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Cancer stem cells may be responsible for tumour regrowth and acquisition of resistance in small cell lung cancer (SCLC). The Hedgehog pathway regulates survival and proliferation of tissue progenitor and stem cell populations, promoting the expression of stem cell related and proliferative genes. We evaluated the Sonic Hedgehog (Shh) embryonic signalling pathway in relapsed SCLC. Expression levels of Shh related genes GLI1, SMO, SUFU, PTCH1, HHIP, BCL2, BMI, ZEB1, ZEB2, N-MYC, Twist1 were analysed by qRT-PCR in matched pre-treatment and relapsed tumour fresh frozen biopsies of three SCLC patients. Expression of each gene was compared using the paired samples t-test, as well as comparison of mean expression levels was done. Data were statistically interpreted using the MedCalc version 10.2.0.0 software. 2.9-fold lower mean mRNA expression of the major Hedgehog activation indicator GLI1 was observed in relapsed samples (p = 0.0529). Mean expression of six Shh inducible genes, PTCH1, HHIP, N-MYC, ZEB2, Twist1, ZEB1, was also downregulated by 2.6-, 2.2-, 1.9-, 1.8-, 1.2-, 1.1-fold, respectively (p = 0.4252, p = 0.1268, p = 0.2480, p = 0.1169, p = 0.1480, p = 0.7595, respectively). 1.8-fold mean expression decrease was found for Gli activator Smo (p = 0.4111). Only the Shh pathway inhibitor SUFU and two other examined Hedgehog signalling inducible genes BCL2 and BMI in relapsed SCLC showed 0.8-, 0.9-,and 0.8-fold increase of expression, respectively (p = 0.3074, p = 0.7921, and p = 0.3822, respectively). To our knowledge, this is the first report of comparison of Shh signalling in matched pre-treatment and relapsed SCLC biopsies. Our data show decreased activity for majority of Shh pathway components in relapsed SCLC, although difference did not reach statistical significance.

The coronavirus disease-2019 (COVID-19) crisis has affected how hospitals work and has had an effect on orthopedic surgery.To compare patient management and low-energy and high-energy trauma treatment at two orthopedic trauma units during the COVID-19 crisis and to clarify resource demands and preparedness in orthopedic clinics during the state of emergency caused by the COVID-19 pandemic.This retrospective study was conducted at two orthopedic trauma units from 14 March 2019 to 14 April 2019 and from 14 March 2020 to 14 April 2020.The proportion of patients admitted in the multi-trauma orthopedic unit decreased by one-third, the mean time interval from admission to surgery significantly decreased, and the number of surgeries and mean length of stay in hospital decreased in 2020 compared to the same test period in 2019. In the orthopedic trauma unit, the number of patients and surgeries also decreased.Our study highlights changes in orthopedic injury characteristics in two orthopedic units during the COVID-19 crisis in Latvia and compares these changes to data from the same time period one year earlier.

Aim Aberrant Sonic hedgehog (Shh) pathway signaling has been described in small cell lung cancer (SCLC), as well discrepancies, when analyzing expression of pathway components in SCLC cell lines vs tumor biopsies. Shh key component GLI1 was evaluated in advanced SCLC and data correlated with patient survival. Materials and methods GLI1 expression was analyzed by quantitative real-time polymerase chain reaction in pre-treatment fresh frozen tumor biopsies of 12 advanced SCLC patients and mRNA level of GLI1 was compared in short-term vs long-term survivor's samples (stratified by median survival, independent samples t-test). Results Expression of GLI1 mRNA was significantly higher in long-term (> 9.6 months, n = 6) survivor's biopsies than in short-term (≤ 9.6 months, n = 6) survivors (p = 0.0196, 95% CI: 0.000016 to 0.000147, two-tailed independent samples t-test). Conclusion High GLI1 mRNA expression in SCLC was found to be positive prognostic marker associated with longer survival. Further research is needed for validation of these results due to the small number of patients in the study.

OBJECTIVE We have compared the performance of two faecal immunochemical tests (FIT) in an average-risk population. MATERIALS AND METHODS Altogether, 10 000 individuals aged 50-74 were selected randomly from the population of Latvia in 2011 and assigned randomly either to OC-Sensor or to FOB Gold single-time testing. Positivity of the test, frequency of colonic lesions, number needed to screen (NNscreen) and scope for the detection of an advanced neoplasm (cancer and advanced adenoma) were compared between the tests using the same cutoff concentrations in µg/g faeces. Confidence intervals (CIs) at 95% were calculated. RESULTS Positivity with the cutoff set at 10 µg/g faeces was 12.8% (95% CI: 11.4-14.2) for FOB Gold and 8.3% (95% CI: 7.2-9.4) for OC-Sensor (P

Breast cancer is a heterogenous disease. It consists of several histological subtypes that can be separated by morphology and immunohistochemistry. The aim of our study was to determine the distribution of breast cancer histological and molecular subtypes, and their relationship with clinical and pathological characteristics. A total of 561 patients who underwent breast carcinoma surgical treatment from January 2003 till December 2012 were enrolled in the study. In total, invasive ductal carcinomas not otherwise specified (IDC-NOS) plus invasive ductal carcinomas no special type (IDC-NST) were observed in 430 patients (76.65% of cases), medullar carcinoma in 14 patients (2.45%), other rare ductal carcinoma subtypes in 13 patients (2.31%), lobular carcinoma in 81 patients (14.4%) and tubulolobular carcinoma in 23 patients (4.19%). Ductal carcinoma, lobular and tubulolobular carcinoma had predominantly luminal A and B subtype, whereas medullar carcinoma had HER2-positive and triple-negative (TN) subtype. Tubular, cribriform, mucinous, papillary, and apocrine carcinomas had predominantly luminal A subtype. Significant differences between breast cancer histological subtypes and clinicopathological characteristics were observed. Our study for the first time reported the distribution and characteristics of breast cancer histological subtypes in Latvian women and relationship to clinical and tumour histopathological characteristics.

Detta examensarbete behandlar genus inom cosplaykulturen, specifikt den delen av kulturendär man väljer att ändra på en karaktärs identitet genom genderbend. Karaktären i fråga får enny könsidentitet. Jag som forskare är själv aktiv medlem och väl bekant med cosplaykulturen.Att arbeta med genus inom skola är viktigt, speciellt för de ungdomar som själva är mitt iprocessen av att finna sin plats i sig själv och i samhället. Cosplay är en kultur som för mångaungdomar blir en del av deras liv och ett sätt för identitetskapande. Att säga att cosplay endastär en skaparhobby som inte skulle ha något med identitetskapande är ignorant och därförviktigt att undersöka den som en ungdomskultur. Syftet med undersökningen är att se hurgenusidentiteter framträder inom cosplay, både bland karaktärerna och bland de som iklär sigde. Syftet är även att få en fördjupad kunskap om unga och deras identitetsarbete i relation tillen skolkontext.Denna undersökning lyckades jag även identifiera hur mitt cosplayskapande ser ut, där jagtvärt emot min fokusgrupp är intresserad av att bli så lik en karaktär som möjligt. Medansderas motiv till att förändra en karaktärs identitet hade att göra med att de anpassadekaraktären till sin egen identitet och därmed låta sig själva få skina igenom karaktären när deär utklädda, vill jag snarare att karaktärens identitet ska ta över min så att jag för tillfället kanfå vara lite mer ut av en pirat eller en prinsessa istället för mig själv. Detta presenteras främst imin gestaltning där jag skapat ett altarliknande monument som kretsar kring en specifikkaraktär jag vill fortsätta jobba med efter denna undersökning. Altaret är byggt på material,tyger, skisser och anteckningar som jag samlat på mig under processen av denna karaktär.Altaret var ett sätt att låta betraktare få en känsla och förståelse för hur jag kan uppfattacosplayprocessen, där det både kan vara en inspirerande underkastelse till karaktären likt ettandaktigt avgudande, men också något dramatiskt och överväldigande.

Internal Fracture Fixation using the Anterior Retroperitoneal Lower Laparotomy Approach in Pelvic Ring and Acetabular Fractures: the First Experience and Outcomes Introduction. The ilioinguinal approach is well established for the treatment of pelvic fractures. As an alternative, the anterior retroperitoneal lower laparatomy (modified Stoppa) approach can be used to expose pelvic and acetabular fractures. We describe our experience with this approach in polytrauma patients with pelvic ring and acetabular fractures. Aim of the Study. The aim of study was to evaluate possibilities and impossibilities of internal fixation of pelvic ring and acetabular fractures using the anterior retroperitoneal lower laparatomy approach. Materials and methods. This retrospective study describes a series of 20 consecutive patients where a modified Stoppa approach was used for pelvic or acetabular fracture fixation. Results. 10 patients with acetabular fractures, six patients with a pelvic ring injury not involving the acetabular joint and 4 patients with a combined fracture were operated through a modified Stoppa approach. Anatomic or satisfactory reduction was achieved in 92% of the acetabular fractures. Pelvic ring fractures had an anatomic (displacement

Her2 Expression and Response of Breast Cancer to Adjuvant Chemotherapy Expression of the human epidermal growth factor receptor type 2 (HER2) in breast cancer patients may predict response to anthracycline or non anthracycline-based adjuvant chemotherapy. A total of 192 breast cancer patients diagnosed at the Latvian Oncology Centre from January 2002 to August 2005 were included in the study. Patients had histopathologically confirmed breast cancer, had undergone radical surgery and received at least four courses of adjuvant chemotherapy. HER2 expression was evaluated by immunohystochemical analysis. Median follow-up time was 32.1 months. In HER2 negative patients, the mean time to recurrence was 26.9 months (SD 1.465; 95%CI 23.9-29.4) for patients received antracycline-based chemotherapy and 33.2 months (SD 1.308; 95%CI 30.6-35.8) in the CMF chemotherapy group (P < 0.05). These HER2 negative patients could be treated with a less toxic regimen of CMF. In HER2 overexpressed patients receiving anthracycline based chemotherapy, mean time to recurrence was 30 months (SD 2.170; 95%CI 25.7-34.4) compared with 29.2 months (SD 1.965; 95%CI 25.4-33.1) in patients who received CMF, but the difference was not significant (P > 0.05).

Background & Aims: Appropriate biopsy sampling is important for the classification of gastritis, yet the extent of inflammation and atrophy of different regions of the stomach with chronic gastritis have been addressed only in a few studies. The aim of our study was to analyze the inflammatory, atrophic and metaplastic changes in the greater and lesser curvature of the antrum and corpus mucosa. Methods: 420 patients undergoing upper endoscopy were enrolled in the study. Four expert gastrointestinal pathologists graded biopsy specimens according to the updated Sydney classification. Results: The obtained results showed that the mononuclear and granulocyte inflammatory cells were more prominent in the corpus lesser curvature compared to the corpus greater curvature (p=0.01 and p=0.0001, respectively). In addition, the extent and degree of atrophy and intestinal metaplasia were more prominent in the corpus lesser compared to the greater curvature (p=0.002 and p=0.0065, respectively). The frequency of distribution of H. pylori did not differ throughout both the corpus and antrum greater and lesser curvature. However, the degree of H. pylori colonization in the corpus was higher in the lesser than in the greater curvature. The interobserver agreement was significantly higher for corpus atrophy compared to antrum atrophy.Conclusions: These findings demonstrated that the more severe atrophic, metaplastic and inflammatory changes were observed in the lesser compared to the greater curvature of the stomach. In routine clinical settings, corpus and antral biopsies should be obtained from both lesser and greater curvature. Analysis of the incisura biopsy is also important.

Promocijas darbs izstrādāts Rīgas Stradiņa universitātes Medicīnas fakultātes Traumatoloģijas un ortopēdijas katedrā un RAKUS klīnikas “Gaiļezers” Traumatoloģijas un ortopēdijas klīnikā. Aizstāvēšana: 2015. gada 25. novembrī plkst. 15.00 Rīgas Stradiņa universitātes Medicīnas promocijas padomes atklātā sēdē Rīgā, Anniņmuižas bulv. 26a, Medicīnas izglītības tehnoloģiju centra (MITC) konferenču zālē (130. telpā). Attītoties tehnoloģijām un pieaugot augstas enerģijas traumatizācijai, proporcionāli pieaug arī iegurņa kaulu lūzumu gadījumu skaits. Lielākā daļa iegurņu lūzumu, aptuveni 75%, tiek uzskatīti par ļoti smagām un dzīvībai bīstamām balsta – kustību aparāta traumām. Iegurņa kaulu lūzumi politraumas pacientiem konstatējami 18% gadījumos. Vaļēji iegurņa kaulu lūzumi ir 1% no visiem iegurņa kaulu lūzumiem, savukārt letalitāte pēc dažādu autoru datiem vaļēju iegurņa kaulu lūzumu gadījumā ir ~ 50%. Iegurņa kaulu lūzumi, it sevišķi intraartikulārie, nereti (~ 10%) noved pie invaliditātes sakarā ar gūžas locītavas posttraumātiskas osteoartrozes veidošanos. Neskatoties uz praksē labi aprobēto ilioingvinālās piejas izmantošanu iegurņa kaulu ķirurģiskajā ārstēšanā, pēdējo gadu publikācijās par iegurņa gredzena un acetabulāro lūzumu operatīvo ārstēšanu tiek meklētas jaunas operatīvas terapijas pieejas un to modifikācijas, piemēram, izmantojot ekstraperitoneālu pieeju ar vēdera apakšējo viduslīnijas griezienu. Šo operatīvās ārstēšanas pieeju iegurņa gredzena un acetabulāro lūzumu gadījumos samērā plaši izmanto ASV un Somijā. Latvijā šo pieeju iegurņa gredzena un acetabulāro lūzumu ārstēšanā ieviesa raksta autors 2008. gadā RAKUS klīnikas “Gaiļezers” Traumatoloģijas un ortopēdijas klīnikā (katedras un zinātniskā darba vadītājs profesors A. Jumtiņš, klīnikas vadītājs Dr. med. G. Lācis). Darbā analizēti 35 pacientu ārstēšanas rezultāti, kuri operēti laika posmā no 2008. gada oktobrim līdz 2012. gada maijam, izmantojot priekšējo ekstraperitoneālo pieeju. Kontroles grupā analizēti 34 pacientu ārstēšanas rezultāti, kuri operēti ar konvenciālo ilioingvinālo pieeju. Darbā izvirzītā hipotēze – priekšējā ekstraperitoneālā pieeja, salīdzinot ar ilioingvinālo pieeju, sarežģītu iegurņa kaulu lūzumu gadījumos ļauj panākt īsāku operācijas laiku, mazāku intraoperatīvo asins zudumu, mazāku perioperatīvo hemotransfūzijas apjomu, labākus iegurņa kaulu fragmentu pēcoperācijas radioloģiskos parametrus un vēlīnos pēcoperācijas funk-cionālos rezultātus. Pētījuma mērķis – izpētīt priekšējās retroperitoneālās un ilioingvinālās ķirurģisko pieeju operācijas un pēcoperācijas periodu klīnisko un radioloģisko parametru, kā arī pēcoperācijas funkcionālo rezultātu atšķirības pacientiem ar sarežģītiem iegurņa kaula lūzumiem un, pamatojoties uz iegūtajiem rezultātiem, izstrādāt praktiskas rekomendācijas ieviešanai praktiskajā traumatoloģijā. Pētījums veikts četru gadu laikā. Vidēji vienā gadā veiktas ~ 12 iegurņa kaulu operācijas pacientiem ar politraumu. No 48 ar priekšējo retroperitoneālo pieeju operētajiem pacientiem analizēti un darbā iekļauti 35 pacientu ārstēšanas rezultāti. Kontrolgrupā iekļauti 34 pacientu ārstēšanas rezultāti. Pirms un pēcoperāciju radioloģisko mērījumu veikšanai izmantota digitāla ortopēdiska programma CENTRICITY PACS-IW 3.7.3.9. Pacientu funkcionālajam izvērtējumam lietota Majeed skala. Secinājumi. Analizējot ķirurģiskos rādītājus (operācijas ilgums, asins zudums operācijas laikā, hemotransfūzijas apjoms), ķirurģiskās korekcijas pēcoperācijas radioloģiskos parametrus un pēcoperācijas vēlīnos funkcionālos rezultātus pacientiem ar sarežģītiem iegurņa kaulu lūzumiem, priekšējās retroperitoneālās pieejas gadījumā tie ir statistiski ticami labāki nekā ilioingvinālās pieejas situācijā. Priekšējā retroperitoneālā pieeja sarežģītu iegurņa kaulu lūzumu gadījumos ir droša un nodrošina kvalitatīvu iegurņa kaulu fragmentu osteosintēzi.

The Treatment of Acetabular Fracture Complications in a Combination of Post-traumatic Hip Joint Osteoarthritis and Femoral Fracture for Polytrauma PatientPelvic bone fractures are related to a high energy injury. Therefore with an increase of the traffic intensity simultaneously grows the number of polytrauma patients, who have pelvic bone fractures of various severity levels. In the case of acetabular fractures, as the most frequent complication is the hip joint post-traumatic degeneratively destructive osteoarthritis, in whose treatment very often the hip joint arthroplasty is necessary. The frequency of this complication is affected by the precision of repositioning and the strength of fixation of an acetabular fracture.

Human papillomavirus (HPV) exists as more than 100 genotypes. It is not well-established whether the different HPV types interfere with infection or pathogenesis by each other. Possible interactions in cervical carcinogenesis between infection with the most common HPV types (6, 11, 16, 18 and 33) were studied in a seroepidemiological case- control study of 218 women with primary untreated cervical cancer and 219 healthy age-matched control women. As previously shown, HPV-16 seropositivity was associated with cervical cancer risk [odds ratio (OR), 2·39], but HPV-16 was not associated with cervical cancer risk among HPV-6 seropositive women (OR, 1·0). The relative excess risk due to interaction between HPV-6 and -16 was −2·35 (95% confidence interval, −0·04 to −4·65), indicating significant antagonism. The results suggest that infection with HPV-6 may interfere with HPV-16-associated cervical carcinogenesis.

This retrospective study presents the mid-term outcome of polytrauma patients with pelvic ring and acetabular fractures operated using a modified Stoppa approach. We examined 32 patients (13 women and 19 men ; mean age 44 years) 24 to 40 months after the trauma. We performed a functional assessment of these patients using Majeed's score. Mean Majeed score was 86.9 +/- 8.22 with a range from 70 to 100. Excellent clinical results were noted in 59% of cases (in 83% of pelvic fractures and 40% of acetabular fractures) and good clinical results in 41% (in 17% of pelvic ring fractures and 60% of acetabular fractures). Fracture healing with anatomical reduction was achieved in all pelvic ring fractures. Healing with anatomic or satisfactory reduction was achieved in 90% of the acetabular fractures.

Background and objective: Pepsinogen levels in plasma are increased by inflammation in the gastric mucosa, including inflammation resulting from Helicobacter pylori infection. A decrease in pepsinogen II level has been suggested as a reliable marker to confirm the successful eradication of infection. The aim of our study was to evaluate the potential role of pepsinogens I and II, gastrin-17 and H. pylori antibodies in confirming successful eradication. Material and methods: Altogether 42 patients (25 women, 17 men), mean age 45 years (range 23–74), were enrolled. Pepsinogens I and II, gastrin-17 and H. pylori IgG antibodies were measured in plasma samples using an ELISA test (Biohit, Oyj., Finland) before the eradication and 4 weeks after completing the treatment. The success of eradication was determined by a urea breath test. Results: Eradication was successful in 31 patients (74%) and unsuccessful in 11 patients (26%). Pepsinogen II decreased significantly in both the successful (P = 0.029) and unsuccessful (P = 0.042) eradication groups. Pepsinogen I decreased significantly in the successful (P = 0.025) but not the unsuccessful (P = 0.29) eradication group. The pepsinogen I/II ratio increased in the successful eradication group (P = 0.0018) but not in the group in which treatment failed (P = 0.12). There were no differences in gastrin-17 or H. pylori antibody values. Conclusions: A decrease in pepsinogen II levels cannot be used as a reliable marker for the successful eradication of H. pylori 4 weeks after the completion of treatment. The increase in pepsinogen I/II ratio reflects differences in pepsinogen production following the eradication irrespective of improvement in atrophy.

Background Either atrophy or intestinal metaplasia of the gastric mucosa are considered premalignant lesions. The new operative link for gastritis assessment staging system is based on the detection of atrophy, and the operative link for assessment of intestinal metaplasia staging system is based on the detection of intestinal metaplasia. Good interobserver agreement is necessary for identification of any premalignant condition. Aims The aim of this study was to compare the agreement between findings of gastric atrophy and intestinal metaplasia by expert and general pathologists and to analyze the possible reasons behind any possible disagreement. Methods Patients with dyspeptic symptoms, aged 55 years and above, without previous Helicobacter pylori eradication were enrolled and analyzed according to the updated Sydney Classification by two expert pathologists and an experienced general pathologist; the results were compared with the consensus driven by the two experts. Results Gastric biopsy specimens from 121 patients (91 women) were included in the analysis; the mean age of the patients was 67.4 years. H. pylori infection was present in 61.2% of patients. The level of agreement between the general pathologist and the two experts (κ-value) was 0.12, 0.46, and 0.87, respectively, for detecting atrophy in the corpus; 0.77, 0.77, and 0.65, respectively, for detecting intestinal metaplasia in the corpus; 0.06, 0.51, and 0.54, respectively, for detecting atrophy in the antrum; and 0.69, 0.85, and 0.79, respectively, for detecting metaplasia in the antrum. Conclusion The agreement was substantially higher for intestinal metaplasia than for atrophy. This could result in discrepancies when the operative link for gastritis assessment and operative link for assessment of intestinal metaplasia staging systems are applied and can be caused by differences in the criteria used to define atrophy.

The nuclear matrix (NM) is the structural framework of the nucleus that consists of the peripheral lamins and pore complexes, an internal ribonucleic protein network, and residual nucleoli. Differences between the nuclear matrix protein (NMP) composition of transformed cells and their normal homologues were detected in numerous cases. Actually several tumor-specific nuclear matrix proteins (NMPs) are proposed for diagnostic of bladder, breast, colon and some other cancers. According to the role of NMPs in development and phenotype of a given neoplasms the tumors can be classified as follows: I. Tumors bearing mutations in the genes encoding NMPs. The group consists of following subgroups: 1) hereditary cancer syndromes with mutations in the NM-attached oncoproteins or tumor suppressor genes; 2) sporadic tumors with somatic mutations in the NM-attached oncoproteins, tumor suppressor genes or replication enzymes; 3) leukemias with fused NMPs. II. Tumors with phenotypic quantitative or qualitative changes of the NMP spectrum.

We report herein the results of the cross-cultural adaptation and validation into the Latvian language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The Latvian CHAQ CHQ were fully validated with 1 forward and 1 backward translations. A total of 141 subjects were enrolled: 80 patients with JIA (16% systemic onset, 32.5% polyarticular onset, 19% extended oligoarticular subtype, and 32.5% persistent oligoarticular subtype) and 61 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the systemic, polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the systemic onset, polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the Latvian version of the CHAQ-CHQ is a reliable, and valid tool for the functional, physical and psychosocial assessment of children with JIA.

Chemotherapy dose calculation for oncologycal patient is using the human body surface area (BSA). BSA is a variable with a difficult constitutional body and physiological assessment. BSA does not reflect the exercise on body composition in relation to the various body modifications: obesity, amputation of body parts, pregnancy. Body surface area despite the documented limitations remains the most commonly used parameter chemotherapy (cytotoxic therapy) of cancer patients. The new guidelines are intended obese patients is to achieve the same maximum dose rate calculated BSA taking into account the full weight rather than using the statement or reduce weight by restricting intake. Experience shows that there are significant restrictions on the dosage given on BSA in obese patients, amputation of a body part or to become pregnant.

The calculation of an accurate dose of chemotherapy for oncological patients reduces the possible medication errors and the toxicity of the body and so it improves the outcome of the treatment (survival). In oncological practice for the calculation of the dose of chemotherapy the human body surface area (BSA) is used. The human body surface area is determined by derived formulas, but it is not directly linked to the pharmacokinetics of the drugs. Pharmacokinetic studies have demonstrated that for the calculation of the chemotherapy dose the actual body weight should be taken into account rather than the ideal one. In the therapeutic dose determination the body fat mass has essential significance. 202 patients aged from 19 to 83 years with various tumor localizations underwent anthropometric measurements (height, weight, circumferences, fatfold thickness, the distance between the hills above the joint), the body mass index (BMI) and the BSA (according to the Mosteller formula). The average weight of 99 men was 78.5 ± 16.4 kg and the mean body weight of 103 women was 70.1 ± 14.6 kg, statistically non-significantly different (F = 0.358, p = 0.551), but the independent-sample t-test arithmetical mean differed statistically significantly (t = 3.839, p

Introduction According to GLOBOCAN 2008 data gastric cancer currently is the fourth most common cancer worldwide and the second most common cause of cancer death. The objective of this study was to get comparable data on gastric cancer for 30 years period, to analyze the trends of incidence and mortality in Latvia and to compare with situation in other countries. Methods Incidence and mortality data from 1980 to 2010 in Latvia were obtained from the National Health Service. IARC (GLOBOCAN 2008) database was used for international comparisons. Incidence and mortality rates were age standardized to the World Standard Population and expressed per 100,000 population. Results There were 24,413 new gastric cancer cases diagnosed during the observed period, of which 55.1% (n=13,456) in male and 44.9% (n=10,957) in female. 57.4% (n=14,006) of new cases were registered in patients at age 60 – 80 years and 6.3% (n=1530) at age below 45 years. Most of all new cancer cases – 15.8% (n=3851) – were diagnosed in patients at age group 70 – 74 years. Out of all new gastric cancer cases 5.2% (n=1268) were diagnosed in stage I, 13.9% (n=3402) in stage II, 26.9% (n=6579) at stage III, and 38.9% (n=9493) at stage IV (no information regarding stage for 15.0% (n=3671) of cases). The age-standardized incidence rate (W) of gastric cancer has decreased from 26.4 per 100,000 population in 1980 to 13.3 in 2010 (in male - from 37.4 to 20.3; in female - from 19.8 to 9.0). First year’s lethality has increased from 55.1% in 1980 to 59.2% in 2010. The overall first year’s lethality for patients in stage I was 8.0%, in stage II – 25.9%, in stage III – 48.7%, and in stage IV – 84.1%. Five year observed survival has decreased from 22.3% for patients diagnosed in 1980 to 16.8% for patients diagnosed in 2005. The overall five year observed survival for patients in stage I was 71.8%, in stage II – 42.6%, in stage III – 20.3%, and in stage IV – 4.1%. The age-standardized mortality rate (W) has decreased from 20.8 per 100 000 population in 1980 to 10.7 in 2010 (in male - from 29.3 to 16.9; in female - from 15.8 to 7.1). Conclusion While the incidence and mortality rates of gastric cancer in Latvia are steady declining, the rates are considerably higher than on average in Europe or in European Union. The incidence and mortality rates based on real data are very close to or are the same as estimated rates calculated by IARC (old world standard population). While in absolute numbers the number of new cases is almost the same for both genders, the age-standardized rates shows that male are affected twice as often as females. Due to late diagnose of gastric cancer, the first year’s lethality is high with tendency to increase and the five years observed survival is low with tendency to decrease. Both improvement of early diagnostics and public health education is necessary to improve the general situation with gastric cancer in Latvia.