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Evaluation of Reinnervation Changes After Reconstructive Procedures on Peripheral Nerves.Nerve Transfers in Patients with Brachial Plexus Lesions: A Comprehensive Evaluation of Outcomes.
Brušáková, Štěpánka ; Holečková, Irena (advisor) ; Vaverka, Miroslav (referee) ; Ehler, Edvard (referee)
Purpose: The purpose of this study is to analyze the results of brachial plexus reconstructive surgery. The work focused on the analysis of the brachial plexus repair at Masaryk Hospital in Ústí nad Labem between 2012 and 2023. The aim of the study was to focus on a set of patients operated using the technique of nerve transfers. In addition to the clinical results, the presence of neuroplasticity was investigated by monitoring postoperative synkinesis and evaluating factors on which the presence of neuroplasticity depends. Methods: A total of 34 proximal nerve transfers were performed in 21 patients for restoration of shoulder abduction, external rotation and elbow flexion. The evaluation of the results was carried out at least 3 years after surgery. The resulting muscle strength, range of motion, Mallet scale, pain quantification, electrophysiological testing and the presence or absence of synkinesis between donor and recipient were assessed. An evaluation of subjective assessment of the effect of decreased function on normal activities of daily living including work capacity (DASH) was recorded. The results were statistically processed. Results: Of the 34 neurotransfers, 20 achieved M3 or greater strength (58.8 %), and 5 transfers achieved M4 or greater strength. The disappearance of synkinesis...
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Prognosis in Ischemic Stroke Patients and Related Prognostic Faktors
Kielbergerová, Lenka ; Rohan, Vladimír (advisor) ; Holečková, Irena (referee) ; Petrák, Ondřej (referee)
Stroke is a significant cause of morbidity and mortality in the developed world. In the theoretical part of the thesis, we try to summarize the overall knowledge of stroke, the definitions and the general approach to the diagnosis and treatment, with a focus on ischemic stroke. Furthermore, the issue of acute phase treatment and secondary preventive treatment of ischemic stroke is reviewed and the modalities of the subsequent neurological deficit evaluation, the occurrence of mood disorders and the assessment of the quality of life of individuals after stroke are discussed. Our research aimed to assess the perspective of ischemic stroke patients admitted to the hospital. The first part is focusing on the mortality of patients with ischemic stroke in the period 2003-2019 in the Westbohemian region and its relation to secondary prevention. The second part aims to identify the main clinical and psychosocial factors affecting the quality of life of chronic stable post-stroke patients after their first in-life episode of stroke. The relation of poor quality of life indicators, mortality and conventional cardiovascular risk factors is prospectively assessed. The mortality of patients after first-in-life ischemic stroke hospitalization the years 2003- 2019 is higher compared to worldwide trends. In the...
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The Relationship Between the Function of the Spinal Cord and the Width of the Spinal Canal Depending on the Change in the Axis of the Cervical Spine
Žídek, Slavomír ; Holečková, Irena (advisor) ; Zeman, Jaroslav (referee) ; Česák, Tomáš (referee)
Introduction: The aim of our study was to assess the effect of dynamic changes in spinal flexion and extension assessed by dynamic magnetic resonance imaging(dMRI) on spinal cord functions assessed by dynamic evoked potentials(dEPs) in group of healthy individuals (group 1) and in group of patients with a small graphical pathology on cervical spine MRI in the neutral position, but with mild objective and progressive subjective difficulties (group 2). Methodology: 10 healthy individuals and 10 patients were included in the study. Examination of dMRI as well as dEPs was performed in neutral position, flexion and extension. The anterior (PD) and posterior spinal cord length (ZD), transverse (PR) and anteroposterior dimension (PZ) and spinal cord area (P) were measured on the cervical spine MRI. The median and tibial nerves SEPs (somatosensory evoked potentials) and BB, APB and TA muscles MEPs (motor evoked potentials) were performed as well. Results: In a group of patients we noticed a changes in the length and shape of the spinal cord but also spinal cord functions, already in the neutral position, even though there was no significant spinal cord compression. There were as well as healthy individuals elongation or shortening of PD and ZD during flexion and extension, There were, in contrast to...
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Residual cognitive capacity in unconscious patients. Event related potentials and cerebral blood flow study
Holečková, Irena ; Choc, Milan (advisor) ; Polívka, Jiří (referee) ; Rektor, Ivan (referee) ; Stejskal, Lubor (referee)
UNIVERSITÉ CLAUDE BERNARD LYON 1 - LYON Ecole Doctorale Biologie Moléculaire Intégrée et Cognitive Année Universitaire 2007 - 2008 UNIVERZITA KARLOVA V PRAZE Lékařská fakulta v Plzni Vědní obor : chirurgické obory THESE EN COTTUTELLE FRANCO - TCHEQUE Irena HOLEČKOVÁ Neurochirurgické oddělení Fakultní nemocnice v Plzni Capacités cognitives chez les patients inconscients Étude des potentiels évoqués cognitifs et du débit sanguin cérébral Kognitivní kapacita u pacientů s poruchou vědomí Studie kognitivních evokovaných potenciálů a mozkového krevního průtoku Cognitive capacity in unconscious patients Event related potentials and cerebral blood flow study 2008 Ce travail de thèse a reçu le soutien financier de l'Ambassade de France en République Tchèque L'ensemble des travaux a été réalisé dans le Service de Neurophysiologie Clinique et Epileptologie de l'Hôpital Neurologique de Lyon, au sein de l'équipe de l' Unité INSERM 821 et au sein de CERMEP-imagerie du vivant de Lyon, France. Remerciements Le mot remerciement s'avère insuffisant pour exprimer ma reconnaissance envers Madame Catherine Fischer, Chargée de recherche, pour avoir diriger ce travail. Sa compétence, ses conseils ont été essentiels à la réalisation de cette thèse. Je vous remercie de m'avoir «ouvert les oreilles» au domaine passionnant des...
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Residual cognitive capacity in unconscious patients. Event related potentials and cerebral blood flow study
Holečková, Irena ; Choc, Milan (advisor) ; Polívka, Jiří (referee) ; Rektor, Ivan (referee) ; Stejskal, Lubor (referee)
UNIVERSITÉ CLAUDE BERNARD LYON 1 - LYON Ecole Doctorale Biologie Moléculaire Intégrée et Cognitive Année Universitaire 2007 - 2008 UNIVERZITA KARLOVA V PRAZE Lékařská fakulta v Plzni Vědní obor : chirurgické obory THESE EN COTTUTELLE FRANCO - TCHEQUE Irena HOLEČKOVÁ Neurochirurgické oddělení Fakultní nemocnice v Plzni Capacités cognitives chez les patients inconscients Étude des potentiels évoqués cognitifs et du débit sanguin cérébral Kognitivní kapacita u pacientů s poruchou vědomí Studie kognitivních evokovaných potenciálů a mozkového krevního průtoku Cognitive capacity in unconscious patients Event related potentials and cerebral blood flow study 2008 Ce travail de thèse a reçu le soutien financier de l'Ambassade de France en République Tchèque L'ensemble des travaux a été réalisé dans le Service de Neurophysiologie Clinique et Epileptologie de l'Hôpital Neurologique de Lyon, au sein de l'équipe de l' Unité INSERM 821 et au sein de CERMEP-imagerie du vivant de Lyon, France. Remerciements Le mot remerciement s'avère insuffisant pour exprimer ma reconnaissance envers Madame Catherine Fischer, Chargée de recherche, pour avoir diriger ce travail. Sa compétence, ses conseils ont été essentiels à la réalisation de cette thèse. Je vous remercie de m'avoir «ouvert les oreilles» au domaine passionnant des...
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