Background and Objectives: preoperative differentiation of enlarged parathyroid glands may be challenging in conventional B-mode ultrasound. The aim of our study was to analyse qualitative and quantitative characteristics of parathyroid gland lesions, using multiparametric ultrasound protocol—B-mode, Colour Doppler (CD), and contrast-enhanced ultrasound (CEUS)—and to evaluate correlation with morphology in patients with hyperparathyroidism (HPT). Materials and Methods: consecutive 75 patients with 88 parathyroid lesions and biochemically confirmed HPT prior to parathyroidectomy were enrolled in the prospective study. B-mode ultrasound, CD, and CEUS were performed with the subsequent qualitative and quantitative evaluation of acquired data. We used 1 mL or 2 mL of intravenous ultrasound contrast agent during the CEUS examination. Correlation with post-surgical morphology was evaluated. Results: seventy parathyroid adenomas were hypoechoic and well contoured with increased central echogenicity (44.3%), peripheral-central vascularization (47%), and polar feeding vessel (100%). Twelve hyperplasias presented with similar ultrasound appearance and were smaller in volume (p = 0.036). Hyperplasias had a tendency for homogenous, marked intense enhancement vs. peripherally enhanced adenomas with central wash-out in CEUS after quantitative analysis. No significant difference was observed in contrasting dynamics, regardless of contrast media volume use (1 mL vs. 2 mL). We achieved 90.9% sensitivity and 72.7% specificity, 93% positive predictive value (PPV), 87.3% negative predictive value (NPV), and 87.3% accuracy in the differentiation of parathyroid lesions prior to post-processing. In a quantitative lesion analysis, our sensitivity increased up to 98%, specificity 80%, PPV 98%, and NPV 80% with an accuracy of 96.4%. Conclusions: CEUS of parathyroid lesions shows potential in the differentiation of adenoma from hyperplasia, regardless of the amount of contrast media injected. The quantitative analysis improved the sensitivity and specificity of differentiation between parathyroid lesions. Hyperplasia was characterized by homogeneous enhancement, fast uptake, and homogeneous wash-out appearance; adenoma—by peripheral uptake, central wash-out, and reduced hemodynamics. The use of CEUS quantification methods are advised to improve the ultrasound diagnostic role in suspected parathyroid lesions.

Introduction: The aging population presents both unique challenges and opportunities for societies around the world. To develop an effective healthy aging strategy, a tool for assessing aging process is needed. Numerous attempts to quantify the aging process have been made. However, there is still a challenge in developing and choosing a good enough score that is easy to apply, has a construct of variables that are available in most nationwide surveys for comparable results, and at the same time reflects the aging process of older individuals. The purpose of this study is to present our approach to construct a comparable Healthy Aging Index (HAI).Materials and methods: In Latvia, data from Wave 8 of the Survey of Health, Aging and Retirement in Europe (SHARE), involving 420 respondents, were used. For comparative analysis, data from a HL20 study on the health and wellbeing of the older adults in Iceland, which included 1,033 respondents, were used.Results: For Latvia, 13 items were selected, and for Iceland, nine items were selected. We constructed the HAI with four similar subscales for both countries—“Autonomy,” “Health,” “Wellbeing,” and “Activities,” and an additional subscale “Cognitive” for Latvia. We found matching items in all four subscales. For the Autonomy subscale, they were related to difficulties with everyday and daily tasks. In the Health subscale, the only matching item was self-rated physical health. One item related to loneliness was found for the Wellbeing subscale and one item related to social participation for the Activities subscale.Discussion: In our study, we found evidence for the successful construction of a HAI in two different datasets. The strength of our construct lies in the use of data from one of the largest social science panel studies in Europe (SHARE). As we were able to apply the construct to the Icelandic study, we believe that items presented in our approach are available in other population-based studies as well, and, therefore, can be easily replicated by others. By examining the existing SHARE data, HAI could be used to analyze long-term changes and could provide a foundation for comparing and monitoring the evolution of aging over time as well as comparing the aging process across societies. This is required for the authorities to conduct further analyses, proposals, and action plans in support of healthy aging.

Background: Prostate cancer is one of the most prevalent cancers in the male population. To determine the aggressiveness of suspected lesions precisely, predictive models are increasingly being developed using quantitative MRI measurements, and particularly the ADC value. This study aimed to determine whether ADC values could be used to establish the aggressiveness of prostate cancer. Methods: A retrospective single-center study included 398 patients with prostate cancer who underwent a multiparametric MRI prior to radical prostatectomy. DWI ADC values were measured (µm²/s) using b values of 50 and 1000. The dominant lesion best visualized on MRI was analyzed. The ADC values of the index lesion and reference tissue were compared to tumor aggressivity according to the Gleason grade groups based on radical prostatectomy results. Statistical analysis was performed using the Mann–Whitney U test, Kruskal–Wallis H test, Spearman’s rank correlation, and ROC curves. Results: A very strong negative correlation (rs = −0.846, p < 0.001) between ADC and GS was found. ROC analysis revealed an AUC of 0.958 and an ADC threshold value of 758 µm²/s in clinically significant prostate cancer diagnoses using the absolute ADC value, with no advantage of using the ADC ratio over the absolute ADC value being identified. Conclusion: DWI ADC values and the calculated ADC ratio have a significant inverse correlation with GS. The findings indicate a strong capability in determining prostate cancer aggressiveness, as well as the possibility of assisting with assigning PI-RADS categories using ADC as quantitative metrics.

This book chapter investigates loneliness among older adults (67+) in Latvia, Lithuania, Estonia, Sweden, Denmark, and Finland, aiming to identify demographic trends in loneliness within these Baltic and Nordic populations. The findings indicate a higher loneliness rate in the Baltics, with Latvia at 45%, compared to lower rates in Denmark and Finland at 17% and 20%, respectively. The overall loneliness prevalence in the Baltic countries is 34%, significantly higher than the 22% in Nordic countries. Gender differences are evident, with women more likely to report loneliness, especially in the Baltics (41% for women vs. 27% for men in the Nordics). Additionally, the study notes age disparities, highlighting that individuals 76 and older in the Baltics are more prone to loneliness (40%) than their Nordic peers (28%). These patterns underscore the need to consider gender and age in addressing loneliness among the elderly, shedding light on the varying experiences of loneliness across these regions.

Background: In order to implement the necessary measures to prevent the consequences of the Covid-19 pandemics, long-term assessment of health status is needed. The objective of the study - to determine the prognostic factors of self-rated health deterioration during the first wave of Covid-19 pandemics. Methods: The study was based on a sample of individuals from wave 7, wave 8 and Covid-19 add-on of the Survey of Health, Ageing and Retirement in Europe (SHARE) in the period from 2017 till 2020. The sample size was 4429 respondents - Latvia: 649, Lithuania: 1083, Estonia: 2697. Descriptive statistics as well as univariate and multivariate binary logistic regression was performed, including health determinants, demographics and factors associated with Covid-19. Results: Based on univariate binary logistic regression analysis, the main predictors for deterioration of self-rated health (unadjusted OR; 95%CI) were: age 80+ years (reference group 50-59 years) for Estonia (3.03; 2.93-3.14), diagnosed with major condition since Covid-19 for Latvia (15.45; 15.14-15.77) and Estonia (6.75; 6.57-6.94), fair or poor health since Covid-19 for Lithuania (4.92; 4.86-4.99), loneliness since Covid-19 for Lithuania (5.03; 4.94-5.12), limited in activities due to health condition for Latvia (4.53; 4.42-4.64), depression since Covid-19 for Lithuania (3.78-3.71-3.85), limited in activities due to age for Latvia (3.01; 2.95-3.08), nervousness since Covid-19 for Lithuania (2.08; 2.04-2.12). All predictors were statistically significant for all three Baltic countries. Conclusions: The results in all three Baltic States indicated a similar trend that, taking into account the influence of other factors, the most important predictive factors were related to health and demographic indicators. Only one factor related to the first wave of Covid-19 (in Latvia - nervousness since Covid-19, in Lithuania and Estonia - less or no direct contact with children since Covid-19) predicts deterioration in health. Key messages: The results indicate that deterioration in health cannot currently be considered to be caused by the first wave of Covid-19. Further research to assess long-term impact of Covid-19 to health is needed.

The COVID-19 in the context of healthy ageing is associated with decline in body functional abilities and serious illness in older individuals. Regular assessment of ageing processes, including intrinsic capacity factors, provides an opportunity for better understanding of the individual’s functional abilities and vulnerabilities. Based on the data (2017–2020) from two waves (7 and 8) of the Survey of Health, Ageing and Retirement in Europe (SHARE), an evaluation and comparison of the intrinsic capacity factors of older individuals (50+ years) before and during COVID-19 was conducted, including data from 4422 individuals in Baltic countries (from Latvia – 648, Lithuania – 1079 and Estonia – 2695). Excellent or very good health status before the outbreak reported 35.3% respondents in Latvia, 54.9% in Lithuania and 45.3% in Estonia (p < 0.001). On worsened health status since the outbreak reported 7% respondents in Latvia, 13.8% in Lithuania and 5.9% in Estonia (p < 0.001). Feeling of nervousness, depression and loneliness during COVID-19 outbreak increased among all respondents, regardless of nationality and severity of symptoms before outbreak (p < 0.001). The results indicate that during COVID-19 outbreak respondents were experiencing deterioration in cognitive and psychological health. To maintain the level of individual’s functional abilities during situations like COVID-19 outbreak preventive actions are needed by promoting physical activities and social networks, especially for older individuals.