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Evaluation of pilot project examination of thyroid gland function in group of pregnant women
Drncová, Jana ; Límanová, Zdeňka (referee) ; Springer, Drahomíra (advisor)
In 2009 took place in selected regions of the Czech Republic pilot project examination of thyroid gland function, through which was tested the proposed scheme of screening of pregnant women. In terms of screening for congenital defects were women in the 1st trimester of pregnancy investigated with the informed consent on TSH, FT4 and anti-TPO in serum. In the case of positive result, woman has been informed immediately and she was undertaken in care of endocrinologist. The project involved 13 pre-selected laboratories. To determine the analyte were used immunoassay methods which differed in individual laboratories and so were also used different reference intervals too. In frame of the project was examined a group of 2843 women with an average age of 29,4 years. In total were captured 19,6% women with a positive finding. From the whole investigated group had elevated TSH 235 women (8.5%), of whom had reduced FT4 34. Reduced level of TSH had 96 females (3.5%), of whom had a slightly elevated FT4 14 women. Elevated anti-TPO had 9% of women. The outcome of the project showed what is the willingness for cooperation between gynecologists and laboratories and where are the weaknesses of the project. It was verified the economic aspects of screening and also was confirmed relatively large number of women who...
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Progression of thyroid diseases in women with thyroid gland disorder diagnosed during pregnancy
Krejčová, Simona ; Límanová, Zdeňka (referee) ; Springer, Drahomíra (advisor)
Diploma thesis is based on a four-year study the goal which was to demonstrate on a group of pregnant and postpartum women the frequency and severity of thyroid disease in pregnancy and after childbirth, and thus support the introduction of screening of function thyreidopathias into normal practice within screening for congenital defects in first trimester of pregnancy. In 3937 sera from women in the 10th - 12 week of pregnancy were, with informed consent of pregnant, determined TSH and anti TPO, in the case of FT4 deviation. Of the total number of examined 6,4 % had TSH higher than 4,00 mIU/l, 4,2 % with TSH less than 0,1 mIU/l and 12,4 % of women with positive anti TPO antibodies. 552 women were recommended visiting endocrinology. 106 pregnant women came to be endocrinologically tested to Third Internal Clinic of VFN and 1st LF UK which is the equivalent to 19,2 % of all positive hits and 2,7 % of all investigated over the period. Only 56 women (52,8 %), came for subsequent checks in which the monitoring of the disease continued. After the endocrinologic examination in pregnancy 60,4 % of women was diagnosed with subclinical hypothyroidism. This subclinical form developed in 39 % of women into an overt hypothyroidism 24 - 30 months after childbirth. Overall, the disease progressed in 41.1% of women....
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The level of autoantibodies against procathepsin D in the different sets of patients
Prokopová, Veronika ; Dršata, Jaroslav (advisor) ; Springer, Drahomíra (referee)
VERONIKA PROKOPOVÁ THE LEVEL OF AUTOANTIBODIES AGAINST PROCATHEPSIN D IN THE DIFFERENT SETS OF PATIENTS ABSTRACT Cathepsin D (E.C. 3.4.23.5, CD) is lysosomal aspartic peptidase syntetized in all of the mammal cells and the ability to catalyze the hydrolitic cleavage peptidic bonds in peptides or proteins belongs to its basis characteristic. During the long-standing research it was discovered, that there exist an increased expression of CD in tumorous cells, which is more than 50 times higher than in normal cells and which leads to secretion of CD from these cells. Only enzymatically inactive zymogen procathepsin D (pCD) with intact activation peptide (AP) attached is being released by the tumorous cells. It was shown, that this activation peptide is probably responsible for the mitogenic activity in the tumorous cells. It comes up very often to the creation of antitumor immune response against tumor antigens at patients suffering from tumorous condition. Determination of these autoantibodies and analysing of diagnosed antigens could employed as diagnostic and prognostic markers. The aim of our study was to verify the hypothesis, that the level of autoantibodies against AP pCD could be employed for diagnostic purposes, first of all as a new tumorous marker. It was necessary to develop and optimalize ELISA...
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Investigation of thyroid disorder in pregnancy and reference intervals in evaluation of maternal thyroid function
Springer, Drahomíra ; Zima, Tomáš (advisor) ; Průša, Richard (referee) ; Zamrazil, Václav (referee)
The importance of maternal thyroxine for the development of the fetus brain early in pregnancy has received increasing acceptance. It has more recently become evident that maternal hypothyroxinemia results in the birth of children with decreased mental and psychomotor development. In our group of 7,530 women in 9-11 week of pregnancy were determined TSH, anti TPOAb and FT4. For evaluation of results was necessary to set reference intervals for pregnant women. The TSH reference interval was determined to be 0.06 - 3.67 mU/l and for FT4 9.8 - 23.43 pmol/l was used. The limit for anti-TPO positivity was determined to be 143 kU/l. A raised concentration of TSH was found in 5.14% of women; and a suppression of TSH was found in 2.90% of women and 11.5% of pregnant women were found positive. Serum concentrations of FT4 were lower in TPOAb positive as compared to TPOAb negative women and differences of FT4 in euthyroid women with suppressed, normal and elevated TSH were found. (...) In Czech Republic, case finding screening is able to disclose only about 20% of asymptomatic mild or deep hypothyroidism or women with positive anti TPO in pregnancy. Foreign study report 70% of these high-risk pregnant women, consequently is evident need of general screening of pregnancy thyroid failure in Czech Republic. Moreover the...
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