Browsing by Author "Berezovska, Marisa Maija"

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    One-step lower leg reconstruction with vascularized functional vastus lateralis muscle flap in the treatment of embryonal rhabdomyosarcoma for a six-month-old boy : A case report
    (2020) Ozols, Dzintars; Berezovska, Marisa Maija; Krasts, Janis; Grutupa, Marika; Petersons, Aigars; Department of Paediatric Surgery
    Rhabdomyosarcoma (RMS) is a common soft tissue sarcoma in childhood, however, it is very rare in the neonatal period (0.4–2% of cases). This case depicts a boy, who presented with RMS at two weeks of age, but officially diagnosed at the age of three months. MRI and scintigraphy determined a soft tissue tumor in the soleus muscle, while biopsy confirmed embryonal RMS with high mitotic activity (Ki67 (monoclonal antibodies) ~80%). CWS (Cooperative Weichteilsarkom Studiengruppe)-2012 with I2VA (ifosfamide, vincristine, actinomycin) chemotherapy regimen was administered per protocol. Surgical treatment was performed at age of six months and 18 days. The operation consisted of radical tumor resection and total triceps surae with partial fibula resection. Immediate reconstruction of triceps muscle was accomplished using a vascularized functional musculocutaneous vastus lateralis flap. Functional outcome was measured using the Lower Extremity Functional Scale (LEFS) and the Foot and Ankle Outcome Score (FAOS) with the results of 92.5% and 99% respectively.
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    Serum and Urine Biomarker Leucine-Rich Alpha-2 Glycoprotein 1 Differentiates Pediatric Acute Complicated and Uncomplicated Appendicitis
    (2021-05-11) Kakar, Mohit; Berezovska, Marisa Maija; Broks, Renars; Asare, Lasma; Delorme, Mathilde; Crouzen, Emile; Zviedre, Astra; Reinis, Aigars; Engelis, Arnis; Kroica, Juta; Saxena, Amulya; Petersons, Aigars; Department of Paediatric Surgery; Department of Biology and Microbiology; Statistics Unit
    Purpose: This prospective, single-center cohort study analyzes the potential of inflammatory protein mediator leucine-rich alpha-2 glycoprotein 1 (LRG1) for the early and accurate diagnosis of acute appendicitis (AA), and differentiation of acute complicated (AcA) from uncomplicated appendicitis (AuA). Methods: Participants were divided into the AcA, AuA, and control groups, and their serum (s-LRG1) and urine LRG1 (u-LRG1) levels were assayed preoperatively on the second and fifth postoperative days. Results: 153 patients participated, 97 had AA. Preoperative u-LRG1 with a cut-off value of 0.18 µg/mL generated an area under the receiver operated characteristic (AUC) curve of 0.70 (95% CI 0.62–0.79) for AA versus control (p < 0.001), while the results for AcA versus AuA were not significant (AUC 0.60, 95% CI 0.49–0.71, p = 0.089). The s-LRG1 levels of AA versus the control with a cut-off value of 51.69 µg/mL generated an AUC of 0.94 (95% CI 0.91–0.99, p < 0.001). The cut-off value of s-LRG1 was 84.06 µg/mL for diagnosis of AcA from AuA, and therefore, significant (AUC 0.69, 95% CI 0.59–0.80, p = 0.001). Conclusions: LRG1 exhibited excellent diagnostic performance as an inexpensive, non-invasive, rapid, and accurate biomarker able to reflect the pathogenesis of AA. LRG1 has the potential to replace advanced imaging to diagnose clinically ambiguous AA cases.
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    Variability of COVID-19 and MIS-C Related Abdominal Surgical Presentations in Children: Case Report Series
    (2021-05-21) Engelis, Arnis; Zviedre, Astra; Pavare, Jana; Zurmutai, Timurs; Berezovska, Marisa Maija; Bormotovs, Jurijs; Laizans, Paulis; Pētersons, Aigars; Department of Paediatric Surgery; Faculty of Medicine