Consumption of thyroid medications as an indicator of increase of thyroid morbidity in Latvia from 2011 to 2014

Funding Information: EU Horizon 2020 research and innovation programme under grant agreement No 634453; project EUthyroid. The authors thank the EUthyroid project leader Henry Völzke and the work package leader Betina H. Thuesen for designing, planning and managing the project and, in particular, morbidity data collection. Publisher Copyright: © 2019 Ieva Kalere et al., published by Sciendo 2019.The most common autoimmune disorders with clinically opposite manifestations are hypothyroidism in Hashimoto's thyroiditis and hyperthyroidism in Graves' disease. The healthcare burden of thyroid disease is substantial, resulting in substantial health care costs. The aim of the present analysis is to assess the use of thyroid medications in Latvia from 2011 to 2014 by age and gender. Our study used reimbursed medication prescriptions data, collected by the National Health Service of Latvia. The main indicator was the number of prevalent users of thyroid medications each year from 2011 to 2014, stratified by age and gender. From 2011 to 2014, the number of thyroxine users per 100 000 revealed a statistically significant increase in all age and gender groups, except in 0- to 9-year-old girls. The number of Thiamazole users among men increased in the age group from 40 to 89 years and in women age groups above 49 years. Increasing sales of both thyroid hormones and antithyroid medications are also observed in Estonia and Lithuania, indicating that growing thyroid morbidity is an issue in the whole region. The substantial increase in number of patients highlights the necessity for national guidelines on the use of thyroid function tests and standards of medical care.publishersversionPeer reviewe

Case Report : Micro-RNAs in Plasma From Bilateral Inferior Petrosal Sinus Sampling and Peripheral Blood From Corticotroph Pituitary Neuroendocrine Tumors

Funding Information: The authors acknowledge the Latvian Biomedical Research and Study Centre and the Genome Database of the Latvian Population for providing infrastructure, biological material and data. Funding Information: This research was funded by the European Regional Development Fund within the project RNA molecular determinants in development of pituitary adenoma” (1.1.1.1/18/A/089). Publisher Copyright: Copyright © 2022 Niedra, Peculis, Konrade, Balcere, Romanovs, Steina, Stukens, Sokolovska, Klovins and Rovite.Objective: Circulating miRNAs are found in bodily fluids including plasma and can serve as biomarkers for diseases. The aim of this study was to provide the first insight into the landscape of circulating miRNAs in close proximity to the adrenocorticotropic hormone (ACTH) secreting PitNET. To achieve this objective next-generation sequencing of miRNAs in plasma from bilateral inferior petrosal sinus sampling (BIPSS) - a gold standard in diagnosing ACTH-secreting PitNETs was carried out and selected miRNA candidates were further tested by RT-qPCR in independent patient cohorts. Methods: Sinistral (left) and dextral (right) BIPSS blood samples of the patient were collected in three time points: before the administration of corticotropin-releasing hormone, 5 and 15 minutes after stimulation. In differential expression analysis, sinistral plasma was compared with dextral. The selected miRNA candidates were tested in plasma by RT-qPCR in two patient groups: 1) in five ACTH secreting PitNET patients with plasma samples taken before and 24 hours after surgery, 2) in 12 ACTH secreting PitNET patients vs. 9 non-functioning PitNET patients. Results: BIPSS concluded that the highest amount of ACTH was released in the sinistral side at the 5th minute mark indicating a presence of a tumor. The highest amount of differentially expressed miRNAs was observed 5 minutes after stimulation (20 upregulated, 14 downregulated). At the 5th minute mark in sinistral plasma, two miRNAs were identified: hsa-miR-7-5p and hsa-miR-375-3p that were highly upregulated compared to other BIPSS samples and peripheral plasma samples. Further testing by qPCR revealed significant reduction of miR-7-5p in plasma 24 hours after surgery and upregulation in plasma of ACTH secreting PitNET patients compared to non-functioning PitNET patients (P =0.0013). Conclusions: By stimulating the ACTH secreting PitNET with CRH a rapid increase of two miRNAs (hsa-mir-7-5p, hsa-mir-375-3p) and ACTH can be observed in sinistral inferior petrosal (tumor side). A decrease of miR-7-5p in plasma after surgery and upregulation in plasma of ACTH secreting PitNET patients was discovered implying that further studies of this miRNA as diagnostic marker is needed.publishersversionPeer reviewe

Genome wide analysis of circulating miRNAs in growth hormone secreting pituitary neuroendocrine tumor patients’ plasma

Funding Information: The financial support given by NSFC with Grant No. 11874034, Taishan Scholar Program of Shandong No. ts201712054, and Shandong Science and Technology Enterprise Innovation Capacity Enhancement Project (2021TSGC1036) are highly appreciated for this research. Publisher Copyright: Copyright © 2022 Niedra, Peculis, Litvina, Megnis, Madrika, Balcere, Romanovs, Steina, Stukens, Breiksa, Nazarovs, Sokolovska, Liutkeviciene, Vilkevicute, Konrade and Rovite.Background: Circulating plasma miRNAs have been increasingly studied in the field of pituitary neuroendocrine tumor (PitNET) research. Our aim was to discover circulating plasma miRNAs species associated with growth hormone (GH) secreting PitNETs versus assess how the plasma levels of discovered miRNA candidates are impacted by SSA therapy and whether there is a difference in their levels between GH secreting PitNETs versus other PitNET types and healthy individuals. Design: We compared plasma miRNA content and levels before and after surgery focusing on GH secreting PitNET patients. Selected miRNA candidates from our data and literature were then tested in a longitudinal manner in somatostatin analogues (SSA) treatment group. Additionally, we validated selected targets in an independent GH secreting PitNET group. Methods: miRNA candidates were discovered using the whole miRNA sequencing approach and differential expression analysis. Selected miRNAs were then analyzed using real-time polymerase chain reaction (qPCR). Results: Whole miRNA sequencing discovered a total of 16 differentially expressed miRNAs (DEMs) in GH secreting PitNET patients’ plasma 24 hours after surgery and 19 DEMs between GH secreting PitNET patients’ plasma and non-functioning (NF) PitNET patients’ plasma. Seven miRNAs were selected for further testing of which miR-625-5p, miR-503-5p miR-181a-2-3p and miR-130b-3p showed a significant downregulation in plasma after 1 month of SSA treatment. mir-625-5p was found to be significantly downregulated in plasma of GH secreting PitNET patients vs. NF PitNET patients. miR-625-5p alongside miR-130b-3p were also found to be downregulated in GH PitNETs compared to healthy individuals. Conclusions: Our study suggests that expression of plasma miRNAs miR-625-5p, miR-503-5p miR-181a-2-3p and miR-130b-3p in GH secreting PitNETs is affected by SSA treatment. Additionally, miR-625-5p can distinguish GH secreting PitNETs from other PitNET types and healthy controls warranting further research on these miRNAs for treatment efficacy.publishersversionPeer reviewe

Importance of diabetes education in understanding course and complications of the disease in hospitalized 2.Type diabetes patients and it effect on patient conpliance

Diabēta izplatība un biežums pieaug visā pasaulē. Tiek prognozēts, ka cilvēku skaits, kuri slimo ar diabētu pieaugs par 35% 2030. gadā salīdzinājumā ar 2015. gadu. 2014. gadā uzskaitē esošu 2. tipa cukura diabēta (2TCD) pacientu skaits Latvijā sastādīja 79986 tūkstošus, kas procentuāli no kopēja pacientu skaita bija 94,45%. 2015 gadā diabēta dēļ bija reģistrēti 5 miljoni nāves gadījumi, no kuriem 85%-90% ir 2TCD pacienti. Pētījuma mērķis: Noteikt diabēta apmācības ietekmi uz 2TCD gaitu un pacientu līdzestību Paula Stradiņa Klīniskā universitātes slimnīcā stacionētajiem pacientiem. Pētījums ir kvantitatīvs, aprakstošs un balstās uz respondentu anketēšanu. Pētījumā tika iesaistīti hospitalizētie 2TCD pacienti, kuri piekrita atbildēt uz jautājumiem. Respondentu anketēšanu veica šī darba autors. Rezultāti: Pētījumā piedalījās 59 respondenti: 34 sievietes; 25 vīrieši, kuru vidējais vecums bija 71,5 gadi. Pacientu vidējais ĶMI - 31,00 kg/m2, glikēmija - vidēji 8,7 mmol/l, HbA1c - vidēji 8,1%. Vidējais 2TCD ilgums respondentiem bija 12 gadi. 34% no aptaujātajiem pacientiem saņēma tikai insulīna terapiju, savukārt 51% - tikai orālo antidiabētisko terapiju. Visi pacienti tika iedalīti 2 grupās: pētāmā grupā iekļauti tie, kuri bija apmācīti specializētā diabēta apmācības programmā vai individuālo konsultāciju laikā (N=31), kontroles grupā – pacienti, kuri nebija apmācīti vai izglītojušies pašmācības ceļā (N=28). Pētāmās grupas pacientiem, salīdzinot ar kontroles grupu, biežāk bija glikometri (χ2= 7,04; p=,008); viņi biežāk veica paškontroli - glikēmijas mērījumu reizes/nedēļā (χ2= 8,16; p=,043); glikēmijas mērījumu reizes/dienā (χ2= 9,8; p=,020). Apmācību izgājušie pacienti bija labāk informēti par hiperglikēmijas un hipoglikēmijas stāvokļiem (χ2= 6,3; p=,012); biežāk zināja ko darīt hiperglikēmijas laikā (χ2= 12,3 un p=,006); bija labāka izpratne par darbībām hipoglikēmijas laikā (χ2= 7,8 un p=,020) un zināšanas par hipoglikēmijas simptomiem (χ2= 9,0 un p=,003). Tika iegūta vāja pozitīva korelācija starp slimības ilgumu un vizītēm pie ģimenes ārsta (r=,274, p=,038). Secinājumi: Pētījums apliecina, ka diabēta apmācība pozitīvi ietekmē diabēta pacientu līdzestību un pacientu izpratni par slimības norisi. Veiktās pacientu anketēšanas dati parāda, ka apmācītiem pacientiem ir labāka izpratne par rīcību hiperglikēmijas un hipoglikēmiju gadījumā, kas būtiski var ietekmēt pacientu vispārējo veselības stāvokli. Kopš 2009. gada Latvijā nav pieejama valsts apmaksāta diabēta apmācības programma, tādēļ pietiekoši bieži pacienti apmācību nesaņem un ir spiesti pašizglītoties. Būtu nepieciešams aptaujāt lielāku skaitu 2TCD pacientu, lai izdarītu plašākus secinājumus.Prevalence and frequency of diabetes is increasing worldwide. Is estimated, that the number of patients with diabetes until 2030 will increase by 35 % compared with 2015. In Latvia, statistics shows that number of patients with T2DM in 2014 was 79986 thousands (94,45 % of all). In 2015 diabetes caused 5 million death. Purspose: Define the diabetes education influence on patient’s adherence and the course of disease among hospitalized Pauls Stradins Clinical University Hospital patients. This research is quantitative, descriptive and is based on patient questionnaire survey. In the research participated all hospitalized patients with T2DM, who agreed to answer the questions. Interweaving of patients was made by this work author. Results: In the research participated 59 patients: 34 women; 25 men, average age was 71,5 years. The average BMI was 31,00 kg/m2, average glycaemia 8,7 mmol/L, average HbA1c 8,1%. Average disease duration was 12 years . With insulin therapy – 34 %, with oral antidiabetic medications – 51 %. Patients were separated in two groups , research group were educated in special programs or with personalized counseling (N=31), group of control – patients, who were not educated or have been educated by themselves (N=28).Patients in research group more frequently had glucometers (χ2= 7,04; p=,008); they more frequently made glycaemia measurements times per week (χ2= 8,16; p=,043); glycaemia measurements times per day (χ2= 9,8; p=,020). Patients, who have been educated were more informed about hyper- and hypoglycemia (χ2= 6,3; p=,012); more frequently knew how to act in the case of hyperglycemia (χ2= 12,3 un p=,006); more frequently knew how to act in the case of hypoglycemia (χ2= 7,8 un p=,020) and had better knowledge about hypoglycemia symptoms (χ2= 9,0 un p=,003). There was not significant, but positive correlation between the length of disease and visits to family doctor (r=,274, p=,038). Conclusions: This research confirm, that the education of diabetes patients positively influence patient’s adherence and patient disease understanding. Information, which was gotten from questionnaires, showed that educated patients more frequently knew how to act in the case of hyperglycemia and hypoglycemia , which highly affect patient health. Since 2009 in Latvia diabetes patient education program is not goverment – funded, that’s why patients do not get needed education , as follows a grade of patient education level depends on patient self education. There is a need for more interweaves to make more conclusions