A comparison of quality of life and postoperative results from combined PPH and conventional haemorrhoidectomy in different cases of haemorrhoidal disease.

OBJECTIVE: To compare the early postoperative results and late patient-related postoperative results by a Short-Form 36 quality of life survey after conventional haemorrhoidectomy and PPH procedure with additional surgical intervention in noncomplicated, complicated and delayed cases of the disease. METHOD: The comparison was made between comparable patient groups after conventional haemorrhoidectomy (n = 168) and after PPH with additional surgical intervention (n = 142). The early and late postoperative results and quality of life analysis according to SF-36 questionnaire were compared. RESULTS: The length of procedure was significantly shorter after the PPH procedure (37.4 vs 49.4 min). The amount of postoperative nonopiate analgesics was similar, but consumption of opiates was more in the conventional group. The rate of early postoperative complications was similar. In the PPH group significant improvement in all quality of life parameters was ascertained 6 months after operation, but 6 weeks after surgery several parameters in this group were lower. In the conventional group improvement was ascertained only for several parameters. The significant improvement of quality of life after PPH operations was ascertained especially at a mean period of 6 weeks. CONCLUSION: The PPH procedure performed in complex cases of the disease and combined with other surgical intervention because of the anorectal comorbidity assures better early postoperative results and better postoperative quality of life in a 6-month follow up in comparison with conventional haemorrhoidectomy. The continuation of quality of life studies with a longer follow up is required concerning Longo operation.

Report on the first PVL-positive community acquired MRSA strain in Latvia.

Infections by community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) have been reported worldwide. Here we present characterisation of the first CA-MRSA isolated in Latvia. A PVL-positive ST30-MRSA-IV strain was isolated from a nasal swab and the central venous catheter of a patient with fever and multiple organ failure. The PFGE pattern of this strain was identical to pattern SE00-3 of MRSA isolated in Sweden from 29 patients during 2000-2003. This strain is related to the South Pacific area, and its appearance in Sweden and Latvia demonstrates its global spread.

Report on the first PVL-positive community acquired MRSA strain in Latvia.

Infections by community-acquired methicillin resistant Staphylococcus aureus (CA-MRSA) have been reported worldwide. Here we present characterisation of the first CA-MRSA isolated in Latvia. A PVL-positive ST30-MRSA-IV strain was isolated from a nasal swab and the central venous catheter of a patient with fever and multiple organ failure. The PFGE pattern of this strain was identical to pattern SE00-3 of MRSA isolated in Sweden from 29 patients during 2000-2003. This strain is related to the South Pacific area, and its appearance in Sweden and Latvia demonstrates its global spread.

Prevalence of nosocomial infections in two Latvian hospitals.

The first point prevalence survey of the nosocomial infection (NI) rate was conducted in two Latvian hospitals. At the time of the survey 17.5% (226/1291) patients had symptoms or were being treated for infection. The overall prevalence rate was 5.6% (72/1291) for NI and 12.7% for community acquired infections (164/1291). Surgical site infection (SSI) was the most common NI (62%) followed by respiratory tract infection (RTI) (7.5%), and urinary tract infection (UTI) (6.4%). NI rate was higher with increasing age of patients, in intensive care units and surgical wards, and among those who had an intravenous device or urinary catheter. Microbiological investigation yielded positive results in 29% (21/72) of patients with NIs. Antibacterial treatment was given to 22.3% (288/1291) of hospitalised patients and in 62% (182/288) of these, cefazolin was prescribed. Results from this study will be used to plan a national prevalence survey.

The influence of kynurenine, neopterin, and norepinephrine on tubular epithelial cells and alveolar fibroblasts.

We have examined the effect of kynurenine, neopterin and norepinephrine on epithelial cells and fibroblasts: the total DNA synthesis (by adding 3H-thymidine), the mitotic index, the amount of pathological mitosis and apoptosis. We have observed that kynurenine, neopterin and norepinephrine induce pathological mitosis and apoptosis of epithelial cells of kidney. The total DNA synthesis increases by the incubation of the epithelial cells with neopterin and norepinephrine. We have found an increase of pathological mitosis after addition of kynurenine, neopterin and norepinephrine to fibroblast cell culture. The total DNA synthesis is promoted by neopterin and norepinephrine, while kynurenine does not alter it. These data allow us to suggest that kynurenine, neopterin and norepinephrine promote epithelial cell damage leading to cell death through apoptosis, and can therefore be added to the factors, which promote the pathological mitosis of fibroblasts.

Kynurenine and neopterin in chronic glomerulonephritis.

The results of our clinical observations of 102 patients with chronic glomerulonephritis with normal renal function have shown that hyperkynureninemia in 22.5% of patients develops in cases of pyridoxal-5-phosphate deficiency (hyperkynureninemia after peroral L-tryptophan load), but in 14.8% of patients through the stimulation of the cellular immune system (hyperkynureninemia at fasting state, increase of serum neopterin concentration). In all 20 patients with chronic renal failure hyperkynureninemia develops due to decreased renal function (increased serum kynurenine, neopterin and creatinine concentrations). Therefore, L-tryptophan peroral loading test with the determination of serum concentration of kynurenine before and at 3rd hour after the load, as well as the detection of serum concentration of neopterin and creatinine are helpful for the differentiation of following pathologies in patients with chronic glomerulonephritis: pyridoxal-5-phosphate deficiency, cellular immune stimulation and chronic renal failure.