Background: Studies on a new coronavirus disease (COVID-19) show the elevation of liver enzymes and liver fibrosis index (FIB-4) independently on pre-existing liver diseases. It points to increased liver fibrogenesis during acute COVID-19 with possible long-term consequences. This study aimed to assess liver fibrosis in COVID-19 patients by serum hyaluronic acid (HA) and FIB-4. Methods: The study included the acute COVID-19 group (66 patients, 50% females, mean age 58.3 ± 14.6), the post-COVID group (58 patients in 3–6 months after the recovery, 47% females, mean age 41.2 ± 13.4), and a control group (17 people, 47% females, mean age 42.8 ± 11.0). Ultrasound elastography was performed in the post-COVID and control groups. Results: Sixty-five percent of the acute COVID-19 group had increased FIB-4 (> 1.45), and 38% of patients had FIB-4 ≥ 3.25. After matching by demographics, 52% of acute COVID-19 and 5% of the post-COVID group had FIB-4 > 1.45, and 29% and 2% of patients had FIB-4 ≥ 3.25, respectively. Increased serum HA (≥ 75 ng/ml) was observed in 54% of the acute COVID-19 and 15% of the post-COVID group. In the acute COVID-19 group, HA positively correlated with FIB-4, AST, ALT, LDH, IL-6, and ferritin and negatively with blood oxygen saturation. In the post-COVID group, HA did not correlate with FIB-4, but it was positively associated with higher liver stiffness and ALT. Conclusion: More than half of acute COVID-19 patients had increased serum HA and FIB-4 related to liver function tests, inflammatory markers, and blood oxygen saturation. It provides evidence for the induction of liver fibrosis by multiple factors during acute COVID-19. Findings also indicate possible liver fibrosis in about 5% of the post-COVID group.

Kolesova O, et al. Anat Cell Biol. 2017 Dec;50(4):265-274. https://doi.org/10.5115/acb.2017.50.4.265

The aim of this study was a statistics-based exploration of a typology of the female pelvis. The research sample included 172 females aged from 18 to 69. For measurements, the three dimensional CT images of pelvis were used. A cluster analysis was performed on anteroposterion and transverse diameters of the pelvic inlet and the midplane. The results revealed three clusters representing gynecoid, “narrow”, and intermediate types of female pelvis. The distribution of pelvic types in age groups indicates a tendency for the “narrow” pelvis to be presented more frequently in the group of younger females.Variability and typology of the female pelvis is a traditional topic in anthropological studies [3, 4, 13, 17]. The best known classification of the female pelvis was suggested by Caldwell and Moloy in 1933 [3] and it was based on the pelvic inlet shape. In the frame of this classification, four main pelvic types were suggested: gynecoid, android, anthropoid, and platypelloid. The development of this classification resulted in the identification of the mixed types and subtypes based on the width of the pelvic outlet [3]. As a result, more than twenty subtypes were suggested that complicated their analytical implication. In addition, the critics of this classification addressed the subjective impression in the judgments of pelvic shapes without a well established statistical base [19].A tendency of increase in cesarean section is observed in the last decades [2,5, 9, 15]. In Latvia, the number of cesarean section delivery is growing from 3.9% in 1980 to 23.7% in 2010 [18]. A narrow pelvis is one of the factors increasing the risk for cesarean section [12]. On the one hand, there is a solution for the narrow pelvis problem from the obstetric perspective. On the other hand, a more detailed analysis is needed from the anthropological perspective because of possible evolutionary trends in the human body in general and in the pelvic shape in particular. The aim of this study was a statistics-based exploration of a typology of the female pelvis.A well recognized anthropological tendency of the last century is the secular trend in growth. Previous studies demonstrate an increase in the mean height about 1–2 cm per decade in different European countries [6, 8]. An investigation of external body parameters of Latvian women also demonstrated significant changes in the period of 70 years. The women’s height increased for 6 cm, shoulder breadth increased for 0.6 cm, and the hip breadth increased for 2.9 cm [8]. Based on the relationship between the lesser pelvic parameters and height observed in previous studies [7, 11, 13], it is possible to expect that parameters of the lesser pelvis also changed during the last 6–7 decades.It should be noted that the female pelvic cavity has a cylindrical shape with the narrowest place in the midplane between two ischial spines (the bispinous diameter). The obstetric importance of the pelvic inlet and the midplane was emphasized in anthropological studies [3, 4, 16, 17]. In a typical female pelvis, a longer diameter of the inlet (the transverse diameter) and a longer diameter ofthe midplane (the anteroposterior diameter) are placed perpendicularly. Therefore, a fetal head rotates from a transverse position in the pelvic inlet to a sagittal position in the midplane. A narrowing of the pelvic cavity in the midplane causes this rotation. Stalberg at al. [12] demonstrated that a narrow pelvic midplane is an important reason for the emergency cesarean section. In addition, an inadequate proportion of the pelvic inlet also causes cesarean section [1].Therefore, both the pelvic inlet and the midplane are highly important from the anthropological perspective and need to be included in a statistics-based exploration of the female pelvic typology. Changing body parameters allow to expect age differences in a distribution of pelvic types between younger and older females. As a result, two research questions were posed for the presentstudy:1. What female pelvic types could be detected on the basis of the measures of the inlet and the midplane of the lesser pelvis?2. How does the distribution of female pelvic types among age groups differ?

Latvia is among European countries with outbreaks of diphtheria and measles. Healthcare workers (HCW) are exposed to infections and can transmit them to unvaccinated patients. We assessed the seroprevalence of antibodies against diphtheria and measles and their association with demographics, self-reported immunity, the presence of the HLA-B27 allele, and level of interferon regulatory factor 5 (IRF5) in Latvian HCW. Anti-diphtheria and anti-measles IgG antibodies and the level of IRF5 in serum were tested by enzyme immunoassay. The presence of the HLA-B27 allele was detected by a real-time polymerase chain reaction. The study involved 176 HCW, including 29% doctors and 44% nurses. Among HCW, 95.5% were seropositive for diphtheria. However, only 65.9% had full seroprotection against it. The seronegativity for measles (21.6%) was higher than for diphtheria (4.5%) without differences in gender and medical staff groups. Older age was associated with waning immunity against diphtheria and a higher rate of seropositivity for measles. Considered immunogenetic factors did not affect the level of antibodies, and variability of the level of IRF5 in serum can reflect ageing processes. Self-reported vaccination status had a low informative value regarding full seroprotection against diphtheria and seropositivity for measles indicating the need for pre-vaccination IgG screening in planning the booster vaccination.

Introduction: Pathogenic mechanisms and long-term consequences of COVID-19 require attention in studies on SARS-CoV-2. The association of the severity of COVID-19 with genetic factors, such as human leukocyte antigen (HLA) genes, remains underexplored. Our study assessed the relationships between HLA class II alleles and COVID-19 severity and blood-based indicators of systemic inflammation and organ damage, serum markers of epithelial cell apoptosis such as caspase-cleaved CK18 fragment M30 (CK18-M30) and the extracellular matrix product hyaluronic acid (HA). Material and methods: The study included 101 hospitalized COVID-19 patients (mean age 60 ±14 years). Clinical tests were performed at admission to the hospital. The levels of CK18-M30 and HA were detected in serum by enzyme-linked immunosorbent assay (ELISA). HLA typing was performed in HLA-DRB1, -DQA1, and -DQB1 loci by the polymerase chain reaction with low-resolution sequence-specific primers. Results: Sixty-one patients had a non-severe and 40 had a severe or critical disease course (following the WHO definition). The severity was associated with older age, male gender, higher HA, CK18-M30, and some indicators of inflammation. Despite the lack of direct association between HLA alleles and the severity of COVID-19, the presence of HLA-DRB1*04 and 12 alleles in the genotype was associated with lowered or elevated HA, respectively. The HLA-DQB1*03:01 allele was associated with lowered CK18-M30, aspartate aminotransferase, and ferritin. In addition, HLA-DQB1*06:01 was associated with elevated alanine aminotransferase. Conclusions: Associations of HLA class II alleles with markers of epithelial cell apoptosis and extracellular matrix production indirectly support the influence of HLA genes on acute COVID-19 severity.

Cytokeratin 18 (CK18) is a specific marker of hepatocellular apoptosis, which is a useful noninvasive indicator of liver fibrosis in the HIV/HCV group. However, data on the CK18 level in serum are limited for this group. This study demonstrated CK18 levels in serum in HIV/HCV co-infected and HIV mono-infected patients; investigated the association of CK18 levels with other non-invasive markers of liver fibrosis; and presents CK18 dynamics in a four-month-long period. The sample included 273 patients with HIV infection (128 of them were with HIV/HCV co-infection) aged from 23 to 65 (35% females). Levels of hyaluronic acid, CK18, ALT, and AST were determined in serum, and the FIB4 index was calculated. All markers had higher levels in the HIV/HCV group than in the HIV mono-infection group. The HIV/HCV group demonstrated coherent correlations among the markers and their associations with the level of CK18 than the HIV mono-infection group. During the four-month-long period, the CK18 level in serum showed no significant changes.