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Identification of new biomarkers and target molecules for the comprehensive treatment (drug-target) via proteomic analysis of body fluids and tissues experimental study
Fremuth, Jiří ; Kobr, Jiří (advisor) ; Nosáľ, Slavomír (referee) ; Hoza, Jozef (referee) ; Slavík, Zdeněk (referee)
The main objective of our prospective experimental study was to develop a clinically relevant model of mechanical ventilation of healthy and damaged lungs ventilated for 12 hours. A widely recommended Vt=6ml/kg was used in comparison with commonly used Vt=10ml/kg. The study included a total of 52 piglets of domestic pig (Sus scrofa f. domestica) age 5-9 weeks. Piglets were divided into 3 groups: group B - Vt = 6ml/kg (11 piglets, 8 died), group C - Vt = 10ml/kg (21 piglets, 5 died) and group D - Vt= 50 ml + instillation of 50 ml saline into the trachea (6 piglets, 1 died). In the presented study we focused on the influence of mechanical ventilation on several organ systems as well as induction of systemic inflammatory reaction. By using higher tidal volume, we aimed to induce possible biotraumatic changes. The ventilator settings were deliberately not changed during the study, except the change of Fi02 values based on the Sp02 value. The first goal was to assess the influence of two different strategies of mechanical ventilation and induced lung injury on respiratory functions of the lungs and pulmonary mechanics. Piglets ventilated with Vt = 6ml/kg maintain the physiological oxemia, but the level of capnia increased over time with an adequate effect on acid-base balance. The highest mortality in...
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Ethical concerns involving the care of infants at the threshold of viability
Zlatohlávková, Blanka ; Payne, Jan (advisor) ; Hoza, Jozef (referee) ; Kuře, Josef (referee)
Introduction: Resuscitation and intensive care from the 26 weeks of gestation is usually mandatory in developed countries because infants born at this week have a very high chance of survival without severe disabilities. The period between the 22-25 week of gestation is known as the grey zone, during which the results of care are uncertain and unpredictable in advance. Thesis: Decision-making about offering intensive care at the threshold of viability is done in uncertainty, whether or not such treatment is at the best interest of the newborn, for out of principle, it is impossible to predict whether the infant will survive at all and if so, if it will continue to live without severe disability. Viability of the fetus and the newborn: Determining the threshold of viability (the ability to survive outside the uterus) is the initial point in considering medical treatment. Viability depends - aside from the level of maturity of the fetus and its health condition - on the advancement of medical technology. It is also based upon given socio-economical, and cultural factors. The threshold of viability in regard of the possibility to be born alive and survive lies between the 22-24 weeks. An expert agreement on providing active care is based upon the probability of survival and survival without serious...
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Identification of new biomarkers and target molecules for the comprehensive treatment (drug-target) via proteomic analysis of body fluids and tissues experimental study
Fremuth, Jiří ; Kobr, Jiří (advisor) ; Nosáľ, Slavomír (referee) ; Hoza, Jozef (referee) ; Slavík, Zdeněk (referee)
The main objective of our prospective experimental study was to develop a clinically relevant model of mechanical ventilation of healthy and damaged lungs ventilated for 12 hours. A widely recommended Vt=6ml/kg was used in comparison with commonly used Vt=10ml/kg. The study included a total of 52 piglets of domestic pig (Sus scrofa f. domestica) age 5-9 weeks. Piglets were divided into 3 groups: group B - Vt = 6ml/kg (11 piglets, 8 died), group C - Vt = 10ml/kg (21 piglets, 5 died) and group D - Vt= 50 ml + instillation of 50 ml saline into the trachea (6 piglets, 1 died). In the presented study we focused on the influence of mechanical ventilation on several organ systems as well as induction of systemic inflammatory reaction. By using higher tidal volume, we aimed to induce possible biotraumatic changes. The ventilator settings were deliberately not changed during the study, except the change of Fi02 values based on the Sp02 value. The first goal was to assess the influence of two different strategies of mechanical ventilation and induced lung injury on respiratory functions of the lungs and pulmonary mechanics. Piglets ventilated with Vt = 6ml/kg maintain the physiological oxemia, but the level of capnia increased over time with an adequate effect on acid-base balance. The highest mortality in...
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Ethical concerns involving the care of infants at the threshold of viability
Zlatohlávková, Blanka ; Payne, Jan (advisor) ; Hoza, Jozef (referee) ; Kuře, Josef (referee)
Introduction: Resuscitation and intensive care from the 26 weeks of gestation is usually mandatory in developed countries because infants born at this week have a very high chance of survival without severe disabilities. The period between the 22-25 week of gestation is known as the grey zone, during which the results of care are uncertain and unpredictable in advance. Thesis: Decision-making about offering intensive care at the threshold of viability is done in uncertainty, whether or not such treatment is at the best interest of the newborn, for out of principle, it is impossible to predict whether the infant will survive at all and if so, if it will continue to live without severe disability. Viability of the fetus and the newborn: Determining the threshold of viability (the ability to survive outside the uterus) is the initial point in considering medical treatment. Viability depends - aside from the level of maturity of the fetus and its health condition - on the advancement of medical technology. It is also based upon given socio-economical, and cultural factors. The threshold of viability in regard of the possibility to be born alive and survive lies between the 22-24 weeks. An expert agreement on providing active care is based upon the probability of survival and survival without serious...
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The role of peripheral quantitative CT in early diagnostics of osteoporosis in chronically ill children
Souček, Ondřej ; Šumník, Zdeněk (advisor) ; Hoza, Jozef (referee) ; Zapletalová, Jiřina (referee)
Patients with Turner syndrome (TS) have increased fracture risk and decreased bone density, patients with severe hemophilia have low bone density. The etiology of these changes hasn't been completely elucidated in any of the two diseases. Our aimes were to assess bone density and geometry at the radius using a new method peripheral quantitative CT densitometry (pQCT) and to describe associations between densitometry parameters and estrogen treatment in TS and laboratory as well as clinical markers of disease severity in haemophilia. Sixty-seven girls with TS (median age 14.3 years, range 6.0-19.4) and 42 boys with haemophilia (median age 12.7 years, range 6.6-19.2) have been measured using peripheral quantitative CT at the radius. The results have been compared to published reference data. Girls with TS had decreased cortical bone density and thinner cortex. These parameters were positively correlated to the length of estrogen treatment. Trabecular bone density was normal in prepubertal girls but it was decreased after puberty. There was no association between trabecular bone density and the estrogen treatment. Boys with haemophilia had decreased trabecular density and low muscle area at the forearm. Densitometry parameters were influenced neither by the clotting factor VIII/IX level nor by the frequency of...
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