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Sociālo veselību noteicošo faktoru ietekme uz sirds un asinsvadu veselību un ģimenes ārsta loma kā netiešo modifikatoru
No full textMedicīnaVeselības aprūpeMedicineHealth CareBackground: Cardiovascular diseases (CVD) are the leading cause of mortality among both genders older than the age of 45 years. The Social Determinants of Health (SDoH) determined in 2003 by the World Health Organization (WHO) are defined as the circumstances in which the individual is born, grows, works, lives, and age. SDoH are the underlying determinants, known as non-medical risk factors for CVD, shaping cardiovascular health (CVH). As the medical risk factors for CVD are well studied, the purpose of this literature review is to examine and emphasise the crucial interaction between SDoH and CVD with a focus on the role of general practitioners (GPs). Moreover, existing intervention strategies, current action goals, and possible further approaches are highlighted.
Methods: A thematic, systematic, and comprehensive literature search using digital evidence-based medical databases, as well as E-books and E-journals was conducted from January to February 2024. Data were accessed digitally using the key words ‘social determinants of health’ and ‘cardiovascular diseases’. Subsequently, only relevant articles were selected for in-depth analysis, excluding articles exceeding a decade in age. Older documents published by international organisations or government institutions were included because of their historical and enduring relevance.
Results: The impact of SDoH on CVH is omnipresent in all six domains identified by the WHO. These domains have been shown to be interconnected, complicating targeted interventions. Socially marginalized groups, particularly ethnic and racial minorities, experience a more pronounced influence of the SDoH. GPs play a crucial role as intermediaries between individuals and the health system. In addition, interventions initiated in early childhood demonstrate more significant and long-lasting effects. Successful multi-level intervention strategies are already implemented and recommended by research teams. However, they need to be distributed more efficiently to health care professionals. Furthermore, artificial intelligence and computer-generated algorithms are of great importance for future interventions. Nevertheless, the irreplaceable role of in-person consultations with general practitioners remains a cornerstone of effective healthcare interventions.
Conclusion: In conclusion, SDoH have not received adequate attention. The most efficient reduction in CVD incidences requires a comprehensive, multi-level approach addressing SDoH in conjunction with lowering of medical risk factors. This strategy benefits the general public, impacting not only CVH, but also other diseases, reducing health inequity, and alleviating the financial burden on states. Moreover, recognizing the crucial role of GPs as indirect modifiers of health outcomes emphasizes the need to integrate their expertise in the holistic approach, contributing to the overall effectiveness of strategies aimed at mitigating the impact of SDoH on CVH
Uroģenitālā hlamidioze: diagnostika un ārstēšana
No full textMedicīnaVeselības aprūpeMedicineHealth CarePētnieciskā darba mērķis: Šī literatūras apkopojuma mērķis ir sniegt visaptverošu pārskatu
par dažādu diagnostisko laboratorisko metožu priekšrocībām un ierobežojumiem, lai noteiktu
nekomplicētu uroģenitālo Chlamydia trachomatis infekciju. Turklāt ir aplūkotas
nekomplicētas Chlamydia trachomatis izraisītas uroģenitālas infekcijas ārstēšanas iespējas.
Pētnieciskā darba mērķi: Noskaidrot dažādu laboratorijas metožu priekšrocības un
nepilnības uroģenitālas hlamidiozes diagnostikā. Sniegt pārskatu par izvēlētajiem pret
Chlamydia trachomatis aktīvajiem antibakteriālajiem līdzekļiem. Pievērsties turpmākās
uzraudzības procedūrai un atkārtotas testēšanas un ārstēšanas pārbaudes nepieciešamībai.
Novērtēt potenciālās pret Chlamydia trachomatis vakcīnas nozīmi un dažādos viedokļus.
Pētnieciskā darba hipotēzes: Nukleīnskābju amplifikācijas tests (Nucleic Acid
Amplification Test (NAAT)) ir optimāla diagnostikas metode nekomplicētas dzimumorgānu
hlamidiozes noteikšanai. Pašreizējās IUSTI Eiropas standarta antibakteriālo medikamentu
lietošanas vadlīnijās noteiktajai terapijai ir augsts eradikācijas rādītājs, bet laboratorijās
konstatē rezistentus Chlamydia trachomatis celmus. Atkārtota testēšana ir jāveic, lai atklātu
pret antibiotikām rezistentu infekciju un reinficēšanos.
Pētniecības dokumentā izmantotās metodes: Pētījums veikts kā zinātniskās literatūras
apkopojums, izmantojot PubMed un Google Scholar datubāzes.
Secinājumi: Lai gan neviena no diagnostikas metodēm nav perfekta, aprūpes punkta testiem
būs potenciāls pārvarēt pašreizējos ierobežojumus uroģenitālās Chlamydia trachomatis
infekcijas diagnostikā. Lai gan maz pacientu atgriežas uz atkārtotu testēšanu, tas ir efektīvs
veids, kā atklāt atkārtotas infekcijas. Dažās iedzīvotāju grupās, piemēram, grūtniecēm, ir
pamatoti veikt testus aprūpes vietā. Standarta aprūpes antibiotiku lietošanas režīmi joprojām ir
efektīvi, un rezistences pret tiem attīstības risks ir zemsAim of the Research Paper: The aim of this literature review is to give a comprehensive
overview over advantages and limitations of different diagnostic laboratory techniques for the
detection of uncomplicated urogenital Chlamydia trachomatis infection.
Objectives of the Research Paper: To identify the advantages and pitfalls of different
laboratory techniques for the diagnosis of urogenital chlamydiosis. To give an overview of
chosen antimicrobial agents active against Chlamydia trachomatis. To address the follow-up
procedure and the need for retesting and test-of-cure. To evaluate the significance and
different approaches to a potential CT vaccine.
Hypotheses of the Research Paper: NAATs are the optimal diagnostic technology for the
detection of uncomplicated genital chlamydiosis. Current standard of care antibiotic regimen
recommended by IUSTI guidelines has a high eradiation rate, but in laboratories detected
resistant strains are emerging. Retesting and point of care testing are effective in detecting
persistent infections and reinfection.
Methods used in the Research Paper: Research is done in form of a literature review.
PubMed and Google Scholar were used to find relevant scientific journals.
Conclusion: Although none of the diagnostic methods is perfect, point of care tests will have
the potential to overcome current limitations in diagnosis of urogenital CT infection.
Although not many patients return for retesting, it is an effective way to detect reinfections.
Point-of-care testing is warranted in certain populations, such as pregnant woman. Standard of
care antibiotic regimens are still effective and the risk for development of resistance against
them is low
Novērotā vides faktoru ietekme uz Covid-19 sezonalitāti un pārnešanu
No full textMedicīnaVeselības aprūpeMedicineHealth CareThe research paper aimed to investigate the effects of environmental (atmospheric quality, surfaces, etc.) and meteorological (temperature, humidity, etc.) factors on COVID-19 transmission rates and seasonal trends. The research gathered studies obtained from google scholar and medical journal keyword searching, followed by "snowballing" sources. SARS-CoV-2 was shown to survive on environmental fomites for varying durations depending on surface material (up to 72 hours on plastic and stainless steel), implying surface to person transmission. Atmospheric PM, wind speed and precipitation were shown to be weak variables in the transmission and case incidence of COVID-19 and sometimes presented conflicting results. UV-radiation had a potent deactivation effect on the virus, achieving near-complete virus inactivation within minutes, suggesting lower transmission risk in outdoor areas. Temperature and humidity were both consistently proven to have an inverse relationship with virus transmission and case incidence, with scientifically-backed theories. The significant role of the environment in the seasonal trends and transmission rates of COVID-19 was proven, albeit not for all investigated factors. Therefore, the alternative hypothesis (Ha) that the environment has a significant impact on the transmission and seasonality of COVID-19 was accepted, and the null hypothesis (H0) was rejected
Latvian Municipal Budget Expenditures on Transport Infrastructure and Production in the Context of Improving the Local Economy
No full textThis article aims to study Latvian municipal budget expenditures on transport infrastructure and production in the context of improving the local economy. The authors hypothesize that the state of the local economy determines the comparative priority of municipal budget expenditures on two items. In municipalities with a more developed economy, it is 'transport' rather than 'production' budget expenses that are more likely to improve the local economy, and in municipalities with a less developed economy – vice versa. The authors tested the hypothesis based on data for 2021 and 2022 (the time after the reform of the territorial-administrative structure of Latvia) for 43 Latvian municipalities using various methods of statistical analysis. The results show that the comparative priorities in budget expenditures of Latvian municipalities are determined not by the state of the local economy but rather by the geographical (or geopolitical/geoeconomic) location of the municipality. As a result, Latvian municipalities are grouped into territorial clusters using the agglomeration effect from the concentration of transport infrastructure or production. Over the past year, there has been a tendency towards 'transport-production' economic restructuring of the territory of Latvia, the reasons for which may be the geopolitical situation in Eastern EuropePeer reviewe
From Biomechanical Properties to Morphological Variations : Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm
No full textPublisher Copyright: © 2024 by the authors.Background: This research explores the biomechanical and structural characteristics of ascending thoracic aortic aneurysms (ATAAs), focusing on the differences between bicuspid aortic valve aneurysms (BAV-As) and tricuspid aortic valve aneurysms (TAV-As) with non-dilated aortas to identify specific traits of ATAAs. Methods: Clinical characteristics, laboratory indices, and imaging data from 26 adult patients operated on for aneurysms (BAV-A: n = 12; TAV-A: n = 14) and 13 controls were analyzed. Biomechanical parameters (maximal aortic diameter, strain, and stress) and structural analyses (collagen fiber organization, density, fragmentation, adipocyte deposits, and immune cell infiltration) were assessed. Results: Significant differences in biomechanical parameters were observed. Median maximal strain was 40.0% (control), 63.4% (BAV-A), and 45.3% (TAV-A); median maximal stress was 0.59 MPa (control), 0.78 MPa (BAV-A), and 0.48 MPa (TAV-A). BAV-A showed higher tangential modulus and smaller diameter, with substantial collagen fragmentation ( p < 0.001 vs. TAV and controls). TAV-A exhibited increased collagen density ( p = 0.025), thickening between media and adventitia layers, and disorganized fibers ( p = 0.036). BAV-A patients had elevated adipocyte deposits and immune cell infiltration. Conclusions: This study highlights distinct pathological profiles associated with different valve anatomies. BAV-A is characterized by smaller diameters, higher biomechanical stress, and significant collagen deterioration, underscoring the necessity for tailored clinical strategies for effective management of thoracic aortic aneurysm.Peer reviewe
Integrating Articular Cartilage Histopathology with CTX-II and COMP as Synovial Fluid Biomarkers for a Comprehensive Analysis in Osteoarthritis Evaluation
Full text linkOsteoarthritis (OA) is the most common form of chronic joint disease characterized by the loss of cartilage as the primary site of the lesion. Both collagenous and non-collagenous proteins of the extracellular matrix (ECM) are dysregulated by the cellular component damage. Alterations in cartilage composition may manifest through variations in synovial fluid concentrations of C-terminal cross-linked telopeptides of type II collagen (CTX-II) and cartilage oligomeric matrix protein (COMP). This study seeks to decode histological alterations in the cartilage and establish a symbiotic relationship with concentrations of specific ECM proteins within the synovial fluid as potential OA biomarkers. Twenty-five surgically obtained cartilage tissue samples were stained with toluidine blue and analysed using the OARSI grading system under a light microscope both quantitatively and semi-quantitatively. The presence of CTX-II and COMP proteins was measured in the synovial fluid samples using ELISA. The SPSS 28.0 program was used for statistical data analysis. The OARSI score median value was 4.0 (3.0;4.5), attributable to the delamination of the superficial cartilage zone. A greater number of single cells in comparison with cellular clusters was found: 60.00 (45.00;84.00) and 26.00 (22.00;48.00), respectively. Proteoglycan staining was 1.00 (1.00;2.00), attributable to low intensity. A negative correlation between ECM oedema and proteoglycan staining was found (r = −0.445; p = 0.043). The mean levels of CTX-II and COMP in synovial fluid were 1092 pg/mL (SD 537.95) and 1262 ng/mL (SD 339.47), respectively. There was a positive correlation between CTX-II and OA severity (r = 0.305; p = 0.041); the COMP and OA severity correlation was negative (r = −0.286; p = 0.049). The identified positive correlation between OA severity and CTX-II levels in synovial fluid suggests that CTX-II may hold promise as a valuable biomarker for tracking OA progression. This implication opens up possibilities for early detection and targeted interventions in the management of the disease.Peer reviewe
Oral mucosal changes caused by nicotine pouches : case series
Full text linkPublisher Copyright: © The Author(s) 2024.Oral nicotine pouches are the latest products in the tobacco industry. They are manufactured by large tobacco companies and entice tobacco or nicotine addicts, although the products are presented as a ‘harmless choice.’ Nevertheless, dentists and oral health specialists worry about oral mucosal changes due to product interactions with the oral mucosa. Unfortunately, there are no case reports of oral mucosal changes from nicotine pouches that are also investigated histopathologically. The aim of the present study was to visually and histopathologically investigate oral mucosal changes in nicotine pouch users. An online retrospective survey regarding medical and dental health, dietary habits, and tobacco consumption habits was conducted (n = 50). Respondents were selected for further intraoral and histopathological investigation based on the inclusion criteria. All five respondents had oral lesions that were histopathologically analyzed. Visually, the lesions varied in form and intensity, but all appeared white at the location where the pouches were placed. Histopathological analyses revealed parakeratosis with acanthotic epithelium, intraepithelial and connective tissue oedema, and chronic inflammatory infiltration with lymphocytes and macrophages. Participants received information about nicotine cessation and oral health recommendations. In conclusion, nicotine pouches significantly impacted oral mucosa with white lesions that revealed important changes at the cellular level.Peer reviewe
Injectable mineralized Sr-hydroxyapatite nanoparticles-loaded ɛ-polylysine-hyaluronic acid composite hydrogels for bone regeneration
Full text linkPublisher Copyright: © 2024 The AuthorsIn this study, multifunctional injectable mineralized antibacterial nanocomposite hydrogels were prepared by a homogenous distribution of high content of (up to 60 wt%) Sr-substituted hydroxyapatite (Sr-HAp) nanoparticles into covalently cross-linked ɛ-polylysine (ɛ-PL) and hyaluronic acid (HA) hydrogel network. The developed bone-targeted nanocomposite hydrogels were to synergistically combine the functional properties of bioactive Sr-HAp nanoparticles and antibacterial ɛ-PL-HA hydrogels for bone tissue regeneration. Viscoelasticity, injectability, structural parameters, degradation, antibacterial activity, and in vitro biocompatibility of the fabricated nanocomposite hydrogels were characterized. Physical performances of the ɛ-PL-HA hydrogels can be tailored by altering the mass ratio of Sr-HAp. The nanocomposite hydrogels revealed good stability against enzymatic degradation, which increased from 5 to 19 weeks with increasing the mass ratio of Sr-HAp from 40 % to 60 %. The loading of the Sr-HAp at relatively high mass ratios did not suppress the fast-acting and long-term antibacterial activity of the ɛ-PL-HA hydrogels against S. aureus and E. coli. The cell studies confirmed the cytocompatibility and pre-collagen I synthesis-promoting activity of the fabricated nanocomposite hydrogels.Peer reviewe
Distribution of Immunomodulation, Protection and Regeneration Factors in Cleft-Affected Bone and Cartilage
Full text linkPublisher Copyright: © 2024 by the authors.Background: Craniofacial clefts can form a significant defect within bone and cartilage, which can negatively affect tissue homeostasis and the remodeling process. Multiple proteins can affect supportive tissue growth, while also regulating local immune response and tissue protection. Some of these factors, like galectin-10 (Gal-10), nuclear factor kappa-light-chain-enhancer of activated B cells protein 65 (NF-κB p65), heat shock protein 60 (HSP60) and 70 (HSP70) and cathelicidin (LL-37), have not been well studied in cleft-affected supportive tissue, while more known tissue regeneration regulators like type I collagen (Col-I) and bone morphogenetic proteins 2 and 4 (BMP-2/4) have not been assessed jointly with immunomodulation and protective proteins. Information about the presence and interaction of these proteins in cleft-affected supportive tissue could be helpful in developing biomaterials and improving cleft treatment. Methods: Two control groups and two cleft patient groups for bone tissue and cartilage, respectively, were organized with five patients in each group. Immunohistochemistry with the semiquantitative counting method was implemented to determine Gal-10-, NF-κB p65-, HSP60-, HSP70-, LL-37-, Col-I- and BMP-2/4-positive cells within the tissue. Results: Factor-positive cells were identified in each study group. Multiple statistically significant correlations were identified. Conclusions: A significant increase in HSP70-positive chondrocytes in cleft patients could indicate that HSP70 might be reacting to stressors caused by the local tissue defect. A significant increase in Col-I-positive osteocytes in cleft patients might indicate increased bone remodeling and osteocyte activity due to the presence of a cleft. Correlations between factors indicate notable differences in molecular interactions within each group.Peer reviewe
AIM AND MEANING OF BREATHING EXERCISES : INTERDISCIPLINARY LITERATURE REVIEW
Full text linkRespiration is an indispensable aspect of life that significantly influences both the physical and mental well-being of individuals, depending on such factors as depth and rhythm. Exploring the distinctions between chest and abdominal breathing is crucial for understanding their profound impacts, and embracing appropriate breathing exercises has proven to be advantageous for short-term relief and long-term holistic health. While acknowledged for diverse therapeutic applications, such as mitigating vocal cord fatigue, a comprehensive exploration of breathing exercises remains essential. Sport scientists and coaches are encouraged to acquire a set of breathing exercises for future implementation in the training routines. This study strives to conduct an interdisciplinary literature review to shed light on the aims, meaning, and classification of breathing exercises. Employing a literature review methodology, were analysed peer-reviewed articles from PubMed and ScienceDirect published during the years from 2000 to 2023, focusing on such keywords as breathing exercises, deep breathing, nasal breathing, abdominal breathing, thoracic breathing, pursed-lip breathing, breathing control, and respiratory muscle training. The research findings illustrate the multifaceted definitions, components, aims, and classifications of breathing exercises. This study establishes a foundation for identifying distinct subtypes, contributing to a more nuanced understanding of the significance and purpose of breathing exercises in enhancing overall well-being.Peer reviewe