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The hospital of St. Paul in Prague
Katovská, Jitka ; Ebelová, Ivana (referee) ; Hojda, Zdeněk (advisor)
The institution of St. Paul 's Hospital in Prague belongs to social-charitable institutions that had taken care of the needed poor, ill, old, widows and orphans in the early modern period. The history of St. Paul 's Hospital had taken place in the area behind Poříčská brána and after the thirty year 's war in so called Temple. Certain amount of information, explaining not only economic and administrative functioning of St. Paul 's Hospital but also the history of day-to-day activities of the inhabitants, has been preserved in the hospital books in the Archive of the capital city Prague. The diploma thesis analyses material background of the hospital, the system of hospital donations, the administrative organisation with an accessible list of hospital clerks, and the quantity of care that the hospital was offering. In the list of the history of St. Paul 's Hospital there is also enumeration of duties and rules that had to be followed in order to stay in the hospital as well as references to the conditions and reasons for the admission of hospital applicants. The comparison with St. Catherine 's Hospital in Regensburg, which is unique for its parity functioning and both catholic and evangelic patients care, brings interesting evidence for the fact that Czech and German institutions do not differ in the basic...
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Safety standards in the department
DRKOŠOVÁ, Petra
The present state: Safety culture is a package of measures increasing safety of a patient in a health resort and in nursing care. These activities are implemented by individuals or organisations with the aim of protecting patient from damage to health, resulting from failure of care (24).Subject: The main purpose of investigation was surveying relations of the level of organisation culture in relation to domains of interest and safety of nursing care. Methodics: The impirical part of the bachelor?s thesis was done with the use of quantitative method of research ? data collecting by questionnaire. Evaluation of the style of leadership of the head nurse and questions applied to communication in team was undertaken with the use of modified questionnaire following Kollárik et al. Range of social atmosphere in a group (35). In statements exploring the culture of safety were included questions adopted from AHRQ methodics (36), Czech translation by Filka and Kotrbová (37). The research was conducted in April 2013 in the IKEM hospital in Prague. The data obtained were processed by statistical analysis with the use of SPSS 16.0 programme.The investigation set: Nurses and nursing assistants employed in the IKEM hospital in Prague. Out of the total of 160 distributed questionnaires, 118 completed pieces were obtained. The return rate was thus 73.8 %.Results: The aim of the research was evaluation of relations among the head nurse leadership, communication in team, and safe care of patients. The results of research concerning communication indicate positive evaluation of nurses as to timely distribution of important informations; somewhat worse were results concerning systematic and timely distribution of information. As to rating of effective communication in the team of nurses, 45.8 % of nurses responded positively and 68.6 % of nurses mentioned possibility of discussion. Complience with rules of correct behaviour and discretness seem to be matter of course. Important is respect to differences in opinion and mutual perception in the team. Unfortunatelly, chicane at the workplace is not an exception. A positive feature is that nurses are not afraid to ask colleagues for advice if patient safety is concerned.In implementation of leadership style in relation to patients head nurse is interested in members of team not only as to professional aspects but also as to personal aspects of nurses. She accepts discussion about about tasks, considers opinions of members of the team as well as individual nurses as to new information. Empathy is a positive character quality of a head nurse and she takes interest concerning problems of individual nurses.Among basic rules of safe care belongs hygiene of hands with the nursing personal and safe identification of a patient. Hands hygiene is the simplest prevention of hospital infection, which hospital personal must keep according to law and which they comply with, according to responses. There is possibility of improvement in application of safe care serving medicine as ordered by phone information and serving generic medicine without correction in consulting room. Doctors should be involved in removing these shortcomings. Highly positive is the approach of nurses in reporting an adverse event; nearly all respondents (98.3 %) would not hesitate to report, disregarding the opinion of the head nurse. According to opinion of nurses, head nurse is interested in adverse events and nurses are informed about mistakes which occur at the department, and discussion on prevention of repeated mistakes takes place.Conclusions: From the results of research follows that safe care is considered by personal positively. It is important that this idea is accepted and supported by head nurse and leadership of the hospital. The nurses percept the head nurse in a positive way. Effort in preventing communication mistakes in the team should include empathy and listening.
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Unsaturated fatty acids in the diet of inpatients
KONHEFROVÁ, Veronika
The thesis with the name "Unsaturated fatty acids in the diet of inpatients" is divided into a theoretical and a research parts. The theoretical part is focused on sorting out lipids and the recommended daily dosing. Next there are described the chemical structure of fatty acids and basic differences between saturated (SFA) and unsaturated (trans and cis) fatty acids. The biggest part of the theory is formed by the unsaturated fatty acids, their characteristics, food source and their effect on people´s health. Dietetic system and its future development is described in the final part. The research part analysis took place in the Centre for prevention of lifestyle diseases in České Budějovice. It was analysed nine fourteen-day diet plans, which are most frequently served in the Jindřichův Hradec hospital, PLC. The research diets are 0 (liquid diet), 1 (mushy diet), 2 (soft diet), 3 (well-balanced diet), 4 (low-fat diet), 9 (diabetic diet), 9/2 (diabetic soft diet), 11 (nutritious diet) and 13 (diet for teenagers). The aim of this thesis is to calculate the amount of monounsaturated fatty acids (MUFA) and polyunsaturated fatty acids (PUFA) in the most frequently served diets of hospitalized patients in the Jindřichův Hradec hospital, PLC, with the help of the nutrition software Nutriservis Profesional/NutriDan and to compare the amounts of both MUFA and PUFA in the particular diets. The results of my analysis show that none of the diets meets the recommended SFA:MUFA:PUFA ratio (<1:1,4:>0,6). In the majority of ratios is the amount of SFA:MUFA about 2:1,4. That means that the diets contain quite high surfeit of SFA. However MUFA:PUFA ratios except diet 0 (both two weeks) and 2 (second week) are above the minimum recommended references, it can be said that these diet's compositions aren't so bad. Only it would be appropriate to reduce SFA in diets, which would improve ratios according to the recommendations. This finding corresponds to the Research question number 1 about the real distribution of unsaturated fatty acids in individual researched diets. The Research question 2 about the total fat intake in each diet is answered as follows. Diets differ in the representation of total fat grams for each day according to standard of Jindřichův Hradec hospital, PLC. Diets 1, 2, 4 have fluctuating levels of total fat and are largely below the references. The diet 0 does not even meet any hospital recommendations for any day, the other diets, 3, 9, 9/2, 11 and 13 have the fat excess. The fat excess is given with the excess of saturated fat acids in diets and a significant part will be probably formed by a NutriDan undefined component of fats (the difference between total fat and SFA + MUFA + PUFA). I assume that those are the trans-unsaturated fatty acids. The results of this thesis will help the nutrition therapists from the Jindřichův Hradec hospital, PLC as a feedback, so that they could improve the percentage of unsaturated fatty acids in their diets according to the recommendations of nutrition companies.
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Thiopurine methyltransferase - clinical importance of genotyping and phenotyping
Černá, Blanka ; Beránek, Martin (advisor) ; Šimůnek, Tomáš (referee)
Charles University in Prague Faculty of pharmacy in Hradec Králové Department of Biochemical science Candidate: Blanka Černá Supervisor: Doc. PharmDr. Martin Beránek, PhD. Title of Diploma Thesis: Thiopurine S-methyltransferase - clinical importace of genotyping and phenotyping. Thiopurine S-methyltransferase catalyzes S-methylation thiopurine's drugs such as 6-mercaptopurine and thioguanine. TPMT genetic polymorphisms represent an important role in clinical pharmacogenetics. The differences in TPMT activity result from mutations in gene for TPMT. The polymorphisms are important factor in efficacy of treatment by thiopurine drugs. Patients inheriting low activity of enzyme TPMT have mutated allels, patients inheriting high activity of TPMT are usualy wild types. TPMT gen was genotypized by method real-time PCR in volunteers (n=55) with autoimmune diseases. The average of patient's age was 16,7 years. From blood collected into EDTA DNA was isolated by using QIAmp Mini Kit (Quiagen, Germany) and it was used for genotyping of TPMT. Genotyping was carried out by real-time PCR in LightCycler (Roche, Germany). TPMT was phenotypized in Hradec Králové in Medical Faculty of Charles University in Department of Pharmacology. The lysate of suspension of erythrocyte was used for phenotyping (The blood was...
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The objectification of therapeutical methods used for improvement of the deep stabilizng spinal system
Malátová, Renata ; Kolář, Pavel (advisor) ; Bunc, Václav (referee) ; Pavlů, Dagmar (referee) ; Marešová, Dana (referee)
5 Summary So far, no commercially used device, capable of evaluating the condition of the deep stabilizing spine system (DSSS), has appeared on the market. Therefore, a so called muscle dynamometer (SD01, SD02), has been constructed that enables to reveal a possible dysfunction of the DSSS. During a six-week-rehabilitation-course, aimed at correcting the body posture and strengthening the DSSS muscles, a statistically significant change (p<0.001) between the values of input and output measurements of the chosen group tested has been obtained. Correctness of the approach to objectify the initial state of the patient and his progress during the treatment was shown by the completed measurements. The effectiveness of therapeutical training was confirmed. Based on positive experience from SD01, a new version of muscle dynamometer, SD02, was constructed. Measurements by SD02 were to establish the condition of DSSS (frontal spine stabilization) by a lay-sit test repeatedly from the test battery UNIFITTEST 6-60 and by the diaphragm test. Measurements were conducted on 45 samples. Basic somatic measurements were performed and then measurements with the SD02 were conducted during the diaphragm test and UNIFITTEST. For comparison of the values the pairing t-test was used (normal data distribution was verified by the...
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Soft drinks and their effects on health
Ramstad, Gunnar Alexander Wilson ; Anděl, Michal (advisor)
The consumption of soft drinks has increased manifold over the last decades. In parallel to this increase it has been noticed an increase in health problems, especially obesity. Dentists continue to urge their patients not to drink soft drinks, and there has also been suggested a link between soft drink consumption and osteoporosis, hypokalemia and diabetes mellitus 2. Other additives, like caffeine, have been associated with headaches, restlessness and trouble with sleeping. Although more research is needed to confirm these relationships, many scientists suggest that we should start taking action to prevent children from developing the habits of large soft drink consumption we witness today. This could be accomplished by cooperation between parents, health practitioners, school system and government.
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Implantation of cryopreserved mitral allograft into tricuspidal position in an experiment with sheep: Technical aspects of implantation and immediate results evaluated with the aid of epicardial echocardiography
Vojáček, Jan ; Špatenka, Jaroslav (advisor) ; Dominik, Jan (referee) ; Třeška, Vladislav (referee) ; Černý, Štěpán (referee)
Aortic, mitral and pulmonary valve replacement is routinely performed with reasonable clinical results. But the optimal substitute for the tricuspid valve remains controversial. Contemporary prostheses either mechanical or bioprosthetic are associated with a high risk of thrombosis and/or structural failure. Mitral allografts could have advantages over existing prostheses, especially in patients with infectious endocarditis. We describe our first experience with cryopreserved mitral allograft processing and implantation into the tricuspid position in a sheep experimental model. Material and Methods: We subjected 20 sheep (age 1 year, weight 23 - 36 kilograms) to general anesthesia and a left thoracotomy. An epicardial echocardiographic study was performed and the mitral valve was harvested. Donor animals were put to death by intravenous anesthetics injection. Allografts were immersed into cultivation medium E 199 with an antibiotic cocktail. After 24 hours storage at the temperature of 37.0oC the valves were kept at + 5 to + 7 oC over a period of 3-5 days. Then they were transferred into the cryoprotective solution (E 199 with 10% dimethylsulfoxide) and sealed into plastic bags using a double-layer technique. Finally, they were programmed cooled and stored in the liquid stage of liquid nitrogen (- 196 oC)...
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Coronary atherosclerosis imaging using CT coronary angiography in patients with high risk of coronary heart disease
Baxa, Jan ; Ferda, Jiří (advisor) ; Vymazal, Josef (referee) ; Mechl, Marek (referee)
Coronary atherosclerosis imaging using CT coronary angiography in patients with high risk of coronary heart disease Coronary heart disease (CHD) belongs to most frequent disorders and in industrial countries is responsible for most deaths in population. The costs of treatment of the clinical manifested CHD are high, so there is tendency to detect this disease in early phase and ideally before development of clinical symptoms. Aim of our study was to evaluate the value of coronary CT angiography (CCTA) in detecting of coronary atherosclerosis in early (preclinical) phase. Our goals were estimation of prevalence of atherosclerosis in group, influence of main risk factors on grade and character of atherosclerotic changes. In follow-up we concerned on occurrence of cardiac events. 205 patients with increased cardiovascular risk underwent CCTA using dual-source CT. Coronary findings were analyzed by character of atherosclerotic changes and degree of event. stenosis. Statistical evaluation of influence of risk factors was made using the odds ratio. The statistically important differences were tested between subgroup of type 2 diabetics and non-diabetics. All patients were under follow-up for two years. Overall prevalence of atherosclerosis in analyzed group was 73 %, calcified lesions were found in 63.9 %...
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The use of comet assay for the estimation of DNA damage during the anticancer chemotherapy.
Voříšková, Jana ; Kovařík, Miroslav (advisor) ; Pávek, Petr (referee)
We have monitored the DNA damage induced by tumor chemotherapy. The combination of platin derivate (cis-platine or carboplatin) and another chemotherapy agent (gemcitabin, paclitaxel or vinorelbin) was applied to patients with lung carcinoma. The whole chemotherapy includes 4 cycles. We have monitored the DNA damage in peripheral blood lymphocytes through the first and the third cycle of chemotherapy and 3 weeks after the last cycle of chemotherapy. For detection we have used comet assay which seems to be accurate and reliable method. Lymphocytes were isolated from whole blood through the medium LSM lymfocyte and then were processed by the alkaline version of the single cell gel electrophoresis. We have analysed single strand breaks (SSB) and interstrand cross links (ICL). For the measurement of ICL isolated lymphocytes were incubated in the presence of 200 µM of styrene oxide (SO) to degrade the DNA by inducing strand breaks. Incubation of peripheral blood lymphocytes with 200 µM SO leads to the formation of comets. If ICLs are present in the DNA, the alkaline unwinding of DNA is blocked and the % of DNA in tail is reduced. Comets were stained with ethidium bromide and then analyzed by the software LUCIA Comet Assay. The damage of DNA caused by SSB before the chemotherapy was relatively low and...
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