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Fractures of the distal radius as serious geronto-traumatology problem and its possible solutions
Pacovský, Vladimír ; Topinková, Eva (advisor) ; Trč, Tomáš (referee) ; Pilný, Jaroslav (referee)
Fractures of the distal radius are the most common fractures treated at our clinics . It accounts for around 16 % of all fractures. Most often we meet them in two age groups - children and especially in postmenopausal women. In this group the fractures are frequently associated with osteoporosis. The most common cause of fracture is a fall on the outstretched extremity. Together with fractures of the proximal humerus, proximal femur and vertebral fractures they are the most common gerontotraumatologic fractures. The frequency of fractures of the distal radius gradually increasing. The reason is the increasing average age of the population and their active way of life. Our group consists of 5,359 patients treated for a fracture of the distal radius in 1998 and from 2001 to 2013 . During this time , the frequency of fractures increased by 19,7%. For women with distal radius fractures occur 3 times more frequently, the average age of treated was 59,1 years. About 80 % of distal radius fractures are treated conservatively. The surgical treatment of seniors decide not only the type and stability of the fracture, bone quality, but especially the overall condition of the patient and his claims to a final functional outcome. Long-term functional results after conservative treatment in the elderly are nearly the...
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Circadian rhythm of parathyroid hormone and bone remodeling: implication for the osteoporosis treatment with teriparatide (parathormone [1-34])
Rašková, Mária ; Zikán, Vít (advisor) ; Žofková, Ivana (referee) ; Perlík, František (referee)
Circadian rhythm of parathyroid hormone (PTH) is well documented, but its physiological role is not fully understood. In healthy individuals, biochemical markers of bone remodeling follow a similar circadian rhythm to PTH with a nocturnal rise in bone resorption and formation. The loss of PTH diurnal variation was observed not only in primary hyperparathyroidism, but also in patients with postmenopausal osteoporosis. Continuously elevated concentrations of PTH lead to excessive stimulation of bone resorption, whereas intermittent PTH administration has a strong osteoanabolic effect in patients with osteoporosis. It has not been examined whether the skeletal sensitivity to PTH action depends also on the time of its application. The aim of our study was to verify the hypothesis that the application of teriparatide (TPTD, recombinant human PTH [1-34]) at different times of the day in the context of its diurnal variability affects the physiological circadian rhythm of bone remodeling and also the bone mineral density (BMD) after the long-term TPTD treatment. Fourteen women with postmenopausal osteoporosis treated with 20 micrograms of TPTD daily, applied subcutaneously either in the morning or evening, were included in the first study. The concentration of serum C-terminal telopeptide of type I collagen...
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Biochemistry and pathobiochemistry of phylloquinone and menaquinones
Dunovská, Kateřina ; Klapková, Eva (advisor) ; Uřinovská, Romana (referee) ; Skoumalová, Alice (referee)
Vitamin K belongs to the family of fat-soluble vitamins, which is not determinated in clinical laboratories. It is a cofactor necessary for posttranslational γ-carboxylation of glutamyl residues in selected proteins such as the osteocalcin, and procoagulation factors II, VII, IX, X. Vitamin K deficient individuals appear to have more undercarboxylated proteins, which are functionally defective. Lack of this vitamin has been associated with risk of developing osteoporosis and cardiovascular diseases. The aim of this work was to develop and validate the HPLC method and the LC-MS/MS method for determination of three vitamin K's forms - vitamin K1, MK-4 and MK-7 in serum. After successful validation of both methods, patient samples and healthy population samples were measured. There were measured 350 patient samples by HPLC method. These samples were divided into two groups - patients with diagnostic of osteoporosis and patients without osteoporosis. We measured 946 samples by LC-MS/MS method. Samples were divided into groups: patients with osteoporosis, patients without osteoporosis, healthy population, patients with osteopenia and patients with cystic fibrosis. The reference range of vitamin K in healthy population was obtained by LC-MS/MS method. The next aim was to compare the effectiveness of...
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Role of inflammation in pathologic bone resorption in axial spondyloarthritis
Šebová, Eva ; Daňková, Pavlína (advisor) ; Tencerová, Michaela (referee)
Introduction: Axial spondyloarthritis (ax-SpA) is an inflammatory rheumatic disease. It is a unique model of bone remodeling disorders because, although one of the main diagnostic parameters is the rate of bone formation, inflammation present in patients' bodies increases the risk of pathological bone resorption, which can lead to osteoporosis. The processes of pathological resorption in ax-SpA have not been fully investigated, both in the disease as such and in the individual forms of the disease, i.e. non-radiographic (nr-axSpA), radiographic axial spondyloarthritis (r-axSpA) and ankylosing spondylitis (AS). This work deals with the influence of inflammatory serum of patients on the process of osteoclast differentiation from peripheral precursors of patients and healthy donors. Material and methods: Monocytes separated from the peripheral blood of either axSpA patients or healthy donors were stimulated for 14 days in vitro with serum from patients and in parallel with serum of age and sex of the corresponding healthy donors. Osteoclasts were evaluated as multinucleated, TRAP positive cells. Their numbers were statistically processed. Results: The inflammatory serum environment of patients with axSpA stimulated the osteoclastogenesis of axSpA monocytes significantly more (P <0,05) than the...
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Multidisciplinary rehabilitation for pubescents patients with cerebral palsy
Buzková, Tereza ; Nývltová, Lucie (advisor) ; Zounková, Irena (referee)
Cerebral palsy is a non-progressive motor funciton development disorder which is caused by disruption of the immature brain. There is about 16 000 - 20 000 patients living in the Czech Republic with this diagnosis to date. Based on the clinical picture, specific forms of this disorder can be classified. Besides the motor funciton development disorder, the patients also suffer from other comorbidities (such as epilepsy, oropharyngeal dysphagia, sensory deficits etc.). Early diagnosis of this disorder is crucial. The severity of the motor function deficit is evaluated by monitoring the gross and fine motor function. Cerebral palsy is a non-progressive, not unchanging, disorder. The theoretic part of the thesis describes secondary issues which are present during pubescent period of the patients. They are dealing with growth disorders, reduced bone density and increased bone fragility. Plenty of risk factors precede these problems. Also, question of sexuality, life priorities and about future play a big role for the patients in their pubescent period. There are possibilities to solve these problems in terms of complex rehabilitation care. Especially in physiotherapy, occupational therapy and nutritional therapy. The practical part of the thesis is an example of an intensive rehabilitation care of a...
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Risk of osteoporosis in postmenopausal women after successful surgical intervention for primary hyperparathyroidism: nutritional factors
Vokounová, Kateřina ; Zikán, Vít (advisor) ; Michalská, Dana (referee)
Introduction: Osteoporosis is a chronical systemic metabolic disease of bone tissue, which is manifested by a decrease in the amount of bone mass and/or a decrease in its quality and may result in a fracture. Fractures are also common for primary hyperparathyroidism due to increased parathyroid hormone secretion. Surgical treatment will help increase bone density in most cases, nevertheless emphasis is placed on reducing risk factors for osteoporosis and fractures. Objective: Purpose of this thesis is to map the nutrition condition with focus on calcium and protein intake of postmenopausal women after successful surgical intervention for primary hyperparathyroidism (PHPT group), and to evaluate the results in relation with osteoporosis and fractures. Methods: Nutritional status was assessed using questionnaires of eating habits and analysis of three-day menus. Intakes of energy, protein, fat, sugar, fiber, free sugar, vitamin C, sodium, calcium nad phosphorus intake were calculated using Nutriservis PROFI program (and other nutritional databases). The degree of vitamin D saturation was obtained from serum calcidiol concentrations. Body composition and bone mineral density parametres were measured using dual energy X-ray absorptiometry. Results: Nutritional analysis of diets showed no statically...
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Calcium intake in individuals with dietary restrictions of milk and dairy foods
Novák, Ondřej ; Meisnerová, Eva (advisor) ; Raška, Ivan (referee)
The goal of my master's thesis is to research calcium intake in individuals with partial or complete dietary restriction of milk and dairy products. The thesis is divided into theoretical and practical part. The theoretical part mostly originates from foreign scholarly articles and describes calcium from various points of view. This part informs about calcium's functions in different parts of a human body, describes its metabolism and factors that could alter it. Furthermore, it describes homeostasis and results of homeostasis corruption. Additionally, this thesis analyses disorders related to calcium phosphate metabolism disorder like osteoporosis, osteomalatia and rachitis. Another disorder analyzed is lactose intolerance and cow's milk protein allergy which are disorders requiring restriction of milk and dairy products. The theoretical part also discusses content and efficiency of calcium in different articles of nutrition as well as daily recommended dosages appropriate for age and sex of individual. The practical part consists of a questionnaire aimed at calcium intake in researched group. Among other things the questionnaire investigates lifestyle of respondents and lifestyle connected risk factors of disorders like osteoporosis. It considers other osteoporosis risk factors such as disorders,...
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Risk of osteoporosis in patients with type 2 diabetes mellitus: nutritional factors
Skalníková, Karolína ; Zikán, Vít (advisor) ; Raška, Ivan (referee)
Introduction: Osteoporosis is a systemic metabolic skeletal disease characterized by a decrease in bone mechanical resistance due to decreased bone mass and/or bone quality defects. The incidence of osteoporosis has been increasing in developed countries. The reason for this is a lifestyle change in terms of a decrease in physical activity and an increase in life expectancy, which is also related to an increase in the number of people with type 2 diabetes mellitus. Type 2 diabetes mellitus is the most common metabolic disease characterized by insulin resistance, insulin deficiency and hyperglycaemia. Type 2 diabetes mellitus and osteoporosis often occur together. Some authors consider osteoporosis to be a chronic complication of type 2 diabetes. Objective: The objective of this thesis is to evaluate dietary habits and intakes of selected nutrients in postmenopausal women with type 2 diabetes mellitus (DM2) and compare this with recommended values and with control group of women without type 2 diabetes mellitus, and to assess possible relationships to the risk of osteoporosis and fractures. Methods: Dietary habits and intakes of selected nutrients were evaluated on the basis of questionnaires and an analysis of three-day dietary plans. Energy, essential nutrients, fiber, sodium, calcium and...
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Analysis of methods of modeling bone loss due to osteoporosis
Orlová, Lucie ; Marcián, Petr (referee) ; Vosynek, Petr (advisor)
Tato bakalářská práce se zabývá biomechanikou kosti. Hlavním cílem je teoretický průzkum řešení pro výpočtové modelování dlouhých kostí a změn této struktury vlivem osteoporózy. V rámci rešerše jsou vysvětleny související biologické pojmy a základní principy mechaniky. Na základě informací shromážděných v teoretické části práce jsou provedeny výpočty pomocí metody konečných prvků v programu ANSYS.
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Calcium intake in the diet of profesional golfers
Chlubnová, Kateřina ; Raška, Ivan (advisor) ; Michalská, Dana (referee)
This bachelor thesis deals with the intake of calcium within the nutrition of professional golfers. The group of examined individuals involves people aged 18 to 66 years old. The theoretical part describes the basic functions of calcium within an organism, its metabolism, food source, recommended daily intake and diseases related to calcium deficiency. Thetheoretical part also deals with golf, describes this sport from its history to the golf swing and strain of individual parts of human body. It refers to unilateral strain during the finish in golf swing, that is fatal mostly to lumbar spine. Due to the physical strain that golf causes, it is necessary to warm up the body properly before physical activity and mainly ensure sufficent nutrient intake to which calcium mainly belongs out of the group of micronutrients. The practical part involves a survey undertaken by means quantitative questionnaire survey, with its purpose to find out the food consumption with higher calcium content within the chosen target group, that comprises of professional golfers visiting the Golf Club Hostivař in Prague. The results are evaluated using graphs and are compared to recommended daily intake of calcium.
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