Allergy to cow’s milk protein and/or soy is common among allergic diseases in infants. They appear at an early infant stage and remain important in clinical practice from one up to three years. According to clinical research, cow’s milk allergy affects about 1.9-4.9% of babies and infants, respectively, and in addition some of them also suffer from soy protein allergy. Dietary prevention of allergic protein by its elimination in food is a significant part of treatment, and allows adequate development of babies and restricts the risk of progressive allergic diseases. Securing exclusive breastfeeding is one of the basic principles in successful therapy treatment. However, there are cases when breastfeeding does not prevent the development of cross milk protein allergy. Only adequate special feeding formulas can provide both energy needs and sufficient quantity of proteins (8.9-11.5%) in food when breastfeeding is not possible. Knowledge of effective compensation mechanisms become apparent by analysing the situation in Europe and USA in the area of different available feeding formulas using both the medical insurance system and randomised formula providing tolerance of the mixture at about 90-95%. The goal of research was to determine the correlation between the availability of a special mixture, parental adherence and treatment outcomes. Applying special formulas is a routine part of treatment, and there is no doubt about its efficacy. No compensation mechanisms exist in present-day Latvia, and the current complicated economic situation in Latvia reduces the ability of parents to choose and buy appropriate formula food. Therefore, a substantial part of therapy treatment is unavailable to infants. Dietary prevention of allergic diseases in infants and small children in Latvia needs special consideration also because of poor knowledge of parents regarding the real situation.
Vitamin D deficiency is common and widespread globally. Vitamin D has an immunomodulatory effect, but it is still unclear whether its deficiency is associated with higher disease activity. The aim of this retrospective study was to determine the serum concentration of vitamin D in children with paediatric arthritis (juvenile idiopathic arthritis and reactive arthritis). Prevalence of hypo-vitaminosis D among 98 children with juvenile idiopathic arthritis and reactive arthritis was determined and association between serum concentration of vitamin D and disease activity markers was found. Prevalence of vitamin D deficiency among children included in this study was 69.07%. Children with juvenile idiopathic arthritis had a significantly lower vitamin D level than children with reactive arthritis. There was a statistically significant moderate negative correlation between serum concentration of vitamin D and patient age, as well as a weak negative correlation between vitamin D level and patient body mass index. The significant correlations found between vitamin D level and inflammatory markers indicate that further research on the role of vitamin D in disease activity is needed.
The aim of the retrospective case-control study was to determine if the health-related quality of life of overweight and obese children is lower than for children with optimal weight, using the KIDSCREEN-52 survey of health-related quality of life. The study examined differences in health-related quality of life assessments between children with optimal weight, and obese and over-weight children, as well as evaluated parental assessments of the quality of life of their children. In total, 200 children aged 8 to 18 years and their parents participated in the study. The results of the study showed that the total quality of life of obese (p < 0.0001) and overweight (p = 0.008) children was lower than for children with optimum weight (p = 0.001). Also, the assessments of quality of life between parents of obese (p < 0.0001) and overweight (p = 0.001) children scored lower than those of parents whose children had optimal weight.
Association Study of Genetic Variants in the 14q11 - 14q13 Proteasomal Genes Cluster with Juvenile Idiopathic Arthritis (JIA) in Latvian Population
The possible role of proteasomes in the development of autoimmune diseases was hypothesised after discovery of the involvement of proteasomal LMP2 and LMP7 subunits in antigene processing. The objective of this study was to determine the association between allelic variants of the genes encoding proteasomal proteins PSME1, PSME2 and PSMA6 and juvenile idiopathic arthritis (JIA) in the Latvian population. One Indel G-4543 CA-4544 →GA and four SNPs related to the PSMA6 gene (A-2486 →G and C-1910 →T, upstream promoter, C-110 →A of promoter, and C-8 →G of 5'UTR), of two cSNP in PSME1 (G1457 →A:Val104, exon 6 and C2536 →A: Lys244 →Thr, exon 11) and in PSME2 (C1153 →G:Arg61 →Gly, exon 4 and A1440 →C:His89 →Pro, exon 6) were geno-typed by means of primer-specific PCR, CAPS assay and/or sequencing in case/control study composed from the 156 JIA patients and 214 healthy individuals. Allele frequency and genotype distribution was similar in cases and controls for Indel, and SNPs A-2486 →G, C-1910 →T and C-8 →G of PSMA6, as well as for all studied cSNPs in PSME1 and PSME2 genes. Differences in A-110 allele and CG genotype frequencies were close to the statistically significant P level in JIA patients and healthy individuals, however, when an additive model was applied, the difference in the C-110 →A locus turned out to be statistically significant. The results support the hypothesis of the possible association of PSMA6 gene allelic variants with JIA in the Latvian population.
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.
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.
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.