Contrast-Enhanced Ultrasound Qualitative and Quantitative Characteristics of Parathyroid Gland Lesions

Funding Information: Funding: This research received funding from Latvian Science Funding, project number Izp-2020/2-0297, Multiparametric ultrasound correlation with morphology in patients with primary hyperparathyroidism. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)— and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.publishersversionPeer reviewe

Beliefs in Conspiracy Theories and Mental Health in the Student Community of Latvia During the COVID-19 Outbreak

BACKGROUND: The objective of this study was to investigate self-reported changes in mental health and their association with various sociodemographic factors and beliefs in conspiracy theories among university and college students in Latvia during the second state of emergency caused by COVID-19. SUBJECTS AND METHODS: This cross-sectional study was conducted as part of an international research project, where university and college students were anonymously asked to complete an online self-report questionnaire. Changes in anxiety and depression were assessed using self-rated questions. Statistical analysis involved Pearson's chi-square test and univariate binary logistic regression.ression. RESULTS: The study comprised 1047 students, with 828 females (79.08% aged 21.71±0.09). Worsening in self-reported anxiety was more prevalent among females (69.3%, p<0.001), unemployed respondents (70.0%, p=0.003), individuals who were were not working during the lockdown (70.3%, p<0.001), those experiencing deterioration in general health condition (93.0%, p<0.001), and those belonging to or having knowledge of someone in a vulnerable group (69.5%, p=0.004). Worsening self-reported depression was more prevalent in respondents who did not work during the lockdown (63.9%, p=0.014) and those with deteriorating general health conditions (93.0%, p<0.001). Increased odds ratios (OR) for experiencing changes in anxiety and depression were associated with beliefs in the following conspiracy theories: 'Recommended measures are an attempt to restrict human rights' (OR=1.49, p=0.019 and OR=2.40, p<0.001, respectively). Furthermore, increased OR for experiencing changes in depression were associated with beliefs in the following conspiracy theories: 'The COVID-19 vaccine was ready before the virus spread' (OR=3.11, p=0.007), 'COVID-19 has a lower mortality rate" (OR=1.85, p<0.001)', 'Recommended measures are an attempt to restrict human rights' (OR=2.40, p<0.001), and 'The COVID-19 outbreak is the creation of world leaders' (OR=2.17, p=0.003). CONCLUSIONS: Self-reported changes in depression and anxiety were associated with certain beliefs in specific conspiracy theories.Peer reviewe

Diagnostic scope of 18 F-PSMA-1007 PET/CT : comparison with multiparametric MRI and bone scintigraphy for the assessment of early prostate cancer recurrence

publishersversionPeer reviewe

Access to healthcare during COVID-19 among ageing population in Latvia

Medical staff has worked tirelessly throughout the COVID-19 pandemic to test and treat coronavirus patients. However, the focus on the virus has caused huge disruption to healthcare services, resulting in delayed treatment for patients with other serious conditions. Additionally, the reasons for forgoing or abstaining healthcare could also relate to individual decisions. We used data from the Survey of Health, Ageing and Retirement in Europe (SHARE), where the respondents aged 50 and older of the Wave 8, version 0, were asked to answer, among other, questions on delayed, postponed or denied healthcare services during the first wave of COVID-19 pandemic in Latvia. For comparative reasons also Estonian and Lithuanian data were included in the study with 2 473 627 valid weighted cases in total. Due to the large sample size, in order to evaluate statistically significant result for Pearson’s chi-square test, strength of association (f) was provided. The results show that 12.7% of the respondents forwent and 14% postponed medical treatment in Latvia. Appointment was denied to 5.5% of the respondents. Generally, older people in Latvia had better access to health care services compared to the average in the Baltic countries. We found significant age and gender differences, but they varied depending on the type of treatment and reason for not receiving it. However, further studies are necessary to analyse how limited access to the healthcare for other reasons has affected health of the ageing population. Also, more knowledge is needed about how to maintain public health and wellbeing for the growing part of the ageing society