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Stroke: Options for Optimising Radiology Imaging
Kremeňová, Karin ; Malíková, Hana (advisor) ; Tomek, Aleš (referee) ; Lambert, Lukáš (referee)
CT perfusion (CTP) is applied to assess brain tissue viability in patients with acute ischemic stroke. CTP results are one of the most significant indication criteria for mechanical thrombectomy (MT) in case of large vessel occlusion in the late time window > 6 hours or in wake-up strokes. However, CTP is not the modality of choice to determine candidates suitable for MT in the early time window < 6 hours, as the benefits of CTP are questionable in this time setting. We studied cohort of patients after technically successful MT performed regardless of CTP results with follow-up imaging 24 ± 2 hours after MT. In the first part of the study, we evaluated the accuracy of 3 types of NeuroPerfusion Suite syngo.via SW parameter settings for CTP aiming to determine the most accurate one in predicting the final infarct volume (FIV) measured on follow-up MRI. The ischemic core was defined as follows: A) cerebral blood flow (CBF) < 30 % compared with the contralateral hemisphere; B) CBF < 20 %; C) cerebral blood volume < 1,2 ml/100 ml. We studied 47 patients. The absolute agreement between ischemic core volume and FIV was poor (ICC 0.64-0.69, RMSE 58.9-66.0). Setting A and C overestimated FIV in 53%, setting B in 26% patients. According to our results, none of the settings was optimal, but we consider...
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Possibilities of aggregometry in antiplatelet prevention of strokes. Relationship between reduced aggregation and stroke risk prevention.
Chýlová, Miroslava ; Kalvach, Pavel (advisor) ; Tomek, Aleš (referee) ; Herzig, Roman (referee)
Background. This dissertation offers an overview of knowledge about platelets, the principle of platelet aggregation, its reduction by antiplatelet drugs and anticoagulation, methods of measuring platelet aggregation and views on resistance to acetylsalicylic acid. The effectiveness of ASA (acetylsalicylic acid) in prevention of vascular events is usually derived indirectly from comparison of individuals taking placebo and not from the results of aggregometric methods. The purpose of our work was 1) to assess the effect of different doses and different routes of ASA administration on platelet aggregation, 2) to compare results of two different aggregometry methods and 3) to assess the effect of anticoagulation treatment on platelet aggregation in patients with chronic ischemic heart disease. Methods. The first study group consisted of 22 healthy individuals and 30 patients with documented ischemic stroke. Platelet aggregation was measured before ASA application and then after different doses and different routes of ASA administration. In the second study the group consisted of 30 patients with documented ischemic stroke who were taking orally 100mg ASA daily. We compared platelet aggregation measured by VerifyNow and by light transmission aggregometry (LTA) using different agonists. In the third...
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Therapeutic use of ultrasound in patients with cerebrovascular diseases.
Kuliha, Martin ; Školoudík, David (advisor) ; Beneš, Vladimír (referee) ; Tomek, Aleš (referee)
Background: Sonolysis is an important factor in therapeutic use of ultrasound in patients with cerebrovascular diseases, it is ultrasound induced lysis of thrombus or embolus. The aim of this work was to asses safety and efficacy of therapeutic ultrasound effect (sonolysis) in acute stroke patients and in patients undergoing carotid artery intervention. First partial aim of this work was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System in subjects with acute ischemic stroke. Second partial aim of this work was to test the clinical efficacy of sonolysis for reducing the risk of incidence of new brain ischaemic lesions detected on brain magnetic resonance imaging in patients undergoing elective CEA or CAS for severe internal carotid stenosis. In addition, we assessed the effects of sonolysis on cognitive function, morbidity, and mortality at 30 days post-surgery. Methods: Patients with acute ischemic stroke and occlusion of the middle cerebral artery or basilar artery were enrolled consecutively to the prospective study tested safety and efficacy of endovascular sonolysis using the EkoSonic Endovascular System (EKOS) in patients with acute stroke. The control group (44 MCA and 12 BA occlusions) was selected from historical controls. EkoSonic...
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The nursing process in a patient with cerebral stroke
Klimová, Andrea ; Tomová, Šárka (advisor) ; Tomek, Aleš (referee)
The topic of my graduate thesis is the nursing process and its role in the care of the ischaemic stroke patient. I was especially interested in the insufficient common knowledge of warning signs and risk factors of stroke that significantly reduces possibilities of its effective therapy. This fact is known to be one of the greatest risk factors of stroke. Thesis is divided to two parts. The first is clinical and describes consise description of cerebrovascular anatomy and physiology, etiopatogenesis, clinical signs, diagnostic procedures, complications and therapy of stroke. It is followed by detailed course and history of chosen patient example. The second part of thesis is dedicated to the nursing process. In the introduction is summarization of nursing history by Marjory Gordon, that confounds nursing diagnoses. The diagnoses including nursin plan and effectivity evaluation are described in the detail in special chapter. Separate chapter is writen about patient education. In the conclusion of the thesis is summarization of nursing process. Powered by TCPDF (www.tcpdf.org)
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Design of Competitive Intelligence for the construction company
Fialková, Veronika ; Molnár, Zdeněk (advisor) ; Tomek, Aleš (referee)
This thesis describes the design of Competitive Intelligence for the selected construction company. The main objective of this work is to choose a competent person responsible for the implementation of activities of CI in this company, identify appropriate sources for information about the company environment and tools for monitoring. The theoretical part is based on the scientific literature and focuses on the characteristics of competitive intelligence and describes the various phases of the intelligence cycle. The theoretical part includes the chapter, which deals with the issue of CI in the small companies. Then, there is the typology of information sources which describes the tools for information monitoring through the Internet. The practical part of this thesis deals with the design system of the competitive intelligence for the selected company. The first part has evaluated the actual situation in the construction industry in the Czech Republic and conducted research information sources suitable for tracking environment of the construction company. Based on this research there are recommended sources of information in the next chapter that should be monitored and there are also selected tools for collecting and monitoring information. Part of the proposed solution is the choice of the officer responsible for the conduct of CI. The last chapter of the practical part describes the processes that must be performed by the specialist in the various stages of the reporting cycle and it also determines the structure of the data entered into the system. The contribution of this work is to improve collecting, processing and distributing information efficiency about the company´s environment and to establish a systematic recording of detected events, opportunities and threats. Another benefit is a practical demonstration of the introduction of the CI system that respects the constraints of small companies and an overview of IT tools, which can be used by these companies for systematic information monitoring and collection.
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