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Analysis of the therapy in patients with juvenile idiopathic arthritis
Procházková, Martina ; Malý, Josef (advisor) ; Rozsívalová, Petra (referee)
Abstarct Analysis of the Therapy in Patients with Juvenile Idiopathic Arthritis Author: Martina Procházková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Methotrexate (MTX) is an effective and safe drug used for the treatment of juvenile idiopathic arthritis (JIA) and is well-known like a golden standart in the treatment of this serious illness. The aim of this study was analysis of therapy in patients with JIA focusing on MTX and faktors affecting its intolerance. Methods: The study was undertaken from January 2017 to February 2018 at the Department of Paediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University in Prague. Patients younger than 18 years old, who have become ill with JIA for the first time or repeatedly between years 2015-2017 and were treated by MTX were included in this study. The prevalence of MTX intolerance was measured by "Methotrexate Intolerance Severity Score" questionaire every 3 months during regular rheumatological examinations. Simultaneously, medical records were reviewed. Data analysis was performed by means of descriptive statistics, correlation dependence and statistical signifikance of dependence was assessed with statistical two-choice...
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Markers of joint inflammation related to disease activity in rheumatoid arthritis.
Hurňáková, Jana ; Pavelka, Karel (advisor) ; Horák, Pavel (referee) ; Hrnčíř, Zbyněk (referee)
Background: Rheumatoid arthritis (RA) is a common chronic autoimmune disorder characterised by persistent synovitis, typically manifested as symmetric polyarthritis of small hand joints with various extra-articular manifestations. Accurate disease activity measurement is a key component of RA management that facilitates therapeutic optimalization in order to slow down the disease progression and to prevent an irreversible joint damage. The aim of this work was to study the role of candidate serum inflammatory markers and their associations with the disease activity in patients with RA presented by traditional variables of disease activity as well as by musculoskeletal ultrasonography. Results: The first part of our work pointed out relationship between serum calprotectin and clinical as well as ultrasound activity in RA. We have revealed that serum calprotectin is an independent predictor of ultrasound synovitis. Moreover, we have demonstrated the potential of calprotectin to identify patients with residual activity in spite of achieving clinical remission. In the second part, we have provided a detailed analysis of 20 candidate serum markers and found out a tight associations between IL-6, IL-7, IL-22, IL-34, YKL-40, CXCL-13, MMP-3, resistin and visfatin with clinical and ultrasound activity....
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Analysis of the therapy in patients with juvenile idiopathic arthritis
Procházková, Martina ; Malý, Josef (advisor) ; Rozsívalová, Petra (referee)
Abstarct Analysis of the Therapy in Patients with Juvenile Idiopathic Arthritis Author: Martina Procházková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Methotrexate (MTX) is an effective and safe drug used for the treatment of juvenile idiopathic arthritis (JIA) and is well-known like a golden standart in the treatment of this serious illness. The aim of this study was analysis of therapy in patients with JIA focusing on MTX and faktors affecting its intolerance. Methods: The study was undertaken from January 2017 to February 2018 at the Department of Paediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University in Prague. Patients younger than 18 years old, who have become ill with JIA for the first time or repeatedly between years 2015-2017 and were treated by MTX were included in this study. The prevalence of MTX intolerance was measured by "Methotrexate Intolerance Severity Score" questionaire every 3 months during regular rheumatological examinations. Simultaneously, medical records were reviewed. Data analysis was performed by means of descriptive statistics, correlation dependence and statistical signifikance of dependence was assessed with statistical two-choice...
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Physiotherapy Case Study of Rheumatoid Arthritis
Mukhtar, Mahera ; Maršáková, Kateřina (advisor) ; Mikulášová, Markéta (referee)
"Physiotherapy Case Study of Rheumatoid Arthritis." The following Bachelor thesis case study was taken place at the Institute of Rheumatology, Prague, Czechia, for 2 weeks of period. The practice was carried under the supervision and guidance of Markéta Mikulášová. The main objective of this case study is to analyse the diagnosis of the patient with rheumatoid arthritis. Physiotherapeutic planned methods were executed on the rheumatoid arthritis patient to reach an optimal healthy state of the patient and to prevent any further complications. The thesis is divided into two main parts. Firstly, the Theoretical part which includes basic general outlook of the disease rheumatoid arthritis. Secondly, the main Practical part of the thesis, which includes the overall analyse of the patient with rheumatoid arthritis. Containing all the physiotherapy examinations required regarding the disease, followed by the therapy sessions done to achieve all the goals that were deducted from the examination, final physiotherapy examination in order to compare the changes or goals achieved from the initial examinations and lastly the results conclusion. The main goal of the therapy was to reduce the pain of the patient, improve the ROM especial of the hands for the ADL and delay the progressions of the deformity. The...
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Joint Deformity of a Hand in Life of a Patient with Rheumatoid Arthritis
SEJRKOVÁ, Lenka
In this bachelor thesis were set out three aims. At first, to point out the problems of patients with joints deformities of the hand before surgery, which is the substitution of the small joints of the hand, in the second case to find out what role the nurse plays in outpatient care before the operation of the patient. The third aim of this thesis is to find out what the role of the nurse is after the operation of the small joints of the hand of the patient. A qualitative research survey using the semi-structured interview method was used to achieve the aims. The interviews were conducted with patients with Rheumatoid Arthritis after replacement of the small joints of the hand. The research has shown that the most common problem in replacing small joints of the hand was pain and problems with joints of hand in the household, work and termination or change of hobbies. Sleep disturbances, fatigue, psychological problems, and side effects of medicaments also occurred. Someone has also changed their roles in life, job loss or changing role of wives or mothers. In the outpatient clinic, patients are more focused on doctors, but for someone, the nurse performs a counselling function in pain and choosing compensatory aids. It was psychological support, a source of information and a helper. Patients perceived the nurse after operation as a work counsellor, support and navigator after surgery. Apart from problems with joints deformities of hand, patients with Rheumatoid Arthritis have other problems and the nurse should take into account these issues, actively talks about them with patients and contributes to their correction. This bachelor thesis may be an inspiration for nurses in understanding and caring about patients with Rheumatoid Arthritis before and after replacing small joints of the hand.
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Quality of life in rheumatoid arthritis patients
HUDEČKOVÁ, Veronika
The diploma thesis deals with the quality of life with rheumatic diseases. The thesis focuses on patients suffering from rheumatoid arthritis (RA) in particular, since the rheumatic diseases are the most common chronic inflammatory rheumatoid disease spread worldwide. The aim of the diploma thesis is to explore the physical quality of life with RA of selected patients aged from 19 to 70 years. The theoretical part offers a literature review on the stated topic with focus on the quality of life with RA. The second part offers the results of a quantitative research which was conducted using a questionnaire in a rheumatologist´s office in Saint Anna Faculty Hospital in Brno and in the Hodonin Spa. The HAQ-DI index; GARS questionnaire; a visual-analogical scale rating the intensity of pain and DAS28 score assessing the activity of hospitals were used to achieve the aim. Two research hypotheses were proposed in order to conduct the research: 1. The patients who have been suffering from RA for up to five years will achieve significantly more positive score; 2. The differences between genders in the physical quality of life will be statistically more important. The hypotheses were statistically verified using the IBM SPSSS Statistics 24 software. The results of the thesis suggest, that the quality of life with RA is influenced by pain, which is more intense for women. We also claim that the patients suffering from RA might be less self-reliant, therefore, most of them are dependent on help of others or they need to use various devices. Furthermore, the results show that gender provides statistically crucial differences in the physical quality of life. The outcomes found by this thesis can be used for patients suffering from RA; to raise awareness of the disease and its impact on life.
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Epidemiological aspects of inflammatory rheumatic diseases and diffusional diseases of binding tissue.
Hánová, Petra ; Pavelka, Karel (advisor) ; Bencko, Vladimír (referee) ; Horák, Pavel (referee)
v anglickém jazyce Introduction: No information was known about frequency of common inflammatory disorders in rheumatology in the Czech Republic. Aims of the study: To estimate the standardized annual incidence (INC) and point prevalence (PREV) of six diseases (rheumatoid arthritis-RA, juvenile idiopathic arthritis-JIA, gout, psoriatic arthritis-PsA, ankylosing spondylitis-AS, reactive arthritis-ReA) in a population-based study in two regions of the Czech Republic (CR). Methods: INC: Incident cases were registered on condition that the definite diagnosis was confirmed according to existing classification criteria during the study period. PREV was studied on the basis of identification of established diagnoses at a time point. Crude rates were standardized for age and sex. Results: Both INC and PREV are shown per 100.000 inhabitants. RA INC:31 (95%CI 20-42), PREV:610 (95%CI 561-658). Gout-INC:41 (95%CI 28-53), PREV:300 (95% CI 266-334). JIA-INC: 13 (95% CI 1-20), PREV:140 (95%CI 117-280). PsA-INC:3,6 (95% CI 1-8), PREV:49 (95%CI 40-60). AS-INC:6 (95% CI 3-11), PREV:94 (95% CI 94-109). ReA-INC:9 (95% CI 6-15), PREV:91 (95% CI 78-106). Conclusion: This is the first population-based study estimating annual incidence and prevalence rates of the most common rheumatological disorders in the Czech...
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Pharmacogenetics in rheumatoid arthritis
Kobrlová, Martina ; Pávek, Petr (advisor) ; Doseděl, Martin (referee)
Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Martina Kobrlová Supervisor: prof. PharmDr. Petr Pávek, Ph.D. Title of diploma thesis: Pharmacogenetics in rheumatoid arthritis Based on scientific progress in the research of human genome and the discovery of polymorphisms, which are involved in the interindividual differences in human population, there is also a growing interest in pharmacogenetics. It is a field combining pharmacology and genetics with the aim of identifying specific features that could explain the different responses of patients to treatment by clinically used drugs. Applying this knowledge could contribute to a simpler choice of medication for a particular patient and it could reduce the risk of side effects or poor response. In this diploma thesis I dealt with the latest scientific knowledge on pharmacogenetics in rheumatology, in particular the rheumatoid arthritis. From available studies, reviews, and meta-analyzes that have been published, I summarized current data on the relationship between polymorphisms and disease modifying drugs (DMARDs) used for the treatment of this disease. The largest amount of data was found on the most commonly used methotrexate. Further, the work examines the leflunomide and other...
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Immunopathology aspects and new treatment options for rheumatoid arthritis
Bartoňová, Michaela ; Šenolt, Ladislav (advisor) ; Drbal, Karel (referee)
Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease, which affects joints. It significantly affects the quality of life and is associated with increased mortality. Although its etiology is not fully known, it is believed that both genetic and environmental risk factors are involved in its outbreak. Knowledge of these risk factors helps us to determine the risk of RA outbreaks in vulnerable populations and provides us with knowledge about possible prevention. Pathogenesis of RA is caused by activated mesenchymal cells and cells of the innate and adaptive immune system, such as endothelial cells, synovial fibroblasts, monocytes, macrophages, dendritic cells, T and B lymphocytes. It is an incurable disease, but there are several medications, which improve disease activity or can even cause remission. Great success has been observed in biological treatment and inhibitors of Janus kinases. In some cases, the response to this relatively new therapy is not sufficient, and new drugs based on other mechanism should be developed. Examples include inhibition of granulocyte and macrophage colony stimulating factor, inhibition of interleukin 6 or interleukin 17 and bispecific antibodies. There is a growing importance of biosimilar drugs, which would make treatment, thanks to a lower price,...
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Quality of Life in Rheumatoid Arthritis Patients
KAAS, Jiří
The objective of the presented thesis is to explore the impact of rheumatoid arthritis on the patient's life and to compare the subjectively perceived quality of life of such patients with that in healthy population. The set objectives were achieved through a combination of quantitative and qualitative research. The quantitative survey took place as part of the team research project GAJU No. 120/2012/S through the use of the standardized WHOQOL-100 questionnaire handed out to 200 patients suffering from rheumatoid arthritis. In addition to further tests, the statistical data analysis included comparison of the quality of life in the aforesaid patient population with the quality of life in the control healthy population, which also participated in the above stated project. The qualitative survey used the technique of semi-structured interviews with 11 patients suffering from rheumatoid arthritis. The research has shown that the patients with rheumatoid arthritis have a worse quality of life in the fields of physical condition and independence than healthy population. On the other hand, a better quality of life was found in the fields of milieu and spirituality. The results also referred to pain and fatigue as the major factors influencing the quality of life of such patients and drew attention to their interconnection with other dimensions. The qualitative survey supplemented the quantitative data with a practical detailed description of individual problems. Among other things, it detected factors that help the patients to overcome obstacles associated with the disease. For example, the research revealed the family influence or the compensation of restraints by adaptations of the environment or changes of the daily routine. Interesting conclusions have been derived from the information about the effect of adaptation to the disease; it was found out that in the course of their life with the disease, patients get used to certain difficulties, so they perceive them as less severe than in the beginnings of the disease. The thesis provides a complex view of the matters of the quality of life of patients suffering from rheumatoid arthritis and refers to this disease not only as to a disease of the body but also to a disease of the human soul. Among other things, it provides evidence that the concept of the quality of life is applicable in the field of nursing. With regard to the above stated facts, the thesis is useful for the extension of the theoretical knowledge in the field of nursing as well as for the clinical practice.
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