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Starting from a blank page: discovering and creating community health nursing in post-Soviet Latvia.

Nurses discovering the practice and creating the tradition of community health nursing without mentors or forerunners have to learn from the practice itself and from each other. Data in the phenomenologic study of 17 Latvian community health nurses (CHNs) consisted of group and individual interviews and observation of practice with families. The focus of this article is the situated practice of nurses in the new role of primary care CHN, revealed through clinical stories that give voice to nurses in a particular historical and social context. The stories of the nurses in this article provide evidence of a growing ability to practice from a health promotion/prevention focus and engage with families and neighborhoods. The practice is still developing, and at this point nurses are not drawing on experience with families to identify and care for vulnerable populations.

Community Health Nursing↗
PubMed2004

[Interventional cardiology in Latvia from 1993 to 2003].

A nationale programme for combatting cardiovascular diseases is being implemented in Letvia. A milestone was reached in 1993 with the establishment of a Letvian Centre for Cardiology. Within 10 years the only cardiac catheterization unit in the country has developed into a centre of excellence. But to meet the cardiological needs for all of Letvia requires at least three additional units for left heart catheterization and one for paediatric a cardiac catheterization.

Adult↗
PubMed2005

Respiratory diphtheria among highly vaccinated military trainees in Latvia: improved protection from DT compared with Td booster vaccination.

An outbreak of respiratory diphtheria occurred among highly-vaccinated trainees at a Latvian military academy in August-September 2000. We reviewed immunization, clinical and laboratory records and administered a questionnaire to obtain data on exposure factors. Among 207 trainees, 45 (22%) diphtheria cases and 79 (38%) carriers of toxigenic Corynebacterium diphtheriae were identified. All patients survived; 1 had severe myocarditis. Sharing cups was a risk factor for infection. Over 85% of trainees had received > or =5 doses of diphtheria toxoid. Neither infection nor disease was associated with the number of doses or interval since last dose. However, the risk of disease was lower and diphtheria antitoxin levels were higher among trainees who received their last booster dose with higher-antigen diphtheria toxoid (DT) instead of lower-antigen Td. Outbreaks of mild diphtheria can occur among highly-vaccinated persons living in crowded conditions with intense exposure; high-antigen diphtheria booster-vaccination might provide better protection under these conditions.

Adolescent↗
PubMed2001

A relatively low prevalence of Helicobacter pylori infection in a healthy paediatric population in Riga, Latvia: a cross-sectional study.

UNLABELLED: The aim of this study was to investigate the prevalence, age of acquisition and risk factors for Helicobacter pylori (H. pylori) among asymptomatic children. 13C-urea breath tests and questionnaires were obtained from 142 children and 40 parents. The prevalence of H. pylori was 19%. H. pylori positivity was higher in children with a positive parent (p=0.003) and independently inversely related to antibiotic treatment during the previous year in preschool children (p = 0.045). CONCLUSION: The prevalence of H. pylori in children in Riga is higher than that in Western countries, but lower than that in Eastern European countries. H. pylori is present during the second year of life and is influenced by parental H. pylori status and previous treatment with antibiotics.

Child↗
PubMed2002

Microsatellite allele A5.1 of MHC class I chain-related gene A is associated with latent autoimmune diabetes in adults in Latvia.

NIDDM is one of the most common forms of diabetes. The diagnosis is based on WHO classification, which is a clinical classification and misses the autoimmune diabetes in adults. Therefore, among the clinically diagnosed NIDDM cases, there can be a certain number of patients with latent autoimmune diabetes in adults (LADA). The MICA gene is located in the MHC class I region and is expressed by monocytes, keratinocytes, and endothelial cells. Sequence determination of the MICA gene identifies trinucleotide repeat (GCT) microsatellite polymorphism, which identifies 5 alleles with 4, 5, 6, and 9 repetitions of GCT (A4, A5, A6, and A9) or 5 repetitions of GCT with 1 additional G insertion for allele A5.1. From our previous studies, we have shown that microsatellite allele A5 of MICA is associated with IDDM. The aim of this study was to test the hypothesis that certain MICA alleles are associated with LADA among clinically diagnosed NIDDM. Out of 100 clinically diagnosed NIDDM patients, 49 tested positive for GAD65 and IA-2 antibodies by use of 35S RIA. Samples from these 49 patients and 96 healthy controls were analyzed for MICA by PCR amplification, and fragment sizes were determined in an ABI prism DNA sequencer. Our results show that MICA allele A5.1 is significantly increased in antibody-positive (GAD65 or IA-2) NIDDM patients [35/49 (72%)] when compared to healthy controls [22/96 (23%)] (OR = 8.4; P < 0.0001). However, we do not see any association with each of the antibodies separately. From our study, we conclude that (a) MICA allele A5.1 is associated with LADA and (b) MICA may play an important role in the etiopathogenesis of LADA.

Adult↗
PubMed2005

Hepatitis B and C virus variants in long-term immunosuppressed renal transplant patients in Latvia.

The incidence of genome variants of hepatitis B and hepatitis C viruses among 38 long-term (2-15 years) immunosuppressed patients after renal transplantation and 10 patients undergoing dialysis was investigated. Twelve patients had only HBV infection, 9 had only HCV infection and 14 were co-infected. Regions corresponding to the HBV X/EnII/BCP, preC/C, preS/S and to the HCV core were sequenced for molecular characterization of the HBV and HCV genomes. Fifty-seven percent of HBV DNA isolates belonged to genotype D and 42% to genotype A, whereas 77% of HCV RNA isolates belonged to genotype 1b and only 17% to genotype 3a. One sample (6%) was of genotype 2c. Detailed analysis of the above-mentioned HBV genome regions revealed the presence of nucleotide point mutations, which, in some cases, resulted in amino acid substitutions. The clinical significance of such mutations is discussed.

Adult↗