Specialists

Algologist – pain therapist who is familiar with pain formation mechanisms and is able to help prevent the suffering caused by pain.

Pain is the body’s warning signal that our existence is threatened. Therefore, the pain must be taken seriously, and the warning signs should not be silenced with pain relief medication. It is important to find the cause of pain and, if possible, a cure for their cause. If the disease is incurable or chronic pain formation system is irreversibly damaged, chronic pain really never stops persisting.

There are a number of chronic diseases causing pain – back, neck and shoulder pain, headache and migraine, rheumatism, joint pain, osteoarthritis, neuropathic pain due to diabetes, cancer, etc.

If the pain is very strong and persists over long period of time, the effects can be devastating on both mental and physical quality of life.

Algologist helps to relieve pain and to find a suitable solution.

Quality pain therapy can significantly improve well-being.

Pricelist of Specialist consultations

We offer allergist consultations and treatment of allergic illnesses.

Frequently asked questions before allergist consultation:

• Could prolonged rhinitis be allergy related?
• Could a long-term cough or coughing fits be allergy related?
• Are watery eyes and itchy skin associated with allergies?
• What can be done to clarify the cause of these complaints?
• What can be done to cure allergies and improve a patient’s quality of life?

Most of the initial visit is spent with the patient answering questions on:

• childhood and adult diseases;
• complaint intensity in different seasons, different times of day and during physical exertion;
• about well-being while in different rooms and surroundings;
• about possible complaints relating to food;
• efficacy of trialed treatments and medcines, etc.

The doctor will assess the patient’s skin, subcutaneous tissue, lymph node condition, examine the cardio – vascular system, and within limits will also assess the digestive system.

If no anti-allergy medications have been used eight to ten days prior the visit, it is possible to do skin prick tests.

Where there is shortness of breath, coughing or stridor, patients need to take a chest x-ray examination of thoracic organs, external respiratory function tests and breathing tests with bronchodilator medication.

If during the first visit a diagnosis is not specified further examinations are required:

• oesophagus, stomach examinations;
• allergy blood tests;
• bronchoprovocation testing;
• nitrous oxide in the expired air;
• CT of thoracic organs;
• ear, nose and throat (ENT) doctor consultation;
• gastroenterologist consultation.

Important factors in the treatment of allergies and prevention:

• suitable environment (living rooms without carpets, animals and green plants to reduce the quantity of a precipitating allergen);
• herbal remedy to fight house dust mites;
• air filters in your apartment and workplace;
• food selection;
• suitable physical activity;
• the need for self-control.

In pollen or house dust mite allergy cases allergen immunotherapy (vaccination) is considered as a  probable treatment. At the beginning a vaccine is administered once a week for three to four months. Later, injections are administered once a month for three to five years. The vaccine can also be taken orally.

Allergist consultations are paid by insurance companies.

Anaesthetists

Anaesthetist provides anaesthesia or narcosis and the maintenance of patient’s vital processes during surgeries and other medical manipulations. They also remove the pain during surgery and help to reduce it after surgery.

The doctor will examine the patient’s medical condition, results of other examinations and analysis, medical history, planned surgeries or types of medical manipulations. After that the doctor will assess whether an anaesthesia is possible and permissible for this particular patient. The anaesthesiologist will also assess any potential risks of anaesthesia, choose an appropriate and acceptable type of anaesthesia for each person and develop an anaesthesia plan for every individual patient. Relevant issues are discussed with patients and other professionals.

For the surgery to run smoothly:

• We will help you choose the most suitable type of anaesthesia for your intended surgery;
• We will prepare you before surgery and provide you with post-operative treatment;
• We will provide you with general information about the types of anaesthesia and personalized advice on your choice of anaesthesia, therefore reducing psychological distress before surgery;
• Before and after the surgery you will be monitored and taken care of by our staff.

For day-patient surgical operations the ARS Medcial company provides two types of analgesia – general anaesthesia or spinal anaesthesia.

Note:

General anaesthesia is a set of measures that, when the medication is administered(intravenously and by inhalation), achieves the loss of consciousness and painful sensations, as well as relaxing muscles, creating the conditions necessary for surgery. Before anaesthesia a cannula is always administered intravenously. It allows medication to be administered uninterrupted during the operation.

Through administering anaesthetic substances, consciousness is cut off and sleep-like state is maintained throughout the duration of the surgery. Using a mask or inhalation tube to access deeper airways the air is supplied in addition to oxygen and, if necessary, provide full ventilatory support. Tubes entered into airways (especially the trachea) fully protect the airways from the inhalation of saliva or stomach contents. At the end of the surgery anaesthetics are not supplied, their effect diminishes, conciousness returns, breathing and other vital function paramenters stabilise. At the end of the surgery you will be awoken, monitored and taken care of by our staff until you are ready to go home.

Spinal anaesthesia or regional anaesthesia provides pain relief in that specific part of the body on which the surgery will be performed – one or both of the legs/ posterior area. A local anaesthetic is administered around nerves which transport sensations from this region. This substance blocks nerve impulse transmission achieving insensitivity in the required area, meaning that the patient can stay awake during the surgery. During the operation only sedatives are administered, which reduce the potential psychological discomfort.

The most suitable type of anesthesia

The anaesthetist will select and recommend the most suitable type of anaesthesia, depending on the part of the body where the surgery will be performed. For example:

• For urology or proctology surgeries the most appropriate type of anaethesia is spinal anaesthesia, also known as a sciatic nerve block. Sciatic nerve block gives numbness to the buttocks, keeping leg movement.
• For trauma surgeries (arthroscopies) the most suitable is spinal anaesthesia where numbness occurs in only one of the legs, leaving the other leg free to move. Patients do not experience psychological discomfort as they do not feel paralyzed.

Note:

Numbness in the relevant part of the body will disappear after a few hours and the patient will be ready to return home. Spinal anaesthesia has a lesser effect on breathing and blood circulation, therefore it is more suitable for outpatient surgery.

At the ARS Medical Company day surgery anaesthesia services are provided by a physician anaesthesiologist – reanimatologist Dr. Aelita MEDJĀNE.

Anaesthesia services for lithotripsy procedures are provided by a physician anaethesiologist – reanimatologist Dr. Irēna Leite.

Our Breast Physician has specialised in benign and malignant breast diseases.

Breast diseases primarily affect women, but they sometimes affect men too. An oncologist-breast specialist consultation for men would be required in the event of an increase in breast glands (gynecomastia) or if a formation has been found in breasts.

More than 1000 Latvian women are diagnosed every year. When discovered early breast cancer is treatable, so it is important to undergo diagnostic examinations – mammography and breast ultrasound.

The ARS Medical Company offer the following breast diagnostic examinations:

• Mammography
• Breast ultrasonography (USG)
• Breast puncture under USG control
• Breast MRI exam

Doctor – specialist consultancy price list

Cardiologists

Cardiovascular diseases are typical of our age and are promoted by stress, sedentary lifestyles, poor nutrition and harmful habits. Increasing numbers of younger people are affected each year.

If you experience pain in the chest area, an erratic heartbeat and shortness of breath after slight activity – do not hesitate to check your heart health. At least once a year, check blood pressure, remember the basic principles of healthy eating, and check the lipids and cholesterol in the blood. High blood pressure and high low-density cholesterol is an important risk factor for serious cardiovascular diseases, but often does not cause any symptoms.

Cardiology specialists give consultations and draw up a comprehensive plan for an examination to assess the severity of disease, and select the most appropriate treatment.

We can perform a variety of heart examinations:

• Electrocardiogram at rest (ECG);
• Cardiac stress test;
• Ultrasound exams – echocardiography and Doppler (including transoesophageal) – also for children;
• Holter monitoring (24 hour ECG recording);
• Continuous computerized blood pressure registration.

The ARS Medical Center is the only Latvian out-patient institution where it is possible to perform a multilayer CT coronary angiography using modern 64-layer CT equipment. CT coronary angiography is a non-invasive method of heart (coronary) vascular permeability determination. Unlike invasive coronary angiography, CT coronary angiography does not require vascular catheterisation. The method is well tolerated, painless and performed on an outpatient basis.

We care for patients who suffer from chronic heart diseases. Cardiovascular diseases often occur together with diabetes, atherosclerosis affects the blood vessels of the brain, and other organ systems can be damaged too – kidneys, eyes. Therefore, various specialists are involved in the treatment process such as endocrinologists, ophthalmologists, nephrologists, neurologists, nutritionists and others.

Children also may suffer from cardiovascular diseases – ailments of the heart valves or the heart muscle changes. In our clinic consultations are given by our paediatric cardiologist and echocardiography specialist Dr. Inguna Lubaua. We perform foetal echocardiography and Doppler echocardiography examinations in cases of familial congenital heart diseases or in cases of suspected foetal heart disease during pregnancy.

Endocrinologists at the ARS Medical Centre consult in cases of diabetes, thyroid, pituitary, adrenal, metabolic disorders, increased body weight and other endocrine diseases.

A full examination is important in order to set a diagnosis and choose an appropriate treatment tactic, executed with the most sophisticated methods:

• The widest range or laboratory and hormonal diagnostic options are available at the E.Gulbis laboratory
• Ultrasound examinations (thyroid, abdominal organs, kidney, head and leg vascular examinations)
• CT, including angiography examinations,
• Magnetic resonance imaging,
• Scintigraphic examinations (thyroid nodules and parathyroid glands, kidney function determination)

The most common of endocrine diseases – diabetes and its complications – affect almost all organ systems. Therefore it is important that a wide variety of specialists are involved in the treatment process, such as cardiologists, neurologists, nephrologists, eye doctors, nutritionists and other specialists. Additionally, if the glucose metabolism is disrupted during pregnancy, the treatment requires close cooperation with gynaecologist.

The ARS Medical Centre employs highly qualified and experienced doctors – endocrinologists, who will both accurately diagnose disease and choose the best method of treatment.

Gastroenterologists

Gastroenterologists will help in cases of various gastrointestinal diseases, where there are problems with the oesophagus, stomach, duodenum, small or large intestine, pancreas or liver and biliary tract.

The most common gastroenterological diseases include gastroesophageal reflux disease (GERD), stomach and duodenal ulcer disease, chronic intestinal diseases, constipation of various origins, gallstones and biliary diseases, including functional indigestion.

Possible additional examinations

Gastroenterologist consultations include a detailed examination of the patient (lasting 30-45 min). If necessary, a patient is reffered to other examinations, which can be done at the ARS Medical Company Diagnotics department:

• Gastroscopy – upper endoscopy,
• Colonoscopy – lower endoscopy,
• Abdominal ultrasonography,
• Xray examinations – oesophagus and stomach examination, defecography,
• Helicobacter pylori diagnostics,
• CT examinations,
• MRI examinations.

Ginekologs

Ginekologs ir ārsts, kas specializējies sieviešu reproduktīvās veselības jautājumos, veic ginekoloģisko slimību diagnostiku, ārstēšanu un profilaksi.

ARS Sieviešu konsultācijā strādā pieredzējuši speciālisti – ārsti-ginekologi un vecmātes, kas nodrošina visu veidu ginekoloģisko palīdzību un grūtnieču aprūpi.

Kad ir nepieciešama ginekologa konsultācija?

Jebkuros jautājumos, kas saistīti ar sievietes reproduktīvo veselību.

Kā sagatavoties vizītei pie ginekologa?

Dodoties vizītē pie ginekologa, ja ir, līdzi jāņem visi ar konkrēto slimību saistītie izraksti un slēdzieni, kas saņemti slimnīcās, ambulatorās iestādēs un pie dažādiem speciālistiem. Tas ārstam palīdz iegūt maksimāli daudz informācijas, atvieglo diagnozes noteikšanu un izvēlēties piemērotāko ārstēšanas stratēģiju. Turklāt šī informācija palīdz taupīt laiku un līdzekļus, jo var gadīties, ka daži izmeklējumi jau ir veikti un vairs nav atkārto.

Kā norit vizīte?

Sarunā ar pacientu tiek noskaidrotas sūdzības, tiek veikta izmeklēšana, izskatīti līdzpaņemtie izmeklējumi un precizēta problēma. Ja nepieciešams, ārsts norīko pacientu uz papildus izmeklējumiem un nozīmē nākamās vizītes laiku.

Zināšanai:

Ginekologu kabineti ir aprīkoti ar modernu, augstas izšķirtspējas Philips HD15 ultraskaņas aparatūru, kas nodrošina nepieciešamās diagnostiskās informācijas ieguvi jau vizītes laikā. Ja nepieciešama padziļināta izmeklēšana – piedāvājam to veikt pie labākajiem ultrasonogrāfijas speciālistiem ar Premium klases ultrasonogrāfu Philips IU22.

Noderīga informācija

ARS sieviešu konsultācija sniedz maksas pakalpojumus, ko apmaksā vairākas apdrošināšanas sabiedrības.

 Medicīnas centrs ARS ir iesaistījusies dzemdes kakla vēža skrīninga programmā. Ar Nacionālā veselības dienesta uzaicinājumu vizīte pie mūsu klīnikas ārstiem ir maksas pakalpojums, bet par citoloģisko izmeklēšanu nav jāmaksā. Šajā gadījumā uzaicinājuma vēstule un tai pievienotā dzemdes kakla citoloģiskā materiāla skrīningtestēšanas karte kalpos kā nosūtījums uz valsts apmaksāto citoloģisko izmeklējumu – tādēļ neaizmirstiet to paņemt līdzi!

Mēs piedāvājam:

• ginekoloģisko saslimšanu ārstēšanu (tai skaitā endokrinoloģiskās saslimšanas ginekoloģijā),
• dažādu analīžu veikšanu,
• grūtniecības novērošanu, kardiotokogrāfiju (augļa sirds toņu pierakstu un novērtēšanu)
• ģimenes plānošanu un kontracepcijas izvēli,
• neauglības diagnostiku un ārstēšanu, sadarbībā ar reproduktīvās medicīnas centru Embrions
• menopauzes problēmu risināšanu,
• mūsdienīgu diagnostiku,
• ārstnieciskas procedūras un manipulācijas,
• ginekoloģiskas operācijas dienas stacionārā.

Ginekoloģiskā diagnostika:

• ultraskaņas izmeklējumi;
• ultraskaņas izmeklējumi grūtniecēm, tai skaitā 4D ultraskaņas izmeklējumi un augļa sirds izmeklējumi;
• ultrasonogrāfiska olvadu caurlaidības noteikšana;
• kolposkopija – dzemdes kakla izmaiņu diagnostika ar kolposkopu, ko izmanto, ja dzemdes kaklā vizuāli diagnosticēta patoloģija,
• histeroskopija – endoskopiska inrauterīnās patoloģijas diagnostikas metode, ko izmanto dzemdes dobuma iedzimtu anomāliju, dzemdes satrpsienu, saaugumu, olvadu intramurālās daļas patoloģiju, submukozu miomu diagnostikā, neskaidru dzemdes dobuma veidojumu un endometrija polipu diferenciālajā diagnostikā (ar vai bez biopsijas);
• aspirāts no dzemdes dobuma
• dzemdes kakla biopsija

Ginekoloģiskās manipulācijas un ārstnieciskās procedūras:

• lāzerterapija – metodi pielieto dzemdes kakla erozijas un endometriozes ārstēšanā, kondilomu un labdabīgu ādas, kā arī gļotādas veidojumu ablācijā, vulvas leikoplakijas ārstēšanā. Šī metode ievērojami samazina apkārtējo audu bojājumu un rētaudu veidošanos un brūces dzīšana ir ātrāka nekā lietojot citas metodes;
• kriodestrukcija (izmantojot šķidro slāpekļa gāzi);
• diatermokoagulācija ar elektrokoagulācijas aparatūru;
• dzemdes kakla medikamentoza apstrāde;
• intrauterīnas spirāles ievadīšana un izņemšana (cenā iekļauta lokālā dzemdes kakla anestēzija);
• vakcinācija pret cilvēka papilomas vīrusu – pieejamas 3 vakcīnas:
  • profilaktiskā kvadrivalentā cilvēka papilomas vīrusa (6.,11.,16., 18. tips) vakcīna Silgard pasargā no inficēšanās ar vīrusu, samazinot risku saslimšanai ar dzemdes kakla vēzi. Vakcīna indicēta meitenēm un sievietēm vecuma grupā no 9-26 gadiem. Vakcīnas sērija sastāv no 3 atsevišķām 0.5 ml devām, kuras ievada atbilstoši shēmai: 0.; 2.; 6. mēnesī.
  • dzemdes kakla vēža un pirmsvēža saslimšanu profilakses vakcīna CERVARIX ar tās sastāvā esošu novatoru adjuvantu sistēmu AS04. Trīs CERVARIX devu ievadīšana 0., 1. un 6. mēnesī izraisa augstu imunogenitāti meitenēm un sievietēm vecumā no 10 līdz 55 gadiem.
  • Gardasil 9 – tā ir vakcīna, ko lieto izteiktas dzemdes kakla displāzijas (CIN 2/3), dzemdes kakla karcinomas, izteiktu vulvas displastisku bojājumu (VIN 2/3) un ārējo dzimumorgānu smailo kondilomu (condyloma acuminata) profilaksē, ko izraisa cilvēka papilomas vīrusa (HPV) 6., 11., 16. un 18. tipi

Lai veiktu vakcināciju nepieciešams ārsta nosūtījums – ir derīgs gan Medicīnas centra ARS, gan citu medicīnas iestāžu ārstu nosūtījumi.

Dienas stacionārā iespējams veikt ginekoloģiskās operācijas:

• dzemdes dobuma un dzemdes kakla proves abrāziju;
• dzemdes dobuma vai kakla palipu noņemšanu;
• histerezektoskopiju;
• elektrokonizāciju;
• intrauterīnas spirāles ievadīšanu un izņemšanu narkozē.

Dienas stacionāra pakalpojumus aicinām izmantot gan Medicīnas centra ARS pastāvīgās klientes, gan citu medicīnas iestāžu klientes.

Vairāk informācijas par šiem pakalpojumiem

Pieteikšanās pā tālruni +371 67201061 vai +371 22010172:

• darbdienās 9:00 – 19:00,
• sestdienās 9:00 – 14:00.

Vakcinācijas cenrādis

Operācijas Dienas stacionāra – ginekoloģija

Internist

Micro-speech therapist’s classes on correct development of infant’s speech!

We offer classes for children of different age groups, instructing children and parents in Latvian and in Russian is possible.

Infants between 3 months and 1 year old

• Evaluation of pre-speech and psychomotor development, development and corrections: developmental irregularities
• Suction, swallowing and feeding disorders.
• Recommendations to parents and instructing parents on further successful child’s speech development and language learning:
  • activation of emotional communication and pre-speech expression,
  • promotion of psychic and physical skill learning by using age – appropriate developmental materials.
• Consultations and individual classes for parents with the child.

Toddlers between 1 and 3 years old

• Evaluation of development of non-talking or little talking toddlers.
• Evaluation of insufficient speech and language learning dynamics, development and correction.
• Recommendations to parents and instructing parents on further daily work with the child at home.
• Consultations and individual classes.

Children between 3 and 7 years old

• Evaluation of the child’s speech quality and language learning level, development and correction.
• Speech disorder correction.
• Help to preschoolers encountering difficulties to get ready for learning at school.
• Consultations and individual classes.

Branch of Medical Centre ARS
ARS Health Centre
Address – R. Blaumaņa Street 11/13, Riga
Phone: +371 67 699 369 or +371 27 827 224

An ophthalmologist or eye doctor is a doctor specialising in the detection, treatment and prevention of eye diseases and vision problems.

An ophthalmologist’s consultation is necessary:

• For children:
  • before the age of 12 months
  • during check-ups at the age of 3 and 6
  • if changes are observed in the development of the eyes and vision.
• For adults:
  • vision check is mandatory once in 1 to 3 years
  • once a year after reaching the age of 40
  • if recommended by a doctor
  • according to a treatment plan.

An ophthalmologist should be visited immediately in case of:

• a sudden loss of vision
• increased watering of the eyes
• unusual eye pain for no obvious cause
• sudden blurring of vision
• flashing lights in the eyes, followed by a dark spot
• a marked sense of dryness, stinging in the eyes
• swollen blood vessels on the white portion of the eye and red eyes.

For a complete visit, you should take with you the following:

• medical discharge reports of any previous eye surgeries or manipulations
• the glasses you’re wearing every day
• if you wear contact lenses habitually, a container to put them in.

Procedures performed during the first-time visit

• vision acuity check
• determination of subjective refraction and glass prescription
• intraocular pressure check
• visual field test
• microscopic examination of the frontal eye fields
• direct ophthalmoscopy exam
• indirect ophthalmoscopy exam
• determination of a diagnosis (if any)
• therapy prescription, if necessary.

If necessary, the ophthalmologist will prescribe additional diagnostic exams, manipulations, laser therapy, medication injections or recommend an eye surgery.

Please note:

In order to be able to examine the eyes and vision, eye-drops dilating the pupils are used during the exam. It can reduce visual acuity for up to 4 hours, so the patient should be aware in advance of the possible impairment of visual functions during this period, preventing from driving a vehicle, reading, writing, and generally from doing any serious work that requires good eye vision. To avoid the discomfort caused by sunlight and bright light, wearing sunglasses is recommended until the effect of the eye-drops is gone.

Childhood diagnosis

Childhood diagnosis clarification and treatment tactics for heart diseases always require heart Doppler echocardiography. Our clinic offers paediatric cardiologist consultations together with echocardiography examinations performed on the latest generation equipment. The visit includes full examination and diagnostics, recommendations for everyday life and physical activities, necessary medication prescriptions and further therapy.

Read more on echocardiographic examinations here.

Foetal echocardiographic examination

Foetal echocardiographic examination may be needed in cases of familial congenital heart diseases or in cases of suspected foetal heart disease during pregnancy. This examination is also available at our clinic.

In the ARS Diagnostic Clinic perform a survey

• MAGNETIC RESONANCE IMAGING (MRI) FOR CHILDREN
• COMPUTED TOMOGRAPHY (CT)

Flebologs (vēnu ārsts)

Ja  Jūs traucē pazīmes, kas norāda uz kāju vēnu saslimšanu – kā kāju pietūkums un “smaguma” sajūta, redzami vēnu mezgli vai kapilāru tīklojums – ir laiks doties pie flebologa. Flebologi ir speciālisti, kuri nodarbojas ar dažādu vēnu slimību diagnostiku un ārstēšanu. Biežākās vēnu slimības ir venozās asinsrites nepietiekamība, dziļo vēnu tromboze (nosprostojums) un tromboflebīts, jeb trombozēto vēnu iekaisums.

Mūsu klīnikā iespējams veikt kāju vēnu doplerogrāfisko izmeklēšanu (USG) un saņemt asinsvadu ķirurga- flebologa konsultāciju vienā ārsta apmeklējuma reizē – ietaupot gan laiku, gan naudu.

Ambulatorā praksē visbiežāk nākas saskarties ar venozās asinsrites nepietiekamību, kas izpaužas kā varikozi paplašinātas vēnas un vēnu zīmējums uz ādas. Šīs saslimšanas cēloņi ir dažādi – gan iedzimta nosliece uz vēnu sieniņu vājumu, gan sēdošs dzīvesveids, gan darbs profesijās, kur nepieciešams ilgu laiku pavadīt stāvus,  liela fiziska slodze (piem. sportistiem), arī grūtniecība un citi faktori.

Lai likvidētu šīs saslimšanas nepatīkamās vizuālās izpausmes, tiek lietotas dažādas metodes. Mūsu klīnikas dienas stacionārā, operējot pacientus, tiek lietota endolumināla lāzerablācija un virspusējo vēnu mikroķirurģiska izņemšana, savukārt kapilāru paplašinājumu likvidēšanai izmantojam putu skleroterapijas metodi.

Katram pacientam piemērotākā vēnu operācija vai operatīvo metožu kombinācija tiek izvēlēta, vadoties no pacienta vispārējā stāvokļa un slimības īpatnībām, kā arī iepriekš asinsvadus rūpīgi izmeklējot ar asinsvadu ultrasonogrāfijas metodi.

Pati vēnu operācija tiek veikta dienas stacionārā, bet jau pēc dažām stundām pacients var doties mājās. Par vēnu operācijām vairāk lasiet sadaļā Vēnu operācijas.

Gan varikozo vēnu slimības profilaksei, gan pēc operācijām nepieciešamas kompresijas zeķes, kuru uzdevums ir palīdzēt venozajai asinsritei kāju asinsvados. Par mūsu kompresijas zeķu piedāvājumu lasiet sadaļā Kompresijas zeķes.

VIDEO:

• Vēnu ārstēšanas iespējas

Psychiatrist

• Dr. Zigrīda TARANDA
• Dr. Ināra KLAGIŠA
• Dr. Pērs KIRKUPS

Psychotherapist:

• Dr. Ināra KLAGIŠA
• Anitas SALNĀJA

Cenrādis

Pulmonologist

Rheumatologist

A speech therapist is a doctor specialising in working with children and adults to identify the sounds missing in one’s speech and to teach the correct pronunciation of any sounds pronounced incorrectly.

Phonopaedia is a subdivision of speech therapy that combines knowledge of methods and techniques for eliminating voice impairments. The phoniatrician’s scope of competence covers issues related to the assessment of voice function and diagnostics for purposes of speech therapy as well as prevention of voice impairments.

Indications for seeking a consultation?

Voice impairments can occur at any age and are observed in 5-6 per cent of children and 3 per cent of adults. People working in professions based on the use of voice – professional singers, teachers, actors, presenters, barristers etc – are among the regular patients. Complete or partial loss of voice due to overload affects the ability to work and causes discomfort. A large proportion of laryngeal disorders are marked by voice function impairment:

• Organic disorders: singer’s nodes, polyps, Reinke’s oedema, haemorrhages;
• Functional disorders: dysphonia (various types), phonasthenia, abnormal voice mutations in children during puberty;
• Oncological diseases of the larynx (in cases where the client has undergone laryngectomy, an important part of the speech therapist’s or phoniatrician’s work is to teach the use of voice required for communication);
• Laryngeal nerve paresis etc.

Preparing for a visit

When going to see a speech therapist, you should take with you all abstracts from your medical record or discharge reports provided by hospitals, outpatient clinics and specialists, if any, that are related to the specific disorder or disease. This helps the doctor to obtain maximum information which facilitates establishing the diagnosis and helps choose the most appropriate treatment strategy. Besides, this information saves time and money as it may turn out that some of the medical examinations required have already been performed and it is not necessary to repeat them.

Course of treatment?

Prevention of voice impairments is a team work involving physicians, speech therapists or phoniatricians, psychologists and physiotherapists. Voice therapy is started upon doctor’s recommendations specifying the desired starting time of phonology exercises and the desired stress intensity of vocal cords. In case of individual functional voice impairments, e.g. in case of phonasthenia, a phoniatrician may perform an assessment of the orotundity (degree of fullness, strength and clarity) and quality of the voice and adopt an individual decision on starting exercises. A phoniatrician performs an auditory assessment of the voice.

The purpose of the phoniatrician’s work is to restore the sonority of the voice and to introduce it in the spontaneous speech. In the phoniatrician’s work, a great deal of attention must be paid to the prevention of voice impairments because only a well-trained voice and awareness of the vocal hygiene prevents loss of the voice. The most frequent methods used for the correction of voice impairments are phonopaedic methods which are based on a balanced gradual activation of the laryngeal muscles and development of proper breathing as well as use of orthophonic exercises.

Phonopaedic programme:

• Regimen to restrict voice usage;
• Breathing exercises;
• Exercises for strengthening neck and larynx muscles;
• Exercises for the voice;
• Vocal exercises.

Specialist services: speech therapist-phoniatrician Dace STRAUTMANE

Price-list

Ķirurgs ir ārsts, kurš specializējies iedzimtu un iegūtu slimību diagnostikā un ķirurģiskā ārstēšanā.

Our surgical department provides consultations with general surgeons and subdepartment specialists: vascular surgeon, reconstructive surgeon, spine surgeon, proctologist and phlebologist.

Kad nepieciešama ķirurga konsultācija?

Ja pacientam ir:

• hernia of the inguinal, umbilical area or in the abdomen;
• pain in the abdomen;
• pain in the rectal area and bowel disorders, with or without blood admixture;
• a variety of skin and subcutaneous formations (moles, lipomas, papillomas, etc.);
• dilated veins;
• skin and subcutaneous infections (furuncles, erysipelas);
• purulent hand, feet, finger and toe inflammations;
• various bruises, joint sprains;
• skin disorders (bruises, burns, etc.);
• poorly healing wounds and ulcers;
• wound (including postoperative) dressing.

Kā sagatavoties vizītei?

Dodoties vizītē pie ķirurga, ja ir, līdzi jāņem visi ar konkrēto slimību saistītie izraksti un slēdzieni, kas saņemti slimnīcās, ambulatorās iestādēs un pie dažādiem speciālistiem. Tas ārstam palīdz iegūt maksimāli daudz informācijas, atvieglo diagnozes noteikšanu un izvēlēties piemērotāko ārstēšanas stratēģiju. Turklāt šī informācija palīdz taupīt laiku un līdzekļus, jo var gadīties, ka daži izmeklējumi jau ir veikti un vairs nav atkārto.

Kā notiek vizīte?

Sarunā ar pacientu tiek noskaidrotas sūdzības, izskatīti līdzpaņemtie izmeklējumi un precizēta problēma. Ja nepieciešams, ārsts norīko pacientu uz papildus analīzēm, speciālistu konsultācijām vai izmeklējumiem.

For thorough diagnostics and treatment, the following tests are necessary:

• laboratory analysis;
• X-ray examinations;
• ultrasound examinations;
• endoscopic examinations (rectoscopy, fibrogastroscopy, fibrocolonoscopy):
  • rektoskopija,
  • fibrogastroskopija,
  • fibrokolonoskopija;
• CT examinations;
• magnetic resonance imaging.

Zināšanai:

If a trauma is sustained, it is necessary to process a wound or dress a wound. These services are provided by the ARS casualty ward on the ground floor of the clinic:

Medical Centre ARS
Skolas ielā 5, Rīga
1. stāvā every day from 8:00-20:00, Sundays – 9:00-20:00.

Cenrādis

Diagnostics is performed and individual footwear soles are made by certified technical orthopaedist Renars GOLDMANIS

Optical Photo-Plantoscopy – foot express diagnostics

Photo-plantoscopy is used to perform functional tests of the feet that help to monitor changes in the heel and other feet bones and identify overloaded segments of the foot.

An optical photo-plantoscopy is performed using a plantoscope illuminated by LED lights and additionally equipped with a built-in HD camera that takes pictures and videos of the feet.

Using this device, a technical orthopaedist performs an analysis of the posture, identification of the type and grade of flat feet (fallen arches), and also evaluates whether a technical aid is required. A medical report with an individual recommendation plan is prepared and issued for each client.

When is photo-plantoscopy recommended?

• It enables effective diagnostics not only for the flat feet but also for any other foot pathologies as well as for preventive purposes in case of musculoskeletal and neurological disorders.
• For people who have thickenings in their feet and problems in finding appropriate footwear.
• For athletes who need comfortable insoles for their sports shoes according to the individual sports specialisation requirements.
• For people after a feet, finger, knee or hip surgery. Limb length discrepancy can be determined if necessary.
• The procedure is safe and simple, it is also recommended for pre-school and school-age children in case of change in the posture or gait as well as in case of complaints of pain in the joints of the feet, knees or ankles.
• It is recommended for preventive purposes for those who spend the whole day in an upright posture; for women wearing high-heeled shoes on a daily basis; in case of overweight, diabetes or rheumatoid arthritis etc.

FYI: The plantoscopy procedure is informative, totally harmless and painless.

Medical company “Medicīnas centrs ARS”
Skolas str. 5, Rīga
Phone +371 67201007
www.arsmed.lv

Traumatologist-orthopedist

Traumatologist-orthopedist carry out diagnostic and therapeutic arthroscopy, blockades and other manipulations.

The ARS Medical Company provides patients with consultations from the leading Latvian traumatologists–orthopaedists with extensive experience in hospital work.

We provide assistance for various bone and joint diseases and injuries. If necessary, experts refer patients for additional tests, such as x-rays, ultrasound, magnetic resonance imaging, multilayer computed tomography and scintigraphy all which can be done in our medical institution.

The human skeleton consists of approximately 206 bones that are connected with each other as immovable joints, joints with a limited movement and flexible joints. In everyday life we don’t think about the mechanics of these movements. You raise your arm above your head or bend your knee without thinking. We are accustomed to relying on our bodies until … suddenly something starts to interfere.

One of the most frequently traumatized and the more vulnerable joints is the knee. Extensive load and high amplitude movements inflicted upon knee joints as well as the complex structure of the joint makes it vulnerable to frequent injury and illness.

What are the most common knee complaints?

Patient complaints can be divided into two groups – pain and instability.

Causes of knee joint pain:

• Pain in young people is more often associated with damage to the meniscus (patients remember the trauma episode, from which the complaint has developed).
• Pain for middle age people is frequently characterized by a meniscus tear, without a single injury – a rupture develops gradually, tissues tear and disintegrate under extensive loads (similar to a worn cloth).
• Pain in older people is generally due to joint deformation – arthrosis (a degenerative, progressive disease of the joints, which is characterized by changes in the articular surfaces). Joints forming cartilage surface become uneven and meniscuses get damaged too. With arthrosis progression changes in the bones appear – osteoarthrosis. It is a slowly progressive disease of the joints, which is characterized by entire joint structure damage, especially cartilage degradation and new bone formation (bone spurs), which causes structural and functional changes in the joints.

The second group of complaints is a feeling of insecurity or instability in the knee joint. The most common reason is a ligament tear. Untreated and unstable joints over time will be accompanied by pain.

Urologists at the ARS Medical Company help solve urological problems for both men and women.

• The most common urological problems in men:

  • Benign prostate diseases;
  • Prostate cancer – early diagnosis;
  • Erectile dysfunction;
  • Premature ejaculation;
  • Male infertility;
  • Men’s contraception – a vasectomy;
  • Sexually transmitted infection – diagnosis and treatment;
  • Testicular diseases – varicocele.

• The most common urological problems in women:

  • Urinary tract infection;
  • Urinary incontinence
  • Overactive bladder.

• Both sexes:

  • Kidney stones;
  • Urinary tract tumour early diagnosis – kidney, bladder tumours;
  • Congenital urinary tract malformations – duplex kidneys, horseshoe kidney;
  • Patient monitoring after cancer treatment.

The ARS Medical Company gives access to all the latest and most advanced urological examinations, including flexible cystoscopy – an endoscopic bladder examination. The ARS Medical Company is the only outpatient clinic that provides urodynamic testing.

We also provide lithotripsy or in other words kidney stone removal procedure which is paid for by the National Health Service (NHS).

If needed, an urologist will refer patients for additional exams, for example,

• scintigraphy,
• magnetic resonance imaging,
• computed tomography
• ultrasonography.

These are provided by the ARS Medical Company using high-end diagnostic equipment. We offer physiotherapy during which a biofeedback method is used, by training and strengthening the pelvic floor musculature.

Pricelist

Asinsvadu ķirurģija ārstē asinsvadu sistēmas, artēriju un vēnu  slimības, pielietojot medikamentozas un ķirurģiskas metodes. Fleboloģija ir asinsvadu kirurģijas nozare, kas ārstē vēnu slimības (vairāk lasīt šeit).

Asinsvadu sistēmas bojājumi rodas aterosklerozes rezultātā. Ateroskleroze ir viena no biežāk sastopamajām asinsvadu slimībām, kas  sašaurina asinsvadus vai arī  tos slēdz. Progresējot aterosklerozei, attīstās maģistrālo artēriju slimības. Nereti  artēriju slimības (sašaurinājumi, slēgumi, asinsvadu sieniņu pārmaiņas – aneirismas) noved pie citu orgānu bojājumiem.  Daži piemēri:

• kāju artēriju stenozes (artēriju sašaurināšanās) vai oklūzijas (slēgšanās) gadījumos pacients sūdzas par izteiktām sāpēm kājās (staigājot),   mijklibošanu un salšanas sajūtu kājās.  Dažreiz sāpes kājās atkārtojas arī miera stāvoklī un naktīs. Slimībai progresējot, parādās trofiskas čūlas uz pēdam, var attīstīties gangrēna.
• miega artērijām ievērojami sašaurinoties, ir raksturīgas galvas sāpes, reiboņi, koordinācijas traucējumi, īslaicīgs aklums, samaņas zuduma epizodes, bet smagākajos gadījumos attīstās galvas smadzeņu infarkts ar attiecīgās ķermeņa puses paralīzi vai parēzi.
• paplašinoties vēdera aortas  aneirismam līdz 5 cm diametrā un lielākam, rodas riska faktori tās plīsumam.

Asinsvadu saslimšanu veicina šādi faktori:

• smēķēšana;
• aptaukošanās;
• cukura diabēts;
• paaugstināts asinsspiediens;
• paaugstināts holesterīna līmenis asinīs;
• cilvēka vecums – vīrieši virs 45 gadiem, sievietes virs 55 gadiem;
• asinsvadu slimības iepriekšējās paaudzēs.

Agrīna un precīza asinsvadu artēriju patoloģiju diagnostika, kā arī  savlaicīga to ārstēšana ļauj saglabāt pacienta dzīves kvalitāti.  Tādēļ liela nozīme, izvēloties ārstēšanas taktiku, ir precīzai diagnostikai, izmantojot mūsdienīgas un ļoti informatīvas metodes  – Duplex asinsvadu ultrasonogrāfiju, CT angiogrāfiju, u.c.

Vertebrologist – spine surgeon