The analysis found that in semi-enclosed method (mean DSS APACHE II 14,0) mortality was 18.6%, with rejection of technique, 59.1%, with semi-open way of reference, provides for 100% use of the method, mortality was 25, 9% (mean DSS APACHE II 15,1). In the group with a complicated course (mean DSS APACHE II 16,1) mortality after application of the method was 59.1%, with rejection of the method - 33,3%. As seen from the results, the expected correlation is absent in the group with a complicated course. Apparently, this is due to the fact that pre-operative patient status at the RSE does not always determine the absence of complications such as failure of the anastomosis of the gastrointestinal tract, occurring usually at 4-6 days after surgery. Of the 13 deceased patients, 7 (54%) developed anastomotic failure or necrosis of the hollow body; of the 15 survivors - only 3 have developed such complications (20%). Determine the total performance indicator method of intestinal intubation and peritoneal-enteral lavage (calculated mortality difference when applying the method and without him in when he was shown). It is at the RSE 29.5%. Thus, in the presence of purulent peritoneal exudate method does not provide a warning most severe complications, but is primarily a component of detoxification.
When semi-enclosed method of total mortality was 10.1%, which defines a group of patients whose treatment may have should be different. The main reasons for the negative results of treatment are underestimating the early signs of organ dysfunction, existing prior to the operation and development of thromboembolic complications. The most informative symptoms correlated with the nature of the exudate were mean arterial pressure, the rate of Glasgow coma scale and frequency of respiratory movements. The bulk of deaths observed in the purulent exudate (19%). With a score of APACHE II> 20 mortality was more than two-thirds (by APACHE II> 30 - 100%), resulting in these cases, the need to clearly justify the refusal of the landmark renovation of the abdominal cavity, or their conduct.
Analysis of the results in the first two groups suggests that the excess value of APACHE II score of 14 is responsible for at least 10%-ing mortality, but at the same time, the lack of classic symptoms of SIRS is not determinative in the choice of tactics. Perhaps there was an element of overdiagnosis, or to determine the half-open tactics of greater importance was given to the characteristics of the exudate, not the symptoms pointing to the generalization of the inflammatory process. Thus, from this group of patients could be treated effectively using semi-method. The presence of preoperative dysfunction of one of the systems at the most seemingly uncompromising - half-open method determines the death of a quarter of patients. On the other hand the presence of symptoms of SIRS can be observed before the operation and fibrinous and serous fluid. Therefore, to better forecast should have a value of resistance in negative symptoms and treatment efficacy in the first day after surgery.
In the group with a complicated course of mortality was 46%. The main factor behind this figure is the late diagnosis (diagnostic time, 150 hours). The main indications for repeated operations were: in 56% of the further development of common inflammation of the peritoneum (the inadequate evaluation of the reorganization of the abdominal cavity, the underestimation of the activity of microorganisms, inadequate drainage, etc.) and in 14% necrosis of the walls of the hollow body, a 21% failure of the anastomosis in 4 % otgranichenny peritonitis. Treatment of patients in this group after repeated operations conducted mostly semi-open way.
Timely and correct prediction of adverse flow is an important task that affects a significant reduction in mortality. Found that when the interval ADD APACHE II [0-10] there was no mortality. Therefore, the use of semi-open technique in cases where a semi-closed totally effective, must be regarded as unjustified, based on hyperdiagnosis RSE, overestimation of symptoms MON, sometimes on a subjective simplification of the indications for a landmark bailouts. In the interval ADD APACHE II [11-15] half-open method has the greatest comparative effectiveness. 2.3 Application of landmark rehabilitation of these patients does not lead to a substantial aggravation of the patient, which determines its relatively high efficiency (reduction of mortality up to 11,5%). When DSS APACHE II> 15 semi efficiency method has no significant advantage before the half-closed manner. When DSS APACHE II> 25 observed 100% mortality regardless of surgical approach (Table 2).
Criteria for the severity of surgical brand viagra infection and quantitative markers of multiple organ failure correlated with preoperative indicators of IIP scales and APACHE II and treatment outcomes. The potential need for semi-open method for the treatment of purulent peritonitis (RSE), which determines mortality in semi-enclosed method is 22%.
The choice of semi method for the treatment of RSE most caused by the absence of mortality in the range of APACHE II ADD ot0 to 10.
Application of semi-open technique is useful when DSS APACHE II ot11do15 and not justified by DOB APACHE II <11.
Definition of indications and complications of high-quality diagnosis still presents considerable difficulties. The presence of dysfunction of two or more organ systems is an opportunity for a semi-open way of managing patients with RP. Dysfunction of the cardiovascular, respiratory system, central nervous system may contribute to the development of complicated postoperative course in the application of a half-closed technique. The undoubted effectiveness of bowel decompression and organo-complex resuscitation measures in purulent peritonitis promotes simplification of the indications for this method and makes giperdiagnosticheskie trends.
Conclusions: 1. The most important tasks in the treatment of RSE are to reduce the diagnostic time in complicated PD and the correct definition of the indications for semi-enclosed and semi-open method of surgical treatment.
2. The preferred method of decompression of the gastrointestinal tract is the total nasogastrointestinal intubation combined with peritoneal-enteral lavage, which, as an independent method, the decrease in mortality to 29% in disseminated purulent peritonitis, and is one of the major components of the complex detoxification of the postoperative period.
3. The greatest difference in mortality in the DSS APACHE II of 11 and 15 causes is preferable to use a semi-open technique for ascertaining DSS in this interval. If you score APACHE II <11 should only be used semi-closed method.
4. The correct diagnosis of complications can be determined by preoperative and follow-up based on the scales assessing the severity of abdominal infection.
Review CNS
opposite effect
long time
myocardial infarction
using diet
quarta-feira, 26 de janeiro de 2011
quinta-feira, 20 de janeiro de 2011
First attempt
Well-known American opera singer back on stage a few months after transplantation of both lungs, according to Fox News. 28-year-old Charity Sunshine Tilleman-Dick (Charity Sunshine Tillemann-Dick) first appearance before the public on May 26 summit, organized by the Cleveland Clinic.
Before the start of their illness winner brand viagra online coloratura soprano Charity Sunshine performed with great success in the best concert halls in the U.S. and Europe. But in 2004, a 21-year-old girl was found of primary pulmonary hypertension - a killer disease, leading to a breach of the blood supply of light and reduce the pumping function of the right ventricle. For several years, the singer went on concert work, struggling with progressive disease, but since early 2009 because of the deteriorating state of health she had to cancel about a hundred speeches.
Doctors warned Charity that her only chance for survival is a transplant donor lungs. The operation was carried out girl in September 2009, surgeons at the Cleveland Clinic.
The first attempt to return to singing Charity has taken several weeks after hospital discharge. At first she tried to perform relatively simple jazz and folk songs. In March this year the singer has resumed training with his old teacher and once again able to carry out some works from its repertoire.
First public appearance Charity Sunshine Tilleman-Dick held on 26 May at the summit of the patients experience, organized by the Cleveland Clinic. "Back to Cleveland to sing here - a dream come true, especially considering that since the operation less generic viagra than a year. It's a miracle, and I am very glad that I can share it with the audience" - the singer said in an interview before the performance.
how not to get sick
diabetes treatment
sweeteners
infusion
Before the start of their illness winner brand viagra online coloratura soprano Charity Sunshine performed with great success in the best concert halls in the U.S. and Europe. But in 2004, a 21-year-old girl was found of primary pulmonary hypertension - a killer disease, leading to a breach of the blood supply of light and reduce the pumping function of the right ventricle. For several years, the singer went on concert work, struggling with progressive disease, but since early 2009 because of the deteriorating state of health she had to cancel about a hundred speeches.
Doctors warned Charity that her only chance for survival is a transplant donor lungs. The operation was carried out girl in September 2009, surgeons at the Cleveland Clinic.
The first attempt to return to singing Charity has taken several weeks after hospital discharge. At first she tried to perform relatively simple jazz and folk songs. In March this year the singer has resumed training with his old teacher and once again able to carry out some works from its repertoire.
First public appearance Charity Sunshine Tilleman-Dick held on 26 May at the summit of the patients experience, organized by the Cleveland Clinic. "Back to Cleveland to sing here - a dream come true, especially considering that since the operation less generic viagra than a year. It's a miracle, and I am very glad that I can share it with the audience" - the singer said in an interview before the performance.
how not to get sick
diabetes treatment
sweeteners
infusion
domingo, 9 de janeiro de 2011
Azlocillin
The second stage begins after the results of bacteriological tests. Complicated intra-abdominal infections in terms of antibiotic therapy is a very complicated problem due to polymicrobial nature, are not always detectable in microbiological research.
When choosing schemes of antibacterial therapy should be observed staged treatment, designation as a means of initial therapy with broad-spectrum agents to take into account anticipated, and their sensitivity to antibiotics. The first correction therapy is carried out after 1836 hours on the basis of antibiotikogrammy, repeated for 34 days according to the full bacteriological examination [7, 8].
Empirical ABT complicated intra-abdominal infections
The choice of empiric AT based on the following factors:
specific clinical situation in view of the etiology, location and duration of the pathological process;
intraoperative findings, including the characterization of peritoneal exudate;
the presence of patient risk factors and brand viagra comorbidities, evaluation of multiple organ dysfunction;
microbiological landscape offices and clinics;
information about the resistance of pathogens to antibiotics [3, 5, 7].
Empiric antibiotic therapy is conducted with mandatory accounting polymicrobial etiology of intra-abdominal infection with E.coli, other Enterobacteriaceae and anaerobes, mainly, Bacteroides fragilis. Effective control of these pathogens can be achieved by using two tactical options: combination therapy or mototerapii.
In many cases, intra-abdominal surgical infections have traditionally used a combination of an aminoglycoside with a b-lactam drugs with antianaerobnoy activity or linkosamidami [1, 2, 3, 5, 6, 7]:
aminoglycoside + piperacillin or azlocillin + metronidazole;
cephalosporin + aminoglycoside I, II, III generation + metronidazole;
aminoglycoside + clindamycin.
Combination antibiotic therapy is shown in the following clinical situations:
polymicrobial in etiology of the pathological process
with peritonitis of any cause
with severe sepsis and septic shock
in the presence of a surgical patient's immune
the allocation of resistant pathogens
when a secondary ekstraabdominalnyh foci of infection associated with nosocomial infection.
Despite the fairly high efficiency of combinations of aminoglycosides with other antibiotics in the treatment of intra-abdominal infection and sepsis, this tactic is not without drawbacks, due viagra Is it possible Viagra will help you to side effects and development of resistance.
Effective monotherapy in complicated intra-abdominal infection was made possible by the introduction of new broad-spectrum drugs antipseudomonal IZP: piperacillin / tazobactam, tikartsilina / klavulanta; IV generation cephalosporins (cefepime) and carbapenems (imipenem, meropenem) [1, 2, 5, 9]. In many clinical situations, intra-abdominal surgical infection of one of these agents (carbapenems, IZP, cefepime) or in combination with antianaerobnym means sufficient for clinical efficacy, even higher than when using a combination of aminoglycosides with other antibiotics. Clinical and bacteriological efficiency of b-lactams for abdominal sepsis are tall enough to account for piperacillin / tazobactam, cefepime c metronidazole and meropenem, respectively, 79,6%, 82,6% and 84,6%. Thus, in severe abdominal sepsis with the severity of more than 15 points on the APACHE II most efficient use of carbapenems [1, 2].
First heaviness
help the body
Dizziness
When choosing schemes of antibacterial therapy should be observed staged treatment, designation as a means of initial therapy with broad-spectrum agents to take into account anticipated, and their sensitivity to antibiotics. The first correction therapy is carried out after 1836 hours on the basis of antibiotikogrammy, repeated for 34 days according to the full bacteriological examination [7, 8].
Empirical ABT complicated intra-abdominal infections
The choice of empiric AT based on the following factors:
specific clinical situation in view of the etiology, location and duration of the pathological process;
intraoperative findings, including the characterization of peritoneal exudate;
the presence of patient risk factors and brand viagra comorbidities, evaluation of multiple organ dysfunction;
microbiological landscape offices and clinics;
information about the resistance of pathogens to antibiotics [3, 5, 7].
Empiric antibiotic therapy is conducted with mandatory accounting polymicrobial etiology of intra-abdominal infection with E.coli, other Enterobacteriaceae and anaerobes, mainly, Bacteroides fragilis. Effective control of these pathogens can be achieved by using two tactical options: combination therapy or mototerapii.
In many cases, intra-abdominal surgical infections have traditionally used a combination of an aminoglycoside with a b-lactam drugs with antianaerobnoy activity or linkosamidami [1, 2, 3, 5, 6, 7]:
aminoglycoside + piperacillin or azlocillin + metronidazole;
cephalosporin + aminoglycoside I, II, III generation + metronidazole;
aminoglycoside + clindamycin.
Combination antibiotic therapy is shown in the following clinical situations:
polymicrobial in etiology of the pathological process
with peritonitis of any cause
with severe sepsis and septic shock
in the presence of a surgical patient's immune
the allocation of resistant pathogens
when a secondary ekstraabdominalnyh foci of infection associated with nosocomial infection.
Despite the fairly high efficiency of combinations of aminoglycosides with other antibiotics in the treatment of intra-abdominal infection and sepsis, this tactic is not without drawbacks, due viagra Is it possible Viagra will help you to side effects and development of resistance.
Effective monotherapy in complicated intra-abdominal infection was made possible by the introduction of new broad-spectrum drugs antipseudomonal IZP: piperacillin / tazobactam, tikartsilina / klavulanta; IV generation cephalosporins (cefepime) and carbapenems (imipenem, meropenem) [1, 2, 5, 9]. In many clinical situations, intra-abdominal surgical infection of one of these agents (carbapenems, IZP, cefepime) or in combination with antianaerobnym means sufficient for clinical efficacy, even higher than when using a combination of aminoglycosides with other antibiotics. Clinical and bacteriological efficiency of b-lactams for abdominal sepsis are tall enough to account for piperacillin / tazobactam, cefepime c metronidazole and meropenem, respectively, 79,6%, 82,6% and 84,6%. Thus, in severe abdominal sepsis with the severity of more than 15 points on the APACHE II most efficient use of carbapenems [1, 2].
First heaviness
help the body
Dizziness
domingo, 2 de janeiro de 2011
Genetics determines
Jews constitute 0.25% of the population, they accounted for 27% of all Nobel Prizes.
Albert Einstein in his office in Princeton (USA), 1939
Study of the American geneticist Henry Hamperdinga and Gregory Kochrana, which has been more than a year excites the world scientific community, given a new impetus - a prestigious publishing house «Cambridge University Press» decided to publish their work as the Internet, and in his journal «Journal of Biosocial Science» .
The essence of the investigation concerns a very small matter: the Ashkenazi Jews, ie, the Jews of Europe, almost destroyed by the Nazis, it turns out, genetically smarter than everyone else. According to the authors of the study, the higher intelligence of Ashkenazi Jews is linked with their usual hereditary diseases - such as Tay-Sachs and Niemann-Pick.
These diseases - not the plague, but not cold, they are brand name viagra much rarer, and both are deadly. Tay-Sachs disease, kills every 25-th Ashkenazi for about Millennium, and now seems to be poutihshaya is a genetic mutation that causes children progressive disorder of the central nervous system - hardly anyone of these people live to the age of four. The sharp decline in the incidence of this plague the U.S. and Israel in recent years due primarily to the fact that young couples prefer to conduct genetic testing of the fetus and in the case of "positive" reaction of the pregnancy terminated. Niemann-Pick disease - also an inherited disease that can lead not only to the central nervous system disorders, but also to dysfunction of the liver and spleen. Too often ends lethal.
Hamperding and Kochran argue that these diseases are responsible for higher mental capacities of the Jews, since they lead, in particular, to an increase in dendritic (branched woody shoots from the nerve cells) in the brain. "It happened in the genetic evolutionary process - the authors say the study - as a result of the discrimination to which Jews were in the ghettos of medieval Europe." Moreover, they believe that only through this deadly disease and the Jews managed to survive, since the Middle Ages, they were allowed to engage only forbidden to Christians professions, such as a trader, the tax collector, pawnbroker, etc., and each of these professions demanded by human mathematical abilities and level of mental development is above average.
In fact, it is not clear where is the chicken and which the egg - it is high intelligence, attributed to the Jews, was the cause of anti-Semitic paranoia in the Middle Ages, so it may be that these deadly genetic mutations, making them smart, once again turned in the persecuted. And much of what these Lucky mutations occurred is anyone's guess ...
And this is only if Hamperding with Kochranom right. What is the big question, because almost the entire scientific establishment in the U.S. fell upon them with criticism, they had hardly dared to speak with his hypothesis. Many of their opponents considered the hypothesis of a "dangerous" and "racist", reminisced about the XVI century, when Luther asserted that Jewish doctors are so smart that prepared a poison that can kill a Christian for less than one day - if it caused a real storm of anti-Semitic.
But they are right or wrong, but the fact remains - the scientists remind us that "the history of the last two hundred years, decorated with many Jewish names of scientists, philosophers, representatives of the intellectual world, such as Oppenheimer, Einstein, Freud, Marx, Kafka, Bellow, Levi Strauss, Allen, Dylan ... ". Number, of course, not too steady, but not given, and statistics: "Despite the fact that Jews make up only 0.25% of the population, they accounted for 27% of all Nobel prizes and 50% of world chess champion." With that something like that be?
Corresponding Member of RAS, Leonid Korochkin, one of the leading Russian geneticists in this field, believes that the buzz around the research and Hamperdinga Kochrana exaggerated.
"The debate is largely far-fetched, - said Professor Korochkin told Nezavisimaya Gazeta. - Intellectual superiority - the concept is very questionable, especially if we mean any group of people.
Neater and more precise - the high intelligence of Ashkenazi caused by both genetic and social conditions. Among the many prominent Jewish scholars? Remarkably, then, fellows Jews who cherish and nurture talent and provide them with all the conditions for implementation! And where will the Nobel laureates at us in Russia, where after the October Revolution, Lenin, first sent abroad, the color of the nation, then, Stalin destroyed thousands of this same color. And now officials are doing their best to extinguish the few foci of true science, which still continues to smolder! So that the persecution does not contribute to the flowering of the mind! "
Korochkin not believe that it is genetics determines the intellectual superiority of the Ashkenazi. According to him, an increased number of dendrites in the brain has not said anything.
"Just this alone is not enough to improve the mental activity - underlines the Leonid Korochkin. - And in general the question arises: Are there any skills and talents associated with national identity? Great African poet and philosopher Leopold Senghor, who was in racism does not suspect, believed that the Creator created the races white, black and yellow in accordance with the three properties of the human psyche - rationality, intuition and emotions. These properties are inherent in all three races, but each is characterized by preferential expression of one of them. White - particularly rational, emotional, black and yellow are known by intuition. And all together due to the development of these qualities provide the best incarnation of the divine plan. You can certainly argue about the views of Senghor, but certain behavioral traits and inclinations may be associated with belonging to a particular nation. I think that no one will argue with the fact that the Italians - the world's best singers, the Brazilians - the world's best players, the Jews - the best violinists. Russian and Germans have traditionally been strong in chemistry, philosophy and aviation, the Japanese - in the applied sciences. This does not mean that other nations do not contribute significantly to these areas of human creativity. Agreement with this is not in any way racist. Racism - is the recognition of any one nation stands above all others and designed to dominate others. Such an argument is unacceptable. Before God all are equal! There is no higher and lower, good and bad races and nations. There are good and bad people. And in every nation of plenty. A study is good or bad can people of different nationalities. In our class there were two of the best student: I - Russian and my bosom friend - a Jew. And two were worse. And also - one of them Russian, the other - a Jew. "
In short, the question is not thin, and thin. And there is a good rule of thumb - if the issue is complicated and you do not know how to answer it, answer like tell you not logic and conscience. In this case, this was the maxim of which just above stated.
Measurement
Vegetable
Albert Einstein in his office in Princeton (USA), 1939
Study of the American geneticist Henry Hamperdinga and Gregory Kochrana, which has been more than a year excites the world scientific community, given a new impetus - a prestigious publishing house «Cambridge University Press» decided to publish their work as the Internet, and in his journal «Journal of Biosocial Science» .
The essence of the investigation concerns a very small matter: the Ashkenazi Jews, ie, the Jews of Europe, almost destroyed by the Nazis, it turns out, genetically smarter than everyone else. According to the authors of the study, the higher intelligence of Ashkenazi Jews is linked with their usual hereditary diseases - such as Tay-Sachs and Niemann-Pick.
These diseases - not the plague, but not cold, they are brand name viagra much rarer, and both are deadly. Tay-Sachs disease, kills every 25-th Ashkenazi for about Millennium, and now seems to be poutihshaya is a genetic mutation that causes children progressive disorder of the central nervous system - hardly anyone of these people live to the age of four. The sharp decline in the incidence of this plague the U.S. and Israel in recent years due primarily to the fact that young couples prefer to conduct genetic testing of the fetus and in the case of "positive" reaction of the pregnancy terminated. Niemann-Pick disease - also an inherited disease that can lead not only to the central nervous system disorders, but also to dysfunction of the liver and spleen. Too often ends lethal.
Hamperding and Kochran argue that these diseases are responsible for higher mental capacities of the Jews, since they lead, in particular, to an increase in dendritic (branched woody shoots from the nerve cells) in the brain. "It happened in the genetic evolutionary process - the authors say the study - as a result of the discrimination to which Jews were in the ghettos of medieval Europe." Moreover, they believe that only through this deadly disease and the Jews managed to survive, since the Middle Ages, they were allowed to engage only forbidden to Christians professions, such as a trader, the tax collector, pawnbroker, etc., and each of these professions demanded by human mathematical abilities and level of mental development is above average.
In fact, it is not clear where is the chicken and which the egg - it is high intelligence, attributed to the Jews, was the cause of anti-Semitic paranoia in the Middle Ages, so it may be that these deadly genetic mutations, making them smart, once again turned in the persecuted. And much of what these Lucky mutations occurred is anyone's guess ...
And this is only if Hamperding with Kochranom right. What is the big question, because almost the entire scientific establishment in the U.S. fell upon them with criticism, they had hardly dared to speak with his hypothesis. Many of their opponents considered the hypothesis of a "dangerous" and "racist", reminisced about the XVI century, when Luther asserted that Jewish doctors are so smart that prepared a poison that can kill a Christian for less than one day - if it caused a real storm of anti-Semitic.
But they are right or wrong, but the fact remains - the scientists remind us that "the history of the last two hundred years, decorated with many Jewish names of scientists, philosophers, representatives of the intellectual world, such as Oppenheimer, Einstein, Freud, Marx, Kafka, Bellow, Levi Strauss, Allen, Dylan ... ". Number, of course, not too steady, but not given, and statistics: "Despite the fact that Jews make up only 0.25% of the population, they accounted for 27% of all Nobel prizes and 50% of world chess champion." With that something like that be?
Corresponding Member of RAS, Leonid Korochkin, one of the leading Russian geneticists in this field, believes that the buzz around the research and Hamperdinga Kochrana exaggerated.
"The debate is largely far-fetched, - said Professor Korochkin told Nezavisimaya Gazeta. - Intellectual superiority - the concept is very questionable, especially if we mean any group of people.
Neater and more precise - the high intelligence of Ashkenazi caused by both genetic and social conditions. Among the many prominent Jewish scholars? Remarkably, then, fellows Jews who cherish and nurture talent and provide them with all the conditions for implementation! And where will the Nobel laureates at us in Russia, where after the October Revolution, Lenin, first sent abroad, the color of the nation, then, Stalin destroyed thousands of this same color. And now officials are doing their best to extinguish the few foci of true science, which still continues to smolder! So that the persecution does not contribute to the flowering of the mind! "
Korochkin not believe that it is genetics determines the intellectual superiority of the Ashkenazi. According to him, an increased number of dendrites in the brain has not said anything.
"Just this alone is not enough to improve the mental activity - underlines the Leonid Korochkin. - And in general the question arises: Are there any skills and talents associated with national identity? Great African poet and philosopher Leopold Senghor, who was in racism does not suspect, believed that the Creator created the races white, black and yellow in accordance with the three properties of the human psyche - rationality, intuition and emotions. These properties are inherent in all three races, but each is characterized by preferential expression of one of them. White - particularly rational, emotional, black and yellow are known by intuition. And all together due to the development of these qualities provide the best incarnation of the divine plan. You can certainly argue about the views of Senghor, but certain behavioral traits and inclinations may be associated with belonging to a particular nation. I think that no one will argue with the fact that the Italians - the world's best singers, the Brazilians - the world's best players, the Jews - the best violinists. Russian and Germans have traditionally been strong in chemistry, philosophy and aviation, the Japanese - in the applied sciences. This does not mean that other nations do not contribute significantly to these areas of human creativity. Agreement with this is not in any way racist. Racism - is the recognition of any one nation stands above all others and designed to dominate others. Such an argument is unacceptable. Before God all are equal! There is no higher and lower, good and bad races and nations. There are good and bad people. And in every nation of plenty. A study is good or bad can people of different nationalities. In our class there were two of the best student: I - Russian and my bosom friend - a Jew. And two were worse. And also - one of them Russian, the other - a Jew. "
In short, the question is not thin, and thin. And there is a good rule of thumb - if the issue is complicated and you do not know how to answer it, answer like tell you not logic and conscience. In this case, this was the maxim of which just above stated.
Measurement
Vegetable
Assinar:
Postagens (Atom)