Browsing by Author "Teibe, Uldis"

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    Anthropometric measurements of the body composition of cancer patients determine the precise role of the body surface area and the calculation of the dose of chemotherapy
    (2012-12-01) Gerina-Berzina, Aija; Vikmanis, Uldis; Teibe, Uldis; Umbraško, Silvija; Institute of Anatomy and Anthropology
    The calculation of an accurate dose of chemotherapy for oncological patients reduces the possible medication errors and the toxicity of the body and so it improves the outcome of the treatment (survival). In oncological practice for the calculation of the dose of chemotherapy the human body surface area (BSA) is used. The human body surface area is determined by derived formulas, but it is not directly linked to the pharmacokinetics of the drugs. Pharmacokinetic studies have demonstrated that for the calculation of the chemotherapy dose the actual body weight should be taken into account rather than the ideal one. In the therapeutic dose determination the body fat mass has essential significance.202 patients aged from 19 to 83 years with various tumor localizations underwent anthropometric measurements (height, weight, circumferences, fat-fold thickness, the distance between the hills above the joint), the body mass index (BMI) and the BSA (according to the Mosteller formula).The average weight of 99 men was 78.5 +/- 16.4 kg and the mean body weight of 103 women was 70.1 +/- 14.6 kg, statistically non-significantly different (F = 0.358, p = 0.551), but the independent-sample t-test arithmetical mean differed statistically significantly (t = 3.839, p <0.001). The oncological patients in the absolute and relative distribution of groups according to the body mass index in relation to the patients gender differed statistically significantly (chi(2) = 11.510, df = 4, p = 0.021). Half of the men had ideal weight (body mass), but only about 1/3 of women were with the ideal body weight. The men's average body mass index was 25.41 +/- 4.73 kg/m(2) and the women's average body mass index was 26.20 +/- 5.90 kg/m(2). After arithmetic calculation of the body surface area using a variety of formulas, men's BSA differs less than 1% compared to the calculated area of Mosteller formula. For women the differences are more than 1%. Distribution of patients in groups body fat content (%) of the patient's shows that male and female patients were primarily from the group with excessive fat in the body, the body fat for men is 25% or more of the total body weight, but for the women it is over 32% of the total body weight. Correlation analysis showed that the body fat for men correlates with the body surface area, calculated using the Mosteller formula (r = 0.663, p <0.001) and the fat content for women correlates with the body surface area, calculated using the Mosteller formula (r = 0.760, p <0.001). The male body volume of the mean value was 75, 0 +/- 17.1 dm(3), the female body volume of the mean value was 68, 6 +/- 15.6 dm(3). After the independent samples t-test between men and women in body volume arithmetical means differed statistically significantly (t = 2.437, p = 0.016).Anthropometric measurements are suitable for the calculation of the doses of chemotherapy, but taking into account the correlation, it cannot be excluded that they reflect the same body surface area. The BMI does not feature the percentage of the fat mass of the whole body. Consequently, it is possible that the patient's body density is a more physiological parameter, which could be determined for comparison by using abdominal computer tomography. The body volume index(BVI) could be one of the most recent parameters for the more accurate calculation of chemotherapy for cancer patients. The Body Volume Index (BVI) is a new measurement for human obesity that has been proposed as an alternative to the Body Mass Index (BMI).
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    Association between inflammatory markers and clinical and metabolic risk factors for cardiovascular diseases
    (2009) Stuķena, Inga; Kalvelis, Andrejs; Bahs, Guntis; Teibe, Uldis; Tretjakovs, Peteris; Lejnieks, Aivars; Rīga Stradiņš University
    The inflammatory reaction plays an important role in the development of atherosclerosis. The clinical significance of the main inflammatory markers - C-reactive protein (CRP), interleukin 6 (IL6), tumour necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1 (PAI1), etc. - has not been fully established. CRP, IL6, TNF-α, and PAI1 were assessed in 100 patients in terms of certain clinical indicators (sex, obesity indicators, blood pressure, and heart rate), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), triglycerides (TG), glucose, insulin, homeostasis model assessment of insulin resistance (HOMA-IR), adiponectin, and leptin levels. CRP and PAI1 levels were elevated in subjects with increased body mass index (BMI) and waist circumference. CRP correlated positively with indicators of carbohydrate metabolism and negatively with TC, HDL-C, and adiponectin. PAI1 correlated positively with insulin levels, HOMA-IR, leptin, and TG, but negatively with HDL-C. IL6 correlated negatively with TC, but TNF-α correlated negatively with HDL-C. Both IL6 and TNF-α correlated positively with leptin levels. TNF-α correlated with TG levels and the indicators of carbohydrate metabolism only in women. CRP and PAI1 are the most sensitive inflammatory markers; their levels were higher in adipose subjects.
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    Characteristics of cardiovascular risk factors and their correlation with the sex and age of patients in the Latvian population
    (2009) Stuķena, Inga; Kalvelis, Andrejs; Bahs, Guntis; Teibe, Uldis; Tretjakovs, Peteris; Lejnieks, Aivars; Rīga Stradiņš University
    Various cardiovascular risk factors (RFs) were determined in 773 out-patients (mean age 55.8 ± 14.5 years). Male individuals had a larger waist circumference (WC) than did female patients (99.1 ± 13.6 cm vs 93.3 ± 15.2 cm), higher diastolic blood pressure (DBP) (83.6 ± 9.6 mmHg vs 81.8 ± 9.6 mmHg), and higher levels of blood glucose (5.73 ± 1.4 mmol/L vs 5.49 ± 1.3 mmol/L) and triglycerides (TG) (1.89 ± 1.3 mmol/L vs 1.60 ± 1.0 mmol/L), but lower levels of total cholesterol (TC) (5.54 ± 1.2 mmol/L vs 5.79 ± 1.2 mmol/L) and high-density lipoprotein cholesterol (HDL-C) (1.21 ± 0.4 mmol/L vs 1.44 ± 0.4 mmol/L). Compared with the younger age group (i.e., males, < 7 years; females, < 65 years), patients in the older age group had a larger WC (98.4 ± 14.2 cm vs 92.8 ± 15.1 cm), higher systolic blood pressure (SBP) (144.2 ± 19.2 mmHg vs 131.6 ± 18.5 mmHg), higher DBP (84.5 ± 8.8 mmHg vs 80.9 ± 9.8 mmHg), higher blood glucose level (5.74 ± 1.3 mmol/L vs 5.46 ± 1.3 mmol/L), and higher low-density lipoprotein cholesterol level (LDL-C) (3.68 ± 1.0 mmol/L vs 3.52 ± 1.0 mmol/L), but lower HDL-C level (1.3 ± 0.4 mmol/L vs 1.41 ± 0.4 mmol/L). Age was significantly correlated with all RFs, with the exception of the level of C-reactive protein. In conclusion, analysis of cardiovascular RFs in different age subgroups of both sexes clearly showed individual peculiarities of risk profile. This conclusion challenges the usual way of risk calculation using "universal" markers like adiposity or dyslipidemia in all population. The new approach requires individual attention depending on sex and age also in management of risk.
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    Genotype-phenotype correlations among BRCA1 4153delA and 5382insC mutation carriers from Latvia
    (2011-10-27) Plakhins, Grigorijs; Irmejs, Arvids; Gardovskis, Andris; Subatniece, Signe; Rozite, Santa; Bitina, Marianna; Keire, Guntars; Purkalne, Gunta; Teibe, Uldis; Trofimovics, Genadijs; Miklasevics, Edvins; Gardovskis, Janis; Pārmantotā vēža pētniecības nodaļa
    Background: Mutations in the high penetrance breast and ovarian cancer susceptibility gene BRCA1 account for a significant percentage of hereditary breast and ovarian cancer cases. Genotype-phenotype correlations of BRCA1 mutations located in different parts of the BRCA1 gene have been described previously; however, phenotypic differences of specific BRCA1 mutations have not yet been fully investigated. In our study, based on the analysis of a population-based series of unselected breast and ovarian cancer cases in Latvia, we show some aspects of the genotype-phenotype correlation among the BRCA1 c.4034delA (4153delA) and c.5266dupC (5382insC) founder mutation carriers.Methods: We investigated the prevalence of the BRCA1 founder mutations c.4034delA and c.5266dupC in a population-based series of unselected breast (n = 2546) and ovarian (n = 795) cancer cases. Among the BRCA1 mutation carriers identified in this analysis we compared the overall survival, age at diagnosis and family histories of breast and ovarian cancers.Results: We have found that the prevalence of breast and ovarian cancer cases (breast: ovarian cancer ratio) differs significantly among the carriers of the c.5266dupC and c.4034delA founder mutations (OR = 2.98, 95%CI = 1.58 to 5.62, P < 0.001). We have also found a difference in the prevalence of breast and ovarian cancer cases among the 1st and 2nd degree relatives of the c.4034delA and c.5266dupC mutation carriers. In addition, among the breast cancer cases the c.4034delA mutation has been associated with a later age of onset and worse clinical outcomes in comparison with the c.5266dupC mutation.Conclusions: Our data suggest that the carriers of the c.4034delA and c.5266dupC founder mutations have different risks of breast and ovarian cancer development, different age of onset and prognosis of breast cancer.
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    Plexus brachialis strain and compression deformation in the costo-axillary-brachial region : A cadaveric study
    (2011) Vasilevskis, Edgars; Skuja, Sandra; Evansa, Irina; Šteina, Eva; Pilipa, Anna Sondore; Vabels, Grigorijs; Teibe, Uldis; Jansons, Haralds; Groma, Valerija; Vanags, Indulis; Rīga Stradiņš University; Department of Morphology; Department of Anaesthesiology, Intensive Care and Clinical simulations
    Objective: The aim of this study was to clarify the role of different mechanisms in nerve injury during arm abduction positions. The tasks were to determine the strain deformation of the plexus brachialis during arm abduction, to measure the pressures in the neurovascular bundle in the cervico-costoclavicular-axillary area, and evaluate the histological changes of nerve after the stretch test. Material and Methods: During the cadaveric study on 7 specimens 7-20 h after death, strain deformation of plexus brachialis as well as compression deformation caused by the surrounding structures of the neurovascular bundle were investigated in the arm abduction position of 0°, 90°, 12°, 150°, and 180°. One nerve sample was studied histologically after 15% stretch on the bench. Results: The relative strain deformation of 3%-23% was documented during 0° to 180° abduction tests. The strain deformation from 0° to 90° was significant (P<0.001). The mean pressure change in the bundle was 13.6 mm Hg at 90°, 53.7 mm Hg at 120°, 73.4 mm Hg at 150°, and 89.0 mm Hg at 180° arm abduction. An increase in pressure was significant in the intervals: 0°-90° (P<0.001), 91°-120° (P<0.001), 121°-150° (P<0.001) and 151°-180° (P<0.05). Conclusions: Nerve traction and tissue compression arising during the arm abduction above 90° were found to be sufficient to induce lesions in neural bundles of the plexus brachialis.
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    Population screening for hereditary and familial cancer syndromes in Valka district of Latvia
    (2010-10-29) Vanags, Andrejs; Štrumfa, Ilze; Gardovskis, Andris; Borošenko, Viktors; Aboliņš, Arnis; Teibe, Uldis; Trofimovičs, Genadijs; Miklaševičs, Edvins; Gardovskis, Janis; Pārmantotā vēža pētniecības nodaļa
    Background: The growing possibilities of cancer prevention and treatment as well as the increasing knowledge about hereditary cancers require proper identification of the persons at risk. The aim of this study was to test the outcome of population screening in the scientific and practical evaluation of hereditary cancer.Methods: Population screening for hereditary cancer was carried out retrospectively in a geographic area of Latvia. Family cancer histories were collected from 18642 adults representing 76.6% of the population of this area. Hereditary cancer syndromes were diagnosed clinically. Molecular testing for BRCA1 founder mutations 300 T/G, 4153delA and 5382insC was conducted in 588 persons who reported at least one case of breast or ovary cancer among blood relatives.Results: Clinically, 74 (0.40%; 95% confidence interval (CI): 0.32 - 0.50%) high-risk and 548 (2.94%, 95% CI: 2.71 - 3.19) moderate-risk hereditary cancer syndromes were detected covering wide cancer spectrum. All syndromes were characterised by high cancer frequency among blood relatives ranging 8.6 - 46.2% in contrast to spouse correlation of 2.5 - 3.6%. The mean age of cancer onset ranged 38.0 - 72.0 years in different syndromes. The BRCA1 gene mutations were identified in 10 (1.7%; 95% CI: 0.9 - 3.1%) probands. Families with established BRCA1 gene founder mutations were identified with the frequency 1:2663 clinically screened persons.Conclusions: Population screening is a useful practical tool for the identification of persons belonging to families with high frequency of malignant tumours. The whole hereditary and familial cancer spectrum along with the age structure was identified adjusting follow-up guidelines. Another benefit of the population screening is the possibility to identify oncologically healthy persons belonging to hereditary and familial cancer families so that appropriate surveillance can be offered. Clinical diagnostics is appropriate for population screening purposes; molecular investigation provides additional information. In collaboration with family doctors, the screening is technically manageable as characterised by high compliance.