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Laboratory diagnostic of mold genus Fusarium
Vitáčková, Petra ; Konečná, Klára (advisor) ; Vejsová, Marcela (referee)
Submitted diploma thesis deals with laboratory diagnostics of filamentous micromycetes (moulds) genus Fusarium in the laboratories of medical mycology. In the first part of the diploma thesis is dedicated space for general familiarization with filamentous microscopic fungi. Next separate chapter describes the genus Fusarium, especially in relation to human medicine. The final part of the diploma thesis summarizes current possibilities of laboratory diagnostics of filamentous micromycetes, focusing on the genus Fusarium. Invasive infections caused by filamentous fungi are increasingly common complication, especially in immunocompromised patients. In most cases they affect the patients with hematologic malignity and patients after hematopoietic stem cell transplantation or solid organ transplantation. The most common etiological agent of such infections is unambiguously the Aspergillus genus. However, in recent years, increasingly cases of infections due to less common filamentous fungi, including Fusarium spp. are described. Invasion fungal infections are associated with very high mortality. The basic requirement thus becomes the speed and accuracy of diagnosis. The most important methods for the laboratory diagnostics of invasive infections caused by filamentous fungi are conventional methods -...
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Humoral aspects of common diseases in musculoskeletal system
Stanžovská, Adéla ; Machač, Stanislav (advisor) ; Vránová, Hana (referee) ; Stollinová Šromová, Lucie (referee)
This research thesis speaks about humoral aspects of common musculoskeletal diseases. In the beginning, we present the most common diagnoses in physical therapy connected to body substances. For that reason, the thesis also gives a brief review of laboratory diagnostic methods that is often crucial for successful diagnosis of certain diseases and their aetiology. Also, the laboratory testing plays an important role in so called Red flags, signalising serious pathologies which should not be excluded forgotten in diagnostic thinking, especially in cases where the therapy is inefficient. Lastly, patient's psychological state significantly influences these parameters.
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Genetické příčiny deficitu cytochrom c oxidázy u dětí
Vondráčková, Alžběta ; Tesařová, Markéta (advisor) ; Brdička, Radim (referee) ; Procházková, Dagmar (referee)
Mitochondria are the key source of vital ATP molecules, which are largely produced within cells by a system of oxidative phosphorylation (OXPHOS). Genetic defects affecting any of the components of the oxidative phosphorylation system or the structure and function of mitochondria lead to mitochondrial disorders, which occur at an incidence rate of 1 in 5000 live births. Cytochrome c oxidase (COX) is the terminal enzyme and electron acceptor of a respiratory chain that catalyses oxygen to produce a water molecule. In addition to complex I deficiency, isolated or combined COX deficiency is the most common respiratory chain defect in paediatric patients, and it can arise from mutations located either in mitochondrial DNA or in nuclear genes encoding the structural subunits or corresponding assembly factors of the enzyme complex. However, the molecular basis of COX deficiency remains elusive in many patients despite advances in the identification of an increasing number of mutations and genes involved in the disease. This thesis focuses on the identification of the genetic causes of mitochondrial diseases in a cohort of 60 unrelated Czech children with clinically and laboratory confirmed COX-deficiency. With the use of a high-resolution melting analysis mutation screen, four heterozygous sequence...
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Laboratory diagnosis of pheochromocytoma
Chlupáčová, Tereza ; Bílek, Radovan (advisor) ; Švandová, Ivana (referee)
1 Phaeochromocytomas are tumors predominantly rare to chromaffin tissue in adrenal glands' medulla. Tumors in the extra-adrenal chromaffin tissue are called paragangliomas. Phaeochromocytomas cause secretion of high amounts of catecholamines, which can lead to fatal consequences if not medically treated. The aim of this thesis is to summarize the so far known facts about this severe disease in a written review. The first part of the study focuses on issues of phaeochromocytoma research and lists general information about these tumors and their clinical manifestations. The importance of genetic influence in connection with treatment strategies for patients with phaeochromocytoma is also discussed. The second part of the thesis summarizes procedures and methods used in laboratory diagnostics of phaeochromocytomas. The conclusion briefly describes the possibilities of tumor localization using imaging technologies and procedures of subsequent treatment of patients with phaeochromocytoma.
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Pertussis, possibilities of managing unsatisfactory epidemiological situation in the Czech Republic.
PINĎÁKOVÁ, Lucie
This thesis deals with the problems of pertussis epidemiological problems in the Czech Republic, especially the possibilities of improvement of the epidemiological situation of pertussis. Pertussis is a serious infectious disease of the respiratory system and is monitored long-term in Czech Republic. The incidence of pertussis in its epidemic cycles continues to increase since the 90s. Last year's reported sickness rate was 11.7 of 100 000 people (1233 cases total).The thesis is divided into theoretical and practical part. The theoretical part shows the characteristics of pertussis and describes the preventive and repressive measures. Last part of the theoretical section describes epidemiological situation of pertussis from history to the present day while last four years are described in more detail. The practical part of the thesis consists of research.The research was conducted using qualitative method. As data collection method was chosen interviews with first contact physicians, which are pediatricians and physicians for adults. Two objectives were set in research area. The first objective was to map the compliance with the conditions laid down under the "case" definition of pertussis and its methods of diagnosis for pediatricians and physicians for adults (first contact physicians). The second objective was to create intervention for affecting the adverse epidemiological situation of pertussis. Intervention is based on the results of research aimed at compliance with procedures of "case" definition of pertussis and on knowledge of pediatricians and physicians for adults about the epidemiology of pertussis issue and their views on vaccination.
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Diagnosis and therapy of Helicobacter pylori infection
POSPÍŠILOVÁ, Michaela
H pylori is a Gram-negative, microaerophilic rod-shaped moving bacterium, notorious for its urease production. It colonizes gastric mucosa and always leads to chronic gastritis, which may result in the development of other serious diseases, such as gastroduodenal ulcer disease and gastric adenocarcinoma. In 1994, H pylori was classified as a category 1 carcinogen. H pylori infection can be tested for invasively and noninvasively. The invasive methods include cultivation, histological examination and a rapid urease test. Noninvasive options are the carbon urea breath test, a stool antigen (HpSA) test and a blood antibody test. H pylori is sensitive to betalactam antibiotics. These should therefore be the essential part of the treatment; the instances of resistance are rare. Should the patient be allergic to betalactam antibiotics, nitroimidazoles can be used instead. H pylori is also sensitive to macrolides. The objective of my bachelor thesis was to acquire practical knowledge necessary for the correct processing of stool and serum samples in laboratory practice. I also intended to describe current trends in diagnosis and treatment of H pylori infection, together with the infection rates depending on age, sex and the season of the year. The findings were discussed in the context of relevant academic literature. Finally, I monitored the ways in which gastroduodenal ulcer disease caused by H pylori infection is diagnosed and treated by gastroenterologists in České Budějovice. The collection of the data for quantitative research was carried out between 1 January 2012 and 31 December 2012 in the microbiological laboratory Synlab czech s.r.o. in České Budějovice, which covers the whole of the South Bohemian Region. The samples were supplied mostly, but not exclusively, by GPs, and two methods of medical examination (euroSCREEN HP and EIA Helicobacter MONO IgG) were used. EuroSCREEN HP is based on the stool antigen (HpSA) detection, EIA Helicobacter MONO IgG is an immunoenzymatic method detecting IgG antibodies against H pylori in human serum or plasma. The data for qualitative research were collected in gastroenterologic ambulances in České Budějovice. Guided semi-structured interviews were carried out with one doctor in each ambulance. The acquired data were then processed as case studies and used to obtain categorization tables. The quantitative research confirmed all three hypotheses subject to evaluation. Higher age groups were found to have higher infections rates. However, no effect of either sex or the season of the year on the infection rates was registered. The qualitative research showed that gastroduodenal ulcer disease is most frequently diagnosed by České Budějovice gastroenterologists by the means of a biopsy check during gastroscopy. The samples are then sent to a microbiological laboratory for cultivation, histological examination and a rapid urease test. H pylori infection is usually treated by the standard triple therapy: amoxicillin, clarithromycin and a proton pump inhibitor. In case of hypersensitivity to betalactam antibiotics clarithromycin, a proton pump inhibitor and metronidazole are used instead. Occassional resistance to metronidazole and clarithromycin was reported. In these situations, cultivation is carried out in order to determine the sensitivity to antibiotics. The effects of the eradication treatment are evaluated by the means of a biopsy check during gastroscopy 6-8 weeks after its application. The samples are analysed in a microbiological laboratory. Some gastroenterologists also use a stool antigen (HpSA) test.
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Cultivation and sensitivity of the stems of Streptococcus pyogenes from the mucus of nasopharynx and ears in children and their sensitivity to {$\beta$}-lactam antibiotics and makrolids
SIVOKOVÁ, Jaroslava
The topic Cultivation and sensitivity of the stems of Streptococcus pyogenes from the mucus of nasopharynx and ears in children and their sensitivity to {$\beta$}-lactam antibiotics and makrolids occupied my mind because I was interested in the question if the increased consumption of antibiotics and the following resistance occur also in this bacterium. Except for gaining practical knowledge on cultivation and identification of Streptococcus pyogenes bacteria the objective of the thesis was the investigation of its sensitivity to {$\beta$}-lactam antibiotics and makrolids. Further I was intersted in how the doctors for children and teenagers proceed in case of suspicion of streptococcus disease of upper airways. Also this topic was one of the objectives. The thesis is composed of two parts, theoretical and practial ones. In the theoretical part I first came out of available information on Streptococcus pyogenes bacteria. I describe its morphology and characteristics, factors of patogenics and virulence. This information is used during the cultivation of bacteria and its following identification. Further I mention the diseases which are caused by pyogenous streptococci. The part is also the description of antibiotics which are recommended for the treatment of the diseases caused by this bacteria. The second part includes the methods of cultivation and identification of Streptococcus pyogenes which are used in microbiology laboratory Laboma mikrobiologická laboratoř s.r.o. (Laboma microbiology laboratory Inc.). Identification methods come out of the application of PYR-test, latex agglutination and the use of identification system Api 20 Strep in ambiguous results. The results gained in microbiology laboratory show that the capture of Streptococcus pyogenes bacteria in diseases of upper airways created 4,4% from all smears sent into the laboratory. These diseases showed seasonal occurrence with the maximum in spring and winter. The results of sensititivity have shown that the sensitivity to penicilin was in 100% and to erythromycin in 91.6%. Cross-resistance between erythromycin and clindamycin ocurred in 57 cases (4.5 %). According to my investigation Streptococcus pyogenes caused otitis in 13 cases (2.7%). The highest ocurrence of otites caused by Streptococcus pyogenes emerged in spring. The stems isolated from ear mucuos were sensitive to penicilin in 100% and to erythromycin in 92.3%. These results apply to the material sent to microbiology laboratory Laboma mikrobiologická laboratoř s.r.o. (Laboma microbiology laboratory Inc.). To gain a complete picture I visited 20 doctors for children and teenagers who were willing to fill in my questionnaire. After the evaluation I found out that all questioned doctors are waiting for the results of cultivation and sensitivity of the stem to antibiotics if the clinical state of a patient is not serious. In preference they apply penicilin. Control smear is carried by most of the doctors only in recurrent infections. From the data of the laboratory I found out that three doctors send the material to the culture investigation and the following sensitivity of the stem to antibiotics after the failure of treatment in a patient.
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