Browsing by Author "Ivanovs, Igors"

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    Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy : A Randomized Controlled Trial
    (2024-12) Opincāns, Jānis; Ivanovs, Igors; Miscuks, Aleksejs; Pāvulāns, Jānis; Mārtinsone, Katrīna Deja; Rudzats, Agris; Kecbaja, Zurabs; Gutnikovs, Olegs; Kaminskis, Aleksejs; Faculty of Medicine
    Background and Objectives: Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Materials and Methods: Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023. The patients were randomised to either Group A (intervention—continuous bupivacaine) or Group B (control—NaCl saline). The primary outcome measures were the quantity of an opioid analgesic administered during the initial 72 h post-surgery and the level of postoperative pain as indicated by the visual analogue scale (VAS). Mann–Whitney U test was used for quantitative analysis while Pearson Chi-square was used for categorical variables. Results: A total of 60 patients completed the trial, with 30 patients in each of the two groups. Patients in Group A reported lower median VAS pain scores at all observed time points following surgery (p < 0.001). No patient in Group A required rescue opioid analgesia, although non-steroidal anti-inflammatory drugs were necessary during the initial 12 h postoperatively. Clinically, Group A patients had a significantly shorter time to first gas (p = 0.001), a shorter time to first bowel movement (p < 0.001), a shorter time to first out-of-bed activity (p < 0.001), and a shorter overall hospitalisation duration (p < 0.001) compared to Group B patients. Conclusions: Bilateral RSB with continuous bupivacaine infusion is effective in managing pain and can reduce the use of opioid analgesics in the postoperative period. Furthermore, it promotes early recovery, and a shorter hospital stay.
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    Clinicopathological Significance of Exosomal Proteins CD9 and CD63 and DNA Mismatch Repair Proteins in Prostate Adenocarcinoma and Benign Hyperplasia
    (2022-02) Folkmanis, Kristofs; Junk, Elizabete; Merdane, Evelina; Folkmane, Inese; Folkmanis, Valdis; Ivanovs, Igors; Eglitis, Janis; Jakubovskis, Maris; Laabs, Sven; Isajevs, Sergejs; Lietuvietis, Vilnis; Faculty of Medicine
    Introduction. Recently, it has been shown that exosomal biomarkers and DNA mismatch repair proteins (MMR) could play an important role in cancer risk stratification and prognosis assessment. The gold standard for prostate carcinoma (PCa) diagnosis is biopsy and histopathological examination. Thus, the complex evaluation of exosomal and MMR proteins could be beneficial for prostate cancer risk stratification and diagnostics. The aim of the current study was to evaluate and compare the expression of exosomal proteins CD9 and CD63 and MMR proteins in the tissue of patients with prostate benign hyperplasia (BPH) and PCa. Methods. The study was retrospective. Altogether, 92 patients with PCa and 20 patients with BPH (control group) were enrolled in the study. Exosomal and MMR protein expression was analyzed by immunohistochemistry (IHC). The follow-up for each PCa patient in our study lasted till disease progression and/or a maximum of 5 years. Results. Low-grade PCa was observed in 56 patients and high-grade PCa in 36 patients. CD63 expression was significantly higher in patients with high-grade PCa compared to those with low-grade PCa. CD9 expression was significantly downregulated in PCa patients compared to the control group. MMR protein expression deficiency was observed in 10 PCa patients. MMR proteins were maintained in all cases of BPH. The study found a negative correlation between MMR protein loss and PCa ISUP grade groups. Progression-free survival (PFS) in patients with MMR deficiency was significantly shorter than in patients with maintained MMR expression. Conclusions. CD9 protein expression was downregulated in PCa, compared to BPH, while CD63 protein expression was upregulated in high-grade PCa but downregulated in low-grade PCa. CD63 protein upregulation, CD9 downregulation, and loss of MMR protein characterized the shorter PFS of high-grade PCa patients. CD9, CD63, and MMR could be the routine immunohistochemical biomarkers for the diagnosis and risk stratification of PCa.
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    Endoscopic Retrograde Cholangiopancreatography Versus Laparoscopic Transcystic Balloon Dilatation of Papilla Vateri in Patients with Choledocholithiasis
    (2024-08) Aleksandrovs, Dmitrijs; Ivanovs, Igors; Plaudis, Haralds; Fokins, Vladimirs; Kaminskis, Aleksejs; Faculty of Medicine
    Two-step therapy, endoscopic retrograde cholangiopancreatography with papillotomy and stone evacuation from common bile duct (CBD), and laparoscopic cholecystectomy (ERCP/LC) is standard treatment of choledocholithiasis and acute cholecystitis in our hospital, Rīga East University Hospital Gaiļezers. The one-step method, LC with intraoperative transcystic balloon dilatation of the papilla Vateri and anterograde evacuation of gallstones to duodenum (BD/LC), has been introduced in our hospital. The aim of this study was to compare two-step and BD/LC methods and report the outcomes from hospital’s clinical experience. A retrospective, comparative study was done from 01.2021 to 10.2023. Patients with acute calculous cholecystitis and choledocholithiasis with gallstone diameter in CBD cm, ASA score I-III were included. Gallstone’s diameter and number, hospitalisation time, and success rate were analysed. A total of 95 patients were included in our study, of which 46 patients underwent BD/LC and in 49 patients ERCP/LC was used. Median diameter of gallstones in the CBD was 6.1 mm in BD/LC and 6.3 mm in the ERCP/LC group ( p = 0.38). Median hospitalisation time for patients with single-step treatment was seven days, and two-step therapy — 14 days ( p = 0.001). The complication rate in BD/LS was 4.34% but in ERCP/LC group — 10.2% after ERCP ( p = 0.049). The success rate in BD/LC was 95.6% and in ERCP/LC group — 89.6% ( p = 0.145). BD/LC is associated with a shorter hospitalisation time, similar success rate and lower complication rate compared with an ERCP/LC.
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    Modular Point-of-Care Breath Analyzer and Shape Taxonomy-Based Machine Learning for Gastric Cancer Detection
    (2022-02) Polaka, Inese; Bhandari, Manohar Prasad; Mezmale, Linda; Anarkulova, Linda; Veliks, Viktors; Sivins, Armands; Lescinska, Anna Marija; Tolmanis, Ivars; Vilkoite, Ilona; Ivanovs, Igors; Padilla, Marta; Mitrovics, Jan; Shani, Gidi; Haick, Hossam; Leja, Marcis; Department of Internal Diseases; Department of Doctoral Studies
    Background: Gastric cancer is one of the deadliest malignant diseases, and the non-invasive screening and diagnostics options for it are limited. In this article, we present a multi-modular device for breath analysis coupled with a machine learning approach for the detection of cancer-specific breath from the shapes of sensor response curves (taxonomies of clusters). Methods: We analyzed the breaths of 54 gastric cancer patients and 85 control group participants. The analysis was carried out using a breath analyzer with gold nanoparticle and metal oxide sensors. The response of the sensors was analyzed on the basis of the curve shapes and other features commonly used for comparison. These features were then used to train machine learning models using Naïve Bayes classifiers, Support Vector Machines and Random Forests. Results: The accuracy of the trained models reached 77.8% (sensitivity: up to 66.54%; specificity: up to 92.39%). The use of the proposed shape-based features improved the accuracy in most cases, especially the overall accuracy and sensitivity. Conclusions: The results show that this point-of-care breath analyzer and data analysis approach constitute a promising combination for the detection of gastric cancer-specific breath. The cluster taxonomy-based sensor reaction curve representation improved the results, and could be used in other similar applications.
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    Oxidative stress parameters in Posttraumatic Stress Disorder risk group patients
    (2012) Voicehovskis, Vladimirs; Ancane, Gunta; Voicehovska, Julija; Orlikovs, Grigorijs; Karpovs, Jurijs; Ivanovs, Igors; Škesters, Andrejs; Ancans, Andrejs; Silova, Alise; Ivaščenko, Tarass; Micans, Janis; Vaivads, Normunds; Umnova, Larisa; Department of Psychosomatic Medicine and Psychotherapy; Department of Internal Diseases; Bioķīmijas zinātniskā laboratorija; Department of Pathology
    Increased excitotoxity in response to stressors leads to oxidative stress (OS) due to accumulation of excess reactive oxygen/nitrogen species. Neuronal membrane phospholipids are especially susceptible to oxidative damage, which alters signal transduction mechanisms. The Contingent of International Operations (CIO) has been subjected to various extreme stressors that could cause Posttraumatic Stress Disorder (PTSD). Former studies suggest that heterogeneity due to gender, race, age, nutritional condition and variable deployment factors and stressors produce challenges in studying these processes. The research aim was to assess OS levels in the PTSD risk group in CIO. In a prospective study, 143 participants who were Latvian CIO, regular personnel, males, Europeans, average age of 27.4, with the same tasks during the mission, were examined two months before and immediately after a six-month Peace Support Mission (PSM) in Afghanistan. PCL-M questionnaire, valid Latvian language "Military" version was used for PTSD evaluation. Glutathione peroxidase (GPx), superoxide dismutase (SOD) and lipid peroxidation intensity and malondialdehyde (MDA) as OS indicators in blood were determined. Data were processed using SPSS 20.0. The MDA baseline was 2.5582 μM, which after PSM increased by 24.36% (3.1815 μM). The GPx baseline was 8061.98 U/L, which after PSM decreased by 9.35% (7308.31 U/L). The SOD baseline was 1449.20 U/gHB, which after PSM increased by 2.89% (1491.03 U/gHB). The PTSD symptom severity (total PCL-M score) baseline was 22.90 points, which after PSM increased by 14.45% (26.21 points). The PTSD Prevalence rate (PR) baseline was 0.0357, which after PSM increased by 147.06% (0.0882). We conclude that there is positive correlation between increase of OS, PTSD symptoms severity level, and PTSD PR in a group of patients with risk of PTSD - CIO. PTSD PR depends on MDA intensity and OS severity. OS and increased free radical level beyond excitotoxity, is a possible causal factor for clinical manifestation of PTSD.