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Santa Purvina and Ruta Medne


Atlantic sturgeon, Acipenser oxyrinchus Mitchill, inhabited and spawned in the territorial waters of Latvia from the early Neolithic. The A. oxyrinchus population in this area started to decline from the end of seventeenth century. By the twentieth century, just several sturgeon catches were documented. In 2012, Latvia joined the initiative to reintroduce native A. oxyrinchus. From 2013 to 2015, the Institute of Food Safety, Animal Health, and Environment (BIOR) released 4,500 A. oxyrinchus juveniles aged 1+ and 2+. The majority of sturgeon juveniles released inhabit the Gulf of Riga and Pärnu Bay and marine areas among the Estonian islands. Nearly all of the sturgeon released exhibit remarkable growth. The absence of visible pathologies suggests that the A. oxyrinchus individuals are in excellent condition. Increases in size and the absence of visible pathologies also suggest that A. oxyrinchus has a sufficient food base. Additionally, results indicate that there is free space in the food web for native Atlantic sturgeon. Sturgeon is caught primarily in salmon traps and other commercial fishing nets deployed at depths of 4-10mor by anglers. While we do not have complete information about the fates (dead or alive) of all sturgeons caught, approximately half of them that were reported by fishers were released back into the sea alive and healthy.

Open access

Konstantins Logviss, Dainis Krievins and Santa Purvina


Introduction. Rare diseases, also called orphan diseases, are life-threatening or chronically debilitating conditions of different origin. Majority of them are genetic disorders, others being rare cancers, congenital malformations, autoimmune, toxic and infectious diseases. Rare conditions may also be related to surgery, e.g. acute sensorineural hearing loss after surgery induced acoustic trauma, scarring post glaucoma filtration surgery, and short bowel syndrome following intestinal surgery. Besides, surgery as a specific area for orphan drugs, has not been studied yet in Latvia.

Aim of the study. This study aims to determine orphan drugs associated with surgery (used pre-, during or post-surgery) and their availability and access in Latvia.

Materials and methods. European register of designated orphan medicinal products and EMA approved Summary of Product Characteristics were analyzed, to find orphan drugs with approved labeled indications related to surgery. Drug availability and access in Latvia were determined, by using data available from State Agency of Medicines of Latvia and National Health Service. A literature review was performed to compare Latvian situation in field of orphan medicines with other European countries.

Results. 15 orphan drugs were identified, 8 of them (53.3%) indicated for different kinds of tumors. 6 drugs (40%) are available in Latvia, including one drug (6.7%) included in the reimbursement list.

Conclusions. Oncology is the biggest therapeutic area of orphan drugs. Majority of orphan drugs are not available in Latvia, moreover those drugs that are available are often not accessible.

Open access

Aleksandra Aitullina, Angelika Krūmiņa, Vinita Cauce and Santa Purviņa


Colistin is used systemically in critically ill patients for treatment of infections caused by multi-drug resistant (MDR) Gram-negative bacteria, e.g., Acinetobacter baumanii. It is potentially nephro- and neurotoxic. It is recommended to decrease the dose of colistin in case of renal impairment or renal replacement therapies (RRT) but clear recommendations are not available yet. The aim of this retrospective study was to determine colistin use patterns in critically ill patients in Pauls Stradiņš University Hospital. Forty patients were included in this study. The most common indications for colistin were pneumonia associated with mechanical ventilation or sepsis caused by MDR A. baumanii. Median duration of colistin therapy was 11.5 (IQR 7.0; 17.0) days and median cumulative dose was 91.5 (43.0; 150.0) million units (MU). The usual regimen was 9 MU as loading dose and 3 MU three times daily as maintenance dose, but in case of renal impairment and RRT colistin regimens varied a lot between the patients. In 21% (7 from 33) of cases, acute kidney injury (AKI) was observed during colistin therapy (serum creatinine increases more than twice from baseline). All these AKI cases occurred in patients with previously normal renal function and none of the patients in this group needed RRT.