Fatty Acid Composition of a Maternal Diet and Erythrocyte Phospholipid Status in Latvian Pregnant Women.

BACKGROUND AND OBJECTIVES: Dietary fats are essential for maternal and fetal health. Fatty acids (FAs) in erythrocytes characterize the FA profile, which is influenced by diet and other factors. The aim of this study was to evaluate the association between the main FAs in erythrocyte membrane phospholipids and their influencing factors-dietary fat and supplement intake and lifestyle factors-in Latvian pregnant women. MATERIALS AND METHODS: This cross-sectional study included 236 pregnant and postpartum women. The data were collected from medical documentation, a food frequency questionnaire, and a questionnaire on demographic, lifestyle, health status, and nutritional habits in outpatient clinics and maternity departments. FAs in erythrocyte membrane phospholipids were determined using gas chromatography. RESULTS: Correlations were found between dietary SFAs and erythrocyte SFAs (r = -0.140, p = 0.032) and PUFAs (r = 0.167, p = 0.01) and between dietary PUFAs and erythrocyte MUFAs (r = -0.143, p = 0.028). Dietary SFAs, MUFAs, and PUFAs positively correlated with the studied n-3 and n-6 FAs in erythrocytes. Vitamin D correlated positively with MUFA and negatively with total PUFA and AA in erythrocytes. There was a negative correlation between dietary vitamin A and linoleic acid in erythrocytes. Physical activity negatively correlated with erythrocyte MUFAs and positively with erythrocyte PUFAs. Alcohol consumption positively correlated with erythrocyte SFAs and negatively with erythrocyte PUFAs. CONCLUSIONS: There are indications that some dietary FAs may be correlated with erythrocyte FAs. Possible influencing factors for this association are alcohol, physical activity, vitamin D, and vitamin A.

Safety Concerns Related to the Simultaneous Use of Prescription or Over-the-Counter Medications and Herbal Medicinal Products: Survey Results among Latvian Citizens.

The use of herbal medicines is increasing worldwide. While the safety profile of many herbal medicines is promising, the data in the literature show important interactions with conventional drugs that can expose individual patients to high risk. The aim of this study was to investigate the experience of the use of herbal medicines and preparations and the risks of interactions between herbal and conventional medicines among Latvian citizens. Data were collected between 2019 and 2021 using a structured questionnaire designed for pharmacy customers in Latvia. Electronic databases such as Drugs.com, Medscape, and European Union herbal monographs were reviewed for the risk of drug interactions and potential side effects when herbal medicines were involved. The survey included 504 respondents. Of all the participants, 77.8% used herbal preparations. Most of the participants interviewed used herbal remedies based on the recommendation of the pharmacist or their own initiative. A total of 38.3% found the use of herbal remedies safe and harmless, while 57.3% of respondents regarded the combination of herbal and regular drugs as unsafe. The identified herbal medicines implicated in the potential risk of serious interactions were grapefruit, St. John's wort, and valerian. As the risks of herb-drug interactions were identified among the respondents, in the future, both pharmacy customers and healthcare specialists should pay more attention to possible herb-drug interactions of over-the-counter and prescription medications.

Barriers and solutions for the integrated care of diabetic patients from the point of view of general practitioners in Latvia.

INTRODUCTION: Ambulatory care sensitive indicators for chronic care patients, such as avoidable hospitalizations and preventable mortality, show worse results in Latvia in comparison with the EU average. Previous studies reveal the situation is not far behind in terms of the quantity of diagnostics and consultations, but it is possible to prevent at least 14% of hospitalizations in the chronic patient group. The aim of this study is to find out the opinions of GPs on the barriers and solutions for better care results for diabetic patients in the context of applying an integrated care approach. METHODS: A qualitative study was conducted in the form of semi-strucured in-depth interviews (5 themes, 18 questions), and analyzed using an inductive thematic analysis. The online interviews were conducted in May and April 2021. The respondents were GPs representing different rural regions (n=26). RESULTS: The results of the study reveal that the main barriers to integrated care are: the workload of GPs, especially in COVID conditions; the limited visit time; the lack of focused informational handouts; long queues for secondary care; and the lack of electronic patient health records (EHRs). GPs point to the need to set up patient EHRs, to develop diabetes training rooms in regional hospitals, and to expand GP practice with a third nurse. DISCUSSION: Special attention should be paid to developing integrated care tools at the healthcare system level and patient data digitization and care of socially isolated and sedentary patients by developing home care services, communication tools and integrating primary, secondary and social care at the regional level.

Inadequacy of self-Implemented preventive measures to control caries increment due to poor dietary habits in 6 and 12 years old children in Riga, Latvia.

AIM: This study investigated whether the self-implemented preventive measures practiced among the 6 and 12 years olds in Riga, Latvia can control the caries increment due to poor dietary habits among this age groups. MATERIAL AND METHODS: Caries examination was performed on Thirty-eight 6 and thirty-nine 12 years olds by visual and bitewing radiographic examination at baseline and after 3 years. All participants and/or their parents completed dietary habits questionnaires. The data was analyzed using t-test, chi-square test, ANOVA and frequency tables, Wilcoxon and Fisher's tests (α=0.05). RESULTS: The mean (SD) values of caries experience at baseline/3-year period in 6- vs.12-year olds were as follows. DMFS: 0.72 (1.02)/3.13 (3.13) (p=0.0000) vs. 6.79 (5.14)/14.79 (9.86) (p=0.0000); dmfs: 11.26(8.71)/7.74 (4.86) (p=0.078) vs. 3.57 (2.03)/1.5 (0.71) (p=0.317). The statistical significance was reported only for the consumption of soft drinks (p=0.032) and sugared tea (p=0.018) for the 6 years olds, and for sugared tea (p=0.017) and number of teaspoons of sugar added to tea (p=0.0095) for the 12-years olds. There was positive caries increment in all the 6 and 12 years olds that reported significant increase in consumption of soft drinks and sugared tea, and increase daily number of teaspoons of sugar used in tea. CONCLUSIONS: The present study demonstrated high cariogenic diet among the children in Riga, which is associated with increased caries experience that the currently practiced self-implemented oral hygiene measures was not capable of controlling.

Iron Status in Pregnant Women in Latvia: An Epidemiological, Cross-Sectional, Multicenter Study According to WHO and UK Criteria.

Background and Objectives: During pregnancy, iron deficiency anaemia is a common problem associated with health risks for both the mother and her foetus/infant. This study aimed to investigate the prevalence of iron deficiency, iron deficiency anaemia, and related dietary patterns in pregnant women in Latvia. Materials and Methods: This cross-sectional, multicentre study included pregnancy data from 974 women. The sample selection was based on the stratification principle (population of women of childbearing age in regions of Latvia). Maternal demographic details, anthropometric measurements, iron status, dietary patterns, and supplementation information were obtained from maternal files and during interviews held in eight outpatient departments of medical institutions and maternity departments. The prevalence was assessed. Chi-square tests and logistic regression were used to identify associations between iron deficiency and sociodemographic characteristics, dietary patterns, and iron supplement intake during pregnancy. The criterion used for the diagnosis of iron deficiency anaemia is a Hb level <110 g/L in the 1st and 3rd trimesters and <105 g/L during the 2nd trimester as recommended by the WHO. However, the UK guideline was used for borderline iron deficiency, which is an SF level <30 µg/L in all trimesters. Results: The observed prevalence of anaemia was 2.8% in the first trimester, 7.9% in the second trimester, and 27.0% in the third trimester. The prevalence of iron deficiency was 46.7% in the first trimester, 78.1% in the second trimester, and 91.7% in the third trimester. No associations with dietary patterns were found. Single women had 1.85 times the odds (95% CI 1.07 to 3.18) of being anaemic than married women. Conclusions: Iron deficiency affects a large proportion of pregnant women in Latvia in all trimesters, with iron deficiency anaemia affecting pregnant women in the third trimester. Monitoring and intervention should be performed in a timely and more targeted manner.

The Potential Use of Herbal Fingerprints by Means of HPLC and TLC for Characterization and Identification of Herbal Extracts and the Distinction of Latvian Native Medicinal Plants.

The growing market of herbal medicines, the increase in international trade in Latvia, and the lack of adequate analytical methods have raised the question of the potential use of herbal fingerprinting methods. In this study, high-performance liquid chromatography (HPLC) and thin layer chromatography (TLC) methods were developed for obtaining chromatographic fingerprints of four taxonomically and evolutionary different medicinal plants (Hibiscus sabdariffa L., Calendula officinalis L., Matricaria recutita L., Achillea millefolium L.). Retention time shifting, principal component analysis (PCA), hierarchical cluster analysis (HCA), and orthogonal projections to latent structures (OPLS) analysis were used to improve and analyze the obtained fingerprints. HPLC data detection at 270 nm was determined superior to 360 nm for the distinction of medicinal plants and used data alignment method significantly increased similarity between samples. Analyzed medicinal plant extracts formed separate, compact clusters in PCA, and the results of HCA correlated with the evolutionary relationships of the analyzed medicinal plants. Herbal fingerprinting using chromatographic analysis coupled with multivariate analysis has a great potential for the identification of medicinal plants as well as for the distinction of Latvian native medicinal plants.

Assessment of Iodine and Selenium Nutritional Status in Women of Reproductive Age in Latvia.

Background and Objectives: Adequate dietary intake of iodine and selenium is essential during pregnancy. While iodine is vital for maternal thyroid function and fetal development, selenium contributes to the regulation of thyroid function and thyroid autoimmunity. This study aimed to assess the consumption of iodine- and selenium-containing products by women of reproductive age and the iodine and selenium nutritional status of pregnant women in Latvia. Materials and Methods: Population health survey (2010-2018) data were used to characterize dietary habits in women of reproductive age. Additionally, 129 pregnant women in the first trimester were recruited; they completed a questionnaire and were tested for thyroid function, urinary iodine concentration (UIC), and serum selenium and selenoprotein P levels. Results: The use of some dietary sources of iodine (e.g., milk and dairy products) and selenium (e.g., bread) has decreased in recent years. Less than 10% of respondents reported the use of iodized salt. The use of supplements has become more common (reported by almost 50% of respondents in 2018). Dietary habits were similar in pregnant women, but the use of supplements was even higher (almost 70%). Nevertheless, most supplements used in pregnancy had insufficient contents of iodine and selenium. Thyroid function was euthyreotic in all women, but 13.9% of participants had a thyroid peroxidase antibodies (TPO-ab) level above 60 IU/mL. The median UIC (IQR) was 147.2 (90.0-248.1) µg/gCr, and 52.8% of pregnant women had a UIC below 150 µg/gCr. The mean selenium (SD) level was 101.5 (35.6) µg/L; 30.1% of women had a selenium level below 80 µg/L. The median selenoprotein P level was 6.9 (3.1-9.0) mg/L. Conclusions: Iodine nutrition in Latvian population of pregnant women was near the lower limit of adequate and a third of the population had a selenium deficiency. Supplements were frequently used, but most did not contain the recommended amounts of iodine and selenium.

Assessment of sapropel use for pharmaceutical products according to legislation, pollution parameters, and concentration of biologically active substances.

Development trends need the necessity for wider use of the local resources and available natural materials are one of the priorities around the world. Freshwater sapropel is a common material in the water basement of the lakes, but still not sufficiently explored. The main goal of the project to start detailed and systematic research on the medical properties of sapropel to be obtained in Latvia, promote its scientifically based use in balneology, develop new medical procedures and services, and promote development of new exportable products. The results include the survey, sampling depths, and processing, evaluation of external signs, physical, chemical, and biochemical parameters, and evaluation of microbiological indicators. Active components from the sapropel samples extracted using the alkaline method. Sapropel extracts were characterized by organic carbon content, humic and fulvic acid concentrations, total phenolic content, trace metal and pesticide concentrations, total antioxidant status, and microbiological flora. Summarizing the article's main findings it was concluded that Latvian freshwater sapropel can be used as raw material for obtaining sapropel extract and use it in the preparation of pharmaceuticals and promote the development of new exportable products and services.

Determination of Fungi and Multi-Class Mycotoxins in Camelia Sinensis and Herbal Teas and Dietary Exposure Assessment.

In this paper, a study of fungal and multi-mycotoxin contamination in 140 Camellia sinensis and 26 herbal teas marketed in Latvia is discussed. The analysis was performed using two-dimensional liquid chromatography with time-of-flight mass spectrometry (2D-LC-TOF-MS) and MALDI-TOF-MS. In total, 87% of the tea samples tested positive for 32 fungal species belonging to 17 genera, with the total enumeration of moulds ranging between 1.00 × 101 and 9.00 × 104 CFU g-1. Moreover, 42% of the teas (n = 70) were contaminated by 1 to 16 mycotoxins, and 37% of these samples were positive for aflatoxins at concentrations ranging between 0.22 and 41.7 µg kg-1. Deoxynivalenol (DON) and its derivatives co-occurred in 63% of the tea samples, with their summary concentrations reaching 81.1 to 17,360 µg kg-1. Ochratoxin A (OTA), enniatins, and two Alternaria toxins were found in 10-37% of the teas at low concentrations. The dietary exposure assessment based on the assumption of a probable full transfer of determined mycotoxins into infusions indicated that the analysed teas are safe for consumers: the probable maximum daily exposure levels to OTA and the combined DON mycotoxins were only 0.88 to 2.05% and 2.50 to 78.9% of the tolerable daily intake levels.

Effect of ecological factors on the accumulation of phenolic compounds in Iris species from Latvia, Lithuania and Ukraine.

INTRODUCTION: It is important to conduct studies on the influence of environmental factors on the accumulation of secondary metabolites in plants, as well as the cultivation of plants and harvesting of their raw material. OBJECTIVE: In this study, we examined the influence of habitat types, soil composition, climatic factors and altitude on the content of phenolic compounds in Iris species from different populations in Latvia, Lithuania and Ukraine. METHODOLOGY: According to high-performance liquid chromatography (HPLC) analysis, 25 compounds (flavonoids, isoflavonoids, isoflavonoid glucosides, xanthones, phenolcarboxylic acids) were identified in the methanol extracts of 16 samples of Iris rhizomes. The quantitative data were further analysed by principal component analysis (PCA) to reveal the impact of environmental factors on the accumulation of compounds in plants. RESULTS: Iris pseudacorus from Latvia and Lithuania had a more diverse composition of phenolic compounds than samples from Ukraine. Sampled plants of the Iris subg. Iris had a higher content of the analysed compounds than those of Iris subg. Limniris. PCA results showed that the levels of phenolic compounds in Iris rhizomes were influenced by the content of soil nutrients. The phosphorus and potassium content had a significant impact on the levels of phenolic compounds, whereas the impact of nitrogen content was not significant. Meteorological factors had a small impact; however, sunshine duration had a significant positive effect and the amount of precipitation had a significant negative impact. CONCLUSION: The results of this study suggest that rhizomes of Iris species may be an important source of pharmacologically active compounds such as flavonoids, isoflavonoids and xanthones. Studies on the effect of environmental factors on the production and accumulation of secondary metabolites in Iris species are important because they contribute to knowledge of quantitative parameters of secondary metabolites in medicinal plants and could be employed for the cultivation and harvesting of raw material for medicinal purposes.

Medicinal plants and their uses recorded in the Archives of Latvian Folklore from the 19th century.

ETHNOPHARMACOLOGICAL RELEVANCE: The records of folk medicine present historical evidence of medicinal plant usage in the territory of Latvia and describe native and imported plants and plant products that were used as medicine. AIM OF THE STUDY: To collect and analyse the ethnobotanical knowledge found in records of Latvian folk medicine available in the Archives of Latvian Folklore. MATERIALS AND METHODS: Following the International Classification of Primary Care, plant uses were grouped into one of the 17 categories based on the body systems and psychological and social problems. Each plant was identified by its scientific name according to The Plant List website. Additionally, the plant parts used, dosage forms of herbal medicines and routes of administration were analysed. RESULTS: In total, 211 genera belonging to 71 families were mentioned in the analysed materials. The most common health conditions were digestive system disorders, respiratory system disorders and skin disorders. The plant families with the largest number of taxa were Asteraceae, Rosaceae, Lamiaceae, and Apiaceae. The most frequently mentioned native plant taxa were Achillea millefolium L., Matricaria chamomilla L., Allium cepa L., Artemisia absinthium L., and Plantago sp. L. Leaves and flowers were the most commonly used parts, and herbal tea was the most common dosage form. Only 59 out of 211 taxa mentioned in this study are included in the official herbal monographs of the European Medicines Agency. CONCLUSIONS: One hundred and fifty-two plant taxa mentioned in the records of Latvian folk medicine are not included in the European Union herbal monographs providing scientific information on the safety and efficacy and deserve further exploration as traditional herbal medicines.

Mycotoxins in herbal teas marketed in Latvia and dietary exposure assessment.

The occurrence of 12 mycotoxins has been analysed by liquid chromatography - time of flight mass spectrometry in the batch of 60 herbal teas purchased from drugstores in Latvia. Among the dry tea samples, 90% were positive for one to eight mycotoxins. Enniatin B and deoxynivalenol (DON) were the most frequently detected mycotoxins in 55% and 45% of the samples, respectively. DON reached the highest level, from 129 µg kg-1 in herbal blend to 5,463 µg kg-1 in wormwood tea. Ochratoxin A (OTA) and aflatoxin B1 (AFB1) were found in 10% and 20% of the samples at the concentrations ranged between 2.99-30.3 µg kg-1 and 3.40-23.7 µg kg-1. Studies of the tea infusion process indicated that 32-100% of DON and zearalenone present in dry teas were extracted into the infusions. Dietary exposure assessment was performed, using the determined mycotoxin levels and the available consumption data.

Identifying the underlying causes of biological instability in a full-scale drinking water supply system.

Changes in bacterial concentration and composition in drinking water during distribution are often attributed to biological (in)stability. Here we assessed temporal biological stability in a full-scale distribution network (DN) supplied with different types of source water: treated and chlorinated surface water and chlorinated groundwater produced at three water treatment plants (WTP). Monitoring was performed weekly during 12 months in two locations in the DN. Flow cytometric total and intact cell concentration (ICC) measurements showed considerable seasonal fluctuations, which were different for two locations. ICC varied between 0.1-3.75 × 105 cells mL-1 and 0.69-4.37 × 105 cells mL-1 at two locations respectively, with ICC increases attributed to temperature-dependent bacterial growth during distribution. Chlorinated water from the different WTP was further analysed with a modified growth potential method, identifying primary and secondary growth limiting compounds. It was observed that bacterial growth in the surface water sample after chlorination was primarily inhibited by phosphorus limitation and secondly by organic carbon limitation, while carbon was limiting in the chlorinated groundwater samples. However, the ratio of available nutrients changed during distribution, and together with disinfection residual decay, this resulted in higher bacterial growth potential detected in the DN than at the WTP. In this study, bacterial growth was found to be higher (i) at higher water temperatures, (ii) in samples with lower chlorine residuals and (iii) in samples with less nutrient (carbon, phosphorus, nitrogen, iron) limitation, while this was significantly different between the samples of different origin. Thus drinking water microbiological quality and biological stability could change during different seasons, and the extent of these changes depends on water temperature, the water source and treatment. Furthermore, differences in primary growth limiting nutrients in different water sources could contribute to biological instability in the network, where mixing occurs.

Drug Policy in Latvia.

We present a general overview of the health care system as well as the pricing and reimbursement environment in Latvia. Overall, the pharmaceutical sector in Latvia, including pricing and reimbursement, is strictly regulated. The main Latvian stakeholder in the pharmaceutical sector is the Ministry of Health. The State Agency of Medicines and the National Health Service (NHS) are also important institutions for regulation of pharmaceuticals, including pricing and reimbursement. The NHS is the most important institution for regulation of reimbursement of pharmaceuticals. It is responsible for health technology assessment and also for implementing decisions regarding the reimbursement of pharmaceuticals by including medicines in the positive reimbursement lists for outpatient care and defining positive lists of medicinal products for inpatient use. The reimbursement of expenditures for medicinal products and medicinal devices for outpatient care is a main part of drug funding in Latvia. Reference pricing is in place and prices are revised 4 times a year. The positive reimbursement list for outpatient care consists of three parts: list A, list B, and list C. All the medicines in the positive list are classified into one of three reimbursement categories (100%, 75%, or 50%) depending on the illnesses for which they have been approved. Pharmaceuticals used for inpatient care are included in the cost of inpatient services and are provided free of charge to patients. Inpatient drugs are purchased by health service providers.

The Neolithic Transition in the Baltic Was Not Driven by Admixture with Early European Farmers.

The Neolithic transition was a dynamic time in European prehistory of cultural, social, and technological change. Although this period has been well explored in central Europe using ancient nuclear DNA [1, 2], its genetic impact on northern and eastern parts of this continent has not been as extensively studied. To broaden our understanding of the Neolithic transition across Europe, we analyzed eight ancient genomes: six samples (four to ∼1- to 4-fold coverage) from a 3,500 year temporal transect (∼8,300-4,800 calibrated years before present) through the Baltic region dating from the Mesolithic to the Late Neolithic and two samples spanning the Mesolithic-Neolithic boundary from the Dnieper Rapids region of Ukraine. We find evidence that some hunter-gatherer ancestry persisted across the Neolithic transition in both regions. However, we also find signals consistent with influxes of non-local people, most likely from northern Eurasia and the Pontic Steppe. During the Late Neolithic, this Steppe-related impact coincides with the proposed emergence of Indo-European languages in the Baltic region [3, 4]. These influences are distinct from the early farmer admixture that transformed the genetic landscape of central Europe, suggesting that changes associated with the Neolithic package in the Baltic were not driven by the same Anatolian-sourced genetic exchange.

Factors influencing the caries experience of 6 and 12 year old children in Riga, Latvia.

AIM: Authors assessed the influence of drinking tea with sugar, level of cariogenic microflora and use of fluoride toothpaste and tablets on caries experience of 6 and 12 year old children in Riga, Latvia. METHODS: 141 six and 164 twelve year old children were examined clinically and with bitewing radiographs to determine their dmft/DMFT and dmfs/DMFS. Children or their parents responded to questionnaire on number teaspoons of sugar (TS) used per cup of tea, number of cups of tea consumed daily, using fluoride or non-fluoride toothpaste (TP), frequency of toothbrushing, using fluoride tablets or not (ft). Salivary mutans streptococci (MS) and lactobacilli (LB) levels were measured in children with dmft/DMFT>4.0 for age of 6 (73% (n=103)), and for age of 12 (54% (n=88)). Impact of variables in caries status was determined using frequency tables and ANOVA, while proportion differences were tested using chi-square test. RESULTS: In 6 year olds, statistically significant associations were observed between the salivary microflora (MS, LB) and dt/DT (p=0.032; dt=3.71, DT=0.42), use of F-toothpaste (p=0.020), and TS (p<0.001). In 12 year olds, statistically significant (p<0.01) associations were observed between salivary microflora and dt/DT, ds/DS and dmft/DMFT. In both age groups, significant (p<0.001) association was demonstrated between dmfs/DMFS and salivary microflora, F-toothpaste and TS. CONCLUSIONS: The present study indicated that the caries development in Latvian children was associated with consumption of sugary tea and use of non-fluoride toothpaste.

Prevention of occlusal caries using a ozone, sealant and fluoride varnish in children.

OBJECTIVES: To compare ozone with fissure sealants and fluoride varnish in the prevention of occlusal caries in permanent premolars of children in 12 months period. METHODS: A clinical trial was conducted on four groups of 10 years old schoolchildren: a group 1 - control group (n=50); a group 2 (n=21) in which fluoride varnish was applied and re-applied up to 12 months; a group 3 (n=17) in which sealant was applied and reapplied up to 12 months; and a group 4 (n=19) in which ozone was applied and re-applied up to 12 months. Percent caries reduction was studied in these initially healthy molars with complete occlusal eruption: 173 (control), 103 (varnish), 78 (sealants) and 103 (ozone) premolars met inclusion criteria. All patients were examined using DMFT index and Greene - Vermillion index at a baseline and in 6 months with a follow up period of 12 months. Each tooth was considered as the unit of the analysis. Data were analyzed using t-test and the chi-square tests. RESULTS: The prevalence of caries was: in group 1 - 3.5% (n=6), in group 2 and group 3 - 0% (n=0), in group 4 - 2.9%, (n=3). The changes in occlusal caries incidence between all groups were not statistically significant. CONCLUSIONS: The placement of fissure sealant, application of fluoride varnish, and application of ozone - are recommended to use in prevention of occlusal pit and fissure caries in permanent premolars in children. Furthermore, they are not significantly different from one another in their effectiveness.

Iodine deficiency during pregnancy: a national cross-sectional survey in Latvia.

OBJECTIVE: Low iodine intake during pregnancy may cause thyroid dysfunction, which results in inadequate fetal brain development. In the absence of a universal salt iodization programme, we conducted a nationwide survey of iodine deficiency in pregnant women in Latvia. DESIGN: A countrywide twenty-cluster survey, with at least twenty women per cluster. Participants completed a questionnaire on dietary habits concerning iodine intake (n 739). Thyroid function (thyroid-stimulating hormone, free thyroxine and thyroperoxidase antibodies) was measured (n 550). Urinary iodine was measured using the ammonium persulfate method (n 696). SETTING: The survey was performed in all regions of Latvia during the spring and autumn seasons in 2013. SUBJECTS: Pregnant women (n 829). RESULTS: The median creatinine (Cr)-standardized urinary iodine concentration (UIC) was 80·8 (interquartile range (IQR) 46·1-130·6) µg/g Cr or 69·4 (IQR 53·9-92·6) µg/l during pregnancy, and 81% of pregnant women had UIC levels below the WHO recommended range of 150-250 µg/g Cr. The UIC was lowest during the first trimester of pregnancy, 56·0 (IQR 36·4-100·6) µg/g Cr, reaching higher concentrations of 87·5 (IQR 46·4-141·7) µg/g Cr and 86·9 (IQR 53·8-140·6) µg/g Cr in the second and third trimesters, respectively. Women taking supplements containing ≥150 µg iodine (6·8% of respondents) had non-significantly higher UIC than did women without supplementation (96·2 v. 80·3 µg/g Cr, respectively, P=NS). Thyroperoxidase antibody concentration did not correlate significantly with UIC: Spearman's ρ=-0·012, P=0·78. CONCLUSIONS: The median UIC indicates iodine deficiency in pregnant women in Latvia. Iodine supplementation (150 µg daily) and regular UIC monitoring should be suggested to overcome iodine deficiency and to reach the recommended levels without inducing autoimmune processes.

INCIDENCE AND SEVERITY OF LEAF AND FRUIT DISEASES OF PLUMS IN LATVIA.

In the present study six plum orchards in Latvia were examined during 2014. One orchard was commercial with integrated pest management (IPM) practices, one was with organic management, two orchards were scientific collections and in two orchards plums were grown as a minor crop, using IPM practices. The shot-hole disease (Wilsonomyces carpophilus) and fruit rot were monitored in the field. Samples of twigs and leaves were taken for further examination if some other disease symptoms were observed. In total, 50 European plum (Prunus domestica) and six diploid plum cultivars were inspected. The fruit rot was assessed also in the laboratory to determine the latent infection with Monilinia spp. on immature fruits. Monilinia spp. isolates from all orchards were subjected to fungicide sensitivity tests. Incidence and severity of shot-hole disease was significantly different among various orchards when the same cultivar was compared, as well as between diploid and European plum cultivars. The average incidence of shot-hole disease was 41% in diploid plums and 80% in European plums, while the average severity was 9 and 15%, respectively. In the field, fruit rot caused only by Monilinia spp. was detected. The average incidence of brown rot on diploid plums was less than 1%, but on European plums it was 3.6%. The latent infection tests showed that plum fruits had higher incidence of brown rot than was observed in the field, up to 44% on particular cultivars. Additionally, from the fruits subjected to these tests, Botrytis cinerea, Diaporthe eres and Colletotrichum spp. were isolated. This means that in specific weather and management conditions the fruit rot incidence in the field could be several times higher. Examination of samples of twigs, leaves and fruits in the laboratory showed the presence of D. eres in samples from all orchards. In one of the scientific collections D. eres was isolated from twigs, leaves and fruits, and was more often found on the individuals located in the part of the orchard close to hedge. In other orchards this fungus was isolated only from fruits, and mainly from the latent infection tests. Monilinia spp. isolates showed high sensitivity to dithianon, penconazole, mancozeb and boscalid with pyraclostrobin, but lower sensitivity to cyprodinil. Several fungi that are known to be antagonistic to pathogenic fungi were isolated from all orchards: Epicoccum nigrum, Clonostachys rosea and Aureobasidium pullulans, mainly from the fruits of latency tests and leaves with disease symptoms.

[Advances of selenium supplementation in posttraumatic stress disorder risk group patients].

Posttraumatic stress disorder (PTSD) is a complex of symptoms developed in a patient after traumatic event. The basis of PTSD pathophysiology is hyper activation of neurones under stress factors influence, so-called excitotoxicity, followed by oxidative stress (OS) because of an accumulation of free radicals. Lipid peroxidation can lead to neurons damage. Neurons are especially susceptible to OS, changing signal transduction and information processing mechanisms. Clinically excitotoxicity preforms as different acute and/or chronic stress reactions and can cause PTSD. Selenium (Se) is involved on different stages of transport and metabolism of Glutamate. Research aim: to access PTSD incidence, OS parameters and their adjustment advances using organic Se in PTSD risk group patients. PTSD symptomatic severity (in PCL-M points) reduced for 5.85% to baseline, Prevalence Rate reduced for 46.03% to baseline in Se group patients. We can conclude that: 1) there is a statistically reliable correlations between the incidence of PTSD and OS parameters, between PTSD symptomatic severity and OS parameters; 2) the use of Se during the mission can reduce the OS parameters, minimize the incidence of PTSD and reduce the PTSD symptomatic severity.