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Phenomenon of homelessness in contemporary Czech society in confrontation with situation and approach in EU
Vízek, Martin ; Háva, Petr (advisor) ; Angelovská, Olga (referee)
The aim of this thesis is an analysis of aspects of establishment of publicly political issue of homelessness in contemporary Czech society. It focuses in particular on the analysis of the dimension of the selected issue and on detecting and defining of various resolution examples applied to homelessness within the framework of the Czech Republic and European Union. It attempts to survey the contemporary homelessness situation in the Czech Republic by means of methods selected from the sphere of public politics from the perspective of experts, general public as well as the perspective of the people without shelter themselves by means of registration of their individual stories acquired by direct questioning. One of the substantial components of the thesis comprises the delimitation and definition of the cognitive problem which constitutes the initial stage for the comprehension of surveyed issue and implementation of the analysis from the perspective of public politics. The thesis focuses in particular on the issue of homelessness in the Czech Republic and on the aspects closely connected with the phenomenon, which reflects in the mirror of public politics at most.
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Retrospective diagnosis of unknown cause of sudden infant death
Strnadová, Kristina ; Lebl, Jan (advisor) ; Janda, Jan (referee) ; Plavka, Richard (referee) ; Vízek, Martin (referee)
Background: Sudden infant death syndrome (SIDS) is defined as sudden unexpected death of an infant that remains unexplained after thorough post-mortem examination, investigation of the scene of death and case history. The autopsy findings and the physiological characteristics of these infants suggest a possible role of insufficient cardiorespiratory control and arousal mechanisms. The etiology is probably multifactorial based on a genetic predisposition combined with environmental factors. Several candidate genes have been studied, e.g. those involved in serotonin transport, autonomic nervous system embryology, inflammation, energy production, nicotine and glucose metabolism. A small number of cases may be caused by monogenic diseases that can lead to sudden death and leave no characteristic autopsy findings and thus imitate SIDS. Fatty acid beta-oxidation disorders (FAOD) have been associated with SIDS since 1976 and it is nowadays estimated that they may be responsible for about 1% of SIDS cases. Congenital long QT syndrome, a cardiac channelopathy, that may cause a fatal arrhythmia was a logical candidate for SIDS and indeed it was found out that about 9,5% of SIDS cases carry a mutation or a function changing variant in one of seven cardiac ion channel genes. We assumed that the severe salt...
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New biomarkers for prognostication after cardiac arrest
Vondráková, Dagmar ; Málek, Filip (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Cardiac arrest is an extremely serious condition characterized by global ischemia followed by reperfusion after successful resuscitation and restoration of spontaneous circulation. Despite all advances in current medicine, the prognosis of cardiac arrest survivors remains very poor. One of the major problems in these patients is, therefore, the early and reliable determination of the prognosis that is necessary for choosing the most appropriate diagnostic and therapeutic approach. However, the current possibilities for early prognostication in cardiac arrest survivors remain very limited. The aims of our work were: (i) to study the possibilities of influencing oxidative stress as one of the key pathogenic factors involved in the development of so-called post-cardiac arrest syndrome; and (ii) to determine the prognostic value of copeptin, neuron-specific enolase (NSE) and markers of oxidative stress in cardiac arrest survivors. In the experimental part of the work we used porcine model of cardiac arrest for the comparison of the effects of hypothermia, ischemic postconditioning (IPC) and administration of nitric oxide (NO) on oxidative stress burden and organ damage; we found that neither NO nor IPC did have a superior protective effect over hypothermia. In the clinical part we have in several...
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Novel Approaches To Protect The Heart Against Postischemic Failure
Hrdlička, Jaroslav ; Papoušek, František (advisor) ; Zicha, Josef (referee) ; Vízek, Martin (referee)
Ischemic heart disease and resulting heart failure (HF) belong to the leading causes of death in developed countries. In order to prevent HF and improve clinical outcome in patients with myocardial infarction, novel therapies are required to protect the heart against the detrimental effect of ischemic injury. Due to the failure to translate numerous available experimental cardioprotective strategies into clinical practice, the need for novel protective treatments persists. We have, therefore, tried to apply a novel approach to cardiac protection against the postischemic HF induced in rats by ligation of the coronary artery. For this purpose, we have studied (i) the preventive and therapeutic effects of adaptation to continuous normobaric hypoxia (CNH; 12% O2) and exercise training (ExT; treadmill running), and (ii) the possible cardioprotective potential of epoxyeicosatrienoic acid (EET)-based therapy in order to attenuate the postischemic HF in rats. Adaptation to CNH and ExT is known for their cardioprotection in acute ischemia/reperfusion (I/R) injury manifested as reduction of infarct size. EETs exert antihypertensive effects and thus seem to be perspective for the research in clinically relevant models of cardioprotection in hypertensive animals. Our results have revealed that: - CNH prior to...
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Mild therapeutical hypothermia and oxidative stress after cardiac arrest
Krüger, Andreas ; Ošťádal, Petr (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Successfull cardiopulmonary resuscitation is an essential life-saving tool; nevertheless, general ischemia during cardiac arrest may trigger different pathways that could turn even into a fatal damage; this condition is called post-cardiac arrest syndrome. It has been repeatedly shown that oxidative stress (OS) plays one of the key roles in the development of ischemia-reperfusion injury. However, current evidence on the possible participation of OS in the pathogenesis of post-cardiac arrest syndrome is insufficient. We tested following hypotheses: (i) ischaemia-reperfusion injury after cardiac arrest is accompanied by OS and (ii) mild therapeutical hypothermia decreases OS cardiac arrest. In the experimental part of our work we studied the effects of hypothermia and normothermia on hemodynamic parameters, markers of organ damage and on the OS burden in porcine model of cardiac arrest. Furthermore, we compared the effects of hypothermia with ischaemic postconditioning and nitric oxide administration in the porcine model of extracorporeal cardiopulmonary resuscitation. We found protective effects of hypothermia on all major endpoints including OS in comparison with normothermia; moreover, hypothermia improved also selected variables compared to ischemic postconditioning and nitric oxide. In the...
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New biomarkers for prognostication after cardiac arrest
Vondráková, Dagmar ; Málek, Filip (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Cardiac arrest is an extremely serious condition characterized by global ischemia followed by reperfusion after successful resuscitation and restoration of spontaneous circulation. Despite all advances in current medicine, the prognosis of cardiac arrest survivors remains very poor. One of the major problems in these patients is, therefore, the early and reliable determination of the prognosis that is necessary for choosing the most appropriate diagnostic and therapeutic approach. However, the current possibilities for early prognostication in cardiac arrest survivors remain very limited. The aims of our work were: (i) to study the possibilities of influencing oxidative stress as one of the key pathogenic factors involved in the development of so-called post-cardiac arrest syndrome; and (ii) to determine the prognostic value of copeptin, neuron-specific enolase (NSE) and markers of oxidative stress in cardiac arrest survivors. In the experimental part of the work we used porcine model of cardiac arrest for the comparison of the effects of hypothermia, ischemic postconditioning (IPC) and administration of nitric oxide (NO) on oxidative stress burden and organ damage; we found that neither NO nor IPC did have a superior protective effect over hypothermia. In the clinical part we have in several...
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The role of protein kinase C and its targets in cardioprotection
Holzerová, Kristýna ; Hlaváčková, Markéta (advisor) ; Alán, Lukáš (referee) ; Vízek, Martin (referee)
The mortality of cardiovascular diseases remains high and it likely tends to increase in the future. Although many ways how to increase the resistance against myocardial ischemia- reperfusion damage have been described, few of them were transferred into clinical practice. Cardioprotective effect of chronic hypoxia has been described during 60s of the last century. Its detailed mechanism has not been elucidated, but a number of components has been identified. One of these components presents protein kinase C (PKC). The role of PKC was described in detail in the mechanism of ischemic preconditioning, but its involvement in the mechanism of cardioprotection induced by chronic hypoxia remains unclear. One reason is the amount of PKC isoforms, which have often contradictory effects, and the diversity of hypoxic models used. The most frequently mentioned isoforms in connection with cardioprotection are PKCδ and PKCε. The aim of my thesis was to analyze changes in these PKC isoforms at two different cardioprotective models of hypoxia - intermittent hypobaric (IHH) and continuous normobaric hypoxia (CNH). We also examined the target proteins of PKCδ and PKCε after the adaptation to IHH, which could be involved in the mechanism of cardioprotection. These included proteins associated with apoptosis and...
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Mild therapeutical hypothermia and oxidative stress after cardiac arrest
Krüger, Andreas ; Ošťádal, Petr (advisor) ; Vízek, Martin (referee) ; Rokyta, Richard (referee)
Successfull cardiopulmonary resuscitation is an essential life-saving tool; nevertheless, general ischemia during cardiac arrest may trigger different pathways that could turn even into a fatal damage; this condition is called post-cardiac arrest syndrome. It has been repeatedly shown that oxidative stress (OS) plays one of the key roles in the development of ischemia-reperfusion injury. However, current evidence on the possible participation of OS in the pathogenesis of post-cardiac arrest syndrome is insufficient. We tested following hypotheses: (i) ischaemia-reperfusion injury after cardiac arrest is accompanied by OS and (ii) mild therapeutical hypothermia decreases OS cardiac arrest. In the experimental part of our work we studied the effects of hypothermia and normothermia on hemodynamic parameters, markers of organ damage and on the OS burden in porcine model of cardiac arrest. Furthermore, we compared the effects of hypothermia with ischaemic postconditioning and nitric oxide administration in the porcine model of extracorporeal cardiopulmonary resuscitation. We found protective effects of hypothermia on all major endpoints including OS in comparison with normothermia; moreover, hypothermia improved also selected variables compared to ischemic postconditioning and nitric oxide. In the...
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Experimental pulmonary embolism - pathophysiological aspects
Mizera, Roman ; Herget, Jan (advisor) ; Lischke, Robert (referee) ; Vízek, Martin (referee)
- Experimental pulmonary embolism, pathophysiological aspects MUDr. Roman Mizera Theoretical part of the thesis deals with mechanisms of pulmonary hypertension after pulmonary embolism (PE) and summarizes the knowledge of literary sources in this issue. Peripherally deals with the mechanical obstruction of pulmonary vessels, particularly discusses vasoconstriction after the PE. In the experimental part are described three separate experiments. The first experiment tested effect of reactive oxygen species (ROS) and preventive administration their scavenger - superoxide dismutase inhibitor tempol on basal perfusion pressure, vasoconstriction, NO synthase activity and the production of NOx after acute PE. Results show that after PE grows NO synthase activity and the production of NOx, the administration of tempol reduces basal perfusion pressure and vasoconstriction after PE. In the second experiment, we measured basal perfusion pressure and vasoconstriction after PE in lungs exposed to 5 day chronic hypoxia. We tested influence of PDE-5 inhibitor sildenafil on the pulmonary vessels tone. Sildenafil decreased basal pressure after PE in chronic hypoxia, its administration does not affect the pulmonary vasoconstriction of pulmonary vessels, but increases their compliance. The last project tested effect...
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Aspects of identification of patients with primary ciliary dyskinesia
Djakow, Jana ; Cinek, Ondřej (advisor) ; Vízek, Martin (referee) ; Panczak, Aleš (referee)
Primary ciliary dyskinesia (PCD) is a rare but underdiagnosed genetic disease. This innate disorder of motile cilia causes a non-functional mucociliary clearance which is the main reason for a clinical picture of recurrent or chronic upper and lower respiratory tract infections. Fertility disorders or abnormal organ situs can also be found in some patients. The diagnosis of PCD is extremely complicated and complex. A combination of several diagnostic procedures as well as skilled personnel and special technical equipment are usually needed for the PCD diagnostics. Although significant progress has been made in understanding the PCD etiopathogenesis and the advanced diagnostics has become available, therapeutic possibilities are rather limited and the treatment efficiency still remains to be confirmed by the evidence base medicine. The dissertation thesis assembles several publications in which different aspects of primary ciliary dyskinesia were addressed. The most extensive part of our research addressed rapidly evolving possibilities of PCD genetic diagnostics. We studied possibility of priority sequencing of several segments of the genes DNAH5 and DNAI1 which were known to be the most frequently mutated genes in the PCD patients at the time of the study. We proved this method being able to...
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