Browsing by Author "Šmitiņš, Emīls"

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    Expression of Gene Runx2, Wnt and OPG in Palate Cleft Reconstruction Material
    (2018) Šmitiņš, Emīls; Danberga, Dace; Pilmane, Māra; Akota, Ilze; Institute of Anatomy and Anthropology; Rīga Stradiņš University
    Introduction. Facial morphogenesis occurs from the fourth to the twelfth gestation week, when the cells from nerve crest migrate to the region of face, forming the primary palate. The cleft palate is an abnormality in embryogenesis period, which is characterized by the absence of fusion of palatal shelves. The incidence of cleft lip and palate is one in 700 live births. In recent years the effect of different genes and signaling molecules, including Runx2, Wnt3 and OPG have been studied in the development of cleft palate, because these substances are considered to be regulators of pathogenesis responsible for formation of bone and cartilage tissue and particularly the bone. Aim of the Study. The aim of the work was to evaluate the expression of Runx2, Wnt3 and OPG in palate bone and nasal cartilage for children with cleft palate. Material and methods. Eleven bone and cartilage samples were obtained from 21 children of the lip, soft and hard palate correction surgery. All the patients were diagnosed with clefts of the lip, alveolar process of maxilla, and palate. In the tissue sections using the immunohistochemistry method (IMH), were determined Runx2 (code: AB192256, 1: 250, Abcam GB, rabbit), Wnt3 (code: AB1992, 1: 800, Abcam GB, rabbit), and OPG (code: A0611, 1: 100, The Orbit USA, rabbit) local expression. We used a semi-quantitative census method for quantifying the positive structures. Results. Runx2 expression was observed in five patient bone tissue samples and six patient cartilage tissue samples. Of the Runx2 positive bone tissue, in one case we observed occasional, in two cases- few, in one case- moderate to numerous and in one case numerous positive osteocytes while in tissue of cartilage in two cases we observed few, in one case- few to moderate, in two cases moderate, and in one case numerous positive chondrocytes. A significant difference in Wnt3 expiation was observed between bone and cartilage tissues. Wnt3 expressing chondrocytes were observed in all samples, where in one case- occasional, in three cases few, in one case-moderate, and in six cases-numerous positive cartilage cells were observed. The expression of the gene in the bone was observed in nine cases, which contained mostly occasional or few positive structures, except in three cases where in one Wnt3 was marked by few to moderate and in two cases numerous positive osteocytes. OPG expression was observed in all samples, but in the cartilage, the expression was more pronounced. In the cartilage in seven cases, there were numerous positive chondrocytes, in one case- few to moderate, in two cases moderate to numerous and in one case few to moderate number of chondrocytes. OPG showed variable expression. In four cases, we observed occasional to few, in one case few to moderate, in one case- moderate, in one case moderate to numerous and in four cases numerous positive bone cells. Conclusion. Cartilage tissue expresses significantly more Runx2, Wnt3 genes and OPG proteins, indicating a greater compensatory tissue capacity. In the case of palate clefts, the high expression of Wnt3 and OPG and lower expression of Runx2 could indicate a significant tissue proliferation which predominates over mineralization and ossification processes.
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    Multisystem Inflammatory Syndrome Cardiovascular Complications in Patient associated with SARS-CoV-2 Infection
    (2023-01-20) Kaķe, Marta; Šmitiņš, Emīls; Apine, Ilze; Lubaua, Ingūna; Department of Paediatrics; Department of Radiology
    Cases of long-term outcomes of a novel disease MIS-C have rarely been reported. The most common cardiac manifestations of MIS-C are myocarditis, coronary artery aneurysms, conduction abnormalities, and arrhythmias. We report a case of an 8-year-old boy, who has Asperger syndrome, with a complicated course of disease called MIS-C during Covid-19 outbreak, when this was the first diagnosis of MIS-C in Latvia. The patient was tested positive for the SARS-CoV-2 (RNA) and Hemophilus influenza (DNA). In 9th day of hospitalization, the diagnosis of MIS-C was performed. He had involvement of gastrointestinal, cardiovascular, respiratory and coagulation systems. The patient received therapy with IVIG, Anakinra as well antibiotics and cardiovascular medicine. During hospitalisation patient had complications such as anemia of a combined nature, post-infectious bone marrow suppression, hepatosplenomegaly and candidiasis due to CVC. The cardiac magnetic resonance imaging (cMRI) after being diagnosed with MIS-C revealed edema and focal changes in LV inferior wall, although volume of both ventricles and LV systolic function were normal. A year after the follow-up cMRI, showed resolution of the myocardial edema. In existing literature there are several cohort studies about long-term outcome of MIS-C myocarditis in 6 month follow-up visit, showing no evidence of scar tissues in cMRI, but in some patients- diastolic dysfunction was detected. This report emphasizes a complicated form of disease in patient who has Asperger syndrome with excellent outcome.
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    MULTISYSTEM INFLAMMATORY SYNDROME IMPACT ON THE CARDIOVASCULAR SYSTEM : SINGLE-CENTRE STUDY OF LATVIA
    (2024-02-01) Šmitiņš, Emīls; Gardovska, Dace; Lubaua, Ingūna; Rīga Stradiņš University
    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.