Sperm DNA damage in men from infertile couples

Aim： To investigate the prevalence of high levels of sperm DNA damage among men from infertile couples with both normal and abnormal standard semen parameters. Methods： A total of 350 men from infertile couples were assessed. Standard semen analysis and sperm chromatin structure assay （SCSA） were carried out. Results： Ninety-seven men （28% of the whole study group） had a DNA fragmentation index （DFI） 〉 20%, and 43 men （12%） had a DFI 〉 30%. In the group of men with abnormal semen parameters （n = 224）, 35% had a DFI 〉 20%, and 16% had a DFI 〉 30%, whereas these numbers were 15% and 5%, respectively, in the group of men with normal semen parameters （n = 126）. Men with low sperm motility and abnormal morphology had significantly higher odds ratios （ORs） for having a DFI 〉 20% （4.0 for motility and 1.9 for morphology） and DFI 〉 30% （6.2 for motility and 2.8 for morphology） compared with men with normal sperm motility and morphology. Conclusion： In almost one-third of unselected men from infertile couples, the DFI exceeded the level of 20% above which, according to previous studies, the in vivo fertility is reduced. A significant proportion of men with otherwise normal semen parameters also had high sperm DNA damage levels. Thus, the SCSA test could add to explaining causes of infertility in cases where semen analysis has not shown any deviation from the norm. We also recommend running the SCSA test to choose the appropriate assisted reproductive technique （ART）.

Computed tomography perfusion measurements for definition of lesions in early acute stroke

Background: Perfusion computed tomography (CT) is an evolving technique in the diagnosis of acute stroke. After complex deconvolution algorithms, perfusion color maps-cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT)— are produced, they give visual confirmation of perfusion deficit in ischemic area, but some discrepancies exist regarding this technique in reliability of quantitative detection of tissue viability: penumbra (tissue at risk) that surrounds core (necrosis). Purpose: The purpose of this prospective study was to define brain tissue viability grade on the basis of the perfusion CT parameters in acute stroke patients. Material and Methods: Multimodal CT imaging protocol (unenhanced CT of the brain, CT angiography of head and neck blood vessels, followed by brain perfusion CT and 24 hours follow-up brain CT) was performed. Perfusion deficit was detected first visually, with subsequent manual quantitative and relative measurements in affected and contra-lateral hemisphere in 87 patients. Results: Visual perfusion deficit on perfusion CT images was found in 78 cases (38 female, 40 male;mean age 30 - 84 years): penumbra lesion (n = 49) and core lesion (n = 42). Both lesion types were detected by increased MTT on perfusion CT map, penumbra area showed mean values 202.40% (113% - 345% ± 57.17) and core (41% - 320% ± 64.53) in comparison to contra-lateral hemisphere. CBV mean values in penumbra group were increased up to 113.10% (45% - 276% ± 36.29) and in core decreased till 41.82% (3% - 107% ± 27.09). CBF values were decreased up to 65.63% (31% - 137% ± 22) in penumbra lesion and markedly decreased till 25.94% (4% - 79% ± 17.35) in core. Conclusion: Our study shows that perfusion CT measurements relative threshold values are recommended in definition of penumbra and core lesions in acute stroke patients.

Risk factors for musculoskeletal injuries in the military: a qualitative systematic review of the literature from the past two decades and a new prioritizing injury model

Background: Musculoskeletal injuries(MSkIs) are a leading cause of health care utilization, as well as limited duty and disability in the US military and other armed forces. MSkIs affect members of the military during initial training,operational training, and deployment and have a direct negative impact on overall troop readiness. Currently, a systematic overview of all risk factors for MSkIs in the military is not available.Methods: A systematic literature search was carried out using the PubMed, Ovid/Medline, and Web of Science databases from January 1, 2000 to September 10, 2019. Additionally, a reference list scan was performed(using the “snowball method”). Thereafter, an international, multidisciplinary expert panel scored the level of evidence per risk factor, and a classification of modifiable/non-modifiable was made.Results: In total, 176 original papers and 3 meta-analyses were included in the review. A list of 57 reported potential risk factors was formed. For 21 risk factors, the level of evidence was considered moderate or strong. Based on this literature review and an in-depth analysis, the expert panel developed a model to display the most relevant risk factors identified, introducing the idea of the “order of importance” and including concepts that are modifiable/nonmodifiable, as well as extrinsic/intrinsic risk factors.Conclusions: This is the qualitative systematic review of studies on risk factors for MSkIs in the military that has attempted to be all-inclusive. A total of 57 different potential risk factors were identified, and a new, prioritizing injury model was developed. This model may help us to understand risk factors that can be addressed, and in which order they should be prioritized when planning intervention strategies within military groups.

Association between inherited monogenic liver disorders and chronic hepatitis C

AIM:To determine the frequencies of mutations that cause inherited monogenic liver disorders in patients with chronic hepatitis C. METHODS:This study included 86 patients with chronic hepatitis C(55 men, 31 women; mean age at diagnosis, 38.36 ± 14.52 years) who had undergone antiviral therapy comprising pegylated interferon and ribavirin. Viral load, biochemical parameter changes, and liver biopsy morphological data were evaluated in all patients. The control group comprised 271 unrelated individuals representing the general population of Latvia for mutation frequency calculations. The most frequent mutations that cause inherited liver disorders [gene(mutation): ATP7B(H1069Q), HFE(C282Y, H63D),UGT1A1(TA)7, and SERPINA1(PiZ)] were detected by polymerase chain reaction(PCR), bidirectional PCR allele-specific amplification, restriction fragment length polymorphism analysis, and sequencing. RESULTS: The viral genotype was detected in 80 of the 86 patients. Viral genotypes 1, 2, and 3 were present in 61(76%), 7(9%), and 12(15%) patients, respectively. Among all 86 patients, 50(58%) reached an early viral response and 70(81%) reached a sustained viral response. All 16 patients who did not reach a sustained viral response had viral genotype 1. Casecontrol analysis revealed a statistically significant difference in only the H1069Q mutation between patients and controls(patients, 0.057; controls, 0.012; odds ratio, 5.514; 95%CI: 1.119-29.827, P = 0.022). However, the H1069Q mutation was not associated with antiviral treatment outcomes or biochemical indices. The(TA) 7 mutation of the UGT1A1 gene was associated with decreased ferritin levels(beta regression coefficient =-295.7, P = 0.0087). CONCLUSION: Genetic mutations that cause inherited liver diseases in patients with hepatitis C should be studied in detail.

The value of magnetic resonance spectroscopy and diffusion tensor imaging in characterization of gliomas growth patterns and treatment efficiency

The objective of the study was to assess the usefulness of magnetic resonance spectroscopy (MRS) and diffusion tensor imaging (DTI) in detection of vital tumor cell infiltration presence in peritumoral brain areas and determination of biochemical changes in the brain parenchyma after received treatment. 73 patients with present, morphologically conformed brain gliomas and 77 gliomas patients in remission stage after combined therapy underwent magnetic resonance imaging (MRI) including MRS and DTI. Fractional anisotropy (FA) and metabolite ratios—choline/creatine (Cho/Cr), myoinositol/creatine (MI/Cr), lactate-lipid/creatine (LL/Cr), N-acetyl aspartate/creatine (NAA/Cr)—were measured in the tumor, perifocal edema zone, distant and contra-lateral normal appearing white matter. We observed gradual reduction of Cho/Cr, MI/Cr, LL/Cr mean ratios and step-by-step increase of NAA/Cr, FA mean values in the direction from the tumor to the distant and contra-lateral normal-appearing white matter. LL/Cr ratios within distal normal appearing white matter decreased in patients after radiotherapy/chemotherapy. Our study suggests that MRS and DTI in combination with structural MRI sequences enhance vital glial tumor cells areas and possible infiltration border. MRS and DTI quantitative measurements in the glioma peritumoral area reveal pathological changes, despite the normal signal intensity in structural MRI. We suggest that increased LL/Cr ratios and decreased FA values may have the superior implications in the detecting of glial tumors extent along the white matter tracts. NAA/Cr reduction and Cho/Cr increase may provide additional diagnostic value. LL/Cr ratio in distal normal signal intensity area could be used as radiation/chemotherapy effectiveness criteria, as this will reduce after the received treatment and in remission period.

Polyprenols isolated from Picea abies L.spruce needles influence atorvastatin-mediated muscle strength weakness in Wistar female rats

OBJECTIVE To assess the effects of polyprenols(isolated from Picea abies L.spruce needles)on muscle strength/tone and coordination,and to investigate whether polyprenols may protect atorvastatin-mediated muscle strength/tone weakness in female Wistar rats.METHODS Polyprenols at doses of 1,10 and 20mg·kg-1,atorvastatin 80mg·kg-1 or their combination were administered once daily per os for 16 consecutive days in Wistar female rats(n=9-10 per group).Assessment of muscle strength was performed by grip strength test(on day 15)and wire hang test(on day 16).Rotarod test was used to measured locomotor coordination and muscle tone(on day 16).General locomotor activity was evaluated in open field test(on day 15).Assessment of plasma cholesterol level and creatine kinase activity was done on day 17.RESULTS Atorvastatin-treated rats exhibited a marked decrease in grasping strength and hanging time.PP(20mg·kg-1)significantly protected against atorvastatin-induced muscle weakness in grip strength test,and restored it to control values.At all doses,polyprenols prolonged hanging time which was decreased by atorvastatin in wire hang test.Polyprenols per se at 1 and 10mg·kg-1 did not show difference compared to control group animals,while only at 20mg·kg-1 h anging time was prolonged vs.control in wire hang test.No changes between control and tested groups were observed in rotarod and open field tests.Blood cholesterol level was not changed in any of tested groups in female Wistar rats.Polyprenols(20mg·kg-1)significantly(by 25%)increased plasma creatine kinase activity but it was not affected by the combined treatment.CONCLUSION Since polyprenols acted as protectors of atorvastatin-induced muscle weakness,the combination of polyprenols with atorvastatin may be helpful for reducing muscle-related side effects in patients receiving a long-term atorvastatin therapy.

Amorphous Calcium Salt Composition Bioavailability Evaluation in Chickens

Despite the market saturation with a wide range of calcium preparations in dietary supplements as well as in pharmaceuticals, calcium product safety and efficacy remain an item for further optimization. Bones and teeth mainly consist of calcium phosphate, but tablets and capsules are predominantly produced from calcium carbonate. On the other hand, in human food Ca2+ is bound with a lot of anions—carbonates, sulphates, chlorides, phosphates, citrates, oxalates etc. It seems that traditional calcium formulations due its low bioavailability cannot provide all spectra of biological calcium-dependant effects and dietary calcium might be safer and more effective than traditional calcium supplements and medicines. To increase calcium salt efficacy a new formulation of calcium salts has been developed. It is a mixture (water suspension) of amorphous calcium carbonate, citrate, hydrocarbonate, as well as magnesium hydrocarbonate and hydrocitrate as stabilizers. The capacity of a cockerel’s duodenal mucosa to absorb Ca2+ after peroral ingestion of the mentioned composition in vivo was as much as 126% higher in comparison with CaCO3 suspension intake. Vitamin D3 enhanced the amorphous antirachitic activity of calcium salts. The aim of the study was to compare original amorphous calcium salt composition bioavailability with Ca salts most often in food and medicines, as well as to evaluate the antirachitic activity of the mentioned composition in combination with vitamin D3 in chickens.

Red Beetroot Juice and Stamina: An Experimental Study

Introduction: Red beet juice is increasingly used in sports to enhance the endurance of athletes. To increase the specific efficiency of red beet juice, the method of its fractionation by ultrafiltration was used for the first time. The purpose of the study was to evaluate the effect of fractionated beetroot juice on the strength and endurance of laboratory rats. Methods: Male Wistar rats (6 groups;n = 10) were used in the study. In addition to the standard chow, some groups of rats 2 h before the exercises received 0.5 ml of native (RBJ) or fractionated (FRBJ) per os. Three groups of animals were trained using a motorized wheel with a gradual speed increase over four weeks: 20 min/day for five days a week. Muscle strength of animals in all groups was measured by electronic dynamometry and the endurance of rats was evaluated once a week using electrical stimulation on a racetrack which moved at a speed of 15 m/min. The test was performed an hour after the ingestion of RBJ or FRBJ. At the end of the experiment, biochemical blood indices were determined. FRBJ was prepared by the original method. Results: Most significant differences in the chemical composition of RBJ and FRBJ were found for glutamic acid, of which the content was 67.2% higher than in native juice. The greatest changes during the experiment were in the mass of the rats’ calf muscles. Regular running exercise caused a 29% increase in muscle mass. The additional increase in m. gastrocnemius was also provided y FRBJ – 12%. The combination of physical activity and the introduction of red beet derivate led to the increase of the calf muscle mass by 121% within a month. Assessing the endurance of animals by frequency of falling from the treadmill, we can conclude that compared with untrained animals, trained rats receiving FRBJ had three times higher levels of endurance. Conclusion: Consumption of FRBJ led to increased muscle strength in rats and the ergogenic effect of the product was significantly higher in combination with physical activity.

After the ＂Oligarchs＂： Argumentation Strategies in the Parliamentary Elections Campaigns

During the period of time starting from 9th Saeima Latvian political scene changed significantly. Emergency parliamentary elections in autumn 2011 completely changed Latvian Republic＇s political scene. So-called ＂oligarchs＂ parties disappeared from the scene and since the elections government leader is liberal-conservative, center-right party. Changes in political discourse were expected also viewing parties election programs. Whether the discourse changed not only theoretically, but practically？ Communication with electorate provides citizens information to be able to vote for the appropriate candidate. Argumentation and speakers interaction are important aspects in the context of political discourse. Unlike more empirical discourse analysis, argumentation theory and its descriptive and evaluative elements intend critical dimension. In the study presented argumentation analysis of media materials is made according to Walton＇s argument classification model. Conclusions about political culture in Latvia are made based on the arguments used by political actors. In the big picture results of the study are related to democratic state order.

Occurrence of Legionella pneumophila in Hot Potable Water in Latvia

Legionellae are found in freshwater environments or wet soil, but the major reservoirs are man-made aquatic environments, particularly warm water systems. Our aim was to study the occurrence of Legionella contamination in hot potable water supply systems in apartment and public buildings. Correlations between Legionella spp. positive cases and water source, sampling point and temperature of hot water at the point of consumption were studied. A total of 149 hot water samples were collected in 16 cities and districts of Latvia. Only Legionella pneumophila was isolated. L. pneumophila was found in 63 out of 149 （42%） hot water samples. From all Legionella spp. positive samples, 17% represented L. pneumophila serogroup 1 and 78% L. pneumophila serogroups 2-14 （15）. In 5% of Legionella spp. positive samples, both serogroups 1 and 2-14（15） were isolated. Statistically significant differences were observed in the distribution of L. pneumophila serogroup 1 in samples from various water sources. L. pneumophila was found in 45% of samples from private apartments and in 27% of samples from public buildings. Data analysis confirmed that the temperature of hot water significantly affects the frequency of L. pneumophila positive cases （p 〈 0.05）. Data showed that 85% of consumers received hot water at a temperature below 50°C.

Cooperation and Collaboration Impact on Policy Development: HIV/AIDS Policy in Latvia

This article describes a case study of trends of governance approach implementation in the health policy development and implementation process in Latvia, in the state in transition, or “new democracy”. Latvia became an independent democratic state in 1991, regaining its freedom after being part of the Soviet Union for 50 years. As the three Baltic States (Latvia, Lithuania, and Estonia) had a common history and starting point in the health reform implementation, the data of Human Immunodeficiency Virus (HIV) incidence and implemented policy steps were analyzed and compared of all the three states. The research provides insight into the HIV/Acquired Immune Deficiency Syndrome (AIDS) situation in Latvia from the time when the first patient was diagnosed till nowadays, describing the initiatives that were implemented to combat the spread of HIV infection and analyze the impact of different stakeholders in the policy development and implementation process. Although the main reform implementation actors in Latvia were Non-Governmental Organizations (NGOs) or patient organizations by performing cooperation and collaboration with all the actors involved in the policy development and implementation process, more profound investigation reveals that major impact came from “old democracies”, international and global organizations as well as from physicians and commercial powers by providing a suitable environment for the reform development.

Non-paraneoplastic Anti-NMDAR Encephalitis： First Confirmed Adult Case Report in Latvia

Anti-NMDAR （Anti-N-Methyl-D-aspartic acid） encephalitis is a rare autoimmune condition mainly affecting young women. It is associated with an underlying tumor in about 50% of reported cases. Antibodies directed against the GIuN1 subunit of the NMDA receptor are responsible for the disease pathogenesis and their detection in the patient＇s serum and cerebrospinal fluid are required to make a definite diagnosis. Classical clinical presentation consists of flu-like symptoms, followed by psychiatric disturbances and impaired consciousness, epileptic seizures and movement disorders. During the past decade, it has become an emerging area of research and discussion as more than 1,000 cases have been reported since the first description of this specific disease entity in 2007. Despite a rather typical clinical course it is frequently diagnosed and treated with a delay up to many months. Overall prognosis tends to be favorable. However, it strongly depends on early diagnosis and rapid treatment initiation. While diagnostic criteria for probable and definite anti-NMDAR encephalitis have been proposed, there are no evidence based guidelines for specific treatment strategies. Glucocorticoids, plasma exchange and IVIG are generally used as 1 st line treatment, in patients who do not respond, 2nd line treatment with Cyclophosphamide or Rituximab is used. We report a case of a confirmed non-paraneoplastic anti-NMDAR encephalitis with a rather classical manifestation in a Latvian woman who is first hospitalized in a psychiatric clinic then transferred to an ICU （intensive care unit）, treated with glucocorticoids, plasma exchange and later Cyclophosphamide with a good outcome.

Vaccum Extraction-Maternal and Neonatal Complications

The purpose of this research was to evaluate the complications for the mother and newborn, using vacuum extraction, and to compare them with spontaneous delivery. This study included group of vacuum-assisted deliveries in time period 2014-2016 （n = 726） in Riga Maternity Hospital, and it was compared to the group of spontaneous vaginal deliveries （n = 726）. Data statistically processed in Microsoft Excel mid SPSS Statistics 22.0. Results of the study： in vacuum-assisted deliveries vaginal lacerations was 13.8% more, cervical lacerations was 9.8% more than in group of spontaneous vaginal deliveries, perineal lacerations were 25.6% less in group with vacuum extraction, neonatal cephalohematomas was 26.9% more, and clavicle factures was 3.3% more in vacuum-assisted deliveries. Vacuum extraction was used for the first delivery in 86.9% of cases, for the second delivery 10,9% of cases. Vacuum-assisted deliveries in comparison with spontaneous vaginal deliveries are associated with higher risks for maternal soft tissue ruptures and neonatal cephalohematomas, clavicle factures. It is important to evaluate the indications for use of vacuum extractor. Staff skills, using vacuum extraction method, should be at a high level.

Patients’ Level of Knowledge of State-Funded Screening Programs in Family Physician’s Practice

Introduction： Screening tests have been shown to find cancer early and to reduce the risk of dying from cancer. In Latvia from 2000-2015 registered oncological patients had increased. At the end of year 2015, the 74,540 patients with oncology were registered. Aim： To evaluate respondents’ knowledge about screening and the reasons for non-use screening. Materials and methods： A cross-sectional study uses a survey of family physician’s patients. Responded data were summarized and processed with IBM SPSS 23 descriptive and analytical statistics. Results： In this study 102 patients’ survey data are used, at age group from 50 to 74 years. And 67% （n = 68） from of overall respondents were women, and 33% （n = 34） of respondents were men. The 35% of respondents visited family doctor 5 to 10 times per year, 29%-2-5 times per year, 19%-more than 10 times per year and 17%-once per year. Knowledge about screening programs of all respondents： 21% （n = 21） rated it as good, 26% （n = 27） rated it as bad and 53% （n = 54） rated it as average. And 49% of respondents said that screening includes colorectal cancer test, 65% that screening includes cervical cancer test, and 62% noted that screening includes mammography. Respondents identified the following reasons why they cannot use screening： 22% lack of informative material, 11% fear that diagnosed oncology, 14% do not feel that this is important, another 53% of respondents always use screening. Correlation was found between the number of family doctor’s visit per year and respondent’s knowledge about screening programs （p = 0.015, r = 0.24）. Conclusions： Despite the increased number of health improvement campaigns, lack of knowledge about screening programs still exists. The results show that half of respondents still do not use screening. Population health and knowledge can be improved by regular health check through family physician.

Lyme Disease： Features of Diagnostic and Management Strategies amongst Latvian General Practitioners

Introduction： Lyme disease （LD）-disease caused by bacteria, spread by ticks. The most common sign is an erythema migrans that begins at the site of a tick bite about a week after it has occurred. LD has been treated by antibiotics. Aim： To figure out the most common LD diagnostic and treatment strategies among general practitioners （GPs） in Latvia and evaluate it basing on worldwide guidelines. Materials and methods： Quantitative cross-sectional study. Main material： GPs of different gender and age. Respondents （R） completed the survey voluntarily, anonymously. Data analysis done by using Microsoft Office Excel 2010 and SPSS 22.0. Results： In total, 126 R were included. 32-Riga, 46-other cities and 48-rural areas. Analysis has shown dependence between percent of using guidelines and location of GP＇s practice. And 70% of FD in Riga use LD guidelines in their practice, 20% use lecture materials and 10% use their previous experience. Among GPs in other cities of Latvia 46.4% use guidelines, 50% -lecture materials and only 3.6% use their previous experience. And 70.6% of GPs from rural areas base on lecture materials, 18.5% on guidelines and 11.1% on their previous experience. Analysis of knowledge about early symptoms of LD has shown that 30-45 years old GPs orient themselves in it better, then elder colleagues. Conclusions： GPs in cities use guidelines more often. Elder colleagues much worse orient themselves in theoretical information. I＇m looking forward to creation of uinted LD diagnostic guidelines for Latvian GPs.

Extramammary Paget’s Disease Manifested by Intraepithelial Adenocarcinoma of the Vulva and Anus Combined with Invasive Adenocarcinoma of the Ampullary Part of the Rectum

The Object of the Study: The author of the given paper describes an unusual combination of two diseases: extramammary Paget’s disease manifested by intraepithelial adenocarcinoma of the vulva and anus combined with invasive adenocarcinoma of the ampullary part of the rectum and describes the atypical manifestations of these diseases. The Content: The content of this research paper includes a description of the patient, an analysis of the clinical picture, diagnostic methods and therapeutic interventions used, a report of the following disease, and the result of the presented case. The Result of the Research Work: The result of the research work is the analysis of a clinical case with two different tumors, where such a combination of tumors is rarely described in the literature. Moreover, no large specific sample with this combination of diseases is available. Patient Characteristics: The given case report describes a patient of the Palliative Care Unit of the Gerontology Clinic with a primary diagnosis of C20-rectal adenocarcinoma in the background of the anal canal, perineal skin Paget’s disease, stage IV. The presented complications of the patient’s primary diagnosis are multiple metastases in the liver;status post palliative chemotherapy;hepatomegaly;metastases to abdominal lymph nodes, inguinal lymph nodes;metastases at Th12, L4 level;pain syndrome. The presented above combination of diagnosed diseases is very rare. Applied Diagnostics: In October 2021, it was performed diagnostic manipulation: biopsy and the pathologist have provided a microscopic description. The first tissue fragment had a pronounced electrothermal lesion and the epithelial structures were not valuable. The second skin tissue fragment was covered with hyperplastic and acanthotic epithelium;its basal and middle layers contained multiple large cells proliferates extending into the medial epidermis, and the cytoplasm of these cells reacted positively with PAS (Periodic Acid Schiff reaction). It needs to be noted that the patient had previously had several years of biopsies from the perineal and anal epidermis, where Paget’s disease had also been diagnosed. The performed immunohistochemistry showed these cells to be CK20 positive, CK7 rare positive and p16 negative. The following pathohistological findings were made: morphological and immunohistochemical picture is consistent with Paget’s disease. According to the ICD-10, the patient was diagnosed with C51 malignant neoplasm of the female external genitalia. Using imaging diagnostics, it became clear that the patient’s rectal adenocarcinoma had progressed to metastatic stage with distant liver metastases in the background of anal canal, perineal skin Paget’s disease. Therapeutic Plan of the Patient: Based on the patient’s main diagnoses, the complications of the principal diagnosis, the patient’s overall severe condition, pain syndrome, age and comorbidities, palliative chemotherapy was approved as a therapeutic option in council of doctors. Monitoring and Outcome of the Patient: The patient’s general condition was becoming worse over time, and she was diagnosed with exitus latalis in December 2022. At that time, the patient was discharged from hospital and was on palliative care at home under the control of her family physician.

Composition of Cereal Bars

The aim of this study was to analyze ingredients of cereal bars--as indicated on the labels of these products, and to perform a factual analysis of nutritional values indicated therein. The analysis of the nutrients of cereal bars was performed at the laboratory of the Institute BIOR （BIOR Institute of Food Safety, Animal Health and Environment）. Results showed that information about nutrients indicated on the labels mostly does not correspond to the actual values, however, they lie within the tolerance range and are lower than the actual determined value. Cereal bars are a source of fiber, but have high sugar content.

Pathological Complete Remission in Young Colon Cancer Patient with a Large Liver Metastasis after FOLFOX-4/Bevacizumab Treatment-A Case Report

Introduction. Pathological complete remission of liver metastases is a rare colon cancer treatment outcome with increased 5-year survival of 76%. Case report. Metastatic colorectal cancer patient with pathological complete remission of large hepatic metastasis after palliative chemotherapy in combination with bevacizumab is presented. Solitary liver metastasis measuring 8 cm was observed in computed tomography (CT) scan before combined treatment. The best radiological response during treatment with FOLFOX-4 and bevacizumab therapy was partial remission and patient underwent partial hepatectomy. Since the operation material was free of viable adenocarcinoma cells the effect of FOLFOX-4 in combination with bevacizumab treatment was interpreted as the pathological complete remission. Conclusion. Use of combination chemotherapy and targeted therapy with the aim to reduce initially unresectable liver metastasis is the best option to achieve complete pathological remission and significantly prolong survival.

Effects of food quality on trade-offs among growth, immunity and survival in the greater wax moth Galleria mellonella

The resources available to an individual in any given environment are finite, and variation in life history traits reflect differential allocation of these resources to competing life functions. Nutritional quality of food is of particular importance in these life history decisions. In this study, we tested trade-offs among growth, immunity and survival in 3 groups of greater wax moth （Galleria mellonella） larvae fed on diets of high and average nutritional quality. We found rapid growth and weak immunity （as measured by encapsulation response） in the larvae of the high-energy food group. It took longer to develop on food of average nutritional quality. However, encapsulation response was stronger in this group. The larvae grew longer in the low-energy food group, and had the strongest encapsulation response. We observed the highest survival rates in larvae of the low-energy food group, while the highest mortality rates were observed in the high-energy food group. A significant negative correlation between body mass and the strength of encapsulation response was found only in the high-energy food group revealing significant competition between growth and immunity only at the highest rates of growth. The results of this study help to establish relationships between types of food, its nutritional value and life history traits of G. mellonella larvae.