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Thyroid disorders in pregnancy - immunoendocrinological and metabolic aspects
Vítková, Hana ; Jiskra, Jan (advisor) ; Kosák, Mikuláš (referee) ; Posová, Helena (referee)
Background: The immunological, hormonal and metabolic changes occur during pregnancy and increase the risk of developing some diseases. The aims of this study were: to compare serum concentrations of antibodies against C1q component of complement (anti-C1q) and mannose-binding lectin (MBL) in pregnant women with autoimmune thyroid disease (AITD) and healthy pregnant women and to compare urinary iodine concentration (UIC), neonatal thyroid stimulating hormone (TSH) and other thyroid laboratory parameters in pregnant women with gestational diabetes mellitus (GDM) and healthy pregnant women. Patients and methods: The "anti-C1q" study included 96 pregnant women with AITD and three control groups: 80 healthy pregnant women, 72 non-pregnant women with AITD and 72 healthy blood donors. The "MBL" study included 212 pregnant women with AITD and 80 healthy pregnant women, and the "urinary iodine concentration" study included 195 pregnant women with GDM and 88 healthy pregnant women. Anti-C1q and MBL concentrations were measured by ELISA, UIC by absorption spectrophotometry after previous alkaline demineralization, and other parameters by standard immunoassay. Results: The anti-C1q and MBL serum concentrations were higher in pregnant women with AITD compared to controls. The anti-C1q concentrations were...
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Aspiration biopsy of the thyroid - the significance of evaluation according to Bethesda classification, differentiated carcinoma incidence in autoimmune thyroiditis
Srbová, Libuše ; Čáp, Jan (advisor) ; Fryšák, Zdeněk (referee) ; Jiskra, Jan (referee)
Aspiration biopsy of the thyroid - the significance of evaluation according to Bethesda classification, differentiated carcinoma incidence in autoimmune thyroiditis. Introduction: Improved diagnostics led to an increased number of detected thyroid nodules. Sonography and fine needle thyroid biopsy has become the basic method for thyroid nodules evaluation. Since 2010 the Bethesda System for Reporting Thyroid Cytopathology is used in some centres. Another common thyroid disease is autoimmune thyroiditis. According to some older studies a nodule in a patient with thyroiditis has a higher risk of malignancy. Current opinions dispute these findings. The difference in data appears to depend primarily on whether cytological or surgical findings are analysed. Objective: The aim of our study was to reclassify thyroid biopsy results according to the Bethesda categories in patients who underwent thyroidectomy and to determine the malignant potential of the individual categories. We then determined in equivocal cytological findings whether the recommendations for surgery, the type of cytologic atypia and the results of repeated biopsies had an impact on the incidence of malignant findings. Another objective was to identify how autoimmune thyroiditis affects the risk of thyroid cancer, particularly by comparing...
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Iodine status among pregnant diabetic women
Radiměřská, Veronika ; Jiskra, Jan (advisor) ; Límanová, Zdeňka (referee)
Inroduction: The target of practical part was to verify the concentration of iodine in the urine (UIC) and its relation to the other thyroid parameters in the blood of pregnant diabetic women in second or third trimester of pregnancy. Methods: We have measured UIC in 163 pregnant women screened positive for pregestational or gestational diabetes in second trimester of pregnancy. I have worked later with results from 154 of them. Currently, serum levels of autoantibodies against thyroid peroxidase (TPOAb) and thyroglobulin (TgAb), thyroid-stimulating hormone (TSH), free thyroxine (FT4) and trijotyronin (FT3) were determined. Results: Median UIC was 91,15 ug/L (range 67,7-112 ug/l). At 136/154 (88 %) women UIC was lower than 150 ug/L, median 86,95 ug/L (range 64,95-106,4) and at 90/154 (58 %) was lower than 100 ug/L. UIC in the range with mild iodine deficiency (50-149 ug/L) was measured at 117/154 (76 %) women and 19 (12,3 %) values were found in the range of moderate UIC deficiency (20-49 ug/L). No value of UIC was lower than 20 ug/L. At 7 (4,5 %) women were measured levels in the adequate range for pregnant women (150-249 ug/L). At 11 women (7,2 %) was UIC higher than 250 ug/L. Conclusion: At 88 % pregnant diabetic women in second or third trimester of pregnancy was identified UIC values at...
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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Computer analysis of ultrasound images of thyroid nodules, focusing on their sonographic features and cytological findings.
Procházka, Antonín ; Smutek, Daniel (advisor) ; Rožánek, Martin (referee) ; Jiskra, Jan (referee)
Ultrasound imaging is one of the fundamental examinations of thyroid nodules, determining whether a patient undergoes a cytological examination, which is essential for the decision on a possible thyroid surgery. Unfortunately, the cytological examination has limited specificity and potential surgery carries risks. Therefore, other diagnostic methods are being sought with hope that they will be able to bring more certainty into diagnostics. One of the new methods is computer-aided diagnosis (CAD), which exhibits promising results using image analysis and machine learning. In this study, we present two somewhat similar, yet different, CAD approaches. The first approach is based on analysing entire nodules using a Segmentation Based Fractal Texture Analysis (SFTA) algorithm that splits the image into individual grayscale bands. Using this approach, we have achieved an accuracy of 92.4% using random forests (RF) and 95% using support vector machines (SVM) on a data set of 40 images evaluated by the cross-validation method. The second CAD approach is also based on the method of multiple image thresholding, but the difference is, that a larger number of predictors describing the binary texture are extracted from the individual grayscale bands. Furthermore, the analysis did not take place on whole nodules, but on...
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Thyroid autoimmunity and thyroid nodule elasticity - relation to thyroid nodule biological nature.
Krátký, Jan ; Jiskra, Jan (advisor) ; Gabalec, Filip (referee) ; Smutek, Daniel (referee)
Thyroid nodules represent a very common pathology. Using modern high-resolution ultrasound, nodules could be found in up to 68 % of patients. The most important task is the diagnosis of thyroid cancer which represents only about 5-15 % of nodules, however the incidence is still growing. Even with the use of a fine needle aspiration biopsy, it is not always possible to decide on the biological nature of the nodule. A significant proportion of such patients have to undergo thyroid surgery for diagnostic reason. Thyroid surgery is associated with risks to the patient and financial costs to the health-care system. In recent decades, the efforts to improve non-invasive diagnostics of thyroid nodules have been made. The thyroid elastography and thyroid autoimmunity are among the examined risk parameters. Using real-time strain elastography, thyroid carcinomas elasticity has been significantly reduced compared to benign thyroid nodules in our group of patients. The elastography of thyroid nodules can be used as a suitable complement to conventional sonographic examination. In our work, the combination of both methods (conventional ultrasound and elastography) increased the negative predictive value compared to both methods individually. The results of our work further indicate that, in case of absence of...
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Effect of small side games and runs on performance in sprints and agility in soccer players.
Jiskra, Jan ; Kokštejn, Jakub (advisor) ; Malý, Tomáš (referee)
Title: Influence of small side games and runs on sprint performance and agility in football players. Purpose: The aim of the thesis is to find out the influence of selected movement interventions (small side games versus runs) on sprint performance and agility in elite football players in U14 category during the preseason period. Methods: The 30-meter Sprint was used to rate speed-strength performance. Players have executed 2 sprints at 30m. Sprint time was measured at 5, 10 and 30m. Agility tests included: test 505 and three-step test. Players also have executed 2 tries (one of each leg). A set of photocells (Alge Timing GmbH, Lustenau, Austria) was used to measure the time of all tests. Results: Both groups significantly improved in the three-step test (p <0.05; r> 0.5). The SSG group, after a two-month intervention, significantly deteriorated in the sprint to 5, 10 and 30m (r = 0.38 - 0.69). The race group did not significantly improve in sprints at 5, 10 and 30m. In the agility test, we saw a significant improvement only in the Run groups and only on the left leg (r = 0.42). Based on the findings, we believe that the training units of the linear speed and speed with the change of direction maintain the level of player's speed during the season. Therefore, I recommend that they should appear in...
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Weight and BMI in relation to the dose of levotyroxin of patients with hypothyreosis
Radiměřská, Veronika ; Jiskra, Jan (advisor) ; Ježková, Jana (referee)
The objective of this study was to define if there is a mutual influence between the daily dose of levothyroxine, positivity/negativity of thyroid antibody, BMI, waistline, hip measurement and other anthropometric parameters. It was also to analyze if the daily dose of levothyroxine is being influenced by degree of hypothyroidismimportance. Methodology: There were 44 patients examined having hypothyroidism and who have been cured with levothyroxine so that their thyroid function has been normal at the time. I have examined those patients' body height, weight, BMI, waistline and hipline. Under the supervision of the medicine doctor I used records available for each of patients regarding concentration of TSH, TPOAb and TgAb, which were defined with patients' blood by a method of immunoassay. Results: The average daily dose of levothyroxine in all patients sample has showed a positive correlation with BMI (Spearman rho coef. 0,429, P value=0,004) and with waistline of women (Spearman rho coef. 0,332, P value=0,028). The concentration of thyroidantibody did not show a statistical relevance regarding the dependence with the dose of levothyroxine, BMI or other anthropometric parameters.The highest average daily dose of levothyroxine was confirmed for examined patients after total thyroidectomy (median of...
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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Aspiration biopsy of the thyroid - the significance of evaluation according to Bethesda classification, differentiated carcinoma incidence in autoimmune thyroiditis
Srbová, Libuše ; Čáp, Jan (advisor) ; Fryšák, Zdeněk (referee) ; Jiskra, Jan (referee)
Aspiration biopsy of the thyroid - the significance of evaluation according to Bethesda classification, differentiated carcinoma incidence in autoimmune thyroiditis. Introduction: Improved diagnostics led to an increased number of detected thyroid nodules. Sonography and fine needle thyroid biopsy has become the basic method for thyroid nodules evaluation. Since 2010 the Bethesda System for Reporting Thyroid Cytopathology is used in some centres. Another common thyroid disease is autoimmune thyroiditis. According to some older studies a nodule in a patient with thyroiditis has a higher risk of malignancy. Current opinions dispute these findings. The difference in data appears to depend primarily on whether cytological or surgical findings are analysed. Objective: The aim of our study was to reclassify thyroid biopsy results according to the Bethesda categories in patients who underwent thyroidectomy and to determine the malignant potential of the individual categories. We then determined in equivocal cytological findings whether the recommendations for surgery, the type of cytologic atypia and the results of repeated biopsies had an impact on the incidence of malignant findings. Another objective was to identify how autoimmune thyroiditis affects the risk of thyroid cancer, particularly by comparing...
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