Neonates typically have a physiological weight loss (PWL) during the first days of life. Several studies about PWL and its influencing factors have been performed worldwide, resulting in the development of normative charts to identify high risk neonates. Up to now there is neither a study about PWL in Latvia nor charts developed for the Baltic region. The objective of the study was to analyse PWL and associated factors in Latvian neonates as well as to evaluate the possibility to use PWL charts of the American Academy of Paediatrics (AAP). The study included data (gestational week, delivery type, sex, feeding type, health status) of 220 Latvian newborns treated in the neonatology department of Children Clinical Hospital Gaiļezers and in-an out-patient praxis in Riga. Their mean PWL was compared among neonates with different factors and plotted on PWL charts. The mean PWL was 6.4% (SD ± 2.31%) and in univariate analysis it was associated with feeding type (p = 0.06) and health status (p = 0.01). In multiple regression analysis PWL was significantly associated with health status (p = 0.01). The usage of AAP charts could be generally recommended to identify high risk neonates, but development of charts for the Baltics should be discussed..
Although benefits of breast-feeding have been known for a long time and breast milk is considered as ideal nutrition for infants, the composition of breast milk is still being studied, since breast milk differs among mothers and populations, as well as during different times of lactation. Further, no study has been performed among lactating women in Latvia during recent years. The objective of the study was to determine the breast milk composition and influencing factors among lactating women in Latvia in different lactation periods, as well as to compare the results with data from other countries. Fifty breast milk samples were obtained from 44 mothers (on the 5th-7th and 11th-28th day of lactation), whose neonates were treated in the Neonatal Care Unit, Children’s Clinical University Hospital, Rīga. Milk analysis (pH, density, protein, fat, and lactose concentration) was performed in the Latvia University of Agriculture. Breast milk composition among lactating women in Latvia on the 5th-7th lactation day more resembled transitional milk containing a higher amount of protein and a lower amount of fat. The composition of the studied milk samples on the 11th-28th lactation day was comparable to data from other countries. Concentration of lactose was correlated with neonatal weight and not gestational age.
Childhood adiposity is increasingly affecting developed and developing countries alike. Body Mass Index (BMI) is a good first approximation of body weight, but interpretation in specific patient populations may be inconsistent. The aim of this study was to compare adiposity rates using three internationally accepted weight reference standards – World Health Organisation (WHO), International Obesity Task Force (IOTF), and US Centers for Disease Control (CDC), plus a local national scale (LV), evaluating 465, 6-to-9-year old school children in Latvia. After obtaining height and weight, BMI was calculated, and the four scales were individually applied by gender and age. Highly significant differences between LV and CDC, LV and IOTF, LV and WHO were found in all age groups (P < 0.01), and between WHO and IOTF reference standards (P < 0.01) in 7- and 8-year olds. We conclude that reference standards should be used with great caution. Reference standards for local ethnic populations are needed to avoid disagreements between scales, as this can lead to incorrect choice of therapy; reliance on any single reference standard may not consider a patient's unique set of circumstances that have resulted in excess weight and information that is vital for a good clinical outcome.
Gastrin-17 (G-17), pepsinogen-1 (Pg1) and pepsinogen-2 (Pg2) reflect the functional state of gastric mucosa and are used for non-invasive diagnosis and screening of atrophic gastritis. The aim of the study was to clarify if erosive reflux disease (ERD) or non-ERD (NERD) can be distinguished from other dyspeptic conditions in patients, in a non-invasive manner using specific biomarkers. Levels of G-17, Pg1, and Pg2 were measured in 141 ERD patients (median age 48 years, males — 68), 122 NERD patients (median age 45 years, males — 32) and 410 control patients (median age 50 years, males — 97). Levels of biomarkers in ERD and NERD groups were compared to controls. Median levels of G-17 (1.94 vs 2.92 pmol/L, p = 0.036) and Pg2 (6.70 vs 7.79 µg/l, p = 0.046) were lower in the ERD group compared to control patients; no difference with respect to the control was found for the NERD group. After exclusion of the patients having at least one potential condition that might modify the levels of the biomarkers (gastric mucosa atrophy, Helicobacter pylori colonisation), no difference in levels of biomarkers was observed with respect to the control for both the ERD and NERD groups. G-17, Pg1, and Pg2 based tests cannot be used to distinguish ERD or NERD from other dyspeptic conditions in patients.
Although Escherichia coli is a part of the commensal flora of the gastrointestinal tract, pathogenic types of E. coli can cause diarrhea, especially in children. Pathogenic types are found also in healthy individuals, but prevalence of pathogenic E. coli among asymptomatic children varies and has not been studied in Latvia. The aim of the study was to determine prevalence of pathogenic E. coli among asymptomatic children and identify factors associated with presence of bacterium. Children (aged 0.5–8 years) without acute gastrointestinal symptoms were included in a cross-sectional study. Parents were asked to answer a questionnaire (demographic data, parental education, type of delivery, breastfeeding, antibacterial therapy, and allergic diseases) and bring a faecal sample of their child. The prevalence of pathogenic E. coli was detected by polymerase chain reaction and analysed in respect to risk factors. Statistical analyses included Chi-Square test, one-way ANOVA, and logistic regression. The patient sample group contained 245 children, mean age 4.5 SD ± 2.1; 46.5% (114/245) had allergies. In total, 16% (39/245) of isolates were positive for pathogenic E. coli. Prevalence of pathogenic types of E. coli was significantly higher among children without allergy compared to children with allergy: 21% (27/131) vs. 11% (12/114), p = 0.03. Prevalence did not differ significantly in respect to other studied factors. In logistic regression analysis pathogenic E. coli positivity was inversely associated with presence of allergy (OR = 0.45, CI: 0.21–0.94, p = 0.03). Asymptomatic carriage of pathogenic E. coli was identified in our paediatric patient sample and was inversely associated with an allergic disease. Microbiota changes related to pathogenic E. coli, as well as duration of carriage of bacterium, should be studied further.