New Modalities in Knee Osteoarthritis Treatment Using Autologous Bone Marrow-Derived Mononuclear Cells

Publisher Copyright: © 2018 Valdis Gončars et al., published by Sciendo 2018.The clinical effects on knee osteoarthritis (OA) symptoms and tissue structure were evaluated after bone marrow-derived mononuclear cell intraarticular injection. A group of 32 patients with 34 knee joints in stage II-III osteoarthritis were treated by intraarticular injection of mononuclear cell suspension. Clinical results were obtained by KOOS (Knee Osteoarthritis Outcome Score) and KSS (Knee Society Score) scores during a 12 months follow-up period. Radiological evaluation was performed using magnetic resonance imaging. A comparison with a control group of 28 patients treated with routinely used three hyaluronic acid intra-articular injections was made. No adverse effects were observed after the bone marrow derived mononuclear cells (BM-MNC) injection. At the end point of the follow up all score results had improved, compared to those at to the starting point. 65% of patients maintained minimal perceptible clinical improvement of the score results. The Whole Organ Magnetic Resonance Imaging Score showed improvement from 44.31 to 42.93 points (p < 0.05) during a 6-7 month period. Comparing score results to the control group, a statistically significant (p < 0.05) improvement in the KOOS pain subscale score at the 6 and 12 months was observed in the mononuclear cell group. BM-MNC injection leads to a decrease of knee OA symptoms and slows changes in structure of the degenerative joint tissue.publishersversionPeer reviewe

Cultivation of 3D dermal tissue by application of autologous matrix

Funding Information: This study was supported in part by Estonian–Latvian cross-border cooperation programme project DELMA (Development of Estonian–Latvian Medical Area) and by grant from corporation Sistçmu Inovâcijas. Publisher Copyright: © 2020 Sciendo. All rights reserved. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.The most common reasons for major skin loss are thermal trauma — burns and scalds that can result in rapid, extensive, deep wounds as well as chronic non-healing wounds. Treatment using common techniques is poor and depending on the trauma level can result in death. There is a substantial need for skin integrity restoration. The main goal of this study was to develop an autologous 3D skin model that could eventually be translated into clinical applications. The study examined a variety of factors — extracellular matrix components, cell count, culture medium modification and role of structurally and functionally high-quality 3D skin dermis layer tissue culture production. The results of this study are an essential prerequisite to standardise the use of both clinical, as well as in vitro test systems. Dermal cell lines applied in the study were isolated form patient biopsies obtained at Pauls Stradiòð Clinical University Hospital. Blood plasma type AB was used for fibrin matrix formation. As catalysts, CaCl2 or calcium gluconate, and tranexamic acid were applied. 3D tissue functionality was assessed by evaluation of gene expression and changes in growth factor secretion. Fibrin matrix formulations with 1% and 1.5% CaCl2 and 5 mg, 7 mg and 10 mg tranexamic acid concentration were tested. Better matrix properties were observed with higher concentration of CaCl2 and tranexamic acid. Differences in levels of collagen gene expression and growth factor secretion were observed. Changes in levels of fibroblast growth factor and gene expression were observed in fibrin matrix samples and the surface-cultivated cell culture monolayer, but structural protein synthesis was not detected.publishersversionPeer reviewe

Current state of angina treatment in the outpatient population and heart rate monitoring survey in Latvia (relity latvia)

The aim of the REALITY Latvia survey was to accumulate information about treated stable angina outpatients regarding their characteristics, heart rate (HR), treatment, and quality of life. Thirty cardiologists were involved with 1-15 patients each. In total, data about 300 patients were obtained. Patients were examined and questioned during one visit. A high HR was defined above 70 beats per minute (bpm), in accordance to recent evidence. Mean HR was 70.3 ± 11.3 bpm and 45% of patients had HR above 70 bpm. The opinion of practitioners regarding HR differed. For example, a HR level within the range 70-80 bpm was perceived by cardiologists as “normal”, “borderline high” and “high”. The mean target HR that physicians wanted to achieve was 60.1 ± 4.7 bpm. Beta blockers were used in 91% of cases. The more widely used beta blockers were metoprolol (47%) and bisoprolol (35%) in mean daily doses 69.7 ± 30.1 mg and 5.3 ± 2.0 mg, respectively. REALITY Latvia data suggest that, despite wide use of beta blockers, HR control in stable angina patients is insufficient. This is caused by insufficient understanding of HR as a treatment target by physicians and use of beta blockers in suboptimal dosages.publishersversionPeer reviewe

Second European Cardiac Resynchronisation Therapy Survey (Crt Survey II): Latvian Data Compared to Europe

The cardiac resynchronisation therapy (CRT) survey II is a joint initiative between the European Heart Rhythm Association and the Heart Failure Association. It compiles real world data about cardiac resynchronisation therapy in European Society of Cardiology member states. 11 088 patients assigned to implantation of CRT with pacemaker function (CRT-P) or CRT with an incorporated defibrillator (CRT-D) were enrolled in the survey starting 1 October 2015 till 31 December 2016 and for each patient, an electronic case report form (eCRF) was completed. Each participating country had each eCRF data-point benchmarked against the total cohort. In total, 79 patients were included from Latvia. The mean age of patients was 68.1, similar to the total cohort of other ESC member states, and 21.8% of patients were female. Latvian patients compared to other countries more often had permanent atrial fibrillation, NYHA class III and IV, ejection fraction 35 %. CRT-Ds and multipolar lead implantation rates were higher. Peri-procedural complication rates were similarly low in both groups. At discharge, prescribed medication rates were similar but more frequently MRAs, ivabradine and calcium channel blockers were prescribed and slightly less frequently ACE inhibitors/ARBs were prescribed. The CRT survey II is a valuable resource that describes ongoing practice of cardiac resynchronisation therapy around Europe and benchmarking against the total cohort is nationally significant for each participating country.publishersversionPeer reviewe

Transcatheter vs. surgical closure of atrial septal defects in adults

Funding Information: This study was supported in part by Latvian National Research Programme “Biomedicine for Public Health” (BIOMEDICINE) and by grant from corporation „Sistçmu Inovâcijas". Publisher Copyright: © 2018 De Gruyter Open Ltd. All rights reserved.Percutaneous transcatheter device closure of secundum atrial septal defects (ASD) has now largely replaced surgical closure in most centres. The aim of this study was to compare results of transcatheter and surgical ASD closure in adults in Latvia during the years 2002-2014 and to analyse long-term outcomes of transcatheter closure. We analysed data from 334 patients with secundum ASD who underwent ASD closure in Pauls Stradiņč Clinical University Hospital. Patients were included into device or surgical closure groups. In the device group, three follow-ups were made 1, 6, and 12 months after the procedure. No follow-up data were available for surgical arm patients beyond their hospitalisation period. The mean age of patients was 45.3 ± 19.9 years for the device group and 40.0 ± 16.9 years for the surgical group (p = 0.023). The mean secundum ASD size in the device and surgical groups was 14.2 ± 5.6 mm and 28.7 ± 10.0 mm, respectively (p < 0.001). No differences were observed regarding procedure success rates: 99.2% in the device group and 100% in the surgical group (p = 0.451). Periprocedural complications generally were more common in the surgical closure group. The study results show a successful introduction of the percutaneous ASD closure method in Latvia with good early and late outcomes and without significant differences in procedure success rate compared to surgical closure.publishersversionPeer reviewe

Chronic total coronary artery occlusion recanalisation with percutaneous coronary intervention - Single centre 10-year experience

Publisher Copyright: © 2018 De Gruyter Open Ltd. All rights reserved.Coronary artery chronic total occlusions (CTO) are common - approximately one-third of patients with significant coronary artery disease on angiography have at least 1 CTO. Invasive treatment of these lesions still remain a major challenge for interventional cardiology due to their complexity. Historically, success rates have improved to about 60-70% by using only the traditional antegrade approach. The results have dramatically improved during the last decade after more widespread application of new retrograde techniques. The aim of our study was to review and analyse single hospital experience in CTO invasive treatment and to evaluate the long-term results. A total of 519 patients undergoing percutaneous coronary interventions (PCI) for CTO at a single tertiary PCI centre (Riga East University Hospital), were included in the study. The median age was 64 years (38-88), and 80% were male. The retrograde approach (RA) was used for 167 (32.2%) of the CTO PCI patients. The overall patient success rate was 81.3% and it increased from 73.9% in 2007 to 95.2% in 2015 (p < 0.001). Mean patient observation time was five years. Overall survival was found significantly better in patients group after successful CTO PCI procedures (Long-rank test, p = 0.013).publishersversionPeer reviewe

A Population-Based Cross-Sectional Study of Cardiovascular Risk Factor in Latvia

Background and Objective. To date, the epidemiological studies of noncommunicable diseases in Latvia were more episodic and covered only selected areas. The first national crosssectional population-based survey of cardiovascular risk factors after regaining independence was carried out to provide reliable information on the cardiovascular risk factor profile in adults. Material and Methods. Computerized random sampling from the Registry of Latvian population was carried out. A total of 6000 enrolled subjects aged 25–74 years were divided into 10 age subgroups. The data of 3807 respondents (63.5% of all) were included into the final analysis. Results. The mean number of cardiovascular risk factors was 2.99±0.026 per subject: 3.45±0.043 and 2.72±0.030 for men and women, respectively. Of all the respondents, 75.2% had an increased total cholesterol level. Hypercholesterolemia was found in almost 56% of men and 41% of women in the age group of 25–34 years. Hyperglycemia was documented in 34.1% of the respondents (41.6% of men and 29.8% of women). More than two-thirds (67.8%) of the persons were overweight, while obesity was found in 25.6% of men and 32.6% of women. Arterial hypertension was identified in 44.8% of the respondents; its prevalence was higher in men than women (52.9% vs. 40.2%). There were more current smokers among men than women (30.5% vs. 11.4%). Conclusions. The levels of cardiovascular risk factors in Latvia were found to be relatively high. The data can be utilized as baseline characteristics that can be compared down the road including the monitoring of health prevention activities