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The phenomenon of dementia in the context of human rights
Mužáková, Monika ; Titzl, Boris (advisor) ; Stejskal, Bohumil (referee) ; Kysučan, Jaroslav (referee)
The main aim of the doctoral thesis is to contribute to the better knowledge of the means by which the notion of the phenomenon "developmental disabilities" (mental disabilities) was created in the past, and which existential opportunities result from this for the life of a mentally challenged person. What does this phenomenon mean for us today? How do we understand the questions related to the existential needs of mentally challenged people in the context of human rights? I searched for the clarification of the ways by which the phenomenon of mental disability was shaped throughout the history of the development of the views of the human mind, body and soul. That is the reason why I define the notion of mental disability from the point of the views of the human mind and in connection with simultaneous growth in the knowledge of human body. Chapter II is shaped by my study of principal human experience with mental differences since mythical notions of a human being. I devote my attention to the ancient knowledge of the substance of mental diseases, derived from the attempts of the first scientific, rational studies of human body. The Middle Ages enriched the care for people with mental impairment - among which the mental disability was also ranked though in phenomenology undistinguished, - by the element of...
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Adrenal function in patients with diabetes mellitus type 1 (young adults)
Šimůnková, Kateřina ; Vondra, Karel (advisor) ; Kršek, Michal (referee) ; Marešová, Dana (referee)
Background: The Addison disease of the autoimmune etiology is mostly appearing as a part of APS2 whereas the most dangerous is a combination of DM1 and an autoimmune adrenalitis. The first evidence of adrenal insufficiency in DM1 is a repetitive hypoglycaemia and lower insulin consumption. Changes in the HPA axis caused by either the activation of the immunity system during the APS2 or by the structural changes in the insulin binding proteins may present the basis for the subclinical adrenal insufficiency. The functional adrenal disorders without autoimmune adrenalitis are frequently observed in autoimmune diabetes mellitus. (...) Conclusions: A rather slow autoimmune adrenalitis progress is observed in adult patients with autoimmune endocrinopathies but rarely ending with a full adrenal destruction. The adrenal antibodies importance is still under study. Higher adrenal disorder count in DM1 patients with first manifestation around the age of 30 is presumed according to our results. Subclinical adrenal insufficiency is still very difficult to diagnose and new diagnostic ways 7 are recently being proposed. We have proven the advantages of salivary cortisol during the test as well as in daily profile. We have shown that adrenal disorders are not caused by cortisol binding peptide structure modifications in...
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Evaluation of the number drowened people in the Czech Republic in the years 1994 - 2010
Bidelnica, Petr ; Fiala, Miloš (advisor) ; Vilášek, Josef (referee)
Title: Evaluation of the number drowned people in the Czech Republic in the years 1994-2010 Aim of the thesis: Evaluate the number of drowning people in the Czech republic. Methods: Searches of available sources. Collecting data from the Czech Statistical office, media, information portals. Results: All the processed data was given in the context of the current causes of drowning people in natural waters, which can not be assessed to the short time generalize. In the month of July was a positive correlation between the number of the people drowned and the temperature. Results of this work can not be compared with foreign countries and assume that the results will be the same. Keywords: Drowning, International Classificasion of Diseases, Water Rescue Service, the casuse of drowning.
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The role of radiologist assistant in myocardial perfusion scintigraphy in children
Kryštůfek, Josef ; Táborská, Kateřina (referee) ; Michalová, Kateřina (advisor)
This thesis is focused mainly on the role of radiology assistant in myocardial SPECT examinations, which are here applied in its entirety, from preparing the patient, recording of data, quality control and processing studies. The aim of this study was to analyse cardiac gated SPECT imaging at children examinated in the Clinic of Nuclear Medicine and Endocrinology in the University Hospital Motol in years 2002-2008 - their numbers, indications and results concerning of impairment of perfusion and function of myocardium of the left ventricle. There were compared normal values of ejection fractions (EF) of gated SPECT (evaluated by software 4D-MSPECT) with normal values of 3D echocardigraphy. 37 children aged 7 do 18 years underwent cardiac gated SPECT imaging in the Clinic of Nuclear Medicine and Endocrinology in the University Hospital Motol in years 2002-2008. The main indications for examinations were: anomalous origin of the left coronary artery, transposition of the great arteries after arterial switch operation, Kawasaki disease, stress related ST depresion on ECG and chest pain. From 37 patients had normal result 19 children, abnormal result 18. The totale count of cardiac SPECT studies are 68 ( some patients had stress and rest examination). 53 studies are gated (35 after stress, 18 in the rest ). 15...
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Prospective study: Influence of BMI, comorbidity and aplication of antibiotics on healing of laparotomical cuts by women
CIMLOVÁ, Ivana
ABSTRACT At the end of the 20th century, the rapid development of new information also affected the gynaecological surgery. Ever new diagnostic and therapeutic procedures have been proposed, huge quantities of ever more effective medicaments are being developed, the physicians are being confronted with the solution of problems resulting from the adverse effects of the environment on the modern man. The care for women and mothers has completely changed in the last twenty years. In the classical gynaecology the diagnostic methods and the classification have changed (the inflammatory diseases, for example), new surgical methods were introduced into the routine practice. In this paper, we address the classical gynaecological surgical methods - the surgical therapy which only uses invasive surgical methods. We monitor the surgical wound healing after abdominal laparotomies. The objective of our work was to ascertain and compare the surgical wound healing after laparotomy surgeries in women with different BMI{\crq}s [Body Mass Index] and to find out during the hospitalisation whether women with an elevated BMI (25.0-29.9) are treated with antibiotics after laparotomy surgery. Three hypotheses were proposed. The first hypothesis reads as follows: ``In women with BMI within the norm (BMI = 18.4-24.9), the operation wound heals per primam{\crqq}. The results have not confirmed this hypothesis completely. Even though the wounds healed per primam in an unequivocal majority of women, there were also women with wound healing per secundam. The second hypothesis says: ``In women with elevated BMI (25.0-29.9) and high BMI (equal or above 30.0) the surgical wound heals per secundam. The results represented in the graphs show that the second hypothesis was also disproved, there was not exclusive secondary healing in the groups with elevated and high BMI; nevertheless, the result was positive. The hypothesis 3 says: ``The women with elevated (25.0-29.9) and high (30.0 and more) BMI are treated with antibiotics during the hospitalisation. This hypothesis was confirmed. The quantitative investigation was carried out using the method of data collection from the medical documentation in randomly selected patients in the period August 2006 - November 2006. The data were collected in the archive of the České Budějovice Hospital, a. s. In this investigation, the healing of surgical wounds in women with different MBI{\crq}s was ascertained and compared. This work has brought us to the conclusion that the postoperative course is generally less complicated in women with BMI within the norm that in women with elevated or high BMI index. Therefore, attention must be paid to the increasing obesity and the connected complications, no only for health reasons. The results of this investigation can expand the health personnel{\crq}s information in the sphere of wound care after laparotomy surgery, and they could also serve as a basis for further investigations into this problem. This work can also be used in the teaching at the South-Bohemian University, published in professional journals and on the Internet.
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The quality of life
Faťunová, Zuzana ; Kebza, Vladimír (referee) ; Hrachovinová, Tamara (advisor)
The quality of life have been a subejct of many studies and thesis for about last fifteen years. This work presents the concept of quality of life, especially from the view of the psychology and the medicine. There are discussed some methodological problems of the measuring and the evaluation of the health-related quality of life and there are also described basic and inportant instruments used in clinical studies. The aim of the second practical part is to illustrate a use of an instrument in a concrete situation - in the evaluation of the health-related quality of life of patients with coronary disease.
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The informed consent of a patient
Semrád, Václav ; Císařová, Dagmar (advisor) ; Sovová, Olga (referee)
58 Informed Consent of Patient 8 Summary Informed consent of patient is as a legal concept excercised in health service on daily basis. Its importance for consumers of medical services oscillates from trivial act that does not require any special attention to crucial decisions, that shall determine further period of patient's life. Significance of cosnent is given by nature of medical situation with which particular patient comes across. Current legal framework is based on both-international and national rules of law. The first are represented by International Convention218 that stipulates fundamental principles, the latter more specificaly elaborates further details of the whole concept. Consent on patient with medical intervention historicaly went through several stages. In the course of own developement was closely related to providing the patient with information. In ancient and medieval times was not usuall that physician informed his patient comprehensively. Means of treatment and their efficiency were rather limited and many diseases and injuries that recent medicine considers as curable lead often to fatal consquences. Maintenance of faith and resolution of patient to fight with adversity seemed to be crucial within such conditions. As a condition of medical intervention was consent introduced by...
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Pendrin in the pathogenesisof congenital hypothyroidism
Banghová, Karolína ; Lebl, Jan (advisor) ; Límanová, Zdeňka (referee) ; Houšťková, Hana (referee) ; Stárka, Luboslav (referee)
Pendrin is an anion transporter that is expressed in several organs. In the thyroid gland, pendrin is localized at the apical pole of thyrocytes and it is responsible for the iodide efflux from thyrocytes into the colloid in the follicular lumen where iodide is organificated. The extrathyroidal expression was shown in the inner ear, kidney, placenta and mammary gland. Carriers of mutations in the pendrin gene (PDS, SLC26A4) display variable phenotypical features following the autosomal recessive manner of the inheritance: combined thyroid and hearing affection (Pendred syndrome - OMIM274600), nonsyndromic autosomal recessive neurosensory deafness (DFNB4 - OMIM600791) or isolated enlarged vestibular aqueduct (EVA - OMIM603545). The thyroid affection is usually manifested as euthyroid or hypothyroid goitre in the second decade of life. In a minority of patients, dyshormonogenesis is present at birth, and the disease is diagnosed in the frame of the nation-wide neonatal screening for congenital hypothyroidism.
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Retrospective diagnosis of unknown cause of sudden infant death
Strnadová, Kristina ; Lebl, Jan (advisor) ; Janda, Jan (referee) ; Plavka, Richard (referee) ; Vízek, Martin (referee)
Background: Sudden infant death syndrome (SIDS) is defined as sudden unexpected death of an infant that remains unexplained after thorough post-mortem examination, investigation of the scene of death and case history. The autopsy findings and the physiological characteristics of these infants suggest a possible role of insufficient cardiorespiratory control and arousal mechanisms. The etiology is probably multifactorial based on a genetic predisposition combined with environmental factors. Several candidate genes have been studied, e.g. those involved in serotonin transport, autonomic nervous system embryology, inflammation, energy production, nicotine and glucose metabolism. A small number of cases may be caused by monogenic diseases that can lead to sudden death and leave no characteristic autopsy findings and thus imitate SIDS. Fatty acid beta-oxidation disorders (FAOD) have been associated with SIDS since 1976 and it is nowadays estimated that they may be responsible for about 1% of SIDS cases. Congenital long QT syndrome, a cardiac channelopathy, that may cause a fatal arrhythmia was a logical candidate for SIDS and indeed it was found out that about 9,5% of SIDS cases carry a mutation or a function changing variant in one of seven cardiac ion channel genes. We assumed that the severe salt...
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Clinical and pathologic correlation of complications of intensively treated hemato-oncological patients with a targeted focus to the involvement of the oral cavity and rare case of secondary neoplasia.
Vokurka, Samuel ; Boudová, Ludmila (advisor) ; Chlumská, Alena (referee) ; Faber, Edgar (referee)
Summary: In this thesis section "Oral Mucositis (OM) and oral Graft versus Host Disease (GVHD) in patients after allogeneic stem cells transplantation and with focus to FLU/MEL conditioning regimen" the author deals with following issues: 1. Literature overview: The overall negative impact of OM is mentioned and the complex pathogenesis, clinical characteristics, incidence and factors influencing both OM and GVHD are described. The histological features of GVHD and classification of it are mentioned, too. Conventional and reducedintensity conditioning transplant regimens, including FLU/MEL are presented. 2. Methodological section: Prospective observational study of 117 patients after allogeneic stem cells transplantation with BU/CY2/±ATG (26%), FLU/MEL (60%), FLU/CY (9%), Bu/FLU/ATG (2%) and HD-CY/ATG (2%) conditioning regimens. OM assed according to WHO criteria, GVHD assessed according to NIH criteria accepted by the EBMT. The statistical univariate analysis performed by means of GraphPad In Stat - Statistica Software (Man- Whitney, Fisher, t-test), p<0,05 considered significant. Multivariate analysis used in OM risk factors assessment. 3. Results: The OM incidence was significantly dependent on pre-transplant conditioning regimen (Bu/CY2/±ATG: 100%, FLU/MEL: 78%, FLU/CY: 9%, p=0,0001) in multivariable...
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