<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction.</bold> The reason for using thrombolytic therapy is to eliminate vascular thrombosis and promote vascular permeability. Acute limb ischemia is associated with significant morbidity and mortality. ROCHESTER, STILE and TOPAS studies showed that thrombolytic therapy for acute limb ischemia decreases the rate of surgical interventions and significantly increases the rate of limb salvage.<bold>Aim of the Study.</bold> The purpose of this study is to assess the efficacy and outcomes of intra-arterial thrombolysis in the treatment of acute occlusions of the lower limb over a four-year period.<bold>Material and Methods.</bold> We analysed 103 patients who had been treated in our department. There were acute ischemias of stage IIa and IIb according to the Rutherford classification. The data prior to, and after thrombolysis was analysed. We used <italic>Alteplase</italic> as a thrombolytic agent (mean dose 62 mg ±23.5). Procedural success was based on angiographic and clinical outcomes. Statistics were calculated by SPSS 16.<bold>Results.</bold> The mean duration of symptoms prior to hospitalisation was 2.5 days (IQR 5-96 hours). The mean age at the time of thrombolysis was 63±11 for males 69±10 years for females. The success of intraarterial thrombolysis was defined by angiographic and clinical outcomes (successful in 86.4% and failed in 13.6%). Adjunctive angioplasty was performed on 39 (37.9%) patients, and immediate reconstructive surgery was required on 19 (18.4%) patients. The incidence of complications was 17,4 %, with the most common being-bleeding from the puncture side, the urinary tract or the gastrointestinal tract. Overall mortality was 8.7%. The women who required thrombolysis were older (p=0,034) and with a higher death rate (p=0.047). A CDT (catheter-directed thrombolysis) for an abdominal aorta thrombosis carries a significantly high mortality rate (p=0.00013). There were no statistically significant differences between the duration of symptoms and limb amputation and between other analysed data.<bold>Conclusions.</bold> Intraarterial thrombolysis is an effective treatment method in acute limb ischemia for selected patients, as long as accurate procedural monitoring is ensured. Thrombolysis often leads to the discovery of underlying vascular lesions. A CDT for an abdominal aorta thrombosis carries a significantly high mortality rate.</abstract>

Riga Eastern Clinical University Hospital

Medical student at Riga Stradins University

Outcomes and Complications after Intraarterial Thrombolysis for Limb Ischemia: a 4 Year Study at a Single Centre

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction.</bold> During the previous years the number of organ transplantations from elderly donors increased, and lack of young donors leads to necessity to allocate organs from elderly into young recipients.<bold>Aim of the Study.</bold> Was to analyse results of “old-to-young” allocation.<bold>Material and methods.</bold> This retrospective study analysed results of all consecutive deceased donor kidney transplantations (DDKT) performed in one transplant centre during the period from 01.01.2004 till 31.12.2007. Patients were selected based on availability of 5-year follow-up and age &lt; 50 years (158 DDKT). Patients were divided into 2 groups according to donor age: age-mismatched group (donor age was > 55 years and at the same time > 15 years older than recipient; n=8, male/female=2/6, age 39,4 + 4,8 years, donor age 59,4 + 2,4 years), and age-matched group (n=150, male/female=88/62, age 36,0 + 11,0 years, donor age 37,3 + 12,0 years). Groups were compared for clinical and demographical features and posttransplant outcomes (delayed graft function, s-creatinin levels at discharge and after 5 years, acute rejection rate, graft and patient 5-year survival).<bold>Results.</bold> Comparison of demographical and clinical features revealed only relatively higher BMI in elderly donors (p=0.081) and higher frequency of age-mismatched allocation into female recipients (p=0.066). Early and late post-transplant outcomes showed no significant difference between groups, with similar 5-year graft and patient survival (p=NS for all compared factors).<bold>Conclusion.</bold> Results showed good kidney allograft function even in cases of age-mismatched allocation, which is significant opportunity in current situation with increasing age of deceased donors.</abstract>

Results of Deceased Donor Kidney Transplantation in Young Recipients after Age-matched and Mismatched (Old-to-young) Transplantation

<abstract xmlns="http://www.w3.org/1999/xhtml"><bold>Introduction.</bold> For acute appendicitis - the most frequent condition to perform an urgent abdominal operation in pediatric surgery - surgical appendectomy still remains the gold standard regarding treatment, nevertheless nonsurgical management has become more and more recognized as a treatment method for uncomplicated acute appendicitis (UAA). However there are still many unanswered questions regarding possible factors that could predict the treatment outcome as well as appropriate antimicrobial drug regimens.<bold>Aim of the Study.</bold> The aim was to investigate if there is a possible association between factors such as C-reactive protein (CRP) level, presence of appendicolith, the diameter of the appendix and treatment outcome; as well as to identify most successfully used antimicrobial drug combinations.<bold>Material and methods.</bold> A retrospective analysis of hospital cases, admitted to a single reference center during the time period from 2013 to 2015. Patients with clinical signs of acute appendicitis, elevated inflammatory markers and radiological findings suggestive for acute appendicitis were included in the study. Nonsurgical treated patients were divided in two groups based on the treatment outcome - successful or unsuccessful. Analysis of the three factors (CRP level, presence of appendicolith and the diameter of the appendix) and most commonly used antimicrobial drug regimen association with treatment outcome was performed.<bold>Results.</bold> Overall 384 children medical records with acute appendicitis were registered and non-surgical treatment was initiated in 147/384 (38 %) cases. Successful treatment outcome of nonsurgical management was identified in 114/147 (78 %) cases. Analyzing prognostic adverse factors results presents no statistically significant difference in association with CRP level >25 mg/l (p=0,479), presence of appendicolith (p=0,183) and the diameter of appendix >1 cm (p=0,183) with successful or unsuccessful treatment outcome. The two most commonly used antimicrobial drug combinations were - Ampicillin/Metronidazole for 49 patients and Ampicillin/Gentamicin for 44 patients. No relevance with treatment outcome and used antimicrobial agents was detected (p=0,597).The overall recurrence rate after initial presentation is 15 % (17/114). In 3 cases (3 %) recurrent appendicitis developed one month after discharge and in 14 cases (12 %) up to one year after discharge.<bold>Conclusions.</bold> Prognostic adverse factors - CRP, presence of appendicolith and diameter of appendix - were not statistically reliable in association with initial non-surgical treatment outcome. The success rate of conservative treatment with narrow spectrum antibiotics was 78 %, which is just as high as in cases treated conservatively with broad-spectrum antibiotics from previous studies. Therefore the question of which factors and antimicrobial drug combinations influence the course of treatment still remains unanswered and further studies are required.</abstract>

Children’s Clinical University Hospital

Nonsurgical Management of Acute Uncomplicated Appendicitis in Children: the Analysis of Treatment Outcome in Relationship with Antimicrobial Regimens and Adverse Prognostic Factors

<abstract xmlns="http://www.w3.org/1999/xhtml">Osteoporosis and other pathological bone conditions can impair bone regeneration properties, consuming in increased morbidity and decreased quality of life. Changes of bone healing can result in poor osteointegration and surgical failures if implants are used. To overcome and facilitate bone regeneration, more attempts are made to develop an ideal synthetic scaffold with better biocompatibility, osteoconductivity, bioactivity, osteoinductivity and interconnected porosity. It is considered that strontium, being similar to calcium, can be incorporated into the mineral phase of the bone remodeling. This quality had led strontium to be used as an osteoporotic medication to improve quality of bone and to reduce the risk of bone fractures. Also local application of strontium has been widely used within different biomaterials in tissue engineering researches.In this review authors wanted to provide an overview about strontium, its mechanisms of action in bone tissue and initiated changes of bone remodeling within biomaterials.</abstract>

Department of Oral and Maxillofacial Surgery

Does Local Application of Strontium Increase Osteogenesis and Biomaterial Osteointegration in Osteoporotic and Other Bone Tissue Conditions: Review of Literature

<abstract xmlns="http://www.w3.org/1999/xhtml">Hemiarthroplasty (HA) of the hip joint is a commonly used treatment method for displaced femoral neck fractures (FNF) in the elderly population. The revision rates following hemiarthroplasty for trauma are 4-24% (2), but there are few studies in the literature presenting bilateral complications of HA following FNF treatment. We present a 67-year-old female with migration and angular deformity of the left unipolar prosthesis followed by malposition and subluxation of the right unipolar prosthesis after sixteen months, which are not common complications and they are even less frequent to occur in one patient.</abstract>

Bilateral Complications of Hemiarthroplasty after Displaced Femoral Neck Fracture Treatment

<abstract xmlns="http://www.w3.org/1999/xhtml">Among HIV-infected women prevalence and incidence of HPV infection are higher, and the risk for developing cervical cancer is increased. We present a case of HIV and HPV co-infection in woman with invasive cervical cancer and cervical and vaginal <italic>condyloma acuminata</italic> in association with vaginal bleeding during pregnancy.</abstract>

Human Immunodeficiency Virus and Human Papillomavirus Co-Infection in Pregnant Woman

<abstract xmlns="http://www.w3.org/1999/xhtml">Mitral regurgitation is common valvular heart disease and a major cause of congestive heart failure and death. It is most often associated with degenerative changes in mitral valve which leads to valve prolapse. Transapical off-pump mitral valve repair is a new minimally invasive procedure to treat mitral regurgitation. Here we report 64-year old female who suffered from grade III mitral regurgitation due to ruptured chorda and posterior leaflet P2/P3 segment prolapse. During surgery 4 artificial chordae were implanted and postoperative echocardiography results showed minimal residual grade I mitral regurgitation, therefore significant clinical improvement can be achieved with minimally invasive approach.</abstract>

Paul Stradins Clinical University hospital

Transapical Off-Pump Neochord Implantation in Case of Severe Mitral Regurgitation

<abstract xmlns="http://www.w3.org/1999/xhtml">A 26 years old patient was admitted to hospital with complaints of abdominal pain and febrile temperature. Initially, elevated serum antigen CA-125, ascites and multiple suspicious nodules in the lungs and abdominal cavity on CT were found, thus, diagnosing ovarian cancer. However, after further preoperative examination, the diagnosis of infiltrative pulmonary tuberculosis with extrapulmonary involvement was set, thereby cancelling the surgery. The patient was treated with first-line antituberculosis agents and discharged home. Almost in all other cases, peritoneal tuberculosis is diagnosed only after surgical intervention.</abstract>

Riga East Clinical University Hospital Gailezers

A Diagnostic Challenge: Peritoneal Tuberculosis Mimicking Ovarian Cancer

AHEAD OF PRINT

Volume 18 (2020): Issue 1 (June 2020)

Volume 17 (2017): Issue 2 (December 2017)

Volume 17 (2017): Issue 1 (June 2017)

Volume 16 (2016): Issue 2 (December 2016)

Volume 15 (2015): Issue 1 (April 2015)

Volume 14 (2014): Issue 2 (December 2014)

Volume 14 (2014): Issue 1 (December 2014)

Volume 13 (2013): Issue 2 (December 2013)

Volume 13 (2013): Issue 1 (December 2013)

Volume 12 (2012): Issue 1 (December 2012)

Volume 10 (2010): Issue 2 (December 2010)

Volume 9 (2009): Issue 1 (December 2009)

Acta Chirurgica Latviensis

 Acta Chirurgica Latviensis is a journal of a broad spectrum published twice a year. The authors of manuscripts can publish original articles, problem-solving articles and case reports in various branches of surgery and fields associated with surgery. Since 2005 the journal has been published only in English (the articles in the previous volumes had abstracts in English). Acta Chirurgica Latviensis provides an opportunity to publish the results of investigation for both experts in the field and junior specialists. Latvian Academy of Sciences has included Acta Chirurgica Latviensis in the list of scientific publications as a scholarly journal under international review.  Why subscribe and read   Official journal of Riga Stradins University, Latvian Association of Surgeons, Latvian Association of Paediatric Surgeons.  Acta Chirurgica Latviensis is a source of high quality information about all fields of surgery and fields associated with surgery mostly from Latvia, Baltic countries, and eastern Europe.  Why submit   Fast, fair and constructive peer review  All articles are in English  Rejection Rate   45 %   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 