Browsing by Author "Krumina, Zita"
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Item Descemet membrane endothelial keratoplasty in pseudophakic bullous keratopathy : Outcomes and evidence-based suggestions(2018) Borroni, Davide; Ferronato, Melanie; Orube, Ineta; Erts, Renars; Sepetiene, Svetlana; Drucka, Eva; Krumina, Zita; Rīga Stradiņš University; Department of Ophthalmology; Department of Biology and MicrobiologyThe purpose of the study was to determine clinical outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) in patients with Pseudophakic Bullous Keratopathy (PBK). The study was conducted at a tertiary referral center. This was a retrospective case series. Pseudophakic eyes having undergone DMEK surgery for Pseudophakic Bullous Keratopathy was considered the object of study. The examination implied the analysis of best corrected visual acuity (BCVA or CDVA), endothelial cell density (ECD), intraocular pressure (IOP), intraoperative and postoperative complications and a follow-up in 1, 3, and 6 months. For the purposes of the study, 25 pseudophakic eyes with PBK were examined. One month after the surgery patients reached a BCVA of 0.49±0.08(M±SD), after 3 months - BCVA of 0.65±0.12(M±SD), and a BCVA of 0.78±0.17 (M±SD) in the last follow-up in 6 months after the surgery (P<0,001). The mean ECD after one month was 1661±133 (M±SD) cells/mm2, after 3 months - 1591±124 (M±SD) cells/mm2, and during the last control in 6 months -1579±128 (M±SD) cells/mm2. The graft detachment rate was 12% (3 cases). Hypertension was observed in one eye (4%), necessitating partial air elimination through a corneal wound within the first hours after the surgery. DMEK may give excellent visual results in Pseudophakic eyes without increasing the risk of complications when compared to Descemet Stripping Automated Endothelial Keratoplasty (DSAEK) and Penetrating Keratoplasty (PKP). Anatomic repair after DMEK is associated with improved corneal clarity and BCVA.Item Genetic variation spectrum in ATP7B gene identified in Latvian patients with Wilson disease(2017-07) Zarina, Agnese; Tolmane, Ieva; Kreile, Madara; Chernushenko, Aleksandrs; Cernevska, Gunta; Pukite, Ieva; Micule, Ieva; Krumina, Zita; Krumina, Astrida; Rozentale, Baiba; Piekuse, Linda; Scientific Laboratory of Molecular GeneticsBackground: Wilson disease (WD) is an autosomal recessive disorder of copper metabolism caused by allelic variants in ATP7B gene. More than 500 distinct variants have been reported, the most common WD causing allelic variant in the patients from Central, Eastern, and Northern Europe is H1069Q. Methods: All Latvian patients with clinically confirmed WD were screened for the most common mutation p.H1069Q by PCR Bi-PASA method. Direct DNA sequencing of gene ATP7B (all 21 exons) was performed for the patients with WD symptoms, being either heterozygous for H1069Q or without it on any allele. Results: We identified 15 different allelic variants along with eight non-disease-causing allelic variants. Based on the gene molecular analysis and patients' clinical data variant p.His1069Gln was found in 66.9% of WD alleles. Wide clinical variability was observed among individuals with the same ATP7B genotype. The results of our study confirm that neurological manifestations of WD are typically present later than the liver disease but no significant association between the presence/absence of the most common genetic variant and mode of initial WD presentation or age at presentation was identified. Conclusions: (1) The most prevalent mutation in Latvian patients with Wilson disease was c.3207C>A (p.His1069Gln); (2) No significant phenotype–genotype correlation was found in Latvian patients with Wilson disease; (3) The estimated prevalence of Wilson disease in Latvia is 1 of 24,000 cases which is higher than frequently quoted prevalence of 1: 30,000.Item Overview of Neuromuscular Disorder Molecular Diagnostic Experience for the Population of Latvia(2022-06-16) Lace, Baiba; Micule, Ieva; Kenina, Viktorija; Setlere, Signe; Strautmanis, Jurgis; Kazaine, Inese; Taurina, Gita; Murmane, Daiga; Grinfelde, Ieva; Kornejeva, Liene; Krumina, Zita; Sterna, Olga; Radovica-Spalvina, Ilze; Vasiljeva, Inta; Gailite, Linda; Stavusis, Janis; Livcane, Diana; Kidere, Dita; Malniece, Ieva; Inashkina, Inna; Rīga Stradiņš University; Scientific Laboratory of Molecular GeneticsBackground and ObjectivesGenetic testing has become an integral part of health care, allowing the confirmation of thousands of hereditary diseases, including neuromuscular disorders (NMDs). The reported average prevalence of individual inherited NMDs is 3.7-4.99 per 10,000. This number varies greatly in the selected populations after applying population-wide studies. The aim of this study was to evaluate the effect of genetic analysis as the first-tier test in patients with NMD and to calculate the disease prevalence and allelic frequencies for reoccurring genetic variants.MethodsPatients with NMD from Latvia with molecular tests confirming their diagnosis in 2008-2020 were included in this retrospective study.ResultsDiagnosis was confirmed in 153 unique cases of all persons tested. Next-generation sequencing resulted in a detection rate of 37%. Two of the most common childhood-onset NMDs in our population were spinal muscular atrophy and dystrophinopathies, with a birth prevalence of 1.01 per 10,000 newborns and 2.08 per 10,000 (male newborn population), respectively. The calculated point prevalence was 0.079 per 10,000 for facioscapulohumeral muscular dystrophy type 1, 0.078 per 10,000 for limb-girdle muscular dystrophy, 0.073 per 10,000 for nondystrophic congenital myotonia, 0.052 per 10,000 for spinobulbar muscular atrophy, and 0.047 per 10,000 for type 1 myotonic dystrophy.DiscussionDNA diagnostics is a successful approach. The carrier frequencies of the common CAPN3, FKRP, SPG11, and HINT1 gene variants as well as that of the SMN1 gene exon 7 deletion in the population of Latvia are comparable with data from Europe. The carrier frequency of the CLCN1 gene variant c.2680C>T p.(Arg894Ter) is 2.11%, and consequently, congenital myotonia is the most frequent NMD in our population.Item Pathogenic APC variants in latvian familial adenomatous polyposis patients(2019) Daneberga, Zanda; Berzina, Dace; Borosenko, Viktors; Krumina, Zita; Kokaine-Sapovalova, Linda; Gardovskis, Andris; Berga-Svitina, Egija; Gardovskis, Janis; Miklasevics, Edvins; Onkoloģijas institūts; Department of Biology and Microbiology; Department of SurgeryBackground and objectives: Familial adenomatous polyposis is one of the APC-associated polyposis conditions described as genetically predetermined colorectal polyposis syndrome with a variety of symptoms. The purpose of this study was to determine sequence variants of the APC gene in patients with familial adenomatous polyposis (FAP) phenotype and positive or negative family history. Materials and Methods: Eight families with defined criteria of adenomatous polyposis underwent molecular genetic testing. Coding regions and flanking intron regions of the APC gene were analyzed by Sanger sequencing. Results: Eight allelic variants of the APC gene coding sequence were detected. All allelic variants of the APC gene were predicted to be pathogenic based on criteria according to the “Joint Consensus Recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology” (2015), four of them c.1586_1587insAT, c.2336delT, c.3066_3067insGA, and c.4303_4304insC, were considered novel. Conclusions: The timely molecular genetic analysis of APC germline variants and standardized interpretation of the pathogenicity of novel allelic variants has a high impact on choice for treatment, cancer prevention, and family genetic counseling.Item Progressive deafness–dystonia due to SERAC1 mutations : A study of 67 cases(2017-12) Collaborators; Krumina, Zita; Department of Biology and MicrobiologyObjective: 3-Methylglutaconic aciduria, dystonia–deafness, hepatopathy, encephalopathy, Leigh-like syndrome (MEGDHEL) syndrome is caused by biallelic variants in SERAC1. Methods: This multicenter study addressed the course of disease for each organ system. Metabolic, neuroradiological, and genetic findings are reported. Results: Sixty-seven individuals (39 previously unreported) from 59 families were included (age range = 5 days–33.4 years, median age = 9 years). A total of 41 different SERAC1 variants were identified, including 20 that have not been reported before. With the exception of 2 families with a milder phenotype, all affected individuals showed a strikingly homogeneous phenotype and time course. Severe, reversible neonatal liver dysfunction and hypoglycemia were seen in >40% of all cases. Starting at a median age of 6 months, muscular hypotonia (91%) was seen, followed by progressive spasticity (82%, median onset = 15 months) and dystonia (82%, 18 months). The majority of affected individuals never learned to walk (68%). Seventy-nine percent suffered hearing loss, 58% never learned to speak, and nearly all had significant intellectual disability (88%). Magnetic resonance imaging features were accordingly homogenous, with bilateral basal ganglia involvement (98%); the characteristic “putaminal eye” was seen in 53%. The urinary marker 3-methylglutaconic aciduria was present in virtually all patients (98%). Supportive treatment focused on spasticity and drooling, and was effective in the individuals treated; hearing aids or cochlear implants did not improve communication skills. Interpretation: MEGDHEL syndrome is a progressive deafness–dystonia syndrome with frequent and reversible neonatal liver involvement and a strikingly homogenous course of disease. Ann Neurol 2017;82:1004–1015.Item Solar retinopathy : a new setting of red, green, and blue channels(2021) Borroni, Davide; Erts, Renars; Vallabh, Neeru A.; Bonzano, Chiara; Sepetiene, Svetlana; Krumina, Zita; Romano, Vito; Parekh, Mohit; Iannetta, Danilo; Rīga Stradiņš University; Department of Biology and MicrobiologyPurpose: To introduce a new color imaging technique using improved settings of red, green, and blue channels for improved delineation of retinal damage in patients with solar retinopathy. Method: A retrospective case series of patients with poor vision secondary to solar retinopathy were analyzed. All patients underwent visual acuity, refraction, and dilated fundus examination. A spectral domain–optical coherence tomography of the macula and color fundus imaging using optimized red, green, and blue color setting was performed. Patients were reviewed over a 6-month period. The data were analyzed for statistical significance using an independent t test and a receiver operating characteristic curve. Results: In total, 20 eyes of 10 patients were included between 2009 and 2017. The mean age was 24.9 ± 18.1 years. Best corrected visual acuity at first consultation was 0.78 ± 0.11 and after 6 months was 0.83 ± 0.09. Spectral domain–optical coherence tomography demonstrated retinal abnormalities at the myoid zone, ellipsoid zone, and the outer segment of photoreceptors. Receiver operating characteristic curve analysis showed an improving effect (area under the curve = 0.62; 95% confidence interval = 0.42–0.79). The color channels parameters, which improve visualization of the lesions were found to be 67-0.98-255 for the R-guided setting, 19-0.63-121 for the B-guided setting, and 7-1.00-129 for the G-guided setting. The ideal red, green, and blue setting was in 24-0.82-229. Conclusion: The use of a new setting of red, green, and blue channels could improve the diagnosis and monitoring of solar retinopathy, hence improving patient care.