Research outputs from Pure / Zinātniskās darbības rezultāti no ZDIS Pure

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1,1′-{[3,5-Bis((dodecyloxycarbonyl)-4-phenyl-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis[4-(anthracen-9-yl)pyridin-1-ium] Dibromide
(2022-09) Ozolins, Reinis; Plotniece, Mara; Pajuste, Karlis; Putralis, Reinis; Pikun, Nadiia; Sobolev, Arkadij; Plotniece, Aiva; Rucins, Martins; Department of Pharmaceutical Chemistry
A synthesis of a cationic moiety and fluorescent moieties containing amphiphilic 1,4-dihydropyridine (1,4-DHP) derivatives was performed starting with the Hantzsch-type cyclization of dodecyl acetoacetate, phenylaldehyde and ammonium acetate. Bromination of the 2,6-dimethyl groups of a parent 1,4-DHP compound, followed by nucleophilic substitution of bromine with 4-(anthracen-9-yl)pyridine, produced the desired 1,1′-{[3,5-bis((dodecyloxycarbonyl)-4-phenyl-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis[4-(anthracen-9-yl)pyridin-1-ium] dibromide. The obtained target compound was fully characterized by the IR, 1H NMR, 13C NMR and HRMS data. Studies of the self-assembling properties and characterization of the nanoparticles obtained by the ethanol injection method were performed using dynamic light scattering (DLS) measurements. DLS measurement data showed that 1,1′-{[3,5-bis((dodecyloxycarbonyl)-4-phenyl-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis[4-(anthracen-9-yl)pyridin-1-ium] dibromide produced liposomes that had average diameters of 200 nm when the samples were freshly prepared, and 140 nm after 7 days or 1 month storage. The PDI values of the samples were approximately 0.50 and their zeta-potential values were approximately 41 mV when the samples were freshly prepared, and 33 mV after storage. The obtained nanoparticles were stored at room temperature for one month and remained stable during that period. The mean molecular area of the cationic 1,4-DHP-anthracene hybrid 4 was 118 Å2, while the mean molecular area of the cationic 1,4-DHP 5 without anthracene substituents was only 83 Å2. The photoluminescence quantum yield (PLQY) value for the EtOH solution of the 1,4-DHP derivative 4 was 10.8%, but for the 1,4-DHP derivative 5 it was only 1.8%. These types of compounds could be used as synthetic lipids in the further development of prospective theranostic delivery systems.
1,1′-{[3,5-Bis(dodecyloxycarbonyl)-4-(naphthalen-2-yl)-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis{4-[(E)-2-(naphthalen-2-yl)vinyl]pyridin-1-ium}dibromide
(2022-09) Rucins, Martins; Kaukulis, Martins; Plotniece, Aiva; Pajuste, Karlis; Pikun, Nadiia; Sobolev, Arkadij
Synthesis of a double-charged cationic amphiphilic 1,4-dihydropyridine derivative with dodecyl ester groups at positions 3 and 5 of the 1,4-DHP ring was performed starting from Hantzsch type cyclization of dodecyl acetoacetate, 2-naphthaldehyde and ammonium acetate. Bromination of this compound followed by nucleophilic substitution of bromine with (E)-4-(2-(naphthalen-2-yl)vinyl)pyridine gave the desired cationic amphiphilic 1,1′-{[3,5-bis(dodecyloxycarbonyl)-4-(naph-thalen-2-yl)-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis{4-[(E)-2-(naphthalen-2-yl)vinyl]pyridin-1-ium}dibromide. The obtained target compound was fully characterized by IR, UV,1 H-NMR,13 C-NMR, HRMS and microanalysis. The characterization of the cationic 1,4-DHP nanoparticles in an aqueous solution was performed by DLS measurements. The obtained results showed that the compound formed nanoparticles with an average diameter of around 300 nm, a PDI value of around 490 and a zeta-potential of around 20 mV for freshly prepared samples. However, after one week of storage at room temperature, an aggregation of nanoparticles was detected.
2014 ESC Guidelines on the diagnosis and management of acute pulmonary embolism
(2014-07-31) ESC/ERS Collaboration; Konstantinides, Stavros V.; Maca, A.
2016 Classification Criteria for Macrophage Activation Syndrome Complicating Systemic Juvenile Idiopathic Arthritis : A European League Against Rheumatism/American College of Rheumatology/Paediatric Rheumatology International Trials Organisation Collaborative Initiative
(2016-03-01) Paediatric Rheumatology International Trials Organisation, the Childhood Arthritis andRheumatology Research Alliance, the Pediatric Rheumatology Collaborative Study Group,and the Histiocyte Societ; Dāvidsone, Zane
Objective To develop criteria for the classification of macrophage activation syndrome (MAS) in patients with systemic juvenile idiopathic arthritis (JIA). Methods A multistep process, based on a combination of expert consensus and analysis of real patient data, was conducted. A panel of 28 experts was first asked to classify 428 patient profiles as having or not having MAS, based on clinical and laboratory features at the time of disease onset. The 428 profiles comprised 161 patients with systemic JIA-associated MAS and 267 patients with a condition that could potentially be confused with MAS (active systemic JIA without evidence of MAS, or systemic infection). Next, the ability of candidate criteria to classify individual patients as having MAS or not having MAS was assessed by evaluating the agreement between the classification yielded using the criteria and the consensus classification of the experts. The final criteria were selected in a consensus conference. Results Experts achieved consensus on the classification of 391 of the 428 patient profiles (91.4%). A total of 982 candidate criteria were tested statistically. The 37 best-performing criteria and 8 criteria obtained from the literature were evaluated at the consensus conference. During the conference, 82% consensus among experts was reached on the final MAS classification criteria. In validation analyses, these criteria had a sensitivity of 0.73 and a specificity of 0.99. Agreement between the classification (MAS or not MAS) obtained using the criteria and the original diagnosis made by the treating physician was high (κ = 0.76). Conclusion We have developed a set of classification criteria for MAS complicating systemic JIA and provided preliminary evidence of its validity. Use of these criteria will potentially improve understanding of MAS in systemic JIA and enhance efforts to discover effective therapies, by ensuring appropriate patient enrollment in studies.
2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
(2021-04-07) Collet, Jean-Philippe; Thiele, Holger; ESC Scientific Document Group; Maca, Aija
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 University
Capsule 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.
A 38-year study on Trichinella spp. in wild boar (Sus scrofa) of Latvia shows a stable incidence with an increased parasite biomass in the last decade
(2015-03-01) Kirjušina, Muza; Deksne, Gunita; Marucci, Gianluca; Bakasejevs, Eduards; Jahundoviča, Inese; Daukšte, Anžela; Zdankovska, Aleksandra; Běrziņa, Zanda; Esite, Zanda; Bella, Antonino; Galati, Fabio; Krumiņa, Angelika; Pozio, Edoardo; Department of Infectology
Background: Trichinella spp. are zoonotic parasites transmitted to humans by the consumption of raw or insufficiently cooked meat of different animal species. The most common source of infection for humans is meat from pigs and wild boar (Sus scrofa). The aim of the present work was to evaluate the incidence of Trichinella spp. infections in wild boar hunted in Latvia over a 38 year interval (1976 to 2013). Methods: A total 120,609 wild boars were individually tested for Trichinella spp. by trichinoscopy and, in case of negativity, by artificial digestion of 25 g muscles, in the 1976-2005 period, and by artificial digestion of 25-50 g muscles in the 2006-2013 period. Trichinella spp. larvae were identified at the species level by multiplex PCR. Results: In the study period, the overall prevalence of infected wild boar was 2.5%. Trichinella britovi was the predominant (90%) species. The incidence of Trichinella spp. infection in wild boar exhibited two different trends. From 1976 to 1987, the incidence of infected/hunted wild boar increased from 0.23% to 2.56%, then it decreased to 0.19 in 1994. Thereafter, the incidence fluctuated between 0.05% and 0.37%. A statistically significant (P∈<∈0.05) correlation (r∈=∈0.54; p∈=∈0.0199) was found between the trend of Trichinella spp. incidence in hunted wild boar and the number of snow cover days from 1976 to 1993. From 1997 to 2013, the estimated wild boar population of Latvia increased by 4.9 times and the hunting bag by 9.7 times, with a stable incidence of Trichinella spp. in the population. It follows that the biomass of Trichinella spp. larvae and of T. britovi, in particular, increased. Conclusions: The incidence trends of Trichinella spp. in wild boar could be related to the role played by the snow in reducing the thermal shock and muscle putrefaction which increases the survival of the larvae in muscle tissues of carrion in the 1976-1993 period; and, in the 1997-2013 period, to the increased biomass of Trichinella spp. due to the increased carnivore populations, which are the main reservoirs of these parasites.
5-aminolevulinic acid based photodynamic therapy for basal cell carcinoma : a 10-years follow-up study
(2013) Griškjans, Žans; Derjabo, Aleksands; Cema, Ingrida; Rīga Stradiņš University
This article presents long-term follow-up after use of topical photodynamic therapy (PDT) for basal cell carcinoma. PDT is treatment option for different tumors, involving use of specific agent which is activated by visible light and results in tissue destruction. Overall 20 patients with 29 tumors were treated at the Latvian Oncology Center. Two illumination techniques were used: superficial for smaller lesions and multifiber contact for nodular tumors. Clinical outcome was evaluated at 1, 7, 44 months and 10 years after procedure. By 10 year follow up, there were 2 tumor recurrences and in one case there was tumor residual tissue after first PDT treatment. Overall after ten years follow-up complete response was 80% of cases. Data in this study supports hypothesis that PDT could be used for the treatment of non-invasive (superficial and nodular) basal cell carcinoma. Results in this study correspond with similar long-term follow-up studies.
5-Item sino-nasal outcome test and 22-item sino-nasal outcome test relationship with endoscopic and radiologic scores in chronic rhinosinusitis with nasal polyps
(2024-03) Misirovs, Rašads; Chan, Rory; Lipworth, Brian; Rīga Stradiņš University
Background: The 22-item sino-nasal outcome test (SNOT-22) is a frequently used patient-recorded outcome measure in patients with chronic rhinosinusitis with nasal polyps (CRSwNPs). Objective findings of nasal polyps and paranasal sinus inflammation are frequently graded using nasal polyp score (NPS) and Lund-Mackay Score (LMS), respectively. Objective: To evaluate a novel, abbreviated, rhinology-focused, five-domain SNOT-5 questionnaire because we had anecdotally noticed a relative disconnect between SNOT-22 and endoscopy and imaging scores. Methods: We performed a retrospective, cross-sectional, single-center review of patients with CRSwNPs who had filled out a SNOT-22, along with post hoc–derived SNOT-5 scores, which were then assessed in relation to NPS and LMS. Results: A total of 129 patients were included in the analysis. SNOT-5 but not SNOT-22 scores significantly correlated vs either NPS (P < .005) and LMS (P < .001), whereas only SNOT-5 differed significantly when comparing the cohort's lowest and highest tertiles for mean LMS: 11.8 vs 16.8 (95% CI, 1.5-8.4; P < .01) and for mean NPS 12.4 vs 15.6 (95% CI, 0.5-5.9; P < .05). Conclusion: In a retrospective, real-life cohort study of CRSwNP, there was a relative disconnect between the significant association of SNOT-5 but not SNOT-22 in relation to objective endoscopy and imaging measures. We, therefore, propose that further prospective intervention studies are indicated in CRSwNP to evaluate the SNOT-5 score including establishing the minimal clinically important difference.
A 5-transcript signature for discriminating viral and bacterial etiology in pediatric pneumonia
(2025-02-21) Viz-Lasheras, Sandra; Gómez-Carballa, Alberto; Pardo-Seco, Jacobo; Zavadska, Dace; DIAMONDS; GENDRES; PERFORM consortia; Rīga Stradiņš University
Pneumonia stands as the primary cause of death among children under five, yet current diagnosis methods often result in inadequate or unnecessary treatments. Our research seeks to address this gap by identifying host transcriptomic biomarkers in the blood of children with definitive viral and bacterial pneumonia. We performed RNA sequencing on 192 prospectively collected whole blood samples, including 38 controls and 154 pneumonia cases, uncovering a 5-transcript signature (genes FAM20A, BAG3, TDRD9, MXRA7, and KLF14) that effectively distinguishes bacterial from viral pneumonia (area under the curve (AUC): 0.95 [0.88–1.00]). Initial validation using combined definitive and probable cases yielded an AUC of 0.87 [0.77–0.97], while full validation in a new prospective cohort of 32 patients achieved an AUC of 0.92 [0.83–1.00]. This robust signature holds significant potential to enhance diagnostics accuracy for pediatric pneumonia, reducing diagnostic delays and unnecessary treatments and potentially transforming clinical practice.
Abdominal negative-pressure therapy : A new method in countering abdominal compartment and peritonitis - prospective study and critical review of literature
(2012) Plaudis, Haralds; Rudzats, Agris; Melberga, Liene; Kazaka, Ita; Suba, Olegs; Pupelis, Guntars
Background: Application of abdominal negative-pressure therapy (NPT) is lifesaving when conservative measures fail to reduce sustained increase of the intra-abdominal pressure and it is impossible to achieve source control in a single operation due to severe peritonitis. The aim of this study is to share the initial experience with abdominal NPT in Latvia and provide a review of the relevant literature. Methods: In total, 22 patients were included. All patients were treated with KCI® ABThera™ NPT systems. Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission, daily sequential organ failure assessment score and Mannheim peritonitis index (MPI) were calculated for severity definition. The frequency of NPT system changes, daily amount of aspirated fluid effluent and the time of abdominal closure were assessed. The overall hospital and ICU stay, as well as the outcomes and the complication rate, were analysed. Results: A complicated intra-abdominal infection was treated in 18 patients. Abdominal compartment syndrome due to severe acute pancreatitis (SAP), secondary ileus and damage control in polytrauma were indications for NPT in four patients. The median age of the patients was 59 years (range, 28 to 81), median APACHE II score was 15 points (range, 9 to 32) and median MPI was 28 points (range, 21 to 40), indicating a prognostic mortality risk of 60%. Sepsis developed in all patients, and in 20 of them, it was severe. NPT systems were changed on a median of every 4 days, and abdominal closure was feasible on the seventh postoperative day without needing a repeated laparotomy. Two NPT systems were removed due to bleeding from the retroperitoneal space in patients with SAP. Intestinal fistulae developed in three patients that were successfully treated conservatively. Incisional hernia occurred in three patients. The overall ICU and hospital stay were 14 (range, 5 to 56) and 25 days (range, 10 to 87), respectively. Only one patient died, contributing to the overall mortality of 4.5%. Conclusions: Application of abdominal NPT could be a very promising technique for the control of sustained intra-abdominal hypertension and management of severe sepsis due to purulent peritonitis. Further trials are justified for a detailed evaluation of abdominal NPT indications.
Abundance and prevalence of ESBL coding genes in patients undergoing first line eradication therapy for Helicobacter pylori
(2023-08) Gudra, Dita; Silamikelis, Ivars; Pjalkovskis, Janis; Danenberga, Ilva; Pupola, Darta; Skenders, Girts; Ustinova, Maija; Megnis, Kaspars; Leja, Marcis; Vangravs, Reinis; Fridmanis, Davids
The spread of extended-spectrum beta-lactamases (ESBLs) in nosocomial and community-acquired enterobacteria is an important challenge for clinicians due to the limited therapeutic options for infections that are caused by these organisms. Here, we developed a panel of ESBL coding genes, evaluated the abundance and prevalence of ESBL encoding genes in patients undergoing H. pylori eradication therapy, and summarized the effects of eradication therapy on functional profiles of the gut microbiome. To assess the repertoire of known beta lactamase (BL) genes, they were divided into clusters according to their evolutionary relation. Primers were designed for amplification of cluster marker regions, and the efficiency of this amplification panel was assessed in 120 fecal samples acquired from 60 patients undergoing H. pylori eradication therapy. In addition, fecal samples from an additional 30 patients were used to validate the detection efficiency of the developed ESBL panel. The presence for majority of targeted clusters was confirmed by NGS of amplification products. Metagenomic sequencing revealed that the abundance of ESBL genes within the pool of microorganisms was very low. The global relative abundances of the ESBL-coding gene clusters did not differ significantly among treatment states. However, at the level of each cluster, classical ESBL producers such as Klebsiella sp. for blaOXY (p = 0.0076), Acinetobacter sp. for blaADC (p = 0.02297) and others, differed significantly with a tendency to decrease compared to the pre- and post-eradication states. Only 13 clusters were common across all three datasets, suggesting a patient-specific distribution profile of ESBL-coding genes. The number of AMR genes detected in the post-eradication state was higher than that in the pre-eradication state, which could be attributed, at least in part, to the therapy. This study demonstrated that the ESBL screening panel was effective in targeting ESBL-coding gene clusters from bacterial DNA and that minor differences exist in the abundance and prevalence of ESBL-coding gene levels before and after eradication therapy.
Academic integrity in education in the context of sustainable development of society
(2022-06-01) Kudeikina, Inga; Mihailovs, Ivans Jānis; Zīvarts, Juris; Rīga Stradiņš University
t is beyond argument that education is a cornerstone of the sustainable development of any society and state. The more educated society and its individual members are, the more capable the state and its economy and security and technology systems are of giving a targeted response to challenges of today’s world. However, education should not be seen as an end in itself. Certain quality requirements and standards should be respected in the educational process, one of them being academic integrity. Academic misconduct is firmly condemned both at educational institutions and in society, and occasionally the lawfulness of acquired education may be questioned. This kind of misconduct represents a phenomenon leading to several threats, and it can be interpreted as an intellectual property theft, which compromises the quality of education, thereby reducing a state’s capacity for development, and undermines confidence in educational institutions and persons who have committed misconduct, adversely affecting society in general. It should be emphasised that, if ignored, academicmisconduct facilitates legal nihilism in the long term. Therefore, one of priorities in education should be associated with solidifying academic integrity as a component of sustainable development. In the light of the above, this article analyses the understanding of academic integrity and how students can be punished for academic misconduct in the context of sustainable development, for which purpose internal regulations of major higher education institutions of the Republic of Latvia have been examined
ACBM : An Integrated Agent and Constraint Based Modeling Framework for Simulation of Microbial Communities
(2020-12-01) Karimian, Emadoddin; Motamedian, Ehsan
The development of new methods capable of more realistic modeling of microbial communities necessitates that their results be quantitatively comparable with experimental findings. In this research, a new integrated agent and constraint based modeling framework abbreviated ACBM has been proposed that integrates agent-based and constraint-based modeling approaches. ACBM models the cell population in three-dimensional space to predict spatial and temporal dynamics and metabolic interactions. When used to simulate the batch growth of C. beijerinckii and two-species communities of F. prausnitzii and B. adolescent., ACBM improved on predictions made by two previous models. Furthermore, when transcriptomic data were integrated with a metabolic model of E. coli to consider intracellular constraints in the metabolism, ACBM accurately predicted growth rate, half-rate constant, and concentration of biomass, glucose, and acidic products over time. The results also show that the framework was able to predict the metabolism changes in the early stationary compared to the log phase. Finally, ACBM was implemented to estimate starved cells under heterogeneous feeding and it was concluded that a percentage of cells are always subject to starvation in a bioreactor with high volume.
Access to biologicals in Crohn's disease in ten European countries
(2017-09-14) Crohn's Disease Research Group; Péntek, Márta; Pokrotnieks, Juris; Rīga Stradiņš University
AIM To analyze access (availability, affordability and acceptability) to biologicals for Crohn's disease (cd ) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic development. METHODS A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, Latvia, Poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/ biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals. An availability score was developed to evaluate the restrictiveness of eligibility and administrative criteria applied in the countries. Affordability was defined as the annual cost of treatment as a share of gross domestic product (GDP) per capita. Correlations with the uptake of biologicals, dimensions of access and GDP per capita were calculated. RESULTS At the time of the survey, infliximab and adalimumab were reimbursed in all ten countries, and vedolizumab was reimbursed in five countries (France, Germany, Latvia, Slovakia, Sweden). Reimbursement criteria were the least strict in Sweden and Germany, and the strictest in Hungary, Poland and Slovakia. Between countries, the annual cost of different biological treatments differed 1.6-3.3-fold. Treatments were the most affordable in Sweden (13%-37% of the GDP per capita) and the least affordable in the Central and Eastern European countries, especially in Hungary (87%-124%) and Romania (141%-277%). Biosimilars made treatments more affordable by driving down the annual costs. The number of patients with cd on biologicals per 100000 population was strongly correlated with GDP per capita (0.91), although substantial differences were found in the uptake among countries with similar economic development. Correlation between the number of patients with cd on biologicals per 100000 population and the availability and affordability was also strong (-0.75, -0.69 respectively). CONCLUSION Substantial inequalities in access to biologicals were largely associated with GDP. To explain differences in access among countries with similar development needs further research on acceptance.
Accuracy of 68Ga-PSMA-11 PET/CT and multiparametric MRI for the detection of local tumor and lymph node metastases in early biochemical recurrence of prostate cancer
(2020) Radzina, Maija; Tirane, Mara; Roznere, Lilita; Zemniece, Liene; Dronka, Laura; Kalnina, Marika; Mamis, Edgars; Biederer, Juergen; Lietuvietis, Vilnis; Freimanis, Arvis; Vjaters, Egils; Department of Radiology
Anatomical and functional imaging plays a decisive role for detection and staging, of prostate cancer both primarily and post-treatment. While multiparametric MRI offers anatomic imaging with excellent soft tissue contrast, hybrid imaging based on positron emission tomography in combination with computed tomography (PET/CT) contributes functional imaging capacities. Since 68Ga-PSMA-11 was expected to be more efficient than the prior Choline-based PET radiotracers, it was the aim of the study to evaluate the diagnostic performance of the 68Ga-PSMA-11 PET/CT and multiparametric MRI in patients with recurrent prostate cancer and low PSA levels. 32 out of a cohort of 128 prostate cancer patients with biochemical relapse were referred for 68Ga-PSMA-11 PET/CT, MRI and bone scintigraphy. According to the histopathologically or clinically defined reference standard all results were classified as true positive, false positive, true negative or false negative. Local recurrence was present in 11/32 patients, lymph node metastases - in 13/32 patients and, bone metastases - in 6/32 patients. Against the standard of reference, sensitivity, specificity and accuracy for local recurrence of PET/CT were 63.6 %; 73.7%; 77.8%, respectively. MRI reached 90.9%; 94.7%; 92.3%, respectively. For local lymph node metastases PET/CT - 83.3%; 80.0% and 90.6%, respectively. MRI - 41.7%; 94.4%; 72.0%, respectively. For evaluation of bone metastases in PET/CT - 83.3%; 92.0%; 71.0%, respectively. Bone scintigraphy - 50.0%; 84.0%; 77.4%, respectively. In conclusion, mpMRI offered the better diagnostic accuracy in the detection of local recurrence and while PSMA PET/CT was superior in the detection of distant and lymph node metastases.
Accuracy of a non-exercise method using seismocardiography for the estimation of V̇O2peak in sub-elite football players
(2024-07) Hansen, Mikkel Thunestvedt; Rømer, Tue; Lange, Kristine Kjær; Dela, Flemming; Helge, Jørn Wulff; Department of Human Physiology and Biochemistry
A non-exercise method equation using seismocardiography for estimating V̇O2peak (SCG V̇O2peak) has previously been validated in healthy subjects. However, the performance of the SCG V̇O2peak within a trained population is unknown, and the ability of the model to detect changes over time is not well elucidated. Forty-seven sub-elite football players were tested at the start of pre-season (SPS) and 36 players completed a test after eight weeks at the end of the pre-season (EPS). Testing included an SCG V̇O2peak estimation at rest and a graded cardiopulmonary exercise test (CPET) on a treadmill for determination of V̇O2peak. Agreement between SCG V̇O2peak and CPET V̇O2peak showed a large underestimation at SPS (bias ± 95% CI: −9.9 ± 1.8, 95% Limits of Agreement: 2.2 to −22.0 mL·min−1 kg−1). At EPS no interaction (p = 0.3590) but a main effect of time (p < 0.0001) and methods (p < 0.0001) was observed between SCG and CPET V̇O2peak. No correlation in V̇O2peak changes was observed between SCG and CPET (r = −20.0, p = 0.2484) but a fair agreement in classifying the correct directional change in V̇O2peak with the SCG method was found (Cohen's κ coefficient = 0.28 ± 0.25). Overall, the SCG V̇O2peak method lacks accuracy and despite being able to estimate group changes, it was incapable of detecting individual changes in V̇O2peak following a pre-season period in sub-elite football players. The SCG algorithm needs to be further adjusted and the accuracy and precision improved for the method to be applicable for use within a trained population.
Accuracy of migraine diagnosis and treatment by neurologists in the Baltic states : e-survey with clinical case challenge
(2023-12) Jokubaitis, Mantas; Vrublevska, Greta; Zvaune, Linda; Braschinsky, Mark; Leheste, Alo Rainer; Saknītis, Gatis; Žukovs, Danils; Ryliškienė, Kristina
Background: Underdiagnosis of migraine causes a significant health burden, including lower quality of life, excessive medication use, and a delay in effective treatment. The purpose of this study was to evaluate migraine diagnosis accuracy and to review the treatment approaches used by neurologists in the Baltic states. Methods: The research was conducted as an anonymous e-survey with four cases in March and April 2021. Results: 119 practicing adult neurologists have participated. The migraine diagnostic accuracy was 63.2%. The most commonly used diagnostic criteria were moderate/severe pain, unilateral pain, and disruption of daily activities. Diagnostic accuracy did not differ significantly between neurologists who always use ICHD-3 criteria and those who don’t (68.4% vs. 58.5%, p = 0.167). It was higher in neurologists who were working in headache centers (91.7% vs. 60.9%, p = 0.012), and was related to a higher percentage of migraine diagnoses in all consulted headache patients (R 2 = 0.202, adjusted R 2 = 0.195, p < 0.001), prophylaxis with onabotulinumtoxin A [OR = 4.332, 95% Cl (1.588–11.814)], and anti-CGRP monoclonal antibodies [OR = 2.862, 95% Cl (1.186–6.907)]. Conclusions: Migraine diagnostic accuracy is improved through practical patient counseling and modern treatment prescription. Although the neurologists in the Baltic states follow current European guidelines, there is room for improvement in diagnostic accuracy to reduce migraine burden.
Accuracy of the Patient Health Questionnaire-9 for screening to detect major depression : updated systematic review and individual participant data meta-analysis
(2021-10-05) Depression Screening Data (DEPRESSD) PHQ Group; Rancāns, Elmārs
OBJECTIVE: To update a previous individual participant data meta-analysis and determine the accuracy of the Patient Health Questionnaire-9 (PHQ-9), the most commonly used depression screening tool in general practice, for detecting major depression overall and by study or participant subgroups. DESIGN: Systematic review and individual participant data meta-analysis. DATA SOURCES: Medline, Medline In-Process, and Other Non-Indexed Citations via Ovid, PsycINFO, Web of Science searched through 9 May 2018. REVIEW METHODS: Eligible studies administered the PHQ-9 and classified current major depression status using a validated semistructured diagnostic interview (designed for clinician administration), fully structured interview (designed for lay administration), or the Mini International Neuropsychiatric Interview (MINI; a brief interview designed for lay administration). A bivariate random effects meta-analytic model was used to obtain point and interval estimates of pooled PHQ-9 sensitivity and specificity at cut-off values 5-15, separately, among studies that used semistructured diagnostic interviews (eg, Structured Clinical Interview for Diagnostic and Statistical Manual), fully structured interviews (eg, Composite International Diagnostic Interview), and the MINI. Meta-regression was used to investigate whether PHQ-9 accuracy correlated with reference standard categories and participant characteristics. RESULTS: Data from 44 503 total participants (27 146 additional from the update) were obtained from 100 of 127 eligible studies (42 additional studies; 79% eligible studies; 86% eligible participants). Among studies with a semistructured interview reference standard, pooled PHQ-9 sensitivity and specificity (95% confidence interval) at the standard cut-off value of ≥10, which maximised combined sensitivity and specificity, were 0.85 (0.79 to 0.89) and 0.85 (0.82 to 0.87), respectively. Specificity was similar across reference standards, but sensitivity in studies with semistructured interviews was 7-24% (median 21%) higher than with fully structured reference standards and 2-14% (median 11%) higher than with the MINI across cut-off values. Across reference standards and cut-off values, specificity was 0-10% (median 3%) higher for men and 0-12 (median 5%) higher for people aged 60 or older. CONCLUSIONS: Researchers and clinicians could use results to determine outcomes, such as total number of positive screens and false positive screens, at different PHQ-9 cut-off values for different clinical settings using the knowledge translation tool at www.depressionscreening100.com/phq. STUDY REGISTRATION: PROSPERO CRD42014010673.
Acetaminophen toxicity induces mitochondrial complex I inhibition in human liver tissue
(2020-01-01) Chrøis, Karoline Maise; Larsen, Steen; Pedersen, Julie Steen; Rygg, Marte Opseth; Boilsen, Astrid Elisabeth Bruun; Bendtsen, Flemming; Dela, Flemming
Acetaminophen (APAP) is used worldwide and is regarded as safe in therapeutic concentrations but can cause acute liver failure in higher doses. High doses of APAP have been shown to inhibit complex I and II mitochondrial respiratory capacity in mouse hepatocytes, but human studies are lacking. Here, we studied mitochondrial respiratory capacity in human hepatic tissue ex vivo with increasing doses of APAP. Hepatic biopsies were obtained from 12 obese patients who underwent a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy surgery. Mitochondrial respiration was measured by high-resolution respirometry. Therapeutic concentrations (≤0.13 mmol/L) of APAP did not inhibit state 3 complex I-linked respiration. APAP concentrations of ≥2.0 mmol/L in the medium significantly reduced hepatic mitochondrial respiration in a dose-dependent manner. Complex II-linked mitochondrial respiration was not inhibited by APAP. We conclude that the mitochondrial respiratory capacity is affected by a hepato-toxic effect of APAP, which involved complex I, but not complex II.

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