Pregnancy and live birth rates in women with endometriosis related infertility in Latvia

Background: Women with endometriosis experience painful symptoms and/or infertility, others have no symptoms at all. According to European Society of Human Reproduction and Embryology guidelines, surgery and assisted reproductive technologies (ART) are an appropriate treatment in cases of endometriosis-associated infertility. There are controversial data on the results of surgery and ART in patients with endometriosis.Methods: Retrospective analysis including 99 infertile patients aged between 25 and 48 years old. All of them had laparoscopic surgery as the primary option. 51 of them undergoing in vitro fertilization or intracytoplasmic sperm injection or frozen embryo transfer from 2003 through 2018 at SIA ‘Clinic EGV’.Results: The mean age of women was 34.2±4.5. In 56 (33.5%) cases was only surgery with 28 (50.9%) biochemical pregnancies and 26 (48.1%) live birth. In 111 (66.5%) cases there were surgery with ART with 48 (47.6%) biochemical pregnancies and 23 (22.7%) live birth. In 1 group patients mean age 30.7±4.6 and 2 group with mean age 35.1±4.2 (p=0.000). It was found that there is significant difference between endometriosis phenotype, infertility type, duration of infertility, repeated laparoscopic surgery, ART cycles, retrieved oocyte count and biochemical pregnancy rate.Conclusions: Patients with endometriosis related infertility should undergo surgical treatment as the primary option. Those patients who do not become pregnant after surgery must be treated with assisted reproductive technology. The optimal time to perform ART is first year after endometriosis surgery

Impact of educational training and C-reactive protein point-of-care testing on antibiotic prescribing in rural and urban family physician practices in Latvia : a randomised controlled intervention study

Funding Information: This work was supported by the Joint Funds for the innovation of science and Technology of Fujian province (2019Y9031) and Startup Fund for scientific research, Fujian Medical University (2021QH2046). Publisher Copyright: © 2022, The Author(s).BACKGROUND: Although self-limiting viral infections are predominant, children with acute infections are often prescribed antibiotics by family physicians. The aim of the study is to evaluate the impact of two interventions, namely C-reactive protein point-of-care testing and educational training, on antibiotic prescribing by family physicians. METHODS: This randomised controlled intervention study included acutely ill children consulted by 80 family physicians from urban and rural practices in Latvia. The family physicians were divided into two groups of 40. The family physicians in the intervention group received both interventions, i.e. C-reactive protein point-of-care testing and educational training, whereas the family physicians in the control group continued to dispense their standard care. The primary outcome measure was the antibiotic prescribing at the index consultation (delayed or immediate prescription) in both study groups. The secondary outcome was CRP testing per study group. Patient- and family physician- related predictors of antibiotic prescribing were analysed as associated independent variables. Practice location effect on the outcomes was specially addressed, similar to other scientific literature. RESULTS: In total, 2039 children with acute infections were enrolled in the study. The most common infections observed were upper and lower respiratory tract infections. Overall, 29.8% (n = 607) of the study population received antibiotic prescription. Our binary logistic regression analysis did not find a statistically significant association between antibiotic prescriptions and the implemented interventions. In the control group of family physicians, a rural location was associated with more frequent antibiotic prescribing and minimal use of CRP testing of venous blood samples. However, in the intervention group of family physicians, a rural location was associated with a higher level of C-reactive protein point-of-care testing. Furthermore, in rural areas, a significant reduction in antibiotic prescribing was observed in the intervention group compared with the control group (29.0% (n = 118) and 37.8% (n = 128), respectively, p = 0.01). CONCLUSION: Our results show that the availabilty of C-reactive protein point-of-care testing and educational training for family physicians did not reduce antibiotic prescribing. Nevertheless, our data indicate that regional variations in antibiotic-prescribing habits exist and the implemented interventions had an effect on family physicians practices in rural areas.publishersversionPeer reviewe

Text messaging (SMS) as a tool to facilitate weight loss and prevent metabolic deterioration in clinically healthy overweight and obese subjects : a randomised controlled trial

Publisher Copyright: © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.Objective: To examine whether SMS text messaging facilitates a reduction of weight and waist circumference (WC) and favourable changes in lipid profile and insulin levels in clinically healthy overweight and obese subjects. Design: A randomised controlled trial. Setting and intervention: Primary care health centre in Riga, Latvia. Text messaging once in two weeks. Subjects: A total of 123 overweight and obese men and women aged 30–45 years with no cardiovascular diseases (CVDs) or diabetes. Main outcome measures: changes in anthropometric parameters (weight, WC, body mass index (BMI)) and biochemical parameters (lipids, fasting glucose and insulin). Results: We found a statistically significant decrease in weight (2.4%), BMI and WC (4.8%) in the intervention group, while the control group showed a statistically non-significant increase in weight and BMI and decrease in WC. Between group results obtained over the course of a year showed statistically significant mean differences between weight (–3.4 kg (95% CI –5.5, –1.3)), BMI kg/m2 (–1.14 (95% CI –1.9, –0.41)), WC (–4.6 cm (95% CI –6.8, –2.3)), hip circumference (–4.0 cm (95% CI –5.9, –2.0)) and fasting insulin (2.43 μU/ml (95% CI 0.6, 4.3)). Mean differences of changes in glucose and lipid levels were statistically non significant: fasting glucose (–0.01 mmol/l (95% CI –0.19, 0.17)), TC mmol/l (–0.04 mmol/l (95% CI –0.29, 0.21)), HDL-C (0.14 mmol/l (95% CI –0.65, 0.09)), LDL-C (–0.02 mmol/l (95% CI –0.22, 0.18)) and TG (0.23 mmol/l (95% CI –0.06, 0.52)). Conclusions: SMS messaging in clinically healthy overweight and obese subjects facilitates a slight decrease in weight, BMI and WC. It is anticipated that the implications of this strategy might facilitate the design of preventive and promotive strategies among high risk groups in Latvia.publishersversionPeer reviewe

Challenges for clinical practice and research in family medicine in reducing the risk of chronic diseases. Notes on the EGPRN Spring Conference 2017 in Riga

publishersversionPeer reviewe

Profesionalas izglitibas modernizacija Latvija Latvijas Nacionalas observatorijas 2000. gada zinojums

Available from Latvian Academic Library / LAL - Latvian Academic LibrarySIGLEEuropean Training Foundation, Turin (Italy); Ministry of Education and Science of the Republic of Latvia, Riga (Latvia)LVLatvi