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Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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LCD a VLCD diet during hospitalization
Zajíčková, Jana ; Matoulek, Martin (advisor) ; Kytnarová, Jitka (referee)
Objective: LCD and VLCD diets are short-term indicated (days to weeks) low caloric and very low caloric diets, which should be supervised by a doctor - e. g. by means a weight loss hospitalization (WLH). LCD and VLCD diets are used in preoperative preparation of obese patients and to break insulin resistance in patients with type 2 diabetes mellitus (DM II). The theoretical part of the bachelor"s thesis is focused on LCD and VLCD in obesity and diabetes mellitus treatment - the two most common diseases that can be found in the medical history of patients indicated for WLH. The aim of the theoretical part is to compare obesity treatment in medical care and commercial weight loss programs (for commercial weight loss programs the term "obesity management" is used). The study evaluate the most common indications for WLH, determine weight changes during the hospitalization and compare the weight of patients with DM II and without DM II (nDM II) one year after the WLH. Methods: The input data were obtained from the Medea database. These are the anamnestic data of patients hospitalized for the purpose of losing weight on the Third Medical Department of First Faculty of Medicine Charles University and General University Hospital in Prague in the period of January 2014 - January 2015. There were 93 WLHs...
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The role of the radiologist assistant in radionuclide brain examination
Horčičková, Zuzana ; Vlček, Petr (referee) ; Špalková, Ingrid (advisor)
Bachelor's thesis "The Role of the radiotherapist in radionuclide brain examinations" is engaged Nuclear medicine imaging methods in the examination of the brain and the role of the radiotherapist at radioisotope nuclear examination in the brain. The work is divided into nine parts. In the first and second part describes anatomy and physiology of the nervous system. The third part is devoted to regional brain blood perfusion - an examination of brain perfusion and assessment of cerebrovascular reserve capacity, which is described preparation and advance in examination, used radiofarmaceutical, evaluation of SPECT examination and contraindication. For testing cerebrovascular reserve capacity are described options burdens. Furthermore, in this chapter refers to the differential diagnostics of dementia, the detection of epileptic focus, the diagnosis of brain death and diagnostics of brain trauma. The fourth part is direct on receptor diagnostics. With respect to commercially supplied by diagnostic ligand is the most common examination dopamine system. The fifth part deals with 18F-FDG - PET examination of the brain. Distribution and intensity of glucose metabolism in the brain can be visualized. The sixth part deals with the diagnosis of brain tumors. In this chapter described the examination using of SPECT...
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Bone densitometry
ŠÍRKOVÁ, Eliška
According to the World Health Organization (WHO) osteoporosis is defined as: "Increasing of systemic disease of skeleton. The characteristic feature is the lack of bone substance and disorders of microarchitecture of bone tissue. The result of the disorder is disposition to fractures. Earlier the disease was not diagnosed until it got to the stage of occurrence of osteoporotic fracture. Nowadays it is anticipated by means of BMD. Especially women at the age of postmenopause and older men are invited for the medical check-up. However, younger people and even children are invited too. The main indications for the BMD measurement are women who stopped a hormonal curing by using estrogen or they are at the age of postmenopause. It is also recommended for patients with increased occurence of fractures caused by small force and for patients who had a big weight loss. Last, but not least, it is good for men in their seventies, patients who are considering the pharmacological treatment and of course patients with visible effects of the treatment. The densitometry medical check-up itself, known as DEXA, is painless and non-invasive method, using which we can find comprehensive information about the amount of bone mineral in examined section of bone. The parts, where the density is measured, are the parts that are the most abraded. These are vertebrae L1 L4, distal antebrachium, proximal femur, ribs and proximal humerus. It is necessary to check BMD patients with the same apparatus and software during the each medical check-up. For the checking measurement the patients comes every year. Nevertheless, not later than after the two years after the first medical check-up. The purpose of the thesis is research including two main points: analysis of the data acquired from densitometric station of 'Nemocnice České Budějovice a.s. and omparison of the data of patients with a regard to age, sex and the kind of disease. Based on the research it was found out, that division of the patients into groups according to the diagnosis is not conforming. 95% of patients are suffering from various stages of osteoporosis. Only 5% of patients have different diagnosis. Based on the data from the research it was found out that there are ten-times more women who undertook the medical check-up. It is clear, why mainly women undertake the osteoporosis medical check-up. The sudden change of metabolism of bones, mostly related to climacteric, the end of treatment using estrogen, or lactation, is difficult situation and it is very stressful for the whole organism.
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The present of nonmalignant radiotherapy
DIBELKOVÁ, Stanislava
Non-malignant radiotherapy is medical exposure, which is done with benign disease after exhausting all other standard treatments. Its goal is relief from problems caused by benign disease, or prevents deterioration of function of the affected organ. The main difference between the radiation treatments of malignant versus non-malignant diseases is in the size of the received dose and irradiation techniques. For irradiation of malignant diseases, often approaching tissue tolerance doses, while those used in non-malignant radiation therapy are significantly lower. These results in simpler techniques of irradiation, often get by with one or two input fields. The main principle of non-malignant radiotherapy is applied as the smallest and most effective individual and total dose into the smallest possible volume of tissue, then use simple techniques (direct one field, or two opposite), if necessary, take the form of individual treatment of irradiated fields, focus the radiation beam from the body of the patient from a radiosensitive organs, using all methods of radiation protection (for example lead shielding of the testes in men, lead collar on the neck, etc.), patient age should not be less than 40 years, younger patients should be treated like this after considering the benefits relation to the possible consequences. The patient is sent to the radiotherapy on the advice of another field. Indication for radiotherapy is entirely the responsibility of the radiation oncologist. Prescriber physician recommendation states that it is a state in which all other treatment methods are exhausted or not applicable. The physician takes into account contraindications treatment, the overall condition of the patient and his age. The patient is on treatment and possible side effects informed by the doctor before starting treatment with signed informed consent to treatment. To indicate a treatment planning is necessary history and other investigations in relation to the disease. After completion of radiotherapy department of radiation oncology ensures borreliosis acute flare reaction. The department will evaluate whether the radiation prescription and treatment plan followed. The patient is a report on the treatment handed over to the care of the sending physician. In this thesis is the research question: Causes the development of therapeutic modalities reduction of treatments of nonmalignant radiotherapy? To answer this research question was obtained data from the archive and irradiation protocols of radiotherapy departments of hospitals in the České Budějovice and in the Jihlava. It was the data of non-malignant indications for radiotherapy conducted in 1979, 1980, 2012 and 2013, irradiation parameters and techniques. In the České Budějovice in 1979-1980 were treated 1471 patients and 854 patients in Jihlava. In 2012-2013, it was only 793 patients in the České Budějovice, which is 48.4% less. In the same period in Jihlava it was 413 patients which mean about 53.9% less. Techniques irradiation in both hospitals significantly differed mainly in the fractionation, the size of individual and total dose varies in the manner of filtration volume. Although the indications for non-cancer radiotherapy declining, it still has for its final effect irreplaceable role.
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Vibration and Acoustic Emission Reduction of Powertrains using Virtual Engine
Svída, David ; Kovář, Rudolf (referee) ; Dundálek, Radim (referee) ; Kovář, Rudolf (referee) ; Dundálek, Radim (referee) ; Píštěk, Václav (advisor)
Doctoral thesis deals with combustion engine cranktrain vibrations and vibration analysis methods. The work applies new computational models aimed at powertrain vibration decrease. The computational models can be used in the first stages of powertrain development. Temperature dependences of the rubber shear modulus and loss factor characteristic are found by response analysis of the free damped vibrations in the first part of the thesis. Viscoelastic model parameters of two dampers with different rubber hardness are calculated using optimization methods. Temperature distribution inside the rubber part during the harmonic oscillation is calculated with the knowledge of previous values. Computational models together with a user interface are assembled in Matlab/Simulink software tool. Computational model results of the viscoelastic rubber damper are verified by measurements on a prototype diesel engine in the whole operating engine speed range. Torsional vibrations of the crankshaft with torsional damper are measured by POLYTEC laser rotational tools. The temperature distribution on the damper surface is obtained by Infratec VarioCAM thermographic system. Combustion pressures in the cylinder are measured by SMETEC Combi indication tools. Both the temperature distributions and combustion pressures are used for computational purposes. All the measurement procedures are described also in the thesis.
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The position of the Teplice Spa in the spa industry with a focus on children's treatment
Křivanová, Daniela ; Mlejnková, Lena (advisor) ; Valentová, Jana (referee)
The aim of this diploma thesis is to analyse and evaluate the position of the Teplice Spa in the spa industry with a focus on children's treatment. The spa towns chosen for a comparison were Janské Lázně and Klimkovice which focus on the same indications for children as well as the Teplice Spa. The theoretical part introduces the concepts related to the spa tourism and deals with the children's treatment in the Czech Republic. The practical part deals with the analysis of the Teplice Spa and the comparison with the chosen spa towns. The outcome of this thesis will be recommendations based on the analysis of the spa facilities.
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