Volume 75 (2021): Issue 5 (October 2021)

Prostate cancer (PCa) remains the second most commonly diagnosed cancer in men, with an estimated 1.1 million diagnoses worldwide in 2012, accounting for 15% of all cancers diagnosed. In many cases, successful treatment of prostate cancer is difficult due to late detection and rate of metastasis. Importantly, the tumours of many patients with prostate cancer become refractory to androgen therapy and progress to metastatic castration-resistant disease. An effective treatment course of prostate cancer patients requires predictive biomarkers in metastatic castration-resistant prostate cancer that support individual treatment. Different risk classification tools have been developed to distinguish patients with early PCa according to the prognosis, including the D’Amico classification system, the Cancer of the Prostate Risk Assessment score, and the National Comprehensive Cancer Network risk groups classification. Unfortunately, there is still no single, universal, cheap, non-invasive, early prostate cancer diagnostic tool, as serum prostate specific antigen (PSA) has not approved expectations and is not implemented in standardised prostate cancer screening. The aim of this review was to provide current state of art knowledge of prostate cancer screening, diagnosis, staging and future perspectives and directions.

Despite the common use of the prostate-specific antigen (PSA) serum level as a tumour marker in diagnosis of prostate cancer, it seems that the PSA doubling time (PSADT) and PSA velocity (PSAV) could be more useful indicators of tumour behaviour and prognosis for patients. The aim of the study was to evaluate the value of PSAV and PSADT in the diagnosis of prostate cancer and their relationship with prostate cancer histopathological characteristics. Eighty-six patients undergoing radical prostatectomy were enrolled in the study. Based on the PSA measurements the PSA dynamic values were calculated: PSADT and PSAV. In addition, clinical and histo-pathological characteristics, including disease stage and prognostic groups were evaluated. The obtained results showed that the first PSA value was 4.29 ng/ml (1.28–13.56), the second PSA value was 7.76 ng/ml (7.60–47.60), and the third PSA value was 9.67 ng/ml (2.56–98.50). The median PSADT was 51.01 months (7.80–311.81) and the median PSAV was 2.66 ng/ml/per year (0.22–4.66). In addition, significant correlations between PSAV and pre- and post-operative Gleason score, and prognostic groups were observed. Significant correlation between PSADT and pre- and pos-toperative Gleason score and prognostic risk groups was demonstrated. This study demonstrated that PSAV and PSADT were significantly correlated with postoperative Gleason score and prognostic risk groups, demonstrating its role in the diagnosis of prostate cancer progression.

Cancer stem cells may be responsible for tumour regrowth and acquisition of resistance in small cell lung cancer (SCLC). The Hedgehog pathway regulates survival and proliferation of tissue progenitor and stem cell populations, promoting the expression of stem cell related and proliferative genes. We evaluated the Sonic Hedgehog (Shh) embryonic signalling pathway in relapsed SCLC. Expression levels of Shh related genes GLI1, SMO, SUFU, PTCH1, HHIP, BCL2, BMI, ZEB1, ZEB2, N-MYC, Twist1 were analysed by qRT-PCR in matched pre-treatment and relapsed tumour fresh frozen biopsies of three SCLC patients. Expression of each gene was compared using the paired samples t-test, as well as comparison of mean expression levels was done. Data were statistically interpreted using the MedCalc version 10.2.0.0 software. 2.9-fold lower mean mRNA expression of the major Hedgehog activation indicator GLI1 was observed in relapsed samples (p = 0.0529). Mean expression of six Shh inducible genes, PTCH1, HHIP, N-MYC, ZEB2, Twist1, ZEB1, was also downregulated by 2.6-, 2.2-, 1.9-, 1.8-, 1.2-, 1.1-fold, respectively (p = 0.4252, p = 0.1268, p = 0.2480, p = 0.1169, p = 0.1480, p = 0.7595, respectively). 1.8-fold mean expression decrease was found for Gli activator Smo (p = 0.4111). Only the Shh pathway inhibitor SUFU and two other examined Hedgehog signalling inducible genes BCL2 and BMI in relapsed SCLC showed 0.8-, 0.9-,and 0.8-fold increase of expression, respectively (p = 0.3074, p = 0.7921, and p = 0.3822, respectively). To our knowledge, this is the first report of comparison of Shh signalling in matched pre-treatment and relapsed SCLC biopsies. Our data show decreased activity for majority of Shh pathway components in relapsed SCLC, although difference did not reach statistical significance.

The involvement of tissue-resident macrophages (TRMs) in health and diseases makes them unique therapeutic targets. TRMs are activated through their surface pattern recognition receptors, such as Toll-like receptors (TLRs) that are essential sensors of danger signals. Here, we determine the activation status of rat peritoneal macrophages (PMs) and microglia (MG) cells under normal and hypoxic conditions and investigate the effect of TLR3 agonist bacteriophage-derived dsRNA (Larifan) on the metabolic profile of TRMs in vitro. We implemented the phenotypic markers CD14 and CD206, arginine metabolism, phagocytic activity and reactive oxygen species generation as metabolic characteristics to evaluate TRMs activation. We showed that normoxic TRMs from different tissue niches responded to Larifan exposure in different ways. PM exhibited signs towards M1 polarisation. In contrast, the MG activation pattern could be considered as neither pro-inflammatory nor anti-inflammatory. We also showed that TRMs, regardless of the tissue niche, responded to hypoxia with a phenotypic shift towards an anti-inflammatory (M2) state. Larifan could attenuate hypoxia-induced TRMs metabolic programming. However, hypoxic conditions could negatively affect the interaction of TRMs with danger signals.

The purpose of this study was to evaluate tear osmolarity changes in a healthy ocular surface in an eye that had been operated on within the first month after cataract surgery. This aim was achieved by forming two groups from the included patients. Patients with one eye exposed to cataract surgery formed the study group, while the eyes of the same patients with no cataract surgery were set as the control group. Both the operated and non-operated eye of each patient were scanned before surgery, the following morning, one week and one month after surgery. Tear osmolarity did not differ between the groups before the operation. On the first day after the surgery, tear osmolarity significantly decreased, below the detection range of the TearLab device (< 275 mOsm/l). The osmolarity level in the control group did not change. One week after surgery, osmolarity in the study group increased to 312.64 mOsm/l, which was significantly different from that of the control group. One month after surgery, tear osmolarity in the study group had returned to the pre-operative level. Tear osmolarity is thus clearly affected by cataract surgery. The average values were seen to change quite significantly during the first postoperative month.

Psoriasis is one of the most common autoimmune dermatoses with a chronic relapsing course. Biologic therapy should be initiated for patients with moderate to severe psoriasis when conventional systemic therapy and phototherapy are ineffective, or their use is limited due to comorbidities. In Latvia, adalimumab is the first choice of biologic drugs for treatment of psoriasis. The correlation between changes in cellular and humoral immunological parameters and clinical signs based on immunological data from psoriasis patients are evaluated in the publication.

Q fever is an important zoonotic disease worldwide. The main sources of human infection are inhalation of aerosols containing Coxiella burnetii bacteria and exposition to infected materials during parturition or slaughtering. The high-risk group includes people who work directly with infected livestock, such as farmers, veterinarians, veterinary medicine students, slaughterhouse and laboratory staff. Here we present a pilot study of risk-group human seroprevalence to C. burnetii in Latvia. The study included 240 sera samples — 190 from the risk groups and 50 from the control group. Samples were tested with Coxiella burnetii (Q-fever) Phase 1 and 2 IgG ELISA kits. All sera from the control group were negative. The seroprevalence among risk group persons was 8.04–11.54%. No statistically significant differences were observed between genders. The highest percentage of seropositive and equivocal sera samples (25%) were detected in age categories 39–48 years and 49–58 years. Working as a practicing veterinarian or former veterinarian was the only risk factor identified as statistically significant, and belonging to the risk group in general. The geographical distribution of seropositive risk group participants indicated that they tend to located more in the northern, central, and eastern part of the country.

It is more common to perform non-invasive examination during general anaesthesia to ensure effective perioperative patient care. To achieve these results, researchers and clinicians are seeking out different technologies and developing new equipment. One such apparatus is a cerebral oximeter, which is used during cardiac surgery with cardiopulmonary bypass for neuroprotection management for reducing risk of postoperative neurological injury (cerebral stroke, neurocognitive dysfunction, and cerebral haemorrhage). A cerebral oximeter performs non-invasive transcutaneous measurements using near infrared radiation to assess the oxygenation of tissues. The objective of the study was to determine if the angle and thickness of a patient’s skull affects measurements. Intralipid water solution, gelatine, and ink were used to make six phantoms with skull thickness ranging from 6 to 11 mm. All phantoms were bent froma0to20 degrees angle. The cerebral oximeter SOMETICS INVOS 5100C was used to perform regional oximetry measurements. For skull thickness of 11 mm, the rSO2 was 45.8% (SD 0.96); for skull thickness of 10 mm, the rSO2 was 45.25% (SD 2.22); for skull thickness of 9 mm, the rSO2 was 32% (SD 1.63); for skull thickness of 8 mm, the rSO2 was 17% (SD 1.83); for skull thickness of 7 mm, the rSO2 was 15% (SD 0); for skull thickness of 6 mm, the rSO2 was 15% (SD 0). No significant changes were observed regarding the angle of the skull phantom. The thickness of the bone layer of the skull phantom affected the regional oximetry results, whereas the angle of the skull did not affect it.

The aim of the study was to determine kidney survival and validate the novel international immunoglobulin A nephropathy (IgAN) prediction tool (PT) in the Latvian population. Adults with morphologically confirmed IgAN were included. Kidney survival was analysed with the Kaplan–Meier method. PT-assigned risk was compared with calculated risk by the Cox regression model. The Kaplan–Meier analysis included 95 patients. The five-year kidney survival Q3 was 24 months. Women had longer median kidney-survival time (> 60 months) than men (58 months). Median kidney survival in participants with MEST T0 was longer than 60 months; T1 and T2 were 40 and 18 months, respectively. Median kidney survival in participants with diastolic blood pressure (DBP) < 99 mmHg was longer than 60 months, whereas in patients with DBP 100–109 and 110 mmHg, it was 40 and 24 months, respectively. Cox regression analysis included 68 patients. A moderate degree of correlation was found between predicted and observed five-year risk (p = 0.001). Gender, tubular atrophy/interstitial fibrosis, DBP are significant factors affecting kidney survival. Since there was statistically significant correlation and reliability between PT and follow-up analysis data, we conclude that PT could be applied for use in the Latvian population.

Childhood obesity carries a high risk of serious life-threatening cardiometabolic diseases in adulthood, which are associated with low-grade inflammation. The aim of the present study was to measure serum cytokine concentrations in obese children recruited during endocrinology consultations and compared to lean control the results. Blood serum concentrations of interferon gamma (IFNγ), IL-1β, Interleukin 6 IL-6, IL-10, and TNF-α were analysed applying Luminex xMap technology with Millipore reagent kits. Statistical analyses were performed using t-test comparisons and Spearman correlations. Obese children had highly significant increased levels of circulating IFNγ (p < 0.0001), IL-6 (p < 0.0001), and IL-10 (p < 0.0001), compared to lean controls. IL-1β and TNFα levels, however, were not elevated. Significant correlation of serum cytokines to per cent excess body mass was only observed with IL-6 (r_s = 0.21, p < 0.03), although IL-1β (r_s = 0.18, p < 0.08) results were suggestive of a trend. A significant association of obesity in childhood with serum concentrations of IFNγ, IL-6, and IL-10 is consistent with a role for low-grade inflammatory processes early in the aetiology of this disease. IL-6 further appears to be a candidate cytokine for assessment of degree of sub-acute inflammation associated with excess weight in the young.

In Latvia, no studies on the quality of life (QoL) of healthy children have been conducted. Determining the quality of life of children is an essential part of evaluating the health status of children. The subjective assessment of the individuals about their quality of life provides an opportunity to evaluate the quality of life of the population in the public health sector. The aim of this cross-sectional study was to evaluate the quality of life of healthy children and adolescents in Latvia in the age group from 8 to 18, as well as to compare the answers between children and their parents living in Latvia. This study also gave an opportunity to compare the results of children and their parents living in Europe. Quality of life measurements were obtained using the KIDSCREEN-52 questionnaire, which was filled out by 100 healthy children/adolescents and 100 of their parents/guardians. The quality-of-life questionnaire consisted of ten dimensions. When evaluating the quality of life of children and adolescents by gender, no statistically significant difference was found in Latvia (p > 0.05). There was no statistically significant difference (p > 0.05) between children of 8 to 11 years of age and children of 12 to 18 years of age. A statistically significant difference was found between the 8 to 11 and 12 to 18-year-old groups of young healthy children in some dimensions. In the response dimensions, self-perception (“SEL”) and emotions (“EMO”), their QoL was significantly higher (p < 0.05) in the age group from 12 to 18 years healthy children than in the age group of 8 to 11 years. Differences in child/adolescent quality of life results between Latvia and Europe were not statistically significantly different in all 10 HRQoL dimensions (p > 0.05).

Ventricular shunting is a well-recognised and commonly practiced method of reducing increased intracranial pressure in patients with neurologic pathology. There are possible complications related to shunt implantation, where the rarest is intracardiac migration of the distal shunt catheter. We present a case where the distal catheter migrated into the right ventricle, causing extrasystoles and was complicated with acute right ventricle failure during the endovascular shunt evacuation procedure.

Identification of sources of increased content of oleic acid glycerides (oleates) and determination of the nature of its variability are prerequisites for improving oil quality. The purpose of this study was to establish the variability of the content of oleic acid glycerides (oleates) in maize oil depending on the genotype and ripening temperature. The experiments were carried out on a series of common maize inbreds and inbred-carriers of the su₁, ae, and su₂ mutations, which were grown for three years. The fatty acid composition of the oil was analysed by the Peisker gas chromatographic method. Genotype–environment interactions were assessed using the Eberhard– Russell algorithm. It was found that the carriers of the su₁ and su₂ mutations had the highest oleate content. The oleate content of maize oil generally increased with increasing ripening temperature. Unrelated inbreds based on one mutation significantly differed in the genetically determined level of oleate and showed non-identical responses to the ripening temperature. In inbreds of the first type, the content of oleates changed significantly with temperature fluctuation, while inbreds of the second type provided a fairly stable level of the trait under these conditions.