Browsing by Author "Ivanovs, Andrejs"
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Item Analysis of Risk Factors for the Prevalence of Tuberculosis in Latvia. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2016) Ivanovs, Andrejs; Rungule, Ritma; Vīksna, LudmilaTuberculosis always is linked to poverty, overcrowding and malnutrition. Historically, this disease mostly affected the most vulnerable part of the society – people with lower socioeconomic statuss and those subdued by harmful habits. Nowadays, despite the advances in medicine and solving social problems, topicality of tuberculosis in recent years has not diminished neither in Latvia nor in the world. Tuberculosis is still widespread throughout the world. Annually, 8–9 million people anew get ill with tuberculosis, but many more are infected. Tuberculosis is second most important infectious cause of death after HIV/AIDS. Development history of tuberculosis shows examples that incidence of the disease decreased prior first medicine against the disease was discovered. Such a positive effect was achieved by reducing the risk of disease exposure on individuals – people’s living and working conditions were improved, as well improved conditions of hygiene and sanitation. Thus, being aware of the risk and decreasing negative impact of factors, attenuation of morbidity in the society can be accomplished. Within the framework of thesis are being covered main health affecting factors, their models, identifying groups of factors most strongly affecting the health. According to the studies published in scientific literature, tuberculosis risk factors are being summarized and classified, their significance and impact strength in other countries. With the help of quantitative research has been clarified significance of risk of a disease conditions and risk factors identified in the literature, both on the individual level and society level in Latvia; most important risk factors have been clarified, which most affect the onset of tuberculosis; and considering interaction of risk conditions and risk factors, expression scheme of TB risk conditions and risk factors impact, that visually illustrates the process of interaction, was developed. Based on the main results of the research, in the perspective of risk conditions and risk factors affecting disease, key recommendations for TB prevention have been developed.Item Analysis of the Spatiotemporal Development of Hematopoietic Stem and Progenitor Cells in the Early Human Embryo(2019-05-14) Easterbrook, Jennifer; Rybtsov, Stanislav; Gordon-Keylock, Sabrina; Ivanovs, Andrejs; Taoudi, Samir; Anderson, Richard A.; Medvinsky, AlexanderDefinitive hematopoietic stem cells (HSCs)first emerge in the aorta-gonad-mesonephros (AGM)region in both mice and humans. An ex vivo culture approach has enabled recapitulation and analysis of murine HSC development. Knowledge of early human HSC development is hampered by scarcity of tissue: analysis of both CFU-C and HSC development in the human embryo is limited. Here, we characterized the spatial distribution and temporal kinetics of CFU-C development within early human embryonic tissues. We then sought to adapt the murine ex vivo culture system to recapitulate human HSC development. We show robust expansion of CFU-Cs and maintenance, but no significant expansion, of human HSCs in culture. Furthermore, we demonstrate that HSCs emerge predominantly in the middle section of the dorsal aorta in our culture system. We conclude that there are important differences between early mouse and human hematopoiesis, which currently hinder the quest to recapitulate human HSC development ex vivo.Item Assessment of Value of Fatigue Severity and Symptoms in Patients with Chronic Fatigue Syndrome/Myalgic Encephalomyelitis and Fibromyalgia(2014) Krūmiņa, Angelika; Vasiljeva, Ginta; Ivanovs, Andrejs; Gintere, Sandra; Kovalchuka, Lilija; Rasa-Dzelzkaleja, Santa; Chapenko, Svetlana; Murovska, Modra; Vīksna, Ludmila; Logina, Ināra; Department of Infectology; Department of Family Medicine; Institute of Microbiology and Virology; Department of Neurology and NeurosurgeryBackground and Objective: Chronic fatigue syndrome/myalgic encephalomyelitis(CFS/ME) remains a challenge for health care professionals because of its complex pathogenesis. Scales and questionnaires have been developed in order to assess the severity of syndrome. Fibromyalgia share similar clinical features with CFS/ME how ever have its own diagnostic criteria. Our study was performed to analyze impact of value of fatigue severity in patients with CFS/ME and fibromyalgia (FM). Materials and Methods: One hundred and three CFS/ME patients and 21 fibromyalgia patients were included in study. CFS/ME patients were diagnosed using the diagnostic criteria of Fukuda et al. 1994. The diagnosis of fibromyalgia was established using the American College of Rheumatology (ACR) 1990 diagnostic criteria. Fatigue Severity scale (FSS) and Fibro Fatigue scale (FFS) were used to assess the severity of fatigue. Factor analysis was performed in order to detect most common combinations of clinical signs inpatients with CFS/ME. The data were calculated using SPSS version 16.0. Results: The most common clinical feature other than fatigue was un-refreshing sleep established in71(68.9%) patients. The mean score of FSS within CFS/ME patients was6.65±0.256. The highest mean scores–6.94±0.243were observed within statements–“Exercise brings on my fatigue”, “Fatigue is among my three most disabling symptoms”. The total score of FSS within CFS/ME patients was59.94±2.045 and 53.62±8.880 in FM patients, (p=0.008). Fatigue was the most severe indicator according to FFS in CFS/ME patients with means score 5.76±0.664. Conclusion: Most part of the CFS/ME patients suffered from un-refreshing sleep. CFS/ME patients had higher rates according to FSS than FM patients, which shows that fatigue in patients with CFS/ME is more intense, affecting their daily activities.Item Cone beam computed tomography evaluation of maxillary sinus before and after sinus floor elevation(2019-08-01) Neimane, Laura; Zamure, Liene; Klimecs, Vadims; Grišuļonoks, Aleksandrs; Skagers, Andrejs; Ivanovs, Andrejs; Rīga Stradiņš University; Statistics Unit; Institute of Public HealthSinus lift surgery elevation is a procedure that requires radiological maxillary sinus evaluation and procedure planning. The condition of the maxillary sinus before and after sinus lift surgery was assessed. Sixty-five sinuses of 49 patients were included in the study. Preoperative and postoperative cone beam computed tomography (CBCT) scans were performed. The sinuses were analysed radiologically for pathological changes: mucosal thickening, ostia obstruction and accessory opening. The presence of concha bullosa in nasal cavity and septa in the maxillary sinus were recorded. The sinus volume also was measured before and after surgery. Thickened mucosa was found more often in postoperative scans than in preoperative scans (63.1% and 67.7%, respectively). Concha bullosa was found in 30 preoperative scans and in 33 postoperative scans. A correlation between mucosal thickening and ostia obstruction was found. The mean sinus volume decreased after surgery and the changes were statistically significant. In conclusion, changes of the maxillarysinus and nasal cavity can be detected with CBCT. Sinus lift surgery does not excacerebate the existing conditions of the maxillary sinus; however, there is a tendency for pathological features to increase after surgery. Sinus lift surgery is a safe surgery with regard to the maxillary sinus if performed with care.Item Construction of healthy aging index from two different datasets(2023) Miķelsone, Madara; Reine, Ieva; Tomsone, Signe; Guðmundsson, Helgi; Ivanovs, Andrejs; Guðmundsson, Halldór S.; Statistics Unit; Rehabilitācijas fakultāteIntroduction: The aging population presents both unique challenges and opportunities for societies around the world. To develop an effective healthy aging strategy, a tool for assessing aging process is needed. Numerous attempts to quantify the aging process have been made. However, there is still a challenge in developing and choosing a good enough score that is easy to apply, has a construct of variables that are available in most nationwide surveys for comparable results, and at the same time reflects the aging process of older individuals. The purpose of this study is to present our approach to construct a comparable Healthy Aging Index (HAI). Materials and methods: In Latvia, data from Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE), involving 420 respondents, were used. For comparative analysis, data from a HL20 study on the health and wellbeing of the older adults in Iceland, which included 1,033 respondents, were used. Results: For Latvia, 13 items were selected, and for Iceland, nine items were selected. We constructed the HAI with four similar subscales for both countries—“Autonomy,” “Health,” “Wellbeing,” and “Activities,” and an additional subscale “Cognitive” for Latvia. We found matching items in all four subscales. For the Autonomy subscale, they were related to difficulties with everyday and daily tasks. In the Health subscale, the only matching item was self-rated physical health. One item related to loneliness was found for the Wellbeing subscale and one item related to social participation for the Activities subscale. Discussion: In our study, we found evidence for the successful construction of a HAI in two different datasets. The strength of our construct lies in the use of data from one of the largest social science panel studies in Europe (SHARE). As we were able to apply the construct to the Icelandic study, we believe that items presented in our approach are available in other population-based studies as well, and, therefore, can be easily replicated by others. By examining the existing SHARE data, HAI could be used to analyze long-term changes and could provide a foundation for comparing and monitoring the evolution of aging over time as well as comparing the aging process across societies. This is required for the authorities to conduct further analyses, proposals, and action plans in support of healthy aging.Item Difference in markers of microbial translocation and cell apoptosis in HIV monoinfected and HIV/HCV coinfected patients(2019-08-01) Madelane, Monta; Krumiņa, Angelika; Simanis, Raimonds; Šķenders, Ģirts; Ivanovs, Andrejs; Sture, Gunta; Viksna, Ludmila; Department of InfectologyImmune activation in human immunodeficiency virus (HIV) infection is driven by microbial translocation and in HIV patients is one of the contributors to faster progression of liver disease along with increased cell apoptosis. The aim of the study was to compare microbial translocation and apoptosis markers in HIV monoinfected and HIV/hepatitis C virus (HCV) coinfected patients, depending on HIV immune status and antiretroviral treatment (ART). We analysed data for 78 HIV monoinfected and 105 HIV/HCV coinfected patients from the Rīga East University Hospital. Lipopolysaccharide (LPS), endotoxin core antibodies (EndoCAb), cytokeratin 18 (CK18) and cyto-chrome c (Cyt-c) levels were measured. No significant difference in LPS, EndoCAb, Cyt-c levels between HIV and HIV/HCV patients was found. The CK18 level was higher in the HIV/HCV group. Correlation between CD4+ cell count and EndoCAb antibodies was found in HCV positive patients. There was a significant effect of ART on markers for EndoCAb IgA and EndoCAb IgM antibodies in the HIV monoinfected group. Correlation between CD4+ cell count and EndoCAb antibodies and LPS was found in HIV/HCV patients on ART. Coinfection with HCV can lead to more pronounced response in EndoCAb antibody production and higher levels of cell apoptosis markers, despite similar LPS levels. ART has a positive effect on immune activation.Item Effects of social isolation on mental health during Covid-19 in the context of ageing(2021) Koroļeva, Ilze; Sniķere, Sigita; Aleksandrovs, Aleksandrs; Reine, Ieva; Trapencieris, Marcis; Ivanovs, Andrejs; Lubkina, Velta; Apsite-Berina, Elina; Znotina, Daina; Vindaca, Olga; Rīga Stradiņš UniversityThe COVID-19 pandemic brought significant changes to the usual rhythm of life. Reduced opportunities to meet with family members and friends in a situation of heightened stress leads to increased feelings of loneliness and social isolation, as well as increases the risk of mental health problems. The aim of this paper is to evaluate the effect of social contacts on the changes in psychoemotional states in the elderly population in Latvia during the crisis caused by the COVID-19 pandemic. The analysis draws upon quantitative data collected by the Survey of Health, Ageing and Retirement in Europe within Wave 8 in Latvia (n=1207). Measurements of the frequency of social contacts were used to construct social isolation indexes. Changes of psychoemotional state, characterized by sleeping problems, nervousness, frustration during the pandemic were included as dependent variables in multinomial logistic regression models that were run to identify the effect of social isolation on psychoemotional health in the context of other factors: age, gender, perceived health status, affluence and feelings of loneliness. The results show that in the group of those aged 50+, close to one-fifth of respondents experienced the effect of the COVID-19 crisis on their mental health. The link between reduced social contacts and changes in psychoemotional states proved to be statistically significant. In the group with the highest level of social isolation, irregularities in psychoemotional health are three times higher compared to other groups.Item Ehinokokozes diagnostikas pilnveidošana, izmantojot etioloģiskus, bioķīmiskus, imunoloģiskus un imūnģenētiskus marķierus, un riska faktoru apzināšana Latvijā. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2019) Laivacuma, Sniedze; Vīksna, Ludmila; Ivanovs, AndrejsPromocijas darba “Ehinokokozes diagnostikas pilnveidošana, izmantojot etioloģiskus, bioķīmiskus, imunoloģiskus un imūnģenētiskus marķierus, un riska faktoru apzināšana Latvijā” ir veltīts Latvijā vēl pilnībā neapzinātai hroniski noritošai parazitārai slimībai, kuras diagnostikas un ārstēšanas principi būtu uzlabojami. Saslimstība ar ehinokokozi Eiropas valstīs ir variabla, svārstoties 0,1–10/100000 gadījumu robežās, arī Latvijā katru gadu ir samērā liels pirmreizēji diagnosticētu ehinokokozes gadījumu skaits neskatoties uz salīdzinoši nelielo iedzīvotāju skaitu. Būtiski, ka Latvija ģeogrāfiski atrodas blakus endēmiskiem šīs zoonozes rajoniem, piemēram, Krievijai, Baltkrievijai, Polijai, bet mērķtiecīgi pētījumi par saslimstību, riska faktoriem, diagnostiku un ārstēšanu tieši mūsu valstī nav bijuši. Darba mērķis bija noteikt ehinokokozes izplatību Latvijā, apzināt saslimšanas riska faktorus, pilnveidot diagnostikas un ārstēšanas taktiku. Lai sasniegtu izvirzīto mērķi, pētījumā tika iekļauti vairāk nekā simts pacienti, kuru dati tika analizēti retrospektīvi, kā arī tika izveidota pacientu grupa, kura tika anketēta, lai konstatētu iespējamos riska faktorus, un šajā grupā arī tika meklēti iespējamie imūnģenētiskie riska faktori un iespējamie diagnostikā noderīgie imunoloģiskie marķieri. Darba rezultātā tika noskaidrots, ka tiešām Latvijas pacientu populācijā var izdalīt riska faktorus, piemēram, risku saslimt palielina dzīvošana lauku sētā, un risks paaugstinās, pieaugot dzīves ilgumam, risku palielina arī mājlopu esamība un to kaušanas paradumi, arī dabiskā mēslojuma izmantošana piemājas dārzos un fakts, ka saimniecībā ir turēti kaķi. Tika konstatēts arī, ka IL-10 noteikšana var būt lietderīga alveolārās ehinokokozes gadījumā, jo tas varētu būt marķieris, kas ļauj precīzāk izvēlēties terapijas ilgumu šiem pacientiem. Promocijas darbā, veicot HLA II klases gēnu alēļu sastopamības analīzi, konstatēts, ka ir alēles un haplotipi, pēc kuriem var noteikt smagākas slimības gaitas iespēju, savukārt, citi ir saistīti ar vieglu un nekomplicētu slimības gaitu. Tika konstatēts, ka ir iemesls pieturēties rekomendētām terapijas shēmām, jo labāks ārstēšanas rezultāts būs tiem pacientiem, kuri terapiju saņem agrīni, proti, jau pirmā gada laikā pēc inficēšanās, kuriem ir pietiekoši gari terapijas kursi, vismaz nepārtraukti 6 mēneši, kā arī terapija tiek lietota katru gadu. Analizējot bioķīmiskos parametrus, var secināt, ka risku nomirt palielina paaugstināts EGĀ, SF, GGT un bilirubīna līmenis. Darba gaitā arī tika konstatēts, ka nozīmīgi ir imūnģenētiskie dati, jo tika secināts, ka cistiskās ehinokokozes gadījumā par smagāku slimības gaitu var liecināt HLA-DRB1 alēles *17:01 un *04:01, -DQB1*03:02, -DQA1*04:01 un haplotipi HLA-DRB1*04/-DQB1*0301/-DQA1*0103, HLA-DRB1*11:01/-DQB1*0602-8/-DQA1*0103, bet alveolārās ehinokokozes gadījumā par smagāku slimības gaitu var liecināt HLA-DRB alēles *17:01 un *11:01, -DQB1*03:01 un haplotipi HLA-DRB1*17:01/-DQB1*03:01/-DQA1*01:02, HLA-DRB1*11:01/-DQB1*03:01/-DQA1*01:03 un HLA-DRB1*11:01/-DQB1*03:01/-DQA1*03:01. Savukārt par protektīvām cistiskās ehinokokozes gadījumā var uzskatīt HLA-DRB1 alēles *01:01 un *15:01, -DQA1 *01:01, bet alveolārās ehinokokozes gadījumā – HLA-DRB alēli *01:01. Kā protektīvus visās pacientu grupās var izdalīt šādus haplotipus: HLA-DRB1*01:01/-DQВ1*03:01/-DQA1*01:01 un HLA-DRB1*01:01/-DQB1*02:01-2/-DQA1*02:01. Viss minētais ļāva secināt, ka ehinokokozes pacientu bioķīmiskajiem, imunoloģiskajiem un imūnģenētiskajiem faktoriem ir būtiska nozīme slimības diagnostikā un ārstēšanā, un tie daļēji ļauj paredzēt slimības gaitu un iznākumu.Item Ehinokokozes diagnostikas pilnveidošana, izmantojot etioloģiskus, bioķīmiskus, imunoloģiskus un imūnģenētiskus marķierus, un riska faktoru apzināšana Latvijā. Promocijas darbs(Rīgas Stradiņa universitāte, 2019) Laivacuma, Sniedze; Vīksna, Ludmila; Ivanovs, AndrejsPromocijas darba “Ehinokokozes diagnostikas pilnveidošana, izmantojot etioloģiskus, bioķīmiskus, imunoloģiskus un imūnģenētiskus marķierus, un riska faktoru apzināšana Latvijā” ir veltīts Latvijā vēl pilnībā neapzinātai hroniski noritošai parazitārai slimībai, kuras diagnostikas un ārstēšanas principi būtu uzlabojami. Saslimstība ar ehinokokozi Eiropas valstīs ir variabla, svārstoties 0,1–10/100000 gadījumu robežās, arī Latvijā katru gadu ir samērā liels pirmreizēji diagnosticētu ehinokokozes gadījumu skaits neskatoties uz salīdzinoši nelielo iedzīvotāju skaitu. Būtiski, ka Latvija ģeogrāfiski atrodas blakus endēmiskiem šīs zoonozes rajoniem, piemēram, Krievijai, Baltkrievijai, Polijai, bet mērķtiecīgi pētījumi par saslimstību, riska faktoriem, diagnostiku un ārstēšanu tieši mūsu valstī nav bijuši. Darba mērķis bija noteikt ehinokokozes izplatību Latvijā, apzināt saslimšanas riska faktorus, pilnveidot diagnostikas un ārstēšanas taktiku. Lai sasniegtu izvirzīto mērķi, pētījumā tika iekļauti vairāk nekā simts pacienti, kuru dati tika analizēti retrospektīvi, kā arī tika izveidota pacientu grupa, kura tika anketēta, lai konstatētu iespējamos riska faktorus, un šajā grupā arī tika meklēti iespējamie imūnģenētiskie riska faktori un iespējamie diagnostikā noderīgie imunoloģiskie marķieri. Darba rezultātā tika noskaidrots, ka tiešām Latvijas pacientu populācijā var izdalīt riska faktorus, piemēram, risku saslimt palielina dzīvošana lauku sētā, un risks paaugstinās, pieaugot dzīves ilgumam, risku palielina arī mājlopu esamība un to kaušanas paradumi, arī dabiskā mēslojuma izmantošana piemājas dārzos un fakts, ka saimniecībā ir turēti kaķi. Tika konstatēts arī, ka IL-10 noteikšana var būt lietderīga alveolārās ehinokokozes gadījumā, jo tas varētu būt marķieris, kas ļauj precīzāk izvēlēties terapijas ilgumu šiem pacientiem. Promocijas darbā, veicot HLA II klases gēnu alēļu sastopamības analīzi, konstatēts, ka ir alēles un haplotipi, pēc kuriem var noteikt smagākas slimības gaitas iespēju, savukārt, citi ir saistīti ar vieglu un nekomplicētu slimības gaitu. Tika konstatēts, ka ir iemesls pieturēties rekomendētām terapijas shēmām, jo labāks ārstēšanas rezultāts būs tiem pacientiem, kuri terapiju saņem agrīni, proti, jau pirmā gada laikā pēc inficēšanās, kuriem ir pietiekoši gari terapijas kursi, vismaz nepārtraukti 6 mēneši, kā arī terapija tiek lietota katru gadu. Analizējot bioķīmiskos parametrus, var secināt, ka risku nomirt palielina paaugstināts EGĀ, SF, GGT un bilirubīna līmenis. Darba gaitā arī tika konstatēts, ka nozīmīgi ir imūnģenētiskie dati, jo tika secināts, ka cistiskās ehinokokozes gadījumā par smagāku slimības gaitu var liecināt HLA-DRB1 alēles *17:01 un *04:01, -DQB1*03:02, -DQA1*04:01 un haplotipi HLA-DRB1*04/-DQB1*0301/-DQA1*0103, HLA-DRB1*11:01/-DQB1*0602-8/-DQA1*0103, bet alveolārās ehinokokozes gadījumā par smagāku slimības gaitu var liecināt HLA-DRB alēles *17:01 un *11:01, -DQB1*03:01 un haplotipi HLA-DRB1*17:01/-DQB1*03:01/-DQA1*01:02, HLA-DRB1*11:01/-DQB1*03:01/-DQA1*01:03 un HLA-DRB1*11:01/-DQB1*03:01/-DQA1*03:01. Savukārt par protektīvām cistiskās ehinokokozes gadījumā var uzskatīt HLA-DRB1 alēles *01:01 un *15:01, -DQA1 *01:01, bet alveolārās ehinokokozes gadījumā – HLA-DRB alēli *01:01. Kā protektīvus visās pacientu grupās var izdalīt šādus haplotipus: HLA-DRB1*01:01/-DQВ1*03:01/-DQA1*01:01 un HLA-DRB1*01:01/-DQB1*02:01-2/-DQA1*02:01. Viss minētais ļāva secināt, ka ehinokokozes pacientu bioķīmiskajiem, imunoloģiskajiem un imūnģenētiskajiem faktoriem ir būtiska nozīme slimības diagnostikā un ārstēšanā, un tie daļēji ļauj paredzēt slimības gaitu un iznākumu.Item Exploration of healthy ageing determinants in the Baltic States(Rēzeknes Tehnoloģiju akadēmija, 2021-05-28) Miķelsone, Madara; Baltmane, Diāna; Reine, Ieva; Sniķere, Sigita; Ivanovs, Andrejs; Tomsone, Signe; Lubkina, Velta; Laganovska, Karīna; Kaupužs, Aivars; Statistics Unit; Rehabilitācijas fakultāteAccording to the WHO, healthy ageing is characterized by such interrelated determinants as intrinsic capacity, functional ability and environment. An individual's intrinsic capacity is a powerful predictor of the future ageing process and includes 5 areas - cognitive, psychological, sensory, locomotion and vitality. Exploration of these areas can provide necessary information for therapeutic and preventive actions that can be tailored to an individual's needs, priorities and values to support participation and quality of life. The objective of this study was to evaluate and compare healthy ageing determinants of older individuals in the Baltic States. The research was based on the sample of older individuals (50 years and older) from wave 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) during the period from November 2019 to March 2020. The obtained results indicate a low level/poor results in such determinants as locomotion, sensory, vitality and functional ability (more than 50% of the respondents among the Baltic countries has poor health, various long-term illnesses, limitations in daily activities, suffer from moderate or severe pain, requires help to meet daily needs, etc.), has various behavioral risks, however has higher assessment of cognitive and psychological determinants.Item Human haematopoietic stem cell development : From the embryo to the dish(2017) Ivanovs, Andrejs; Rybtsov, Stanislav; Ng, Elizabeth S.; Stanley, Edouard G.; Elefanty, Andrew G.; Medvinsky, AlexanderHaematopoietic stem cells (HSCs) emerge during embryogenesis and give rise to the adult haematopoietic system. Understanding how early haematopoietic development occurs is of fundamental importance for basic biology and medical sciences, but our knowledge is still limited compared with what we know of adult HSCs and their microenvironment. This is particularly true for human haematopoiesis, and is reflected in our current inability to recapitulate the development of HSCs from pluripotent stem cells in vitro. In this Review, we discuss what is known of human haematopoietic development: the anatomical sites at which it occurs, the different temporal waves of haematopoiesis, the emergence of the first HSCs and the signalling landscape of the haematopoietic niche. We also discuss the extent to which in vitro differentiation of human pluripotent stem cells recapitulates bona fide human developmental haematopoiesis, and outline some future directions in the field.Item Improvement of Echinococcosis Diagnostics Using Ethiological, Biochemical, Immunological and Immunogenetic Markers and Identification of Infection Risk Factors in Latvia. Summary of the Doctoral Thesis(Rīga Stradiņš University, 2019) Laivacuma, Sniedze; Vīksna, Ludmila; Ivanovs, AndrejsThe doctoral thesis “Improvement of Echinococcosis Diagnostics Using Ethiological, Biochemical, Immunological and Immunogenetic Markers and Identification of Infection Risk factors in Latvia” is devoted to the chronic parasitic disease that is not yet fully understood in Latvia and its diagnostic and treatment principles should be improved. The incidence of echinococcosis in European countries varies, ranging from 0.1 to 10/100,000 cases, and Latvia also has a relatively high number of newly diagnosed cases every year despite the relatively small population. It is important to mention that Latvia is geographically close to endemic areas of this zoonosis, such as Russia, Belarus, Poland, but there have been no targeted studies of morbidity, risk factors, diagnosis and treatment in our country. The aim of the thesis was to determine the prevalence of echinococcosis in Latvia, to identify risk factors of disease and to improve diagnostic and treatment tactics. To achieve our goal the study included more than a hundred patients whose data were analyzed in retrospective manner and a group of patients was surveyed to identify potential risk factors also immunogenetic and we also sought for new immunologic markers that could improve diagnostics. As a result of the analysis, it was found that risk factors can be distinguished in the Latvian patient population, for example, the risk will be increased if patient lives in a rural household as well if he owns livestock and slaughter them at home as well there is increased risk in owning dogs and cats. It was also found that IL-10 detection may be useful in cases of alveolar echinococcosis, as it could be a marker that allows a more accurate choice of treatment duration for these patients. The analysis of the prevalence of HLA Class II gene alleles revealed that there are alleles and haplotypes that can determine severity of the disease. There is also a reason to comply with the recommended treatment regimens as better result of the treatment will be for those patients who receive treatment early, that is, in the first year after the detection of the infection, those who have longer courses of treatment, at least continuously for 6 months and those who have the treatment every year. Analyzing biochemical parameters, it can be concluded that the risk of dying is increased in those patients who have increased levels of ESR, SF, GGT and bilirubin. From immunogenetic data it was concluded that in the case of cystic echinococcosis, a more severe course of the disease may be connected with alleles HLA-DRB1*17:01 and *04:01, -DQB1*03:02, -DQA1*04:01 and haplotypes HLA-DRB1*04/-DQB1*0301/-DQA1*0103, HLA-DRB1*11:01/-DQB1*0602-8/-DQA1*0103 but in case of alveolar echinococcosis more severe presentation with alleles *17:01 and *11:01, -DQB1*03:01 and haplotypes HLA-DRB1*17:01/-DQB1*03:01/-DQA1*01:02, HLA-DRB1*11:01/-DQB1*03:01/-DQA1*01:03 and HLA-DRB1*11:01/-DQB1*03:01/-DQA1*03:01. On the other hand we concluded that following alleles may be protective: in case of cystic echinococcosis HLA-DRB1*01:01 and *15:01, -DQA1*01:01, in case of alveolar echinococcosis alleles HLA-DRB*01:01. And protective haplotypes in all patients were HLA-DRB1*01:01/-DQВ1*03:01/-DQA1*01:01 and HLA-DRB1*01:01/-DQB1*02:01-2/-DQA1*02:01. All of this has led to the conclusion that biochemical, immunological and immunogenetic markers of echinococcosis patients play an important role in the diagnosis and treatment of the disease, as well may partially predict the course and outcome of the disease.Item Intergenerational solidarity in family : Influence of the education level on frequency of contacts(2024) Kuligina, Nadezda; Dobelniece, Signe; Ivanovs, Andrejs; Vilka, L.; Krumina, J.; Rīga Stradiņš UniversityThe aim of this study was to research the influence of the adult child’s and parent’s education level on the frequency of contacts between the adult child and parent, since the frequency of contacts is recognised by the intergenerational solidarity model as one of the factors strengthening the intergenerational solidarity in the family. Influence of the adult child’s and parent’s education level on time spent on the way to the parent’s home, and time spent on the way as a factor promoting frequency of contacts or preventing contacts was studied as well. Participants of the study were 332 adult children aged 18-62, residing in Latvia, and having at least one living parent. Results of the study showed that education of an adult child and a parent affected the frequency of meetings in person, frequency of contacts by phone, and the use of the information technologies. Time spent on the way to the parent’s home affected the frequency of meetings in person and of the frequency of contacts by phone.Item Overcoming Social Isolation with Digital Technologies Among Ageing Populations During Covid-19(Rēzeknes Tehnoloģiju akadēmija, 2021-05-28) Reine, Ieva; Ivanovs, Andrejs; Mieriņa, Inta; Gehtmane-Hofmane, Ilona; Koroļeva, Ilze; Lubkina, Velta; Laganovska, Karīne; Kaupužs, Aivars; Statistics Unit; Institute of Public HealthDuring Covid-19 social isolation has become more common worldwide, however, some groups, especially elderly people, might have experienced dramatically limited communication due to the lack of skills and access to digital technologies. In this paper, we examined if education was associated with the use of digital technologies to maintain contacts with a family, friends, other social networks and services. The survey was conducted in June-August 2020 by doing 1089 computer-assisted telephone interviews. The questions examined how people aged 50 years and older coped with socioeconomic and health-related impact of COVID-19.We used logistic regression analysis to study the association between the use of digital technologies and the level of education by gender and age. The higher the education was, the more it strongly associated with the use of digital technologies (OR 5.85; 95% CI 3.78-9.03). As expected, age was a strong explanatory factor, however, we did not find consistent age and gender differences. Among those who used digital technologies, analyses showed that overcoming social isolation was related to the education level. The conclusion of the study is that education has inevitable impact on the use of digital technologies and social contacts, however high education level is not crucial for the acquisition of information. It seems that digital technologies are important tools to prevent social isolation and are related to education that includes digital access and competencies.Item OVERVIEW AND OUTCOMES OF PATIENTS HOSPITALISED WITH COVID-19 PNEUMONIA IN RĪGA EAST UNIVERSITY HOSPITAL(2024-02) Rugājs, Reinis; Madelāne, Monta; Ivanovs, Andrejs; Vīksna, Ludmila; Department of Infectology; Statistics UnitThe COVID-19 pandemic is still a burden to the global health care system, affecting its capacity to maintain essential health services. Even though specific treatment and prevention options are available, the SARS-CoV-2 virus keeps accumulating mutations over time and challenging the efficiency of vaccines, causing new outbreaks and increasing hospitalisation. Early studies suggest that mortality from COVID-19 is increased by age and certain comorbidities. Thus, the goal of this study was to analyse patients hospitalised with COVID-19 pneumonia in terms of age, sex, and comorbidities. Additionally, the influence of treatment with Remdesivir and vaccination on hospitalisation duration and disease outcome was also analysed. The results showed that lethal disease outcome is mainly increased by age and gender, where older and male patients are at a higher risk. There were less deaths in patients with primary arterial hypertension. Other comorbidities did not have a statistically significant influence on disease outcome. Among those who survived, a higher number of patients had been treated with Remdesivir. Vaccination did not have an impact on disease outcome. It could be concluded that older and male patients are the risk group with a worse disease outcome. Treatment with Remdesivir shows a positive effect on disease outcome, although further detailed analysis is necessary.Item Prevalence and incidence of myalgic encephalomyelitis/chronic fatigue syndrome in Europe—the Euro-epiME study from the European network EUROMENE: a protocol for a systematic review(2018) Estévez-López, Fernando; Castro-Marrero, Jesus; Wang, Xia; Bakken, Inger Johanne; Ivanovs, Andrejs; Nacul, Luis; Sepúlveda, Nuno; Strand, Elin B; Pheby, Derek; Alegre, Jose; Scheibenbogen, Carmen; Shikova, Evelina; Lorusso, Lorenzo; Capelli, Enrica; Sekulic, Slobodan; Lacerda, Eliana; Murovska, Modra; on behalf of the European Network on ME/ CFS (EUROMENE)Introduction Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic disease involving central nervous system and immune system disorders, as well as cardiovascular abnormalities. ME/CFS is characterised by severe chronic fatigue lasting for at least 6 months, including clinical symptoms such as tender cervical or axillary lymph nodes, muscle pain, joint pain without swelling or redness, post-exertional malaise for more than 24 hours and unrefreshing sleep. Studies on the epidemiology of ME/CFS in Europe only include single countries and, therefore, the prevalence and incidence of ME/CFS in Europe (as a whole) is unknown. One of the purposes of the European Network on ME/CFS (EUROMENE; European Union-funded COST Action; Reference number: 15111) is to address this gap in knowledge. We will systematically review the literature reporting figures from European countries to provide a robust summary and identify new challenges. Methods and analysis We will systematically search the literature databases Scopus, PubMed and Web of Science for studies published in the last 10 years (ie, after 2007). No language restriction will be applied. Two independent reviewers will search, screen and select studies as well as extract data about their main characteristics and evaluate their methodological and reporting quality. When disagreements emerge, the reviewers will discuss to reach a consensus. We plan to produce a narrative summary of our findings as we anticipate that studies are scarce and heterogeneous. The possibility of performing meta-analyses will be discussed in a EUROMENE meeting. Ethics and dissemination Ethical approval is not required as only publicly available data will be included. Findings will be described in EUROMENE reports, published in peer-reviewed journal(s) and presented at conferences. The findings will be also communicated to policy-makers, healthcare providers, people with ME/CFS and other sections of society through regular channels including the mass-media.Item Riska faktoru analīze saslimšanai ar tuberkulozi Latvijā. Promocijas darba kopsavilkums(Rīgas Stradiņa universitāte, 2016) Ivanovs, Andrejs; Rungule, Ritma; Vīksna, LudmilaTuberkulozi vienmēr saista ar nabadzību, pārapdzīvotību un nepietiekamu uzturu. Vēsturiski šī slimība visbiežāk ir skārusi visneaizsargātāko sabiedrības daļu – cilvēkus ar zemāku sociāli ekonomisko statusu un kaitīgiem ieradumiem pakļautajiem. Mūsdienās, neskatoties uz sasniegumiem medicīnā un sociālo problēmu risināšanā, tuberkulozes aktualitāte pēdējos gados nav mazinājusies ne Latvijā, ne pasaulē. Tuberkuloze joprojām ir plaši izplatīta visā pasaulē. Ik gadu ar tuberkulozi no jauna saslimst 8–9 miljoni cilvēku, bet inficējas daudz vairāk. Tuberkuloze ir otrais svarīgākais infekciozais nāves cēlonis aiz HIV/AIDS. Tuberkulozes attīstības vēsture rāda piemērus, ka saslimstība ar šo slimību samazinājās pirms tika izgudroti pirmie medikamenti pret šo slimību. Tāds pozitīvais efekts tika panākts, samazinot saslimšanas riska faktoru iedarbību uz indivīdiem – tika uzlaboti cilvēku dzīves un darba apstākļi, uzlabots uzturs, tika uzlaboti higiēnas un sanitārie apstākļi. Tādējādi, apzinoties un samazinot riska faktoru negatīvo ietekmi, var panākt saslimstības samazinājumu sabiedrībā. Promocijas darba ietvaros tiek apskatīti galvenie veselību ietekmējošie faktori, to modeļi, identificējot veselību visstiprāk ietekmējošās faktoru grupas. Pēc zinātnes literatūrā publicētiem pētījumiem tiek apkopoti un klasificēti saslimšanas ar tuberkulozi riska faktori, to nozīme un ietekmes stiprums citās valstīs. Ar kvantitatīva pētījuma palīdzību noskaidrota literatūrā identificēto saslimšanas riska apstākļu un riska faktoru nozīme gan indivīda līmenī, gan arī sabiedrības līmenī Latvijā; ir noskaidroti svarīgākie riska faktori, kuri visvairāk ietekmē saslimšanu ar tuberkulozi; un, ņemot vērā riska apstākļu un riska faktoru mijiedarbību, tika izveidota TB riska apstākļu un riska faktoru ietekmes izpausmes shēma, kurā vizuāli ir atspoguļots mijiedarbības process. Pamatojoties uz galvenajiem pētījuma rezultātiem, ir izstrādātas galvenās rekomendācijas TB prevencijai saslimšanu ietekmējošo riska apstākļu un riska faktoru aspektā.Item Riska faktoru analīze saslimšanai ar tuberkulozi Latvijā. Promocijas darbs(Rīgas Stradiņa universitāte, 2016) Ivanovs, Andrejs; Rungule, Ritma; Vīksna, LudmilaTuberkulozi vienmēr saista ar nabadzību, pārapdzīvotību un nepietiekamu uzturu. Vēsturiski šī slimība visbiežāk ir skārusi visneaizsargātāko sabiedrības daļu – cilvēkus ar zemāku sociāli ekonomisko statusu un kaitīgiem ieradumiem pakļautajiem. Mūsdienās, neskatoties uz sasniegumiem medicīnā un sociālo problēmu risināšanā, tuberkulozes aktualitāte pēdējos gados nav mazinājusies ne Latvijā, ne pasaulē. Tuberkuloze joprojām ir plaši izplatīta visā pasaulē. Ik gadu ar tuberkulozi no jauna saslimst 8–9 miljoni cilvēku, bet inficējas daudz vairāk. Tuberkuloze ir otrais svarīgākais infekciozais nāves cēlonis aiz HIV/AIDS. Tuberkulozes attīstības vēsture rāda piemērus, ka saslimstība ar šo slimību samazinājās pirms tika izgudroti pirmie medikamenti pret šo slimību. Tāds pozitīvais efekts tika panākts, samazinot saslimšanas riska faktoru iedarbību uz indivīdiem – tika uzlaboti cilvēku dzīves un darba apstākļi, uzlabots uzturs, tika uzlaboti higiēnas un sanitārie apstākļi. Tādējādi, apzinoties un samazinot riska faktoru negatīvo ietekmi, var panākt saslimstības samazinājumu sabiedrībā. Promocijas darba ietvaros tiek apskatīti galvenie veselību ietekmējošie faktori, to modeļi, identificējot veselību visstiprāk ietekmējošās faktoru grupas. Pēc zinātnes literatūrā publicētiem pētījumiem tiek apkopoti un klasificēti saslimšanas ar tuberkulozi riska faktori, to nozīme un ietekmes stiprums citās valstīs. Ar kvantitatīva pētījuma palīdzību noskaidrota literatūrā identificēto saslimšanas riska apstākļu un riska faktoru nozīme gan indivīda līmenī, gan arī sabiedrības līmenī Latvijā; ir noskaidroti svarīgākie riska faktori, kuri visvairāk ietekmē saslimšanu ar tuberkulozi; un, ņemot vērā riska apstākļu un riska faktoru mijiedarbību, tika izveidota TB riska apstākļu un riska faktoru ietekmes izpausmes shēma, kurā vizuāli ir atspoguļots mijiedarbības process. Pamatojoties uz galvenajiem pētījuma rezultātiem, ir izstrādātas galvenās rekomendācijas TB prevencijai saslimšanu ietekmējošo riska apstākļu un riska faktoru aspektā.Item Systematic Review of the Epidemiological Burden of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Across Europe: Current Evidence and EUROMENE Research Recommendations for Epidemiology(2020-05-21) Estévez-López, Fernando; Mudie, Kathleen; Wang-Steverding, Xia; Bakken, Inger Johanne; Ivanovs, Andrejs; Castro-Marrero, Jesús; Nacul, Luis; Alegre, Jose; Zalewski, Paweł; Słomko, Joanna; Strand, Elin Bolle; Pheby, Derek; Shikova, Evelina; Lorusso, Lorenzo; Capelli, Enrica; Sekulic, Slobodan; Scheibenbogen, Carmen; Sepulveda, Nuno; Murovska, Modra; Lacerda, Eliana; on behalf of The European Network on ME/CFS (EUROMENE)This review aimed at determining the prevalence and incidence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) in Europe. We conducted a primary search in Scopus, PubMed and Web of Science for publications between 1994 and 15 June 2019 (PROSPERO: CRD42017078688). Additionally, we performed a backward-(reference lists) and forward-(citations) search of the works included in this review. Grey literature was addressed by contacting all members of the European Network on ME/CFS (EUROMENE). Independent reviewers searched, screened and selected studies, extracted data and evaluated the methodological and reporting quality. For prevalence, two studies in adults and one study in adolescents were included. Prevalence ranged from 0.1% to 2.2%. Two studies also included incidence estimates. In conclusion, studies on the prevalence and incidence of ME/CFS in Europe were scarce. Our findings point to the pressing need for well-designed and statistically powered epidemiological studies. To overcome the shortcomings of the current state-of-the-art, EUROMENE recommends that future research is better conducted in the community, reviewing the clinical history of potential cases, obtaining additional objective information (when needed) and using adequate ME/CFS case definitions; namely, the Centers for Disease Control & Prevention−1994, Canadian Consensus Criteria, or Institute of Medicine criteria.Item Unraveling the dynamics of loneliness in the Baltic-Nordic region : a comparative analysis in the wake of COVID-19(2024-04-22) Reine, Ieva; Miķelsone, Madara; Tomsone, Signe; Guðmundsson, Helgi; Ivanovs, Andrejs; Guðmundsson, Halldór S; Koroļeva, Ilze; Statistics Unit; Department of RehabilitationINTRODUCTION: The primary aim of this study is to thoroughly investigate the prevalence and determinants of loneliness among older adults in the Baltic-Nordic region. Utilizing high-quality data sources and employing a methodologically rigorous approach, the study endeavors to enhance our understanding of how loneliness manifests and varies across different cultural and socio-economic contexts within these regions. By identifying key factors influencing loneliness, including demographic, social, and economic variables, the research seeks to contribute significantly to the existing body of knowledge on loneliness and inform targeted public health strategies and interventions tailored to the unique needs of older adults in the Baltic and Nordic countries. MATERIAL AND METHODS: This research, centered on older adults aged 67 and above within the Baltic-Nordic region, draws upon data from the Survey of Health, Ageing and Retirement in Europe (SHARE), specifically its eighth wave conducted between June and August 2020. The demographic analysis of this study covers a diverse sample of 5,313 participants from the Baltic and Nordic regions. Specifically, the sample includes 2,377 participants from Nordic countries, namely Sweden, Denmark, and Finland, and 2,936 from the Baltic countries of Estonia, Latvia, and Lithuania. The investigation extends to the financial well-being of households, involving an analysis of 3,925 individuals, with 1,748 from Nordic countries and 2,177 from Baltic countries. Although Iceland is categorized as a Nordic country, the analysis within this study is conducted separately due to the unavailability of SHARE data for this region. Instead, the HL20 study, focusing on the health and well-being of the older adult population in Iceland, contributes data for 1,033 respondents. This methodological distinction allows for a comprehensive understanding of regional differences, highlighting the importance of specialized approaches to examine the intricate dynamics of loneliness and well-being across the Baltic-Nordic region. RESULTS: The study reveals significant regional variations in loneliness among older adults during the COVID-19 outbreak, with the Baltic countries (Estonia, Latvia, Lithuania) reporting a lower prevalence of loneliness compared to the Nordic countries (Sweden, Denmark, Finland). Iceland, while grouped with the Nordic countries, was analysed separately. Employment emerges as a key factor in reducing loneliness across all regions, suggesting the benefits of social interactions and structured routines. Gender and marital status significantly influence loneliness, with notable disparities in the Baltic region and smaller gaps in the Nordic countries, reflecting the impact of societal and cultural norms. Additionally, educational attainment and health status show varied associations with loneliness, highlighting the complex interplay of individual and societal factors in these regions.