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Objectives: The aim of this study was to describe the factors that affect the normal dental development of preschool children in Latvia, and to investigate sources that mothers use to get information on children’s oral health. Materials and Methods: A cross-sectional study was performed in two kindergartens in Latvia (cluster sampling). The study sample comprised 141 child–mother pairs of preschool children aged 4–7 years. The dental situation of all children was assessed including evaluation by an orthodontist and a speech therapist, and mothers of children filled out the survey on oral health-related habits and information about it. Statistical analysis: We described individually factors related to orthodontal situations, children’s speech problems, and factors that can affect tongue thrust. We investigated relationships between sources of mothers’ information and oral health-related behaviors using univariate (Kruskal–Wallis test, a chi-squared test, a Fisher test, or Cramer’s V test) and multivariate analyses. We built a multiple logistic regression model adjusted for the demographic and oral health-related factors to investigate the factors associated with tongue thrust. Results of multiple logistic regression were presented with odds ratio (OR) and 95% confidence intervals (CI). Results: In total, 36.9% of children grazed vegetables several times a week, and 61.0% cleaned their teeth twice a day. Of mothers, 12% did not receive any information about child dental care from their general physician, and 23.4% found the received information insufficient. A total of 43.3% of mothers received oral health-related information from friends, and it was significantly related to less carbonated water (p < 0.01), more help during teeth cleaning (p = 0.03), starting cleaning teeth in earlier age (p = 0.03), and more frequent visits to a child dentist (p = 0.03). Conclusions: A lack of knowledge was found to be prominent in mothers of kindergarten children in Latvia, and most of them received information not from official sources such as their general physician. This can be related to some problems in oral health behaviors and oral health-related diseases. Communication among dental health specialists, state authorities, and families is crucial for the improvement of children’s dental situation.

(1) Background: Little research is conducted on the link between diabetic kidney disease (DKD) progression and diabetic gastroenteropathy in type 1 diabetes (T1D). (2) Methods. We performed a cross-sectional study with 100 T1D patients; 27 of them had progressive DKD, defined as an estimated glomerular filtration rate (eGFR) decline ≥3 mL/min/year or increased albuminuria stage, over a mean follow-up time of 5.89 ± 1.73 years. A newly developed score with 17 questions on gastrointestinal (GI) symptoms was used. Faecal calprotectin was measured by ELISA. Lower GI endoscopies were performed in 21 patients. (3) Results: The gastrointestinal symptom score demonstrated high reliability (Cronbach’s α = 0.78). Patients with progressive DKD had higher GI symptom scores compared to those with stable DKD (p = 0.019). The former group demonstrated more frequent bowel movement disorders (p < 0.01). The scores correlated negatively with eGFR (r = −0.335; p = 0.001), positively with albuminuria (r = 0.245; p = 0.015), Hba1c (r = 0.305; p = 0.002), and diabetes duration (r = 0.251; p = 0.012). Faecal calprotectin levels did not differ between DKD groups significantly. The most commonly reported histopathological findings of enteric mucosa were infiltration with eosinophils, lymphocytes, plasmacytes, the presence of lymphoid follicles, and lymphoid aggregates. Conclusion: The progression of DKD is positively correlated with gastrointestinal symptoms; however, more research is needed to clarify the causal relationships of the gut-kidney axis in T1D.

Background. Ophthalmologists treat diabetic macular edema before cataract surgery to reduce possible complications. Despite improvements in diagnostic techniques, whether cataract surgery per se causes the progression of diabetic retinopathy with macular edema remains unclear. This study aimed to evaluate the impact of phacoemulsification on the central retina and its correlation with diabetes compensation as well as changes in the retina before surgery. Methods. Thirty-four type 2 diabetes mellitus patients who underwent phacoemulsification cataract surgery were included in this prospective longitudinal study. Of them, 29.4% had macular edema before surgery, and 70.6% had a normal macular structure. All patients underwent ophthalmic examinations, including optical coherence tomography angiography, at baseline and at one and three months after surgery. The Mann-Whitney test was performed to compare the area of the foveal avascular zone, perimeter of the foveal avascular zone, and mean vascular density in the para- and perifoveal deep and superficial capillary plexuses. All parameters were measured before and at one and three months after surgery. Multiple linear regression models with adjustments for glycated hemoglobin and duration of diabetes mellitus were constructed to assess the association between the area of the foveal avascular zone and diabetic macular edema. Results. Significant differences in the area of the foveal avascular zone, perimeter of the foveal avascular zone, and perifoveal density in the deep capillary plexus were observed at all three time points. In the fully adjusted linear regression model, those without diabetic macular edema had a reduced probability for changes in the foveal avascular zone at one and three months after surgery (effect estimate β = −0.20 [95% CI −0.31; −0.09] and β = −0.13 [−0.22; −0.03] for one and three months, respectively) compared with those with diabetic macular edema. Conclusions. Cataract surgery itself does not cause significant and permanent increase in diabetic macular edema three months post-surgery. On the contrary, in a group with diabetic macular edema before the surgery, central retinal thickness tended to stabilize three months after surgery. If the duration of diabetes is shorter and diabetes is better compensated, the possibility of changes in the foveal avascular zone is reduced.

We aimed to determine the diagnostic value of anti-parietal cell antibodies (anti-PCA), anti-intrinsic factor antibodies (anti-IFA), pepsinogen ratio (PGI/II), and gastrin-17 (G-17) in corpus-restricted atrophic gastritis (CRAG) detected by ELISA (Inova, Biohit). Our study compared 29 CRAG cases against 58 age- and sex-matched controls with mild or no atrophy. Anti-PCA and anti-IFA positive cutoff values were ≥25 units for both. PGI/II value H. pylori IgG were >5 pg/L and >30 EIU. Anti-PCA was positive in 65.5% For CRAG cases and 13.8% of the controls (p < 0.0001), anti-IFA was positive in 13.8% and 0% (p = 0.01), respectively. Decreased pepsinogen levels were present in 79.3% of CRAG cases and 10.3% of the controls (p < 0.0001). PGI/II ratio was the best single biomarker, with sensitivity = 79%, specificity = 90%, and AUC 0.90. The combined use of PGI/II and anti-PCA resulted in AUC 0.93 for detecting CRAG. Our study suggests that the best combination of non-invasive biomarkers for detecting CRAG is PGI/II with anti-PCA. The addition of G-17 and anti-IFA is of little utility in clinical application.

Introduction––Serum pepsinogen tests for gastric cancer screening have been debated for decades. We assessed the performance of two pepsinogen assays with or without gastrin-17 for the detection of different precancerous lesions alone or as a composite endpoint in a Latvian cohort. Methods––Within the intervention arm of the GISTAR population-based study, participants with abnormal pepsinogen values by ELISA or latex-agglutination tests, or abnormal gastrin-17 by ELISA and a subset of subjects with all normal biomarker values were referred for upper endoscopy with biopsies. Performance of biomarkers, corrected by verification bias, to detect five composite outcomes based on atrophy, intestinal metaplasia, dysplasia or cancer was explored. Results––Data from 1045 subjects were analysed, of those 273 with normal biomarker results. Both pepsinogen assays showed high specificity (>93%) but poor sensitivity (range: 18.4–31.1%) that slightly improved when lesions were restricted to corpus location (40.5%) but decreased when dysplasia and prevalent cancer cases were included (23.8%). Adding gastrin-17 detection, sensitivity reached 33–45% while specificity decreased (range: 61.1–62%) and referral rate for upper endoscopy increased to 38.6%. Conclusions––Low sensitivity of pepsinogen assays is a limiting factor for their use in population-based primary gastric cancer screening, however their high specificity could be useful for triage.

Due to the severe impact of COVID-19 on public health, rollout of the vaccines must be large-scale. Current solutions are not intended to promote an active collaboration between communities and public health researchers. We aimed to develop a digital platform for communication between scientists and the general population, and to use it for an exploratory study on factors associated with vaccination readiness. The digital platform was developed in Latvia and was equipped with dynamic consent management. During a period of six weeks 467 participants were enrolled in the population-based cross-sectional exploratory study using this platform. We assessed demographics, COVID-19-related behavioral and personal factors, and reasons for vaccination. Logistic regression models adjusted for the level of education, anxiety, factors affecting the motivation to vaccinate, and risk of infection/severe disease were built to investigate their association with vaccination readiness. In the fully adjusted multiple logistic regression model, factors associated with vaccination readiness were anxiety (odds ratio, OR = 3.09 [95% confidence interval 1.88; 5.09]), feelings of social responsibility (OR = 1.61 [1.16; 2.22]), and trust in pharmaceutical companies (OR = 1.53 [1.03; 2.27]). The assessment of a large number of participants in a six-week period show the potential of a digital platform to create a data-driven dialogue on vaccination readiness.

Background and objectives: In kidney transplant recipients (KTR), hyperuricemia (HU) is a commonly-observed phenomenon, due to calcineurin inhibitors and reduced kidney graft function. Factors predicting HU, and its association with graft function, remains equivocal. Materials and Methods: We conducted a retrospective longitudinal study to assess factors associated with HU in KTR, and to determine risk factors associated with graft function, measured as glomerular filtration rate (GFR). Moreover, GFR > 60 mL/min/1.73 m2 was considered normal. HU was defined as a serum uric acid level of > 416 μmol/L (4.70 mg/dL) in men and >357 μmol/L (4.04 mg/dL) in women, or xanthine-oxidase inhibitor use. We built multiple logistic regression models to assess predictors of HU in KTR, as well as the association of demographic, clinical, and biochemical parameters of patients with normal GFR after a three-year follow-up. We investigated the effect modification of this association with HU. Results: There were 144 patients (mean age 46.6 ± 13.9), with 42.4% of them having HU. Predictors of HU in KTR were the presence of cystic diseases (OR = 9.68 (3.13; 29.9)), the use of diuretics (OR = 4.23 (1.51; 11.9)), and the male gender (OR = 2.45 (1.07; 5.56)). Being a younger age, of female gender, with a normal BMI, and the absence of diuretic medications increased the possibility of normal GFR. HU was the effect modifier of the association between demographic, clinical, and biochemical factors and a normal GFR. Conclusions: Factors associated with HU in KTR: Presence of cystic diseases, diuretic use, and male gender. HU was the effect modifier of the association of demographic, clinical, and biochemical factors to GFR.

Two commonly used models to assess air pollution concentration for investigating health effects of air pollution in epidemiological studies are Land Use Regression (LUR) models and Dispersion and Chemistry Transport Models (DCTM). Both modeling approaches have been applied in the Ruhr area, Germany, a location where multiple cohort studies are being conducted. Application of these different modelling approaches leads to differences in exposure estimation and interpretation due to the specific characteristics of each model. We aimed to compare both model approaches by means of their respective aims, modeling characteristics, validation, temporal and spatial resolution, and agreement of residential exposure estimation, referring to the air pollutants PM2.5, PM10, and NO2. Residential exposure referred to air pollution exposure at residences of participants of the Heinz Nixdorf Recall Study, located in the Ruhr area. The point-specific ESCAPE (European Study of Cohorts on Air Pollution Effects)-LUR aims to temporally estimate stable long-term exposure to local, mostly traffic-related air pollution with respect to very small-scale spatial variations (≤100 m). In contrast, the EURAD (European Air Pollution Dispersion)-CTM aims to estimate a time-varying average air pollutant concentration in a small area (i.e., 1 km2), taking into account a range of major sources, e.g., traffic, industry, meteorological conditions, and transport. Overall agreement between EURAD-CTM and ESCAPE-LUR was weak to moderate on a residential basis. Restricting EURAD-CTM to sources of local traffic only, respective agreement was good. The possibility of combining the strengths of both applications will be the next step to enhance exposure assessment.