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The response of patient organizations to the first phase of the COVID-19 pandemic : A qualitative study in Latvia
Full text linkPatient organizations have proven to be crucial stakeholders for patient needs in the health system. However, the global health crisis due to the emergence of COVID-19 has affected the routine of organizations. This qualitative study explores the experience of patient organizations in adapting their services to the situation during the first phase of the COVID-19 pandemic in Latvia in Spring-Autumn 2020. Fifteen chairpersons of patient organizations were recruited and interviewed using a semi-structured key informant interview. The interviews were recorded, transcribed, and thematically analyzed with manual thematic coding. Four main themes were identified: information needs on COVID-19; diversification of communication channels and their adjustment to the COVID-19 situation; continuity of routine management of patient organization; support mechanisms for patient organizations in the context of the COVID-19 pandemic. Patient organizations experienced a rapidly changing environment as a result of COVID-19 and have had to react immediately to ensure the provision of the service to the patient community they serve.Peer reviewe
A Narrative Review of Psychobiotics : Probiotics That Influence the Gut–Brain Axis
Full text linkPublisher Copyright: © 2024 by the authors.Mental health disorders and dementia have become a serious public health concern, with a heightened frequency of diagnoses observed in the wake of the global COVID-19 pandemic. Psychobiotics, a novel area of research at the intersection of microbiology and neuroscience, explore the potential of probiotics to influence the nervous system and mental health outcomes. This review explores the intricate mechanisms by which psychobiotics interact with the gut–brain axis, shedding light on their effects on mood, cognition, and the stress response. Through a comprehensive analysis of the current literature and recent advancements, we discuss the therapeutic potential of psychobiotics in various mental health disorders, including depression, anxiety, and neurodegenerative diseases like dementia. The findings from this research highlight the promising potential of psychobiotics as innovative interventions in mental health treatment. Further investigation into their mechanisms of action and clinical applications is warranted to fully realize their therapeutic benefits.Peer reviewe
Effect of NAT2, GSTM1 and CYP2E1 genetic polymorphisms on plasma concentration of isoniazid and its metabolites in patients with tuberculosis, and the assessment of exposure-response relationships
Full text linkPublisher Copyright: Copyright © 2024 Ulanova, Kivrane, Viksna, Pahirko, Freimane, Sadovska, Ozere, Cirule, Sevostjanovs, Grinberga, Bandere and Ranka.Objectives: Isoniazid is a key drug in the chemotherapy of tuberculosis (TB), however, interindividual variability in pharmacokinetic parameters and drug plasma levels may affect drug responses including drug induced hepatotoxicity. The current study investigated the relationships between isoniazid exposure and isoniazid metabolism-related genetic factors in the context of occurrence of drug induced hepatotoxicity and TB treatment outcomes. Methods: Demographic characteristics and clinical information were collected in a prospective TB cohort study in Latvia ( N = 34). Time to sputum culture conversion (tSCC) was used as a treatment response marker. Blood plasma concentrations of isoniazid (INH) and its metabolites acetylisoniazid (AcINH) and isonicotinic acid (INA) were determined at three time points (pre-dose (0 h), 2 h and 6 h after drug intake) using liquid chromatography-tandem mass spectrometry. Genetic variations of three key INH-metabolizing enzymes (NAT2, CYP2E1, and GSTM1) were investigated by application PCR- and Next-generation sequencing-based methods. Depending on variables, group comparisons were performed by Student's t-test, one-way ANOVA, Mann-Whitney-Wilcoxon, and Kruskal-Wallis tests. Pearson correlation coefficient was calculated for the pairs of normally distributed variables; model with rank transformations were used for non-normally distributed variables. Time-to-event analysis was performed to analyze the tSCC data. The cumulative probability of tSCC was obtained using Kaplan-Meier estimators. Cox proportional hazards models were fitted to estimate hazard rate ratios of successful tSCC. Results: High TB treatment success rate (94.1%) was achieved despite the variability in INH exposure. Clinical and demographic factors were not associated with either tSCC, hepatotoxicity, or INH pharmacokinetics parameters. Correlations between plasma concentrations of INH and its metabolites were NAT2 phenotype-dependent, while GSTM1 genetic variants did not showed any effects. CYP2E1*6 (T > A) allelic variant was associated with INH pharmacokinetic parameters. Decreased level of AcINH was associated with hepatotoxicity, while decreased values of INA/INH and AcINH/INH were associated with month two sputum culture positivity. Conclusion: Our findings suggest that CYP2E1, but not GSTM1, significantly affects the INH pharmacokinetics along with NAT2. AcINH plasma level could serve as a biomarker for INH-related hepatotoxicity, and the inclusion of INH metabolite screening in TB therapeutic drug monitoring could be beneficial in clinical studies for determination of optimal dosing strategies.Peer reviewe
Brodmann Areas, V1 Atlas and Cognitive Impairment : Assessing Cortical Thickness for Cognitive Impairment Diagnostics
Full text linkPublisher Copyright: © 2024 by the authors.Background and Objectives: Magnetic resonance imaging is vital for diagnosing cognitive decline. Brodmann areas (BA), distinct regions of the cerebral cortex categorized by cytoarchitectural variances, provide insights into cognitive function. This study aims to compare cortical thickness measurements across brain areas identified by BA mapping. We assessed these measurements among patients with and without cognitive impairment, and across groups categorized by cognitive performance levels using the Montreal Cognitive Assessment (MoCA) test. Materials and Methods: In this cross-sectional study, we included 64 patients who were divided in two ways: in two groups with (CI) or without (NCI) impaired cognitive function and in three groups with normal (NC), moderate (MPG) and low (LPG) cognitive performance according to MoCA scores. Scans with a 3T MRI scanner were carried out, and cortical thickness data was acquired using Freesurfer 7.2.0 software. Results: By analyzing differences between the NCI and CI groups cortical thickness of BA3a in left hemisphere (U = 241.000, p = 0.016), BA4a in right hemisphere (U = 269.000, p = 0.048) and BA28 in left hemisphere (U = 584.000, p = 0.005) showed significant differences. In the LPG, MPG and NC cortical thickness in BA3a in left hemisphere (H (2) = 6.268, p = 0.044), in V2 in right hemisphere (H (2) = 6.339, p = 0.042), in BA28 in left hemisphere (H (2) = 23.195, p < 0.001) and in BA28 in right hemisphere (H (2) = 10.015, p = 0.007) showed significant differences. Conclusions: Our study found that cortical thickness in specific Brodmann Areas—BA3a and BA28 in the left hemisphere, and BA4a in the right—differ significantly between NCI and CI groups. Significant differences were also observed in BA3a (left), V2 (right), and BA28 (both hemispheres) across LPG, MPG, NC groups. Despite a small sample size, these findings suggest cortical thickness measurements can serve as effective biomarkers for cognitive impairment diagnosis, warranting further validation with a larger cohort.Peer reviewe
MULTISYSTEM INFLAMMATORY SYNDROME IMPACT ON THE CARDIOVASCULAR SYSTEM : SINGLE-CENTRE STUDY OF LATVIA
Full text linkPublisher Copyright: © The Authors This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).MIS-C (Multisystem inflammatory syndrome in children) is a hyperinflammatory syndrome caused by the Sars-CoV-2 virus, still an ongoing issue worldwide. MIS-C is associated with an impairment of various organ systems, including the cardiovascular system, and up to 100% of all MIS-C patients have a broad spectrum and severity of symptoms. Identifying MIS-C early and starting therapy is crucial to minimise possible complications and clinical worsening. A prospective cohort study in a single centre was conducted at the Children’s Clinical University Hospital in Latvia from January to December 2021. Patients between the ages of one and seventeen years who met the MIS-C criteria were included in the study. We evaluated the patient's demographic data, blood pressure, echocardiographic data, ESG data, and cardiac biomarkers such as proBNP and troponin I. Thirty-one patients were included who met the MIS-C criteria. The median age was 8.0 years, and 52% were boys. Of all patients, 77% initially presented with hypotension, and 42% required inotropic support. Treatment in the paediatric intensive care unit (PICU) was required in 58% of patients. Reduced left ventricular ejection fraction was observed in 35% of patients. Mildly decreased ventricular ejection fraction (< 55%) was observed in 19% of cases, and moderate dysfunction (ejection fraction < 45%) in 16% of patients. Twelve per cent of patients received milrinone to improve left heart function. Left heart function significantly improved in all patients during the hospitalisation. In 6% of all patients, coronary artery dilations were observed. All patients had dilation resolution at the time of discharge. The median length of hospitalisation was twelve days, and the median length of PICU stay was three days. Multisystem inflammatory syndrome in children is a significant and potentially life-threatening illness with cardiovascular involvement in 100% of cases. Patients who present primarily with higher ProBNP levels are more likely to have decreased left ventricle ejection fraction, which should be kept in mind when evaluating patients with MIS-C. Overall, patients with MIS-C have a good prognosis, and most cardiovascular changes have been resolved by discharge, but further follow-up and studies are needed to judge the long-term outcome.Peer reviewe
Psychometric properties of the Montreal Cognitive Assessment v8.2. test : Pilot study
Full text linkObjectives. The world is rapidly ageing and, with the increasing age, there is a potential increase in the number of patients with Alzheimer’s disease or dementia. This calls for a reliable screening tool that easily and rapidly could identify the symptoms of pathological cognitive decline. As currently such tools are limited in Latvia, the objective of this study was to examine the psychometric properties of the newly translated Montreal Cognitive Assessment test. Materials and Methods. Sixty-five Latvian native speakers aged 55-90 (M = 72.11, SD = 10.26) participated in the study and were divided into three groups – with diagnosis of dementia (n = 21), mild cognitive impairment (n = 18) and control group (n = 26). All participants were assessed using the Montreal Cognitive Assessment test [1], and a test-retest was conducted after 2 weeks (n = 37). Results. Almost all mean values and inter-item correlation coefficients were acceptable (.2-.8), apart from indices in the Naming task and Verbal fluency task. The items showed very high reliability (α = .95) and the test-retest reliability showed consistent results (r = .98). Conclusions. Overall, the results from the pilot study show acceptable psychometric properties; however, the pilot study should be continued and criterion validity should be tested.Peer reviewe
Assessment of Indoor Radon Gas Concentration in Latvian Households
Full text linkPublisher Copyright: © 2024 by the authors.Exposure to radon gas in households presents serious health risks, including an increased likelihood of lung cancer. Following the COVID-19 pandemic, the change in individual habits has led to more time spent in indoor environments with remote activities; thus, the need to raise the awareness of air quality in dwellings and to mitigate the exposure of inhabitants to radon has emerged. This study investigated radon gas concentrations in the air of Latvian dwellings. RadTrack2 passive detectors were deployed in a representative sample of households across 106 municipalities of Latvia (98% of the territory), yielding data from 487 households (973 detectors). The data revealed a median radon concentration of 52 Bq/m3 (Q1 and Q3 were 29 and 93 Bq/m3), with the majority of samples (95.6%) falling below the national reference limit of 200 Bq/m3. The building type and presence of a cellar significantly impacted radon levels, with structures lacking cellars and older buildings exhibiting higher concentrations. Mechanical ventilation proved to be more effective in reducing radon levels, compared to natural ventilation. These findings emphasize the necessity of proactive measures to mitigate indoor radon exposure and to ensure the well-being of occupants. Additionally, the dissemination of research data on radon exposure through open-access scientific publications is vital for raising awareness and implementing effective mitigation strategies.Peer reviewe
The Indentity of the Doctoral Student in the Implementation of the new doctoral student model in Latvia
Full text linkThe article analyzes issues related to the introduction of the new doctoral study model in Latvia. The transition affects several dimensions -institutional, quality, funding, etc., while the identity of the doctoral student is of great importance. Qualitative scientific research is of interest not only to the doctoral student himself, but also to the university and the country as a whole. The authors of the article believe that the new identity of the doctoral student can be strengthened by emphasizing the understanding of his duties and responsibilities, including so that the results of the doctoral student's scientific research work are used, realized and contribute to the development of the country. economy (and not only)Peer reviewe
Tick-borne encephalitis infections without CNS involvement : An observational study in Latvia, 2007-2022
Full text linkPublisher Copyright: © 2024 Public Library of Science. All rights reserved.BACKGROUND: Tick-borne encephalitis (TBE) is a human viral infectious disease involving the central nervous system (CNS). It is caused by the tick-borne encephalitis virus (TBEV). At present, there is very limited information regarding the clinical importance and health burden of TBE infections without signs of CNS inflammation. Moreover, such cases are omitted from official TBE surveillances and there are no reports of population-based studies. METHODS AND FINDINGS: A nationwide population-based study was conducted in Latvia by intensively searching for symptomatic TBEV infections recorded in outpatient and hospital settings between 2007 and 2022. In total, 4,124 symptomatic TBEV infections were identified, of which 823 (20.0%) had no CNS involvement. Despite the lack of neurological symptoms, non-CNS TBE patients still experienced severe health conditions that required management in a hospital setting for a median duration of 7 days. Furthermore, lumbar puncture information was available for 708 of these patients, with 100 (14.1%) undergoing the procedure, suggesting a high suspicion of CNS involvement. CONCLUSIONS: Clearly, non-CNS TBE has the potential to negatively impact the health of patients. The actual burden of non-CNS TBEV cases may be higher than we think as these cases are omitted from official TBE surveillances and are challenging to recognize.Peer reviewe