 85 million inhabitants who live in the Baltic Sea region, who can be isolated or cut off from the rest of the European Union, or may face serious travel problems.

Rolands petersons cpm trading The power generated by the economy and innovation provides the Baltic Sea Region with opportunities to create a modern, forward-looking transport system that will also contribute to the creation of a socially balanced economic policy. Traffic congestion can lead to a loss of billion euros The mobility of goods is an essential component of the EU internal market; this greatly contributes to the competitiveness of the industry and services in Europe.

Rolands petersons cpm trading The types of lengthy transportation as railway can reduce their costs, which arise in connection with the traffic congestion on the roads. Rolands petersons cpm trading In the future, it is possible to increase the volume of rail transportation. Rolands petersons cpm trading The volume of transit cargo from the total amount of international rail freight transport amounted to Rolands petersons cpm trading In , in Latvia, by rail, Rolands petersons cpm trading Increase of the average commercial speed of freight trains.

Rolands petersons cpm trading The actual train system needs to be adapted to the needs of the railway freight transport sector, especially in the EU freight rail corridors. Rolands petersons cpm trading The state should provide a proper support for organizations managing infrastructure, and rail transport enterprises should strive to improve the competitiveness of rail freight services, especially in regards to reliability, filling, elasticity, customer orientation, and the duration and cost of transportation, as these are the main aspects which are considered by an average consignor in selecting any of the available modes of transport.

Rolands petersons cpm trading Elimination imperfections in the liberalization of the freight transport process In cooperation with both, the public and private sectors, at the international level, imperfections related to the liberalization of freight rail transport, communication lines procedures, administrative and technical restrictions, monitoring and anticipating performance in the rail freight industry, and fair competition between different modes of transportation.

Rolands petersons cpm trading Not only update, but also regularly support It is essential to take to the new level not only the quality of the services provided to carriers and shippers of rail freight but, in general, to improve the competitiveness of rail freight transport; infrastructure managing organizations should not only update and modernize the railway network but also to regularly support it.

Rolands petersons cpm trading This is especially important for the corridors of rail freight. Rolands petersons cpm trading. Rolands petersons cpm trading Every year it is emphasized that this sector should be recognized as a priority and extend its promotion, however, the representatives of the transport and logistics sector are looking forward to more concrete and long-term solutions. Rolands petersons cpm trading 9. Rolands petersons cpm trading The port is actively implementing various investment projects related to the construction and development of industrial and distribution parks.

Rolands petersons cpm trading There is a strong need for the services with high added value, the increase of the processed volumes of cargo by attracting new freight flows, high-quality passenger service and an introduction of modern technologies and information systems in the area of transit and logistics.

Rolands petersons cpm trading Latvia as a distribution center for cargos from Asia and the Far East. Rolands petersons cpm trading Latvia can serve as a distribution center for cargos in the Baltic and Scandinavian countries for Asia and the Far East f. Rolands petersons cpm trading This allows traders to conclude an agreement on investment and tax concession until December 31, , until they reach a contractual level of assistance from the investments made.

Rolands petersons cpm trading Road congestion is the most urgent problem in a trip planning because it affects the total time of transportation and, therefore, costs that have a particular relevance to the logistics industry. Rolands petersons cpm trading The quality of the roads, a painful subject in the past, has a significant impact on transportation time.

Rolands petersons cpm trading Promises against statistics At the end of , according to the report "Global Competitiveness Index", which was annually compiled by experts from the World Economic Forum, Latvia was not ranked among the top countries of the world's rating. Rolands petersons cpm trading out of countries participating in the ranking, Latvia took th place, and Lithuania and Estonia took the 37th and 38th places Despite this, VAS State Roads of Latvia announced that, despite the increase in traffic on Latvian roads, their quality has been improved in recent years.

Rolands petersons cpm trading EU assessment - Stable 3 points. Rolands petersons cpm trading In the same year, it was also planned to spend 37 million more, compared with the previous year. Rolands petersons cpm trading However, even these investments have not resulted in the average level of road quality in the European Union.

Rolands petersons cpm trading The most remote regions of Latvia can develop tourism facilities, offer industrial premises for entrepreneurs, etc. Rolands petersons cpm trading Financing is eight times less than it needs to be. At the same time, we make the mistake of struggling only with the consequences of the disease, when we need to identify the root of the problem and take the preventive measures.

Rolands petersons cpm trading The number of vehicles will also increase, so the question is: how to increase financing, which is the most important addition to the urgent issues. Rolands petersons cpm trading Without the excise tax on fuel, there is no chance for survival The fact that the change is expected in , the spring of is said to be the moment to start an intensive work and stimulate actions - change existing arrangements related to the existing tax system only a third of the tax, paid by road users, are redirected to roads.

Rolands petersons cpm trading The time when it was possible to pull out a part of the income from tax has passed. Rolands petersons cpm trading Furthermore, we need to increase the number of public-private partnership projects in the sphere of the road construction, although this stage requires a proper preparation. In addition to financing, other necessary support measures need to be introduced: dumping water from roads in certain areas, timely planning, more restrictive control on roads, etc.

Rolands petersons cpm trading has released new forecasts on Poland becoming the logistics centre of Europe. Rolands petersons cpm trading Experts at OECD has appreciated a change in the Polish labour market - a fall of the unemployment level to the lowest ever, reaching the lowest point in the last twenty years; labour demand is growing; and everything indicates a significant growth of average wages in the near future.

Rolands petersons cpm trading GDP will go on increasing, but a little bit more slowly. Rolands petersons cpm trading Poland should think more about the agricultural production export area. Rolands petersons cpm trading By developing its infrastructure, Poland would be able to succeed exports.

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Rolands petersons cpm trading It is also necessary to develop new ways of cooperation in order to actively identify airlines that are ready to join the development of new travel destinations and to expand their market share in the airport. Rolands petersons cpm trading Apart from this, it is necessary to work on the incentive prerequisites for launching new flights. The fact that the change is expected in , the spring of is said to be the moment to start an intensive work and stimulate actions - change existing arrangements related to the existing tax system only a third of the tax, paid by road users, are redirected to roads.

There are four international airports operating in Lithuania - in Kaunas, Palanga, Siauliai, and, of course, in Vilnius, and there are more than 30 smaller airports and military airfields. Rolands petersons privatbank In Estonia, airports are mainly located in the capital in Tallinn, as well as in Tartu, Kuressaare, Kerdle and Parnu. Rolands petersons privatbank Latvia still has only two international airports - in Riga and in Liepaja; there are also small airdromes, for example, in Spilva, in Tukums and Ventspils, and several other military flight platforms though.

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Liepaja airport is the only example nowadays in terms of Latvian regional airports, however, I see several competitive regional airports in Latvia. Rolands petersons minicredit To promote their development, a thorough analysis of the passengers ' potential is needed, starting with linking their activities with the existing types of transport in the surrounding region, forming a support strategy to attract new aviation communities, passengers, and additional services for client groups, bearing in mind that the added value of airports is formed by airlines operating there, strategic cooperation partners and service providers.

The airport in Liepaja did a great job - in after its reconstruction was completed. Rolands petersons minicredit After Liepaja Airport was certified for commercial flights for the summer season in , the Latvian national airline "AirBaltic" launched regular flights between Riga and Liepaja. Rolands petersons minicredit It is not enough for Latvia to have only one high-capacity airport - we have a regional leader who can serve as an example of a successful market behavior for others.

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FRANK BETTINGER KRITISCHE SOZIALE ARBEIT IM

The mechanism of action is thought to involve inhibition of late sodium influx in the heart, which can reduce abnormalities Ranolazine increases the exercise capacity, reduces angina, and diminishes the use of nitroglycerine. The drug has an excellent safety profile and may be a valuable addition to the treatment of chronic stable angina Behandling af juvenile angiofibromer med partikelembolisering og endoskopisk kirurgi.

Since , Odense University Hospital OUH has used preoperative particle embolization and endoscopic surgery to combat this problem. Behandling af peritoneal karcinose med laparoskopisk intraperitoneal kemoterapi under tryk. PIPAC has a favourable profile regarding safety for patients and occupati PIPAC has a favourable profile regarding safety for patients Klinik, diagnostik og behandling af Lyme-borreliose. Lyme borreliosis is an infection caused by the Borrelia burgdorferi sensu lato complex and transmitted by Ixodes ricinus ticks in Denmark.

It can manifest itself in several different forms of which erythema migrans is the most common and is diagnosed by clinical assessment of the characteristic Faecal microbiota transplantation FMT is the transferral of faeces from a healthy donor to a patient with a disease linked to disturbances in the gut microbiota. The treatment has been implemented at several hospitals in Denmark, and banks with frozen donor stool material have been established The effect of FMT for recurrent Clostridium difficile infection is well-documented.

FMT cannot be recommended for routine clinical use for inflammatory bowel disease and irritable bowel syndrome because of lack of data from clinical trials It is evident that by offering housing, homelessness may be reduced, but the comparison of independent housing and group living did not reveal big differences RM is probably a multifactorial disease and evaluation includes parental karyotyping, testing for uterine anomalies, thyroid dysfunction, thrombophilia and immune factors.

Further treatments are directed against the underlying cause: surgery, hormone supplementation, anticoagulation and immunomodulation. However, the effect of these treatments needs further documentation Omkostningseffektivitet ved behandling af type 1-diabetes med insulinpumpe.

This study's aim was to project the long-term clinical and economic outcomes of continuous subcutaneous insulin infusion CSII treatment compared to multiple daily injections MDI in type 1 diabetes patients in Denmark The survival was the same after resection Farmakologisk behandling af mild ukompliceret hypertension i almen praksis.

However, current Danish guidelines have taken this into consideration in their recommendations of pharmacotherapy Hypertension is an important risk factor for cardiovascular disease. In Denmark, patients with hypertension are primarily managed in primary care. A recent Cochrane review concluded that pharmacotherapy of patients with mild hypertension systolic blood pressure mmHg; diastolic blood We describe the symptoms of terminal COPD and suggest criteria for defining the palliative ph Behandling af kroniske sygdomme hos patienter med demens.

Ongoing goal setting is important, and advance care planning is recommended. In general, comorbidity must be carefully and holistic assessed and managed according to each patient's general status of health and stage of dementia. As the dementia develops, focus should primarily Gastrisk aspirationsbehandling er et muligt alternativ til behandling af fedme.

Aspiration therapy with AspireAssist is a novel endoscopic obesity treatment. Bivirkninger ved N-acetylcystein- behandling af paracetamolforgiftede patienter. In this retrospective study we evaluated the incidence of side effects of NAC in patients admitted to the Department of Hepatology, Rigshospitalet, Copenhagen, over a four-year Twenty-six 8.

Side effects were anaphylactoid, mainly from skin 25 rash, pruritus or flushing , in rare cases more serious four bronchospasm, three angioedema, one hypotension. None were life-threatening and all patients received The patient made uneventful recovery to normal activity within six weeks and had a stable result after one year follow-up. The case is a reminder of the importance of early intervention and preventive management of pressure ulcers and elaborates the benefits A year-old multi-morbid, paraplegic male with five pressure ulcers and a left-sided open trochanter fracture with chronic osteomyelitis was admitted to hospital.

His condition required exarticulation of the left hip joint. A radical wound revision and a pedicled lower extremity fillet flap Acute appendicitis has traditionally been treated surgically. Conservative approach with antibiotic treatment has been suggested as an alternative to the surgical procedure. The available studies on surgery versus antibiotics may indicate the safe use of conservative treatment for uncomplicated Thus, further studies are needed to clarify the role of conservative treatment, and in the meantime appendectomy remains the standard treatment for acute appendicitis Nyt antikolinergikum til behandling af kronisk obstruktiv lungesygdom.

Tiotropium is a new anti-cholinergic drug with a long duration of action designed for maintenance treatment of chronic obstructive pulmonary disease COPD. Tiotropium is the first drug specifically developed for the treatment of COPD, but it is also amongst the most expensive drugs used for this Tiotropium is the first drug specifically developed for the treatment of COPD, but it is also amongst the most expensive drugs used The clinical pharmacology of tiotropium and results from published controlled clinical trials are reviewed.

It is concluded that tiotropium seems suitable as a symptomatic treatment for patients with moderate to severe COPD typically a forced expiratorical volume FEV1 predicted Metformin-associated lactate acidosis is rare but serious and characterized by metabolic acidosis and elevated lactate. We describe a single-institution experience of four cases in one year.

Despite pH levels of 6. Two o Treatment includes fluid replacement, IV sodium bicarbonate and haemodialysis Narrativ og evidensbaseret behandling af komplekst traumatiserede mennesker. Many survivors of potentially traumatizing events develop serious psychological problems. This article aims to critically examine two fundamentally different treatment paradigms. The article presents and discusses Michael White's narrative therapy, Metin Basoglu's modified behaviour therapy and F Most patients complain of symptoms such as ophthalmoplegia, ataxia and confusion.

Heavy alcohol drinking is commonly associated with the disease, but other clinical conditions also can provoke it. In pregnant women, hyperemesis gravidarum can lead to the depletion of body thiamine due to poor oral intake and a high metabolic demand.

This case suggests that although the initial presentation may include atypical symptoms e. Overvej cannabinoid hyperemesis -syndrom ved recidiverende opkastninger. Cannabinoid hyperemesis syndrome CHS is characterised by unrelenting nausea, recurrent vomiting, abdominal pain and compulsive, hot bathing behaviour. The symptoms contrast the traditional effects associated with cannabis use. We report a "textbook example" of a year-old man with CHS.

Early recognition may prevent extensive, unnecessary medical examinations and frequent hospital admissions Association of transient hyperthyroidism and severity of hyperemesis gravidarum. Background Transient non-immune hyperthyroidism in early pregnancy is hyperthyroidism diagnosed for the first time in early pregnancy, without evidence of thyroid autoimmunity or clinical findings of Grave's disease and resolved spontaneously as the pregnancy progressed.

Materials and methods We conducted a cross sectional study to determine the prevalence of transient hyperthyroidism in patients with hyperemesis gravidarum and its relation to the severity of nausea and vomiting. Severity of nausea and vomiting in pregnancy was assessed using the modified pregnancy-unique quantification of emesis PUQE scoring system. Each patient had urine and blood investigations which also included a full blood count and thyroid and renal function tests.

Patients with abnormal thyroid function were retested at 20 weeks of gestation. The patients' demographic data, electrolyte levels, thyroid function and their respective PUQE score were analyzed. Results The prevalence of transient hyperthyroidism in women with hyperemesis gravidarum was 4. Free T4 and TSH values of all women with transient hyperthyroidism were normalized by 20 weeks of gestation.

Conclusion Transient hyperthyroidism in pregnancy is not significantly associated with the severity of the PUQE score. Women with transient hyperthyroidism in pregnancy are normally clinically euthyroid, hence a routine thyroid function test is unnecessary unless they exhibit clinical signs or symptoms of hyperthyroidism. When antithyroid drugs must be started in patients with hyperemesis gravidarum. To find out role of anti-thyroid drugs in patients with Hyperemesis gravidarum and thyroid dysfunction.

One hundred thirty five patients with hyperemesis gravidarum who were admitted to obstetric and gynecology hospital were enrolled in this study. Thirty two patients were excluded because of diabetes mellitus and thyroid diseases. Hence, one hundred three patients underwent investigations including thyroid function test and beta-hCG Human chorionic gonadotropin.

Thyroid function test was normalized in 11 patients with hyperemesis graridarum but remained abnormal in 22 patients. Routine assessment of thyroid function is necessary for women with hyperemesis gravidarum especially in patients with clinical features of hyperthyroidism. We must consider PTU propylthouracil in hyperemesis gravidarum with severe weight loss, vomiting and biochemical hyperthyroidism.

Cannabinoid hyperemesis syndrome CHS is typically unresponsive to conventional pharmacologic antiemetics, and patients often require excessive laboratory and radiographic testing and hospital admission. We report 4 cases of CHS that failed standard emergency department therapy but improved significantly after treatment with haloperidol.

Although the exact mechanism for CHS remains unclear, dysregulation at cannabinoid type 1 seems to play a role. Recent animal data demonstrate complex interactions between dopamine and cannabinoid type 1 signaling, a potential mechanism for haloperidol success in patients with CHS. Our success with haloperidol in these 4 patients warrants further investigation of haloperidol as an emergency department treatment for CHS.

Koffein som adjuverende analgetikum til behandling af akutte smerter — en gennemgang af et Cochranereview. Based on 19 studies 7, participants a Cochrane review concludes that the addition of caffeine to an analgesic drug provides superior analgesia compared with the analgesic drug alone. The benefit is small, with a number needed to treat of approx. The use of analgesics containing caffeine Combination analgesics with caffeine should only be used temporarily and exclusively for the treatment of acute pain conditions Prognostiske faktorer af betydning for den recidivfrie overlevelse efter kirurgisk behandling af hoved-hals-melanom.

The clinico-pathological and therapeutic data of patients with clinical stage I invasive head and neck melanoma of the skin were re-evaluated. There were females and males. The median age at primary surgery was 65 years, range 18 to 96 years. The median observation period was 5 years, Ultralydskanning ved diagnostik og behandling af hoftedysplasi.

Vurdering af en selektiv screeningsprocedure. This paper describes and evaluates No relationship was seen between morphological parameters at the first US and the outcome of hips classified as minor dysplastic or not fully developed NFD. A statistically significant relationship was seen between the degree of dysplasia and the time until US normalization of the hips p There was no relapse of dysplasia after treatment. The median duration of treatment was six, eight and nine weeks for mild, moderate and severe dysplasia respectively.

With the intention of reducing the treatment frequency of Developmental Dysplasia of the Hip DDH , two hospitals in Copenhagen implemented a screening and treatment procedure based on selective referral to ultrasonography of the hip US. This paper describes and evaluates the procedure From to children with risk factors or with positive Ortolanis or Barlows test were referred to US.

Systemisk prokinetisk behandling af postoperativ ileus efter abdominalkirurgi. Gennemgang af et Cochrane-review. Based on the evidence presented in the Cochrane review "Systemic prokinetic pharmacologic treatment for postoperative adynamic ileus following abdominal surgery in adults", routine administration of systemic prokinetics for the prevention of postoperative ileus is not recommendable. The potential Betydningen af kroppens stilling for det diuretiske respons ved behandling af dekompenseret cirrose og morbus cordis.

The diuretic effect of the supine position was evaluated in six patients with cirrhosis and ascites and six with congestive cardiac failure. All patients received 1 mg bumethanide intravenously and were randomly assigned to either bed rest in the supine position or normal daily activity in the up Sex, age, ulcerated tumor and tumor thickness were found by Cox multivariate regression analysis to act as independent prognostic factors for recurrence-free survival.

In addition, size of the excision margin was found of no significance for survival without relapse when The organization of treatment and control of type 2 diabetic patients in Denmark has undergone a major development within the last decade. From being based on local hospital guidelines, treatment and control have moved towards a more organized collaboration between primary and secondary care based Quality indicators from primary and secondary care are collected routinely, and gradually an increasingly precise depiction is documented in the National Indicator Project Kvaliteten af diagnostik og behandling af kronisk obstruktiv lungesygdom i almen praksis--sekundaerpublikation.

We investigated whether the quality of management of COPD in general practice could be improved by the participation of general practitioners and their staff in a COPD-specific educational programme. One-hundred and fifty-four doctors participated in the study, and patient record forms were We observed a significantly increased utilisation of spirometry from the first We conclude that participation in an educational Placenta percreta is a rare life-threatening obstetrical condition, often resulting in severe haemorrhage and hysterectomy.

The incidence seems to be increasing, probably secondary to the increase in caesarean section rates. We present a protocol for an elective multidisciplinary approach with pr A total of 79 patients with Hyperemesis Gravidarum and 71 healthy pregnant women were enrolled.

The study and control groups were compared according to results on the Brief Psychiatric Rating Scale and sociocultural factors specific to the region. RESULTS: Anxiety, somatic concern, tension, depressive mood, hostility, motor retardation, uncooperativeness and blunted effect were found to be statistically significantly higher in patients with Hyperemesis Gravidarum p Hyperemesis Gravidarum.

Conclusion: H. However, given the high background prevalence of H. We examined twinning and fetal gender in births of women with a hospital diagnosis of pre-eclampsia or hyperemesis. We also investigated sex ratio in infants whose mothers had had hyperemesis or pre-eclampsia in a different pregnancy. From all the hospitalized cases in Denmark between and Twins were more frequent in pregnancies with either condition. The male to female sex ratio was 1. Helicobacter pylori infection amongst Arab Israeli women with hyperemesis gravidarum--a prospective, controlled study.

Helicobacter pylori has been associated with hyperemesis gravidarum in some geographical regions. Subjects with hyperemesis gravidarum carrying a singleton fetus were recruited prospectively. Women with an uncomplicated pregnancy served as controls. All patients underwent 13 C-urea breath testing to assess for H. A total of 72 subjects, including 24 patients with hyperemesis gravidarum and 48 controls, aged Published by Elsevier Ltd..

Full Text Available Introduction. Physiologic changes of pregnancy promote renal potassium wasting, but serum potassium levels are kept in the physiologic range by increased levels of progesterone, which resist kaliuresis. In the presence of GS, this compensatory mechanism is easily overwhelmed, resulting in profound hypokalemia. We present a case of an year-old primigravida with undiagnosed GS who presented with hyperemesis gravidarum in her 7th week of pregnancy. This report adds to the limited experience with GS in pregnancy as reported in literature and provides additional information on medical management that leads to successful maternal and fetal outcomes.

Wernicke-Korsakoff syndrome associated with hyperemesis gravidarum. The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. We experienced a year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation.

Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.

Depression, anxiety, stress and hyperemesis gravidarum: temporal and case controlled correlates. Third pregnancy trimester controls were recruited from routine antenatal clinic attendees who were matched to gestational age at the second DASS assessment in the HG cohort. Within the hyperemesis gravidarum cohort, nausea, vomiting depression, anxiety and stress reduced significantly by an absolute In the third trimester, when comparing the hyperemesis gravidarum cohort to controls, the risk of nausea or vomiting was similar but depression, anxiety and stress were significantly lower: adjusted odds ratio AOR 0.

This observation imply that much of the psychological distress in acute hyperemesis gravidarum is self-limiting and probably in the causal pathway of hyperemesis gravidarum. Care in women with. We present a case in which a young woman was diagnosed with acute myeloid leukaemia, FAB-classification type M2. As a member of Jehovah's Witnesses she refused to accept any treatment involving blood transfusions.

A modified induction and consolidation chemotherapy regimen was applied, tailored Despite severe anaemia, she survived to achieve complete remission. She is currently under treatment-free observation after two courses of consolidation treatment Skal alkoholmisbrug overhovedet behandles i almen praksis. Grooten, Iris J. Background: Hyperemesis gravidarum HG , or intractable vomiting during pregnancy, is the single most frequent cause of hospital admission in early pregnancy.

HG has a major impact on maternal quality of life and has repeatedly been associated with poor pregnancy outcome such as low birth weight. Fremtidssikring af kloaknet. Full Text Available Hyperemesis gravidarum is a severe manifestation of nausea and vomiting of pregnancy and it is associated with weight loss and metabolic abnormalities. It is known that abnormal laboratory values, including mildly elevated serum lipase level, could be associated with hyperemesis gravidarum.

However, in this case report details of two women with hyperemesis gravidarum but with significantly elevated serum lipase levels were discussed. These patients presented with severe nausea and vomiting but without abdominal pain. In the absence of other findings of pancreatitis, they were treated with conservative measures for hyperemesis gravidarum, with eventual resolution to normal lipase levels.

Although significantly elevated lipase level in pregnant patients with nausea and vomiting is a concern for acute pancreatitis, these two cases of significantly elevated serum lipase without other clinical findings of pancreatitis led to this report that serum lipase could be quite elevated in hyperemesis gravidarum and that it might not be an accurate biochemical marker for acute pancreatitis.

Imaging studies are thus necessary to establish the diagnosis of acute pancreatitis. Is hyperthyroidism underestimated in pregnancy and misdiagnosed as hyperemesis gravidarum? Thyroid changes are considered to be normal events that happen as a large maternal multiorganic adjustment to pregnancy.

However, hyperthyroidism occurs in pregnancy with clinical presentation similar to hyperemesis gravidarum HG and pregnancy itself. Variable frequency of both hyperthyroidism and HG worldwide might suggest the puzzlement of inclusion criteria for both diagnoses enhanced by the alternation of thyroid hormone levels assessed in normal pregnancy. Increased number of hyperthyroidism among women population without the expected rise in gestational hyperthyroidism encouraged us for creating the hypotheses that hyperthyroidism could be underestimated in normal pregnancy and even misdiagnosed as HG.

This hypothesis, if confirmed, might have beneficial clinical implications, such as better detection of hyperthyroidism in pregnancies, application of therapy when needed with the reduction of maternal or fetal consequences. Copyright Elsevier Ltd. Full Text Available Background: A year-old Caucasian man presented with intractable nausea, psychogenic vomiting, abdominal pain and compulsive hot-water bathing behaviors following the habitual use of cannabis for years, consistent with the uncommon and frequently overlooked diagnosis of Cannabinoid Hyperemesis Syndrome.

This was his third admission to the emergency department with the same complaints and symptoms which had persisted for over two years without a recognizable etiology. All imaging studies done on each visit were unremarkable. Results: The patient was clinically symptomatic with the aforementioned presenting complaints, but disappeared upon discontinuation of the cannabis. Within two days of supportive treatment in addition to temporary relief of symptoms with bathing.

To date, no effective cure has been sought for this unique diagnosis other than abstaining from cannabis use. Conclusion: A complete recovery was made three days following admission. The presenting symptoms were attributed to the smoking behaviors.

The patient was followed up by his primary care physician once released from the hospital. A very rare diagnosis surfaced a number of times with the same patient in the same setting over the span of a couple years, but was overlooked due to its rarity.

Hence, physicians should list it higher on their differentials when dealing with a patient with a history of drug abuse. Cannabinoid Hyperemesis Syndrome CHS is a rare condition that includes cyclic severe vomiting in subjects who have been consuming large doses of cannabis for several years. One of the major diagnostic criteria is the alleviation of symptoms by hot showers. The syndrome was first described in and is so far neither completely understood nor well known.

The latter leads to continued morbidity in concerned subjects and unnecessary expenses for futile investigations. Standard treatments of vomiting as 5-HT3 or D2-receptor antagonists have been shown to be ineffective in alleviating the symptoms. The only long-term satisfying treatment option is the complete abstinence from cannabis consumption.

Case Summary. In this case report we describe a year-old male Caucasian long-term cannabis consumer who repeatedly presented in our emergency room with cyclic severe nausea and vomiting ceased by hot showers and resistant to all other treatments. The final diagnosis was not established until his third visit to the ER. CHS is an important differential diagnosis in patients who present with cyclic vomiting and abdominal pain with a history of long-term cannabis use. Recognition of this syndrome is important in order to avoid unnecessary clinical testing and to help the patients break the cycle of drug use.

AF Sites. Air Force Bands U. Digitalisering af sygeplejepraksis. Metodik til studiet af strategiske ledelsesprocesser i organisationer. Neurodevelopmental delay in children exposed in utero to hyperemesis gravidarum. The purpose of this study is to determine the frequency of emotional, behavioral, and learning disorders in children exposed in utero to hyperemesis gravidarum HG and to identify prognostic factors for these disorders.

Neurodevelopmental outcomes of children from mothers with HG were compared to neurodevelopmental outcomes from children from 89 unaffected mothers. Then the clinical profiles of patients with HG and a normal child outcome were compared to the clinical profiles of patients with HG and a child with neurodevelopmental delay to identify prognostic factors.

Binary responses were analyzed using either a Chi-square or Fisher Exact test and continuous responses were analyzed using a t-test. Children exposed in utero to HG have a 3. We found no evidence for increased risk of 13 emotional, behavioral, and learning disorders, including autism, intellectual impairment, and obsessive-compulsive disorder.

However, the study was not sufficiently powered to detect rare conditions. Medications, treatments, and preterm birth were not associated with an increased risk for neurodevelopmental delay. Women with HG are at a significantly increased risk of having a child with neurodevelopmental delay. Common antiemetic treatments were not linked to neurodevelopmental delay, but early symptoms may play a role.

There is an urgent need to address whether aggressive treatment that includes vitamin and nutrient supplementation in women with early symptoms of severe nausea of pregnancy decreases the risk of neurodevelopmental delay. Consequences of hyperemesis gravidarum for offspring: a systematic review and meta-analysis. Veenendaal, M. There is evidence that hyperemesis gravidarum HG is associated with a predominance of female fetuses, lower birthweights and shorter gestational ages at birth.

As the adverse effects of prematurity and low birthweight on disease risk in later life have become increasingly clear, the repercussions. What can go wrong in hyperemesis gravidarum: Wernicke-Korsakoff syndrome in Bulawayo, Zimbabwe. Oral thiamine was administered intravenous unavailable locally. However, both the patient's condition improved in the first 48 h and progressively over a month. Initially, WKS is missed due to rare feature of full classical triad of symptoms, especially in nonalcoholics.

Energirenovering af parcelhuse. Anvendelse af alternative isoleringsmaterialer. Hyperemesis gravidarum presenting as jaundice and transient hyperthyroidism complicated with acute pancreatitis. Hyperemesis gravidarum is an extreme form of nausea and vomiting during pregnancy. It is rare for a hyperemesis gravidarum patient to present with jaundice, hyperthyroidism and idiopathic acute pancreatitis during the same hospitalization period.

Here, we report such a case. A year-old pregnant woman without underlying liver or thyroid disease was admitted due to jaundice noted for 2 days at 8 weeks of gestational age. Hyperthyroidism symptoms of tachycardia and finger tremor also bothered her. After treatment with parenteral fluid and antithyroid agents, her clinical condition improved.

However, an episode of idiopathic pancreatitis occurred after nausea and vomiting subsided. Bowel rest with parenteral fluid and nutrition supplement was given and the increased pancreatic enzyme level gradually subsided. Follow-up liver and thyroid function were normal after gestational age of 26 weeks. She delivered a healthy female baby without low birth body weight at gestational age of 39 weeks.

Rapid diagnosis and supportive care are important for the hyperemesis gravidarum patient with the complication of acute pancreatitis. For the treatment of background pain opioids were prescribed for the majority of the cancer patients.

Morphine and oxycodone were prescribed most frequently. The strong opioids were prescribed for the treatment Background pain is treated with long-acting opioids. Breakthrough pain can be treated with shorter acting non-opioid analgesics or opioids. The aim of this study Differences in the prescription of analgesics were studied. The study was performed as a cross section study of prescribed analgesics.

Data was collected Observational studies have shown that bariatric surgery can lead to remission of diabetes mellitus type 2 DMII , but randomized controlled trials have been lacking. Recently, randomized controlled trials comparing bariatric surgery with optimal medical treatment in patients suffering from poorly These trials show that bariatric surgery in general, and the malabsorptive procedures in particular, are more effective than medical treatment in achieving remission of DMII.

These procedures should therefore be considered in the treatment of patients with DMII A year-old woman was admitted to the emergency unit due to respiratory distress. Initially the blood pressure was normal. During intubation, she developed in-hospital cardiac arrest Cardio pulmonary resuscitation was initiated, but sufficient spontaneous circulation was not obtained.

We successfully initiated extracorporeal life support, and the patient survived with a good outcome A new Cochrane metaanalysis has reviewed the literature on the use of angiotensin receptor blockers ARB in patients with heart failure and left ventricular systolic dysfunction.

The conclusion supports the present recommendation from the European Society of Cardiology that angiotensin converting Artiklerne belyser vejledning af unge og vejledning af voksne. I relation til unge drejer det sig om: 1. Undervisning af tosprogede elever. Artiklen fremdrager hovedresultaterne fra Virginia P. Collier's og Wayne P. Resultaterne diskuteres i relation til udviklingen af en Lyden- af -Leg. Energirenovering af Sems Have. Energirenovering af Traneparken.

Beregning af nitratudvaskning. Of consecutive patients with acute stroke or TIA had high blood It is concluded that reduction of high blood pressure in patients with stroke or TIA is attempted too often. As autoregulation is commonly impaired in acute stroke, reduction of systemic blood pressure may enhance ischaemic tissue damage. Reduction of blood pressure in acute stroke should In 15 patients the stroke was so severe that treatment was not considered.

None of the patients had symptoms or signs of hypertensive Ny behandling af peritoneal karcinose fra kolorektal cancer. Cytoreduktiv kirurgi og hyperterm intraperitoneal kemoterapi. Peritoneal carcinomatosis PC is commonly seen in colorectal cancer and is uniformly fatal. CS includes peritonectomy procedures and resection Peritoneal perfusion with mitomycin C at a temperature of 40 degrees degrees C is performed at the end of surgery.

Median survival is years Due to the risk of intracranial haemorrhage, treatment regimens tend to be active. We present treatment data from 17 paediatric departments RESULTS: 1 In 10 of the 20 departments, which perform breast surgery, wound infections were treated by reopening the wound in most cases Ten per cent were admitted to other surgical departments and had their wounds reopened. This should include intervention at the family, school, municipal, regional and national levels, including the commercial sector and food companies.

Treating childhood obesity has not been very successful, but some comprehensive community-based treatment programmes have There is a need to establish such community-based treatments with emphasis on psychological aspects Hypophosphataemic rickets is a rare, genetic disorder resulting in defect bone mineralisation and rickets. The current medical treatment consists of phosphate supplementation and alfacalcidol, but side effects such as secondary hyperparat-hyroidism and nephrocalcinosis are common.

This treatment Bell's palsy is defined as an idiopathic peripheral facial nerve paralysis of sudden onset. It affects persons per , per annum. The available evidence from randomized controlled trials shows significant benefit from treating Bell's palsy with corticosteroids but shows no benefit from antivirals Diagnostik og behandling af maturity onset diabetes of the young type 3.

Maturity onset diabetes of the young type 3 MODY3 is the most prevalent type of monogenetic diabetes. Treatment guidelines differ from both Type 1 diabetes and Type 2 diabetes. First-line treatment is a long-acting sulphonylurea, which lowers the plasma glucose level effectively, however When hypoglycaemia is a problem, short-acting sulphonylureas, glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors may be used as alternatives.

Metformin, glitazones and sodium glucose transporter 2-inhibitors have only limited applicability in MODY Lightning strike is an unpredictable weather phenomenon which can cause a variety of injuries to the human body. We present a case report with a year-old male football player, who survived prolonged cardiac arrest after a lighting strike and then presented with multiple organ dysfunction due t We describe the clinical observations, therapy and injuries which may be expected.

Furthermore, the pathophysiology and factors influencing the survival of this patient are discussed Disease-modifying anti-rheumatic drugs til behandling af ankyloserende spondylitis. Ankylosing spondylitis AS is an inflammatory disorder affecting the axial skeleton, peripheral joints, entheses and extra-articular sites. Toxoplasmosis is a major and preventable cause of severe visual loss and blindness in young people.

Ocular toxoplasmosis is the leading cause of posterior uveitis and in most cases it represents a late manifestation of a congenital infection. The clinical picture and anti-Toxoplasma therapy It is important to inform pregnant women about prophylactic measures, and to perform a serological screening of newborns, since treatment of congenital toxoplasmosis from birth improves the prognosis There is currently no agreement on the initial evaluation programme for women referred Women with PCOS have an increased risk of the metabolic syndrome upon diagnosis and increased long-term risk of type 2 diabetes, cardiovascular disease and endometrial cancer.

In the present overview, we give recommendations for relevant follow Udgivelsesdato: Jan Balloon dilation of Eustachian tube is a novel method for managing chronic ventilatory dysfunction in patients with chronic otitis media, as an alternative to classic grommet insertion. Although few retrospective studies have been conducted the method seems to be rapid, simple and safe In the course of an uncomplicated sigmoidostomy a year-old male who had severe comorbidity developed a critical bleeding due to dabigatran intoxication induced by acute kidney injury.

Massive blood transfusions, tranexamic acid, Octaplex and haemodialysis were not effective. Pulmonary embolism PE as the direct cause of cardiac arrest is well known but probably under-diagnosed. Treatment of menorrhagia with antifibrinolytics is a well documented treatment modality and it is considered safe although thromboembolic complications have been reported.

We describe a case We present a case report with a year-old male football player, who survived prolonged cardiac arrest after a lighting strike and then presented with multiple organ dysfunction due The routine practice in the diagnosis and treatment of urinary incontinence was investigated by means of a questionnaire to which all 32 departments replied. Miction charts were employed routinely in 17 departments and for selected patients in eight departments.

Weighing of diapers was employed Mulig forbedret behandling af kolorektal cancer med sentinel lymph node-diagnostik. Possibly improved treatment of colorectal cancer by sentinel lymph node mapping Prognosis for colorectal cancer is dependent on radical surgical intervention. Chemotherapy in patients with advanced disease has improved the survival. A considerable proportion of the patients going through radical Adjuvant chemotherapy is reserved for patients with lymph node metastases, why undetected malignant lymph nodes will result in understaging and exclusion from the possible benefit of adjuvant chemotherapy.

With sentinel lymph node mapping it may be possible to detect Epilepsy surgery is done in order to obtain seizure freedom or to reduce the number of epileptic seizures in selected patients not responding to medical treatment. Few Danish children have had this treatment, most probably because of some restrictions imposed by The Danish National Health Board. We present a clinical comparison of short stretch bandage versus a two-layer compression bandage and early mobilization after split skin grafting to lower leg defects.

A total of 38 patients were included. The first group were immobilized for four days and given a short stretch support bandage. The C-T mutation does not seem to be a useful genetic marker of this syndrome. This review discusses the mineral bone disorders in patients with chronic kidney disease. We focus on the management of these conditions by administration of calcium, vitamin D ergocalciferol and cholecalciferol , vitamin D receptor activators calcitriol, alphacalcidiol , phosphate binders and In this meta-analysis, four of five placebo-controlled studies showed that antihypertensive treatment prevented stroke recurrence, most markedly in a study with a combination of an angiotensin-converting enzyme inhibitor and a diuretic.

Studies with beta-blockers were not included. Two head Antihypertensive treatment should be started or intensified in such patients Although few retrospective studies have been conducted the method seems to be rapid, simple and safe with promi Treatment with dopamin agonists, particularly cabergoline, is the primary and preferred therapy for prolactinomas and symptomatic hyperprolactinaemia due to its effectiveness and tolerability.

However, an association has been demonstrated between fibrotic heart valve disease and high-dose dopamin Such observations have prompted a number of studies of valvular function in cabergoline-treated hyperprolactinaemia patients. These studies have failed to show an increased prevalence of clinically significant valvular Until now, ethosuximide ESM , sodium valproate VPA and lamotrigine have been considered the drugs of choice in the management of childhood absence epilepsy, and there has been no high-validated evidence to distinguish their effects.

In situations involving serious bleeding and anaemia, a refusal of blood transfusion puts the clinician in an ethical and medical dilemma, as standard treatment is not an option, and the patient risks dying of a potentially reversible cause. This status article describes methods of treatment under This is in contrast to Danish legislation regarding informed consent, where adolescents aged 15 years can consent to The first group were immobilized for four days and given a short stretch support bandage We report that haemostasis was obtained by the use of SEMS in two patients with bleeding oesophageal varices which failed conventional therapy vasoactive drugs, antibiotics, endoscopy, and Sengstaken balloon tamponade.

One patient subsequently died of sepsis; the other was treated with TIPS Organtransplanterede patienter har behov for intensiv kontrol og behandling af hudcancer. Field-directed rather than lesional therapy is preferred for actinic keratosis in field-cancerized skin; and high-efficacy therapies are recommended in NMSC due to an increased risk of recurrences and metastases The two groups were compared with respect to demographic data, length of hospital stay, number of glands harvested The aim of this study was to compare the outcome of laparoscopic versus open resection for right-sided colon cancer.

The results and the thesis that LRH will result in fewer hernias and better cosmetic outcomes makes LRH a promising surgical procedure Certain groups of patients may benefit from adjuvant systemic treatment. However larger randomized trials are needed This review investigates existing literature concerning relevant Systematic process triage is a relatively unknown concept in Denmark.

Currently there are no national recommendations regarding triage models for use in the emergency department ED. Four medium-sized EDs from different regions across the country cooperated in a joint venture to develop a new The main factors that drive them to this are the aim, the hope, the belief, and knowledge how to cure diabetes. The existing studies mostly based on quantitative methods of patients with diabetes Behandling af ustabil angina pectoris.

Questionnaires about therapy in unstable angina pectoris were sent to 63 Danish medical departments and were answered by 52 departments Nitroglycerin is commonly used but only in half of the departments is Nitroglycerin administered intravenously. Calcium-receptor-blockers are used in more Ventetid og omkostninger ved diagnostik og behandling af stabil angina pectoris.

Introduction: The objective of this pilot study was to examine possible consequences of a logistically non-optimal regimen, for the diagnosis and treatment of stable angina pectoris, on waiting time and costs to inform whether a larger study is warranted. Material and methods: Retrospective cohort Data on the diagnostic regimen was systematically collected from patient files and data on other resource use was collected using a questionnaire for self- reporting.

Non-parametric bootstrapping was applied. However, these potentials should be examined in a larger- scale study Gallbladder stones will rarely lead to colic pain attacks and even more seldom to complications. A conservative watchful waiting strategy may be an alternative to cholecystectomy for uncomplicated symptomatic gallbladder stone disease.

Evidence for whether the optimal treatment should be cholecys This narrative-condensed review critically analyses current evidence with special focus on epidemiological risk factors of developing symptoms or complications related to gallbladder stones. The evidence for treatment is discussed This article presents recommendations regarding early management of patients after intake of corrosive chemicals, based on best evidence and clinical experience.

Risk assessment built on clinical history, presentation and endoscopy is discussed as well as initial treatment, surgical appraisal All the patients were given antibiotics. Group 2 were mobilized one day after the operation with a two-layer compression bandage Pro-Guide. There was no difference in healing or frequency of complications. The patients treated with Pro-Guide had significantly fewer admission days and out-patient consultations.

Larger randomized trials Faecal transplantation as a treatment for Clostridium difficile infection, ulcerative colitis and the metabolic syndrome Faecal transplantation as a therapeutic tool is increasingly reported in the scientific literature. Faecal transplantation is currently becoming a treatment for nosocomial Furthermore, faecal transplantation has been suggested as a treatment for ulcerative colitis as well as for the metabolic syndrome.

In the accumulated literature faecal transplantations appear to be safe, effective and superior to current treatments. Delirium is a common and often under-recognised neuropsychiatric disorder in paediatric critical care, secondary to a general medical condition. Paediatric delirium PD is associated with high morbidity and mortality and prolonged stay at the intensive care unit.

This review introduces the reader The purpose of this master thesis is to examine the field of research with relevance to the topic geriatric malnutrition in order to propose recommendations that can stimulate the appetite, increase food intake, and stabilize the nutritional status of the geriatric patient at risk of malnutrition. Based on these searches an analysis of the Congenital melanocytic naevi CMN appear in approximately 2.

There is a major demand for treatment but no vital indication. Laser therapy, curettage and excision are available treatment modalities, but there is no ideal treatment with documented long-term effect and without side Retrograd intrarenal stenkirurgi--en minimalinvasiv metode til behandling af nyresten. Retrograde intrarenal stone surgery RIRS is a safe and effective minimally invasive method for the treatment of minor ESWL-resistant kidney stones where resistance is due e.

Severe sepsis is a leading cause of death characterised by infection-induced endothelial and cardiac dysfunction leading to hypovolaemia, maldistribution of flow, tissue ischaemia and organ failure. A clinical approach with focus on cardiovascular diagnostics and rational goal-directed therapy The majority of patients During recent years, azathioprine has been increasingly replaced by mycophenolate mofetil. Currently, age-related macular degeneration AMD is untreatable, except for its neovascular complications.

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It has a powerful insulinotropic effect and stimulates beta-cell growth and is therefore being developed for treatment of type 2 diabetes. Hyperparathyroidism is frequent. The immunosuppressive regimens used for kidney-transplanted patients are currently changing Lyden af musik - er lyden af idealisme. Styring af kommunal digitalisering.

Med udgangspunkt i en konkret kommune analyseres styringen af digitalisering gennem et hierarki af offentlige digitaliseringsstrategier. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial. All participants also received thiamine and an antiemetic intravenously.

Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being by point visual numerical rating scale at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours. Persistent ketonuria rates after the hour study period were 10 of 9.

Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different. Skoling af lyst. I afhandlingen udvikles to teoretisk-analytiske optikker: Skolen som ideologisk rum - med inspiration fra Slavoj Zizeks ideologikritik, samt Skolen som affektivt Om distributionen af hvidhed.

Udforskning af journalistiske moralnormer. Kirsten Mogensen beskriver professionelle journalistiske normer. Metoden er en kombinatio En verden af medier. Ensretning af historieundervisningen. Dette udvalg havde regeringen nedsat; men bid Det vises, at flere kanonpunkter ikke er fagligt funderede, men af mytologisk art Globalisering af uddannelse.

Livscyklusvurdering af basiskemikalier. Digital formidling af kulturarv. Digital formidling af kulturarv Af Upraktiske Grunde. A woman with thyrotoxicosis- and hyperemesis gravidarum-associated Wernicke's encephalopathy. Although hyperthyroidism arising from primary thyroid disease is rare in pregnancy, transient gestational hyperthyroidism is not uncommon.

This condition can be associated with hyperemesis gravidarum HG , and Wernicke's encephalopathy. We present the case of a woman with toxic nodular goiter complicating HG-associated Wernicke's encephalopathy. A year-old Caucasian woman, who had received a diagnosis of hyperthyroidism and HG early in her pregnancy, had intrauterine fetal death at Week 16 of gestation. One day after undergoing therapeutic abortion, she was admitted to our clinic with persistent thyrotoxicosis, nausea, and vomiting.

A toxic thyroid nodule was detected. She was given antithyroid medication, total parenteral nutrition. On Day 10 of hospitalization, she developed ataxia, aphasia, and somnolence. Cranial magnetic resonance imaging showed increased bilateral thalamic signalization. She was given a diagnosis of Wernicke's metabolic encephalopathy, for which she received thiamine and multivitamin preparations.

She responded dramatically on the second day of thiamine therapy. Her consciousness improved rapidly and she began to speak. Her muscle tone was slightly weak and she had paresthesias in both legs. Absorption of thiamine may be particularly impaired in pregnant women with hyperemesis and hyperthyroid disease.

Wernicke's encephalopathy should be considered in hyperthyroid women with HG who develop neurological abnormalities. Full Text Available Cannabinoid hyperemesis syndrome CHS is a rare constellation of clinical findings that includes a history of chronic heavy marijuana use, severe abdominal pain, unrelenting nausea, and intractable vomiting.

A striking component of this history includes the use of hot showers or long baths that help to alleviate these symptoms. This is an underrecognized syndrome that can lead to expensive and unrevealing workups and can leave patients self-medicating their nausea and vomiting with the very substance that is causing their symptoms.

Long-term treatment of CHS is abstinence from marijuana use—but the acute symptomatic treatment of CHS has been a struggle for many clinicians. Many standard medications used for the symptomatic treatment of CHS including ondansetron, promethazine, and morphine have repeatedly been shown to be ineffective. Here we present the use of lorazepam as an agent that successfully and safely treats the tenacious symptoms of CHS.

Additionally, we build upon existing hypotheses for the pathogenesis of CHS to try to explain why a substance that has been used for thousands of years is only now beginning to cause this paradoxical hyperemesis syndrome. Desk study underbygger dette ved at pointere, at patientskole med Cannabinoid hyperemesis syndrome: potential mechanisms for the benefit of capsaicin and hot water hydrotherapy in treatment.

Cannabinoid hyperemesis syndrome is a clinical disorder that has become more prevalent with increasing use of cannabis and synthetic cannabinoids, and which is difficult to treat. Standard antiemetics commonly fail to alleviate the severe nausea and vomiting characteristic of the syndrome.

Curiously, cannabinoid hyperemesis syndrome patients often report dramatic relief of symptoms with hot showers and baths, and topical capsaicin. In this review, we detail the pharmacokinetics and pharmacodynamics of capsaicin and explore possible mechanisms for its beneficial effect, including activation of transient receptor potential vanilloid 1 and neurohumoral regulation.

Putative mechanisms responsible for the benefit of hot water hydrotherapy are also investigated. An extensive search of PubMed, OpenGrey, and Google Scholar from inception to April was performed to identify known and theoretical thermoregulatory mechanisms associated with the endocannabinoid system. The searches resulted in articles. These articles were screened for relevant mechanisms behind capsaicin and heat activation having potential antiemetic effects.

References from the selected articles were also hand-searched. A total of articles were considered relevant and included. Capsaicin: Topical capsaicin is primarily used for treatment of neuropathic pain, but it has also been used successfully in some 20 cases of cannabinoid hyperemesis syndrome. The pharmacokinetics and pharmacodynamics of capsaicin as a transient receptor potential vanilloid 1 agonist may explain this effect.

Topical capsaicin has a longer half-life than oral administration, thus its potential duration of benefit is longer. Capsaicin and transient receptor potential vanilloid 1: Topical capsaicin binds and activates the transient receptor potential vanilloid 1 receptor, triggering influx of calcium and sodium, as well as release of inflammatory neuropeptides leading to transient burning, stinging, and itching.

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