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Physiotherapy after arthroplasty procedures for rheumatic patients
Suchá, Petra ; Jalovcová, Miroslava (advisor) ; Pavelka, Karel (referee)
Title Physiotherapy after arthroplasty procedures for rheumatic patients. Defining the problem The main problem this thesis solves is to find and compare findings on the practice of physiotherapy in rheumatic patients, patients with rheumatoid arthritis (RA) who have undergone surgery, joint replacement of lower limb arthroplasty, with a focus on the ankle joint. It will be a comparison of the approaches used in the workplace catchment for the Czech Republic, Institute of Rheumatology (RU) in Prague and the world. Aim The aim is to create a comprehensive overview and comparison of physiotherapy procedures used in rheumatic patients who underwent joint replacement legs, zjm. ankle joint, in the CR is in the hands, and in the world and see whether these practices vary significantly, or are identical. The method of solution The work is prepared by comparing the findings relating to the care of patients with available literature. The findings are grouped and arranged tables are created with recording procedures. The work is written in the form of research. Key worlds revmatoidní artritida totální náhrada hlezenního kloubu (TEP) hlezenní kloub fyzioterapie
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Expression analysis of new follicullar B cell populations characterized by absence of CD27 molecule and down-modulation of CD38 molecule.
Kerdíková, Zuzana ; Růžičková, Šárka (advisor) ; Drda Morávková, Alena (referee)
Two novel B cell populations were characterized in peripheral blood of patients with common variable immunodeficiency and healthy controls were observed using flow cytometry in the study supported by the grant IGA MZ ČR NKT11414-3. These B cell populations were defined as CD19+ CD27- CD21+ CD38low CD24+ IgM+ FO I and CD19+ CD27- CD21+ CD38low CD24++ IgM++ cells. Since none of found populations has ever been described, the aim of this thesis was to characterize these populations with focus on analysis of variable regions of the heavy chains of immunoglobulins and genes coding proteins participating in the process of VHDHJH formation (Rag 1, Rag 2, and TdT) produced by cells of these populations. Flow cytometry, single cell sorting, single-cell RT-PCR, IgVH, Rag 1, Rag 2, and TdT specific PCR amplification and cycle sequencing were employed to perform the molecular analysis in individual B lymphocytes. Both populations in two patients with common variable immunodeficiency, two healthy controls, and in two patients with autoimmune diseases - rheumatoid arthritis and systemic lupus erythematosus (as the disease control) - were examined. Finally, the statistical analysis was used to evaluate the differences in expression of variable regions of the heavy chains of immunoglobulins and in Rag1 and 2, and...
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Case report patients diagnosed with rheumatoid arthritis
Váňová, Tereza ; Žáková, Hana (advisor) ; Jarošová, Hana (referee)
Title of bachelors thesis: Case report patients diagnosed with rheumatoid arthritis Summary: The work is focused on diseases rheumatoid arthritis and its physiotherapy care. It consists of two parts. Part of the general anatomy of the joint contains a general, deals with the disease rheumatoid arthritis, its diagnosis, treatment and comprehensive rehabilitation treatment. Part has its own special case report physiotherapy sessions on this topic. Key words: rheumatoid arthritis, comprehensive rehabilitation, physiotherapy Vypracovala: Tereza Vá ová Vedoucí bakalá ské práce: Mgr. Hana Dušková Rok obhajoby: 2012
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Case of physiotherapy care for patients diagnosed with rheumatoid arthritis and the condition after total hip arthroplasty for traumatic fracture
Žarković, Dragana ; Nováková, Tereza (advisor) ; Jarošová, Hana (referee)
Title of bachelor's thesis : Case of physiotherapy care for patients diagnosed with rheumatoid arthritis and the condition after total hip arthroplasty for traumatic fracture Author : Dragana Žarković Supervisor : PhDr. Tereza Nováková, PhD. Academic year : 2012 Aim : Thesis accentuates the role of the physiotherapist, as part of a team of experts in the care of patients with rheumatoid arthritis, as well as the importance of a comprehensive rehab therapy and possible use of physiotherapy procedures. Part of the thesis is a detailed case report of a patient with rheumatoid arthritis and the condition after total hip arthroplasty for traumatic fracture. Methodics Thesis is divided into general and special parts. The general part is divided in the issue of rheumatology, orthopedics and traumatology, describes the problems of disease and types of surgical procedures. The following section describes the physiotherapy sessions for patients suffering from rheumatic diseases and also after total hip arthroplasty. Special part, case report describes a patient with a diagnosis of rheumatoid arthritis and the condition after total hip arthroplasty for traumatic fracture. This case report was prepared during clinical practice in the Institute of Rheumatology in Prague, in the period from 9.1.2012 to 3.2.2012...
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HLA complex and association with autoimmune diseases
Karasová, Alexandra ; Slavčev, Antonij (advisor) ; Šírová, Milada (referee)
Autoimmune diseases are serious and sometimes life-threatening disorders that affect approximately 5 % of the world population and therefore represent a major socio-medical problem. The HLA complex is the best studied part of the human genome that encodes the HLA antigens, whose function is to present peptides to immune system (T-lymphocytes). During the study of the HLA complex it has been found that certain HLA antigens are strongly associated with the occurence of autoimmune diseases, despite the great progress in clarifying disease etiopathogenesis the mechanism of these associations is, however, not fully explained. Sometimes the association of autoimmune disease with the HLA complex is very strong, such as in ankylosing spondylitis or celiac disease, while in other diseases the association is relatively weak, suggesting a role of other genetic and / or environmental factors. The aim of this work is to briefly explain the structure and function of the HLA complex and its association with some severe autoimmune diseases.
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Characterization of biological and functional features of a new type of CD27- memory B lymphocytes.
Bajzíková, Martina ; Růžičková, Šárka (advisor) ; Šinkora, Marek (referee)
The increased frequencies of two novel B cell populations defined as IgM+ CD19+ CD27- CD21low CD38low CD24+ and IgM+ CD19+ CD27- CD21low CD38low CD24- in peripheral blood of patients with common variable immunodeficiency (CVID) compared to healthy donors were found. The aim was to search for such B cells in patients with rheumatoid arthritis (RA) and their further characterization. The production of immunoglobulin (Ig) mRNA in single B cells was analyzed using flow cytometry, single cell sorting and RT-PCR, IgVH-specific PCR, cycle sequencing and statistical analysis. The study was focused on analysis of variable regions of the heavy chains of Igs and significant differences in the usage of VH, DH and JH gene segments, mutational frequencies, distribution of silent and replacement mutations, length and composition of CDR3 regions, clonal relation and RAG gene expression in above mentioned B cell populations were found. Because of lack of the surface CD27 molecule being regarded as marker of B cells that have undergone antigen-driven germinal reactions, analyzed populations were considered as naive. However, the pattern and type of mutations suggested that these cells could represent a new type of differentiated memory/antigen- experienced B lymphocytes (in CVID less maturated) with the likely role in...
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Specifics of nursing access to patients with rheumatoid arthritis
JINDROVÁ, Monika
Rheumatoid arthritis, a chronic autoimmune disease that changes the lives of patients, determine its quality and values. Today, due to advances in medicine and available drugs, doctors are able to halt disease progression, and induce a remission, which improves the prospects of patients with rheumatoid arthritis in the future life. Changes in needs of patients during the illness are closely related to changes in attitude and nurses in providing nursing care. Each phase of this disease requires specific knowledge and skills on the part of nursing staff.This thesis has two goals. Objective 1: Determine what specific interventions nurses use to approach patients with rheumatoid arthritis. Objective 2: Determine what nursing interventions are patients with rheumatoid arthritis expecting. The objectives of the research questions were raised. Research question 1: What specific activities will nurses focus on in providing nursing care to patients with rheumatoid arthritis? Research Question 2: What specific actions nurses apply while carrying for patients with rheumatoid arthritis? Research Question 3: What patients with rheumatoid arthritis expect from nurses due to their disease? Data for the empirical part of this work were collected using research. To collect data, semi-structured interview was chosen. The research group in which the survey was conducted, consisting of 14 respondents. Half are nurses working in outpatient rheumatology and internal departments. The second half is represented by patients suffering from rheumatoid arthritis who were already hospitalized in rheumatology departments or attended the rheumatology clinic. The respondents' answers were recorded on either audio recorder, or written form. Subsequently, the answers were transcribed into Microsoft Word. Open coding system was used or data processing. Coded were categorized based on the similarity.
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Possibilities of physiotherapy methods of psoriatic arthritis
DROBNÁ, Martina
This bachelor thesis deals with the problems of psoriatic arthritis, which has chronic evolution among most cases and can lead to articular deformities in patients. This disease has an unclear pathogenesis conditioned by genetic, external and immunologic factors. It affects above all patients with type I psoriasis with emerging symptoms such as swellings with articular pains, morning stiffness and overall fatigue. PsA often shows positive antigen HLA B27, without presence of rheumatoid nodules and negative rheumatoid factor (Štolfa, 2012). PsA causes both physical handicap in patients and substantial disturbance of their social and psychical life. The thesis is divided into theoretical and practical part. The theoretical part briefly outlines the anatomy of skin as well as structure and function of joints. Onward it describes psoriasis, its forms and methods of treatment. The next chapter explains the term arthritis and presents RA as an example. It is followed by detailed description of PsA, definition of the disease, its causes and occurrence, clinical picture and some therapy possibilities. In the practical part, the method of qualitative research was used, with participation of three female patients suffering from PsA. Therapy was initiated by input kinesiologic analysis, including specific examinations such as goniometric examinations of joints, grasp examinations, muscle palpation examinations and others. Patient appointments were held regularly each week for a period of eight-week therapy. On each appointment, previously applied therapy was consulted, exercises were repeated, possibly uncertainties were clarified. Each therapy lasted about 45 minutes, during which hypertonic muscles along with trigger points were relaxed according to specific patient issues. In the last session, output kinesiologic analysis was done and patients were informed about the importance of adhering to regimen measures. The results of the research clearly show overall posture improvement in all patients. A very substantial indicator of therapy success is noticeable reduction of swellings and pain, and hand function improvement. The therapy also focused on adjustment of faulty breathing stereotype manifesting itself with upper type, thereby causing overexertion of cervical spine muscles and frequent headaches. Strong emphasis was also put on activation of the transverse arch, which was collapsed in all patients. This bachelor thesis can be used in clinical practice of physiotherapists or as an educational material for patients.
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The use of physiotheraphy procedures for treating inflammatory rheumatic disease selected from the perspective of patients.
CIHLÁŘOVÁ, Irena
Rheumatology is a part of internal medicine that deals with diseases of musculoskeletal system. It is primarily devoted to diagnosis and treatment of these diseases. Rheumatoid diseases primarily affect joints and muscles, but other organs can also be affected endocrine glands, the nervous system, internal organs such as the kidneys, liver, lungs, human gastrointestinal tract, and skin. The diseases are classified as follows: inflammatory, degenerative, metabolic bone and joint diseases, extra-articular rheumatism, septic arthritis, etc. The causes of these diseases are unknown, but internal and external factors play an important role. They may be infectious, immunogenetic factors and effects of the external environment such as drugs and chemicals. The aim of this work is to map the use of physical procedures in the treatment of inflammatory rheumatic diseases. To do this, the following research questions were formulated: 1. Which are the most commonly used physical methods in the treatment of rheumatic diseases? 2. What effects does the application of physical therapy have on the patient? 3. How does inflammatory rheumatic disease affect the patient's life? 4. Which procedures can the patient apply in the home environment? 5. Are patients satisfied with physical therapy? Qualitative methods were chosen for the research part of this work and a semi-structured interview was used as the technique for data collection. The respondents were asked 28 questions. The research sample consisted of 10 respondents. The respondents were chosen from rheumatologic surgeries in Tábor and Pelhřimov. They consist of 5 respondents with a diagnosis of Bechterew's disease and 5 respondents with a diagnosis of rheumatoid arthritis. The interviews were conducted as previously arranged in the respondents' homes or via email. The results show that in most of the respondents the disease occurred between the ages of twenty and thirty. The first symptom was a painful and swollen joint. They most often use disease modifying drugs, anti-inflammatory drugs, and analgesic drugs for the treatment. Examples of disease modifying drugs include Methotrexate, Sulfasalazine, Aflamil, and Arava. Aulin is among the most commonly used NSA. Enbrel was mentioned by the respondents as a preparation used in biological therapy. Among the regime measures which the respondents take to reduce symptoms, were most often mentioned home workouts, changes of diet, compresses, ointments, and other compensation aids. As regard physical therapy, the respondents were most satisfied with balneotherapy, namely with massages and warm packs. The most used method is magnet. Physical therapy primarily helps to ease pain and relax muscles and stiff joints. Nurses educate patients about drug effects, the changes that are to come in their lives and to which they need to prepare; about the importance of workouts, rehabilitation, and compensatory aids. The quality of the respondents' lives is substantially limited by pain, stiff joints, and severe fatigue. For these reasons, the respondents are unemployed and have to receive a disability pension. In the initial period, the respondents suffered from the feelings of anxiety, helplessness, hopelessness, and depression. The family plays an important role in this context, helping and supporting the respondents. According to the data obtained it can be concluded that physical therapy helps to customers with rheumatoid inflammatory disease to relieve from pain and stiffness in joints. The course of the disease can be influenced by regular workouts that can help ease the symptoms. In some cases, the symptoms disappear for some time. It is very important to appropriately inform customers about their disease, therapy, rehabilitation and the changes they will have to undergo in life. The doctors and nurses deal those problems in the rheumatic clinics and spas. This thesis points to common problems of patients with inflammatory rheumatic diseases.
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Physiotherapeutic procedures in patients with rheumatoid arthritis with maximum difficulties in the joints of the hand area
LEDVINOVÁ, Eva
This bachelor thesis is focused on physiotherapeutic methods used in patients with rheumatoid arthritis whose difficulties are mainly in the joints of their hand. Rheumatoid arthritis is a chronic inflammatory joint disease in most cases with a protracted course and it may cause joint deformations. These lead to handling issues which complicate normal daily activities of the patients. Thus this disease causes both physical disability of the patient and as well significantly disrupts their social and psychological life. In the first part, which is concerned with theory, I briefly outlined the functional anatomy and kinesiology of the upper limb and shoulder girdle. Furthermore there is a detailed description of rheumatoid arthritis, definition of the disease, its causes and occurrence, clinical features, laboratory and x-ray examination, differential and functional diagnosis and all the treatment possibilities. In the conclusion of theoretical part there is the prognosis of the disease and practical difficulties during the care of patients with rheumatoid arthritis. The aim of this thesis is to map the possibilities of physiotherapy in patients with rheumatoid arthritis and the use of physiotherapeutic procedures and methods in individual patients with this disease. The qualitative research method, in which three patients treated in Berta Spa in Třeboň participated, was used for the practical part of the thesis. The therapy was initiated by an entrance kinesiological analysis, including the specific examination such as the examination of joint-play in small joints of hands, examination of the gripping, palpation of muscle tonus in muscles of the upper limbs and goniometric examination of joints of the upper limbs. This was followed by nine individual therapies, during which we focused mainly on upper limb joints. At the last session an output kinesiological analysis was conducted and the patients were taught about the necessity to comply with regime measures. At the end they spoke about their subjective feelings connected with the therapy and with their Balneotherapy stay in the spa. The results of the treatment were recorded for each individual case. This bachelor thesis may serve as an educational material for students in medical fields, general public to increase awareness of rheumatoid arthritis and last but not least for patients themselves or their families.
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