Browsing by Author "Derovs, Aleksejs"
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Item 2L of Polyethylene Glycol as the Main Small Bowel Cleansing Regimen Component Prior to Video Capsule Endoscopy : Interim Analysis(2020-05-26) Derovs, Aleksejs; Derova, Jeļena; Kleina, Regīna; Pokrotnieks, Juris; Rīga Stradiņš UniversityCapsule Enteroscopy (CE) is a fundamentally new method in diagnostic endoscopy. However, there are several factors influencing the quality of this procedure, including impermeable fluids, food remains etc. The aim of the study was to assess one of the most popular currently used bowel preparation methods and evaluate possible effects of various factors. 136 CE examinations were analysed. Each patient was prepared using 2 litres of polyethylene glycol (PEG) one day prior to examination. There was a special form filled in for each patient, which included relevant parameters (anamnesis, CE data etc.). Of 136 CE cases, 84 (61.8%) were female patients and 52 (38.2%) were male. The small bowel (SB) transit time in 112 patients varied from 39 to 502 minutes, but in 24 cases the capsule did not reach caecum. The degree of bowel cleanliness was as follows: very good - 30 (22.1%) patients, satisfactory - 97 (71.3%), and poor - 9 (6.6%). A positive correlation was observed between the degree of SB cleanliness and the SB transit time (p = 0.015). A longer SB transits time was associated with poor SB cleanliness. The results obtained in this study showed that the quality of SB cleanliness is affected by SB transit time. A relatively large percentage of cases rated as satisfactory bowel cleanliness and comparatively small percentage of bowel cleanliness cases rated as "very good" were observed when 2 litres of PEG were used prior to CE, indicating an important issues in preparation of the bowel prior to CE.Item CLINICAL APPLICATION OF THE GLASGOW BENEFIT INVENTORY AND GLASGOW BENEFIT INVENTORY WITH FIVE FACTORS : CURRENT EVIDENCE(2024-08) Kondratisko, Jekaterina; Kremneva, Anna; Trups-Kalne, Ingrida; Derovs, Aleksejs; Briģis, Ģirts; Rīga Stradiņš University; Psychology Laboratory; Department of Internal Diseases; Department of Infectology; Institute of Public HealthThe purpose of this review is to assess the worldwide clinical utilisation of Glasgow Benefit Inventory (GBI) and New Five-factor Glasgow Benefit Inventory (GBI-5F) for various clinical and scientific objectives, as well as to validate its application in Latvia. Numerous articles indexed in the MedLine Library (Pubmed.gov) were examined, spanning from the initial GBI publication to the present. Various applications of these questionnaires have been investigated across multiple medical specialties, including otolaryngology, ophthalmology, urology, paediatric practice, neurosurgery, gastroenterology, oncology, and maxillofacial surgery in different countries. The use of the questionnaire in Latvia, following examples from other countries, can aid in assessing factors such as General Health, Support, Quality of Life, Self-Confidence and Social Involvement post-intervention in chronic conditions. This could help compare treatment outcome data both in clinical practice within our country and within the scientific community on an international level.Item The Clinical Significance of the Excavated Lesions (Aphthae/Erosions, Ulcers) in the Small Bowel Detected by Capsule Endoscopy. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2012) Derovs, Aleksejs; Pokrotnieks, JurisThe aim of the study was to evaluate the clinical significance of the excavated lesions (aphthae/erosions and ulcers) diagnosed by capsule endoscopy in the small bowel. Clinical implication of the excavated lesions in the upper and lower gastrointestinal tract is investigated and estimated very well. There is no data available in the literature, which shows the incidence of the excavated lesions in the small bowel farther than distal part of duodenum, in other words, farther than conventional endoscopical techniques possibilities allow. We hypothesize that clinical significance of the excavated lesions in the small bowel, which were ascertained by using a new diagnostic method - capsule endoscopy, should be similar to the clinical value of similar lesions in other regions of the gastrointestinal tract, ascertained by conventional endoscopic studies. In particular, taking into account the anatomical features of the small intestine, as well as the specific methods of the capsule endoscopy. Clinical implication of the excavated lesions in the small bowel is predominantly unknown. At this moment most data, which is related to the excavated lesions in the small bowel, is connected with bleeding and anemia, developing of strictures and risk of perforation. These data was obtained predominantly with “non-capsule” diagnostic modalities. Our research, for the first time is evaluating the relationship between the excavated lesions, diagnosed by capsule endoscopy, and patients’ vital signs, diagnoses and other lesions of the small bowel. This study is unique, because such research has not been published yet. Obtained results prove that the excavated lesions in the small bowel diagnosed by capsule endoscopy because of its anatomical difference (incomparably wider surface than in stomach or colon) are always with high clinical implication. Even in case of superficial (erosive) lesions occupying insignificant part of the bowel (segmental enteropathy).Item Distribution of HLA allele frequencies in patients with cystic and alveolar echinococcosis in Latvia(2019-08-01) Laivacuma, Sniedze; Eglite, Jeļena; Derovs, Aleksejs; Viksna, Ludmila; Department of Infectology; Klīniskās imunoloģijas un imunoģenētikas starpkatedru laboratorija; Department of Internal DiseasesThe aim of this study was to assess the relationship between HLA Class II alleles in two groups of patients in Latvia: patients with cystic and alveolar echinococcosis. The study included 37 patients from the Rīga East Clinical University Hospital with echinococcosis (29 patients with cystic echinococcosis and eight patients with alveolar echinococcosis) and 100 healthy control persons without echinococcosis. HLA Class II allele genotyping was performed using Real-time polymerase chain reaction-sequence specific primer (RT-PCR-SSP). The odds ratios (OR), with 95% confidence intervals (95% CI), were calculated using statistical analysis performed with IBM SPSS Statistics for Windows, Version 22.0, to evaluate the risk of developing the disease in an individual having a particular HLA genotype. In the case of cystic echinococcosis a more severe course of a disease can be anticipated in the presence of HLA-DRB1 alleles ∗17:01 and ∗07:01, -DQB1 ∗03:02, and ∗03:01, -DQA1∗04:01 and haplotypes HLA-DRB1∗04:01/-DQB1∗03:01/ -DQA1∗03:01, HLADRB1∗11:01/ -DQB1∗03:01 /-DQA1∗05:01. However, in the group with alveolar echinococcosis it was associated with the HLA-DRB1 alleles ∗17:01 and ∗07:01, -DQB1 ∗05:01 and haplotypes HLA- DRB1∗17:01/-DQB1∗02:01-2/-DQA1∗01:01, HLA-DRB1∗11:01/ -DQB1∗03:01/-DQA1∗01:03 and HLA-DRB1∗11:01/-DQB1∗03:01/-DQA1∗03:01. HLADRB1∗15:01/-DQÂ1∗06:02-8/-DQA1∗05:01 and HLA-DRB1∗13:01/-DQB1∗02:01-2/-DQA1∗05:01 haplotypes were protective in all patient groups. The limitations of this exploratory study indicate that a broader study needs to be conducted for revealing specific risk and protective HLA Class II haplotypes for patients with cystic and alveolar echinococcosis in Latvia.Item Establishing the cut-offs of leaky gut syndrome diagnostic : where are we now?(2022-12) Rodina, Jekaterina; Derovs, Aleksejs; Department of Internal Diseases; Department of InfectologyGastrointestinal mucosa forms a surface that interacts with many external factors. Beside the digestion and absorption of nutrients, it also acts as a barrier to allergens, pathogens, and toxins. Leaky gut syndrome is defined as a gut mucosal barrier dysfunction, which results in abnormally increased intestinal permeability. Research shows that leaky gut syndrome (LGS) has a pathogenetic relationship with a series of gastrointestinal and extra-intestinal disorders. This review discusses the current understanding of intestinal barrier composition and pathological contribution of LGS to various diseases. The major aim of this paper is to review different methods for diagnostics and evaluation of intestinal wall permeability, identifying their priorities and disadvantages.Item EXPLORING INTESTINAL PERMEABILITY : CONCEPT, DIAGNOSIS, CONNECTION TO BOWEL DISEASE, AND IRON DEFICIENCY(2024-08) Basina, Olesja; Derovs, Aleksejs; Derova, Jelena; Lejniece, Sandra; Department of Internal Diseases; Department of InfectologyOver the recent years, intestinal permeability has become a major feature of gut health. The objective of this paper is to present a literature-based overview of the current understanding on intestinal permeability. The concept of intestinal permeability started its development from the discovery of tight junctions — protein complexes that are separated between the epithelial cells. Histopathology is the main option of microscopic diagnosis, which allows to determine changes that occur in the tight junction, inflammation, and damaged epithelial cells. Additionally, intestinal fatty acid-binding protein I-FABP and zonulin are suggested as biomarkers of epithelial barrier abruption. As for visual detection, literature proposes capsule endoscopy and confocal laser endomicroscopy. Using the latter it is possible to produce images of small intestinal morphology and visualise the small intestinal luminal elements, cells, villi as well as crypts. However, advancements in digital capsule endoscopy are more applicable and aid in research of intestinal permeability and enteropathy, also giving promising results in treatment. Although damage to intestinal permeability can be classified as a certain enteropathy and then the association of some enteropathies with iron deficiency already has been established, direct association of iron deficiency and intestinal permeability is yet to be explored.Item FATAL PERITONITIS — CAUSES, CONTRIBUTING FACTORS AND DIAGNOSTIC CHALLENGES : AN AUTOPSY CASES STUDY(2022-12-10) Lindholm, Marie; Franckeviča, Ivanda; Derovs, Aleksejs; Dabuzinskiene, Anita; Kleina, Regīna; Department of Pathology; Department of InfectologyDelayed diagnosis of stomach, intestines, pancreas, and gallbladder diseases plays a significant role in the complicated non-traumatic peritonitis. The aim of the study was to analyse the causes of fatal peritonitis, and contributing factors to mortality and diagnostic discrepancies. A retrospective study of 52 peritonitis cases from selected 1350 autopsy records in three years was done. We analysed age, sex, length of hospital stays, clinical and pathological diagnosis, complications, comorbidities, laboratory values and diagnostic discrepancies. The results were statistically assessed by Excel and IBM SPSS® Statistics version 26. The most common causes of fatal peritonitis were non-oncological gastrointestinal pathologies (26%), malignancies (23%), pancreas and gallbladder (16%), HIV related (10%), vascular (7%) and other diseases (18%). Mean age of patients at death was 65 years. 61.4% were males. Median hospitalisation time was two days. Six patients died outside the hospital. In 17.4% cases misdiagnoses were found. Common situations when misdiagnoses had occurred were intestinal ischaemia, malignancies of various origins and perforation of peptic ulcer. Fatal peritonitis was determined by the patient’s delayed hospitalisation with untreated oncological and non-oncological diseases of organs of the abdominal cavity and multiple concomitant diseases. Other contributing factors included not visiting general practitioners and lack of adherence to patients themselvesItem Higher CTX-M, TEM, and SHV extended-spectrum beta-lactamase plasmid gene combination frequency in ESBL producing Klebsiella pneumoniae compared with ESBL producing Escherichia coli(Central Bohemia University, 2016) Skuja, Vita; Pekarska, Katrina; Derovs, Aleksejs; Viksna, Ludmila; Piekuse, Linda; Kempa, Inga; Caune, Una; Rudzite, Dace; Lejnieks, Aivars; Krumina, Angelika; Department of Internal Diseases; Rīga Stradiņš University; Scientific Laboratory of Molecular GeneticsItem Intriguing findings of liver fibrosis following COVID-19(2021-12) Koļesova, Oksana; Vanaga, Ieva; Laivacuma, Sniedze; Derovs, Aleksejs; Koļesovs, Aleksandrs; Radzina, Maija; Platkājis, Ardis; Eglīte, Jeļena; Hagina, Elvīra; Arutjuņana, Seda; Putriņš, Dāvis Sīmanis; Storoženko, Jeļena; Rozentāle, Baiba; Vīksna, Ludmila; Klīniskās imunoloģijas un imunoģenētikas starpkatedru laboratorija; Department of Infectology; Department of Radiology; Department of Public Health and EpidemiologyBackground: Studies on a new coronavirus disease (COVID-19) show the elevation of liver enzymes and liver fibrosis index (FIB-4) independently on pre-existing liver diseases. It points to increased liver fibrogenesis during acute COVID-19 with possible long-term consequences. This study aimed to assess liver fibrosis in COVID-19 patients by serum hyaluronic acid (HA) and FIB-4. Methods: The study included the acute COVID-19 group (66 patients, 50% females, mean age 58.3 ± 14.6), the post-COVID group (58 patients in 3–6 months after the recovery, 47% females, mean age 41.2 ± 13.4), and a control group (17 people, 47% females, mean age 42.8 ± 11.0). Ultrasound elastography was performed in the post-COVID and control groups. Results: Sixty-five percent of the acute COVID-19 group had increased FIB-4 (> 1.45), and 38% of patients had FIB-4 ≥ 3.25. After matching by demographics, 52% of acute COVID-19 and 5% of the post-COVID group had FIB-4 > 1.45, and 29% and 2% of patients had FIB-4 ≥ 3.25, respectively. Increased serum HA (≥ 75 ng/ml) was observed in 54% of the acute COVID-19 and 15% of the post-COVID group. In the acute COVID-19 group, HA positively correlated with FIB-4, AST, ALT, LDH, IL-6, and ferritin and negatively with blood oxygen saturation. In the post-COVID group, HA did not correlate with FIB-4, but it was positively associated with higher liver stiffness and ALT. Conclusion: More than half of acute COVID-19 patients had increased serum HA and FIB-4 related to liver function tests, inflammatory markers, and blood oxygen saturation. It provides evidence for the induction of liver fibrosis by multiple factors during acute COVID-19. Findings also indicate possible liver fibrosis in about 5% of the post-COVID group.Item Iron Deficiency Anaemia and Anaemia of Inflammation in Enteropathies Caused by Commonest Small Intestine Disorders: Current Evidence(2022-12) Basina, Oļesja; Derova, Jeļena; Derovs, Aleksejs; Lejniece, Sandra; Department of Internal Diseases; Department of InfectologyIt is no mystery that iron deficiency is the most common anaemia and multiple studies have shown that anaemia is a main factor for decreased quality of life. The focus of our article is an up-to-date review of different enteropathies caused by specific disorders and the prevalence of iron deficiency anaemia (IDA), starting with the understanding of physiology of iron absorption and regulation in the intestine. The pathologies that we tried to cover were celiac disease, Crohn’s disease, nonsteroidal anti-inflammatory drugs (NSAID)-induced enteropathy and protein losing enteropathy. Unfortunately, not everything still understood and questions still remain. The main questions are associated with our understanding of iron regulation beyond the ferroportin-hepcidin axis and what mechanism is behind changes of epithelium in different conditions. Depending on the study and pathology of enteropathy, almost half of the studied patients had iron deficiency anaemia. However, in all enteropathies, IDA is more an additional finding or an additional symptom that needs further investigations. That is why many authors consider that IDA is caused by secondary mechanisms and not enteropathy per se and should be correlating with undernourishment, severe mucosal atrophy, malabsorption, and bleeding.Item Kapsulas endoskopijas klīniskā nozīme iegremdēto bojājumu (aftas/erozijas, čūlas) diagnostikā tievajā zarnā. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2012) Derovs, Aleksejs; Pokrotnieks, JurisŠī darba mērķis ir noteikt tievajā zarnā ar kapsulas endoskopiju diagnosticēto iegremdēto bojājumu klīnisko nozīmi. Ilgstoši pētītajiem iegremdētajiem bojājumiem (aftas/erozijas un čūlas) konvencionālās gastrointestinālās endoskopijas pieejamības zonās (barības vads, kuņģis un divpadsmitpirkstu zarnas proksimālā daļa un resnā zarna) ir korekti precizēta to klīniskā nozīme. Literatūrā netika atrasti pētījumi, kas parādītu iegremdēto bojājumu sastopamību tievajā zarnā, veicot šī orgāna endoskopiskus izmeklējumus tālāk par divpadsmitpirkstu zarnas distālo daļu vai tālāk par konvencionālās ezofagogastroduodenoskopijas iespējām. Pētījuma hipotēzē pieņemam, ka ar kapsulas endoskopiju diagnosticētiem tievajā zarnā iegremdētiem bojājumiem (aftas/erozijas un čūlas) būtu jābūt ar savu klīnisko nozīmi. Lai arī tā varētu būt līdzīga klīniskajai nozīmei pie analoģiskiem bojājumiem atklātiem ar konvencionālajām endoskopijas metodēm citās gastrointestināla trakta daļās, to ievērojami ietekmēs tievās zarnas anatomiskās īpatnības. Ir svarīgi apzināties tievo zarnu iegremdēto bojājumu klīniskas izpausmes. Šobrīd šī nozīme ir zināma praktiski vienīgi ar asiņošanu un anēmijas, striktūru veidošanos un perforāciju risku, kas galvenokārt ir iegūti ar „nekapsulas” izmeklēšanas metodēm. Mūsu darbs pirmo reizi novērtē tievo zarnu kapsulas endoskopijā konstatēto iegremdēto bojājumu saistību ar pacientu fizikāliem datiem, kapsulas endoskopijas diagnozēm un citiem tievās zarnas bojājumu veidiem. Šī pētījuma shēma pirmoreiz atspoguļo šāda veida bojājumu klīnisko nozīmi. Līdz šim šādi pētījumi nav publicēti. Iegūtie rezultāti pierāda, ka kapsulas endoskopijā diagnosticētie tievajā zarnā iegremdētie bojājumi tās anatomisku atšķirību dēļ (nesalīdzināmi lielāka virsma par kuņģi un resno zarnu) ir klīniski vienmēr nozīmīgi, arī virspusēju (erozīvu) bojājumu gadījumos un pat aizņemot nelielu zarnas daļu (segmentārā enteropātija).Item Kapsulas endoskopijas klīniskā nozīme iegremdēto bojājumu (aftas/erozijas, čūlas) diagnostikā tievajā zarnā. Promocijas darbs(Rīgas Stradiņa universitāte, 2012) Derovs, Aleksejs; Pokrotnieks, JurisŠī darba mērķis ir noteikt tievajā zarnā ar kapsulas endoskopiju diagnosticēto iegremdēto bojājumu klīnisko nozīmi. Ilgstoši pētītajiem iegremdētajiem bojājumiem (aftas/erozijas un čūlas) konvencionālās gastrointestinālās endoskopijas pieejamības zonās (barības vads, kuņģis un divpadsmitpirkstu zarnas proksimālā daļa un resnā zarna) ir korekti precizēta to klīniskā nozīme. Literatūrā netika atrasti pētījumi, kas parādītu iegremdēto bojājumu sastopamību tievajā zarnā, veicot šī orgāna endoskopiskus izmeklējumus tālāk par divpadsmitpirkstu zarnas distālo daļu vai tālāk par konvencionālās ezofagogastroduodenoskopijas iespējām. Pētījuma hipotēzē pieņemam, ka ar kapsulas endoskopiju diagnosticētiem tievajā zarnā iegremdētiem bojājumiem (aftas/erozijas un čūlas) būtu jābūt ar savu klīnisko nozīmi. Lai arī tā varētu būt līdzīga klīniskajai nozīmei pie analoģiskiem bojājumiem atklātiem ar konvencionālajām endoskopijas metodēm citās gastrointestināla trakta daļās, to ievērojami ietekmēs tievās zarnas anatomiskās īpatnības. Ir svarīgi apzināties tievo zarnu iegremdēto bojājumu klīniskas izpausmes. Šobrīd šī nozīme ir zināma praktiski vienīgi ar asiņošanu un anēmijas, striktūru veidošanos un perforāciju risku, kas galvenokārt ir iegūti ar „nekapsulas” izmeklēšanas metodēm. Mūsu darbs pirmo reizi novērtē tievo zarnu kapsulas endoskopijā konstatēto iegremdēto bojājumu saistību ar pacientu fizikāliem datiem, kapsulas endoskopijas diagnozēm un citiem tievās zarnas bojājumu veidiem. Šī pētījuma shēma pirmoreiz atspoguļo šāda veida bojājumu klīnisko nozīmi. Līdz šim šādi pētījumi nav publicēti. Iegūtie rezultāti pierāda, ka kapsulas endoskopijā diagnosticētie tievajā zarnā iegremdētie bojājumi tās anatomisku atšķirību dēļ (nesalīdzināmi lielāka virsma par kuņģi un resno zarnu) ir klīniski vienmēr nozīmīgi, arī virspusēju (erozīvu) bojājumu gadījumos un pat aizņemot nelielu zarnas daļu (segmentārā enteropātija).Item Liver Abscesses — Seven-Year Experience of a Single Tertiary Care Hospital(2020) Krūmiņa, Angelika; Laivacuma, Sniedze; Drjagunovs, Iļja; Zeltiņa, Indra; Vīksna, Ludmila; Derovs, Aleksejs; Department of Infectology; Department of Internal DiseasesWe reviewed medical records of cases of liver abscesses (LA) registered in Riga East University Hospital clinical centre "Gaiiezers" from January 2012 to October 2018 to assess sociodemographic factors, clinical, laboratory, microbiological and radiological findings, as well as therapeutic modalities and their efficacy associated with LA. A total of 95, including five recurrent, cases were included in this study. No statistically significant differences in gender distribution were found. Mean patient's age was 64.5 +/- 15.9. The most common documented risk factors for the development of LA were underlying biliary tract abnormalities (37.9% of cases), and diabetes mellitus (12.7%), while in 21.1% of cases, LA were defined as cryptogenic. Most patients presented with fever (70.5%); right upper abdominal pain was reported in 61.1%, while vomiting and / or nausea - in 25.3% of cases. The most common isolates identified from LA were Klebsiella pneumonia (40.3% of cases), mainly in monomicrobial LA, and Escherichia coli (22.6% of cases), predominantly in polymicrobial LA. Ceftriaxone and metronidazole intravenous formulations were used in 35.5% cases as the principal antimicrobial combination at hospital. Median overall expected duration of antimicrobial treatment was 15 days. LA drainage was performed in 87.4% of cases for the median duration of seven days. In 86.3% of cases both approaches were combined.Item Microbial Community of Kefir and its Impact on the Gastrointestinal Microbiome in Health and Disease(2020) Lazda, Ilva; Krūmiņa, Angelika; Zeltiņa, Indra; Krūmiņa, Nikola; Ķibilds, Juris; Siksna, Inese; Vīksna, Ludmila; Derovs, Aleksejs; Rīga Stradiņš UniversityKefir is a fermented dairy product, created by fermentation of milk by bacteria and yeasts. Kefir is the most common traditional non-sweetened fermented dairy beverage in the Baltic countries. Whole kefir and specific fractions and individual organisms isolated from kefir provide a multitude of health benefits, including regulation of composition of the gut microbiome. This review aims to summarise the available data about influence of kefir consumption on the gut microbiome in healthy individuals and to highlight the effects that kefir consumption as well as separated fractions of kefir can have in disease states via modulation of the host microbiome.Item On the X Anniversary Latvian Gastroenterology Congress with International Participation(2022-12-01) Derovs, Aleksejs; Derova, Jelena; Pokrotnieks, Juris; Rīga Stradiņš UniversityThe X Anniversary Latvian Gastroenterology Congress with International Participation has been held for the first time for a two-day period (3-4 December, 2021). The first day was devoted to international and local satellite symposia, with a total number of ten, which corresponded to the number of Congresses held. The second day of the Congress was devoted to the plenary session. Due to the severe COVID-19 epidemiology situation in Latvia, for the first time in its history since 2003, it was decided to hold the Congress not in person but remotely from the Rīga Stradiņš University Great Hall stage, with live video broadcasting. Despite the fact that the Congress was virtual, the two days attracted a significant number of participants - 753 registered colleagues. The invited guests included foreign lecturers from the United States, Israel, Germany, Croatia, UK, Italy, and other countries and the discussion panel was led by field leaders from around the world. We continued our tradition of preparing published reports of the congress in a special issue of Proceedings of the Latvian Academy of Sciences, Section B, in collaboration with the Latvian Academy of Sciences.Item Predictors of spontaneous and treatment-induced viral clearance of acute hepatitis C infection : the national research data : Предикторы спонтанного и посттерапевтического вирусного клиренса острого гепатита C : данные национального исследования(2019) Derovs, Aleksejs; Vanaga, Ieva; Zeltiņa, Indra; Rīga Stradiņš UniversityBackground/Aims. Our study retrospectively evaluated the predictors of spontaneous viral clearance and treatment-induced viral clearance of acute viral hepatitis C. Methods. The study included the data of 286 patients (156 male aged 18-79 years and 130 female aged 18-81 years) with acute hepatitis C in Latvia over a 5 year period (from 2008 till 2012). We performed retrospective analysis of the epidemiology, mode of transmission, clinical course, changes of laboratory tests (alanine aminotransferase, aspartate aminotransferase, total bilirubin, INR), changes of ultrasonography in an attempt to identify factors that could predict the outcome of the disease. Results. Among the 286 patients studied, transmission associated with healthcare-related exposure was the primary risk factor in 45% of patients, intravenous drug use in 11%, tattooing, body piercing, manicures in 7%, sexual transmission in 6%, needle stick injuries in 3% and source of infection undetermined in 28% of patients. In our study 92% of patients noted complaints, 79% of patients presenting with jaundice. Hepatomegaly in ultrasound was reported in 13% of cases and intra-abdominal lymphadenopathy was reported in 38% of cases. The spontaneous clearance of acute hepatitis was observed in 41% patients. We did not establish any significant correlation between spontaneous viral clearance and patient age, gender, clinical features or changes of laboratory tests. But we observed that patients with intra-abdominal lymphadenopathy in ultrasonography recovered more often compared to patients without intra-abdominal lymphadenopathy (r=0,219, p=0,016). Treatment with interferon alpha 2b was generally initiated by 228 patients. 86% of patients had a SVR after a 6 months post-treatment follow-up, 4% relapsed. We found that treatment with interferon alpha 2b was more effective in women compared to men (r=0.170, p=0.047). We did not did not determine any significant correlation between efficacy of antiviral therapy and clinical features and changes of laboratory tests. Conclusion. Hepatitis C virus (HCV) infection spontaneously clears in 41% of patients. We cannot predict spontaneous viral clearance by patient age, gender, clinical features or changes of laboratory tests, but patients with intra-abdominal lymphadenopathy in ultrasonography recovered more often compared to patients without intra-abdominal lymphadenopathy. None of the parameters accurately predicts spontaneous resolution at the individual level. KeywordsItem A quick guide to diagnosis and treatment of cytomegalovirus infection in the gut: current dilemmas(2022-12-10) Drjagunovs, Iļja; Laivacuma, Sniedze; Zeltiņa, Indra; Derovs, Aleksejs; Department of Infectology; Department of Internal DiseasesItem Rare liver tumour - epithelioid haemangioendothelioma: a case report(2022-12-01) Laivacuma, Sniedze; Zeltiņa, Indra; Derovs, Aleksejs; Norko, Andris; Isajevs, Sergejs; Makejeva, Karīna; PH Drenth, Joost; Department of Infectology; Department of Internal DiseasesEpithelioid haemangioendothelioma (EHE) is a rare vascular soft tissue malignant tumour with unknown etiology; the estimated prevalence of EHE is less than one in 1 million. A 56-year-old man was admitted in our department due to pain in the right side of the abdomen lasting for two years and weight loss up to 10 kg. Since 2012, the patient underwent lung and abdominal CT scanning as well as biopsy, however the diagnosis was challenging. In 2015, repeated abdominal CT scanning and a liver core biopsy was performed. The epithelioid haemangioendothelioma was diagnosed based by histopathological examination with subsequent radiological and clinical correlation. Therefore, accurate histopathological examination with radiological and clinical correlation is essential in the diagnosis of epithelioid haemangioendothelioma.Item Replication study of ulcerative colitis risk loci in a Lithuanian-Latvian case control sample(2013-10) Skieceviciene, Jurgita; Kiudelis, Gediminas; Ellinghaus, Eva; Balschun, Tobias; Jonaitis, Laimas V.; Zvirbliene, Aida; Denapiene, Goda; Leja, Marcis; Pranculiene, Gitana; Kalibatas, Vytenis; Saadati, Hamidreza; Ellinghaus, David; Andersen, Vibeke; Valantinas, Jonas; Irnius, Algimantas; Derovs, Aleksejs; Tamelis, Algimantas; Schreiber, Stefan; Kupcinskas, Limas; Franke, Andre; Department of Internal DiseasesBackground: Differences between populations might be reflected in their different genetic risk maps to complex diseases, for example, inflammatory bowel disease. We here investigated the role of known inflammatory bowel disease associated single nucleotide polymorphisms (SNPs) in a subset of patients with ulcerative colitis (UC) from the Northeastern European countries Lithuania and Latvia and evaluated possible epistatic interactions between these genetic variants. Methods: We investigated 77 SNPs derived from 5 previously published genome-wide association studies for Crohn's disease and UC. Our study panel comprised 444 Lithuanian and Latvian patients with UC and 1154 healthy controls. Single marker case control association and SNP-SNP epistasis analyses were performed. Results: We found 14 SNPs tagging 9 loci, including 21q21.1, NKX2-3, MST1, the HLA region, 1p36.13, IL10, JAK2, ORMDL3, and IL23R, to be associated with UC. Interestingly, the association of UC with previously identified variants in the HLA region was not the strongest association in our study (P = 4.34 × 1023, odds ratio [OR] = 1.25), which is in contrast to all previously published studies. No association with any disease subphenotype was found. SNP-SNP interaction analysis showed significant epistasis between SNPs in the PTPN22 (rs2476601) and C13orf31 (rs3764147) genes and increased risk for UC (P = 1.64 × 1026, OR = 2.44). The association has been confirmed in the Danish study group (P = 0.04, OR = 3.25). Conclusions: We confirmed the association of the 9 loci (21q21.1, 1p36.13, NKX2-3, MST1, the HLA region, IL10, JAK2, ORMDL3, and IL23R) with UC in the Lithuanian Latvian population. SNP-SNP interaction analyses showed that the combination of SNPs in the PTPN22 (rs2476601) and C13orf31 (rs3764147) genes increase the risk for UC.Item Risk Factors that Determine Less Favourable Hospitalisation Course and Outcome in Patients with ESBL Producing Enterobacteriaceae Infection : Preliminary Results(2016-08-01) Skuja, Vita; Pekarska, Katrīna; Caune, Una; Piekuse, Linda; Kempa, Inga; Rudzīte, Dace; Kigitoviča, Dana; Derovs, Aleksejs; Vīksna, Ludmila; Lejnieks, Aivars; Krūmiņa, Angelika; Department of Internal Diseases; Scientific Laboratory of Molecular Genetics; Department of InfectologyHospitalisation course and outcome for patients with extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae infection is less favourable due to extensive antibacterial resistance. This study was conducted to identify possible risk factors that could influence the hospitalisation course and outcome in these patients. The study protocol included demographic, clinical, hospitalisation, bacteriological and plasmid genetic data. The preliminary study results showed that hospitalisation course and outcome was less favourable for internal medicine profile patients with ESBL producing bacteria, TEM gene presence in the bacterial plasmid genome, patient age < 65 years and patients with infectious and musculoskeletal diseases. The study includes preliminary data only and further studies should be carried out to verify the suggested risk factors.