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Analysis of AVG signals
Musil, Václav ; Sekora, Jiří (referee) ; Rozman, Jiří (advisor)
The presented thesis discusses the basic analysis methods of arteriovelocitograms. The core of this work rests in classification of signals and contribution to possibilities of noninvasive diagnostic methods for evaluation patients with peripheral ischemic occlusive arterial disease. The classification employs multivariate statistical methods and principles of neural networks. The data processing works with an angiographic verified set of arteriovelocitogram dates. The digital subtraction angiography classified them into 3 separable classes in dependence on degree of vascular stenosis. Classification AVG signals are represented in the program by the 6 parameters that are measured on 3 different places on each patient’s leg. Evaluation of disease appeared to be a comprehensive approach at signals acquired from whole patient’s leg. The sensitivity of clustering method compared with angiography is between 82.75 % and 90.90 %, specificity between 80.66 % and 88.88 %. Using neural networks sensitivity is in range of 79.06 % and 96.87 %, specificity is in range of 73.07 % and 91.30 %.
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The issue of care of a patients with the critical ischemia of lower limbs.
SVATOŠOVÁ, Gabriela
Peripheral arterial disease (PAD) is a disease which may cause gradual narrowing and possibly congestion of arteries that are responsible for nourishing the lower limbs. Most often this condition develops consequently with atherosclerosis. The most advanced stage of PAD is called critical limb ischemia. The changes induced by atherosclerosis affect not only the lower limb arteries, but at the time of the diagnosis of PAD all arteries in the body are already affected. Therefore PAD belongs among cardiovascular diseases and its diagnosis is a negative prognostic factor of the overall cardiovascular risk. The aim of treatment interventions is to reduce complications that accompany this ailment and their impact on the patient's life. The aim of the thesis was to find out to what extend the patients are informed about the causes of PAD, options of its treatment and the impact of prevention and life style on the overall prognosis of the disease. The first objective of the thesis is to find out if patients are aware of the risks of PAD treatment, one of which is leg amputation. The second objective is to find out whether the patients are sufficiently informed about their condition. The third objective is to evaluate whether patients follow the prescribed treatment. The fourth objective is to find out whether patients are willing to change their life style in order to eliminate the risk of lower limb amputation. A part of interviews with patients was to educate them about their condition, the necessity of following the treatment regimen and the impact of lifestyle on the affected leg prognosis. At the end, the interviewed received educational handouts with information about the most important suggested procedures to follow. The practical part of the thesis is based on qualitative research. The data was collected in semi-structured interviews. The interviews were conducted in two steps. The first step was to educate patients about PAD and distribute informational handouts. The second round of interviews took place intentionally several months after the first ones. Their purpose was to assess the impact of education on patients' compliance with treatment and regimen. The research shows the majority of the interviewed were well-informed about the crucial aspects of their condition and treatment procedures. The participants understood the given information and considered it satisfactory. However, it was surprising that patients had not looked for information themselves. Simultaneously, it was ascertained that most of the respondents were aware of the prognosis and risks related to the treatment. The two-step interviews showed some respondents were not aware of the causes of their disease. It can be therefore assumed that their ignorance of the risk factors and their impact on the development of the disease is the reason why patients do not give enough importance to the suggested treatment regimen. Furthermore, it was found out that they had not look for a substitute solution if they are not able to follow the recommended treatment regimen. The results of this thesis show that although the elimination of the risk factors is crucial for patients' future they do not pay enough attention to them. There are two aspects to it; either patients trivialize the potential risks or are apathetic or are not sufficiently informed. It is hard to have some impact on patients' apathy and trivialization of their condition. Nevertheless, it is possible to influence the second aspect, which is the subject of the final part of the thesis and the educational handout. As was discovered during the interviews, the information provided by doctors during ambulatory treatment is not thorough and does not include practical advice how to follow treatment regimen. Patients should be informed by nurse either personally or during the sessions. In this way the patient should be also selfmotivated in their treatment.
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Quality of life of patients with peripheral arterial disease
HRADOVÁ, Helena
Theoretical foundation Arterial disease which gradually leads to narrowing of artery, up to complete vascular closure and to subsequent manifestation of ischaemia is called ischaemic disease of the lower extremities (IDLE). We need to understand ischaemic disease of the lower extremities not only as a disease causing patients a range of difficulties and significantly impacting their life quality, but also as a very important indicator of overall cardiovascular condition of whole organism. Ischaemic disease of the lower extremities becomes more and more accepted as a chronic disease associated with a substantial cardiovascular risk. This disease causes primarily walking limitation by which it impacts daily activities and significantly decrease the life quality. Goal of the thesis: A goal was set for the thesis: Finding out in which areas the ischaemic disease of the lower extremities impacts the life quality. Hypotheses: 6 hypotheses were set for the thesis: H1: Patients with IDLE feel pain H2: Patients with IDLE are limited in moving H3: Patients with IDLE are limited socially H4: Patients with IDLE feel concern for their future H5: Patients with IDLE perceive their life quality as a low one. H6: Patients with IDLE are limited in the area of basic daily activities. Methodology: The research part of the thesis was implemented based on quantitative inquiry within the grant Project No. 120/2012/S ?Reflection of life quality in nursing?. For the empirical part of the thesis the quantitative method was used, the survey was carried out in form of questionnaires, more precisely a standardized questionnaire EQ-5D-5L, selected questions from a questionnaire WHOQOL 100 and specific non-standardized complementary questions for patients with ischaemic disease of the lower extremities. The survey was carried out by addressing practising physicians , doctors from specialized outpatient departments and inpatient wards. Nurses who were, along with the doctors, responsible for explaining the significance of the survey to the patients were an integral part to the data gathering process. The respondents were selected intentionally, the basic factor of selection was presence of the ischaemic disease of the lower extremities. The selection sample was designed using selective quota, the only quota being the age of respondent. Results: All results obtained were statistically processed in the SASD (Statistical Analysis of Social Data) software. The results were divided into three areas. Firstly results describing the structure of selection sample, secondly results depicted graphically and thirdly results processed using a descriptive statistics. The last two areas were then arranged according to the used questionnaire. The results provided us with information regarding patients' perceiving of pain, the difficulties in moving, the social area, the basic daily activities, the concerns for the future and subjective perceiving ot the life quality. Based on the results, the set hypotheses were evaluated as follows: H1: Patients with IDLE feel pain ? confirmed, H2: Patients with IDLE are limited in moving - confirmed, H3: Patients with IDLE are limited socially - confirmed, H4: Patients with IDLE feel concern for their future - confirmed, H5: Patients with IDLE perceive their life quality as a low one ? not confirmed, H6: Patients with IDLE are limited in the area of basic daily activities - confirmed. Conclusion: The thesis provides a comprehensive view on the areas impacting the life quality of patients with ischaemic disease of the lower extremities. In practice the results can facilitate the choice of effective intervention and improve communication with patients, especially due to the gained knowledge. The results will be published in journals and presented at conferences. The results could also be used as a foundation for another survey and as a studying material for students of nursing.
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The education of a patient with lower limb ischemia in secondary care
ONDRÁČKOVÁ, Zdeňka
The thesis dealing with {\clqq}The education of a patient with lower limb ischemia in secondary care`` is divided into two parts, theoretical and practical. The first objective {--} to find out if patients are informed enough about prevention measures in secondary prevention of lower limb ischemia {--} was accomplished. to find out if patients are familiar with principles of treatment of lower limb affected. To find out if nurses educate patients with lower limbs ischemia. A quality nursing care is based on an individual approach to the patient. The process of education must be tailored to the patient´s needs and it should be easy to understand.
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Diagnosis and endovascular treatment of iliac and femoropopliteal occlusive disease
PĚČKOVÁ, Kristýna
The occlusion disorder in the area pelvic and femoral arteries should be for the patient fatal health complication. Therefore it is important know all risks, which should go before, know the disorder and last but not least is a crucial chapter diagnostics and in final phase treatment. I chose this subject, with the view of give to pertinent readers all above - mentioned information on those problems. For diagnostics of occlusion disorder we use imaging radiodiagnostic methods. For spatial display were developed method of spiral CT angiography ( CTA ), magnetic resonance angiography ( MRA ), a modification of classical angiography {--} digital subtraction angiography ( DSA ) and ultrasonografi (UZ). UZ is part of the basic investigate method of his noninvazive. Spiral CTA is method, which is based on two and three dimensional display using special programmes. Display magnetic resonance is noninvasive examination procedure and is derived from classical nuclear MR. MRA is once from possible examination practice which serves complex information on relation surrounding weaving to vessels and haemodynamic blood flow. DSA allows observation of flow vessels and by the help of digitizing image its graphical processing. Medication of okluziv disorder areas saucepan s and femur s arterys including percutaneous transluminal angioplasty ( PTA ) and implantation stent.
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