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Molecular Markers with Impact on Kidney Graft Survival and Glomerulopathies Progression
Brabcová, Irena ; Viklický, Ondřej (advisor) ; Jirsa, Milan (referee) ; Rychlík, Ivan (referee)
The progression of chronic glomerulopathy and graft rejection is affected by a number of proinflammatory cytokines, whose role in the pathogenesis of damage is poorly understood. The aim of this dissertation was to identify reliable risk markers of renal dysfunction progression and thereby contribute to a more effective patient treatment. Human native kidney biopsies with histologically confirmed diagnosis of glomerulopathy or kidney graft biopsies were analysed. Intrarenal gene expressions were measured by RT-qPCR. Single nucleotide polymorphisms were detected by methods based on PCR-RFLP. Immunohistochemical staining was used to identify and quantify the mononuclear cell infiltration. Gene expression of TGF-β1, HGF, BMP7, MCP-1, RANTES and mononuclear cell infiltration were associated with poor renal function and proteinuria at the time of IgA nephropathy diagnosis. Progression of IgA nephropathy during the 2-year follow-up was shown to be dependent on the degree of chronic vasculopathy and TGF-1 expression in the kidney. Patients with graft dysfunction and enhanced intrarenal expression of TGF-1, MCP-1 had significantly shorter graft survival. Higher mRNA expression of IL-10, TGF- 1, IL-6, MCP-1, RANTES and TNF- was observed in patients with graft dysfunction presented at the time of biopsy....
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ANCA-Associated Vasculitides : Complex Diagnostic Approach
Hrušková, Zdenka ; Posová, Helena (advisor) ; Stříž, Ilja (referee) ; Žák, Aleš (referee)
Objectives: The aim of this study was to assess cellular immunity parameters in patients with ANCA (Anti-Neutrophil Cytoplasmic Autoantibodies)-associated vasculitides (AAV) at different stages of the disease, with different treatment modalities, and with respect to the long-term prognosis of the patients. Methods: We examined 69 patients with AAV, 30 healthy individuals and 20 patients with chronic kidney disease. Using flow cytometry, the following markers were assessed in peripheral blood cells: surface molecules (CD4, CD8, CD3, CD19, CD80, CD86, HLA-DR, CD28, CXCR3, CCR5, CD30 and CRTH2) and intracellular cytokines (interferon gamma (IFN), tumor necrosis factor alpha (TNF), interleukin (IL)-2 and IL-4 in CD3+ T cells and IL-10 and IL-12 in monocytes). Results: Patients with AAV had decreased total number of lymphocytes, CD4+ cells, and CD4+CD45RA+ cells compared to healthy controls (p<0.001). Active patients had increased CD30 and CRTH2 expression (p<0.05). Increased CCR5 expression persisted in remission. Increased HLA-DR expression, expansion of CD28 subpopulation and increased IFN production were noted in remission but not in active disease. Patients in remission who developed a relapse during follow-up had significantly lower IL-10 production than those without relapse (p<0.01). Conclusions: Taken...
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Vascularity of Female Urethra in Correlation to Urinary Incontinence : Diagnostic Algorithms and Its Clinical Implications
Švabík, Kamil ; Martan, Alois (advisor) ; Halaška, Michael (referee) ; Adamík, Zdeněk (referee)
Introduction: Intrinsic and extrinsic urethral factors play a significant role in urinary continence mechanism in women. Urethral wall structure including inervation, perfusion of submucosal layer etc. is not clinically assessed despite its important role in urethral closure function. The association of incontinence and pelvic floor reconstructive surgery is well known. Every postoperative healing process is associated with factors of ischemia and neovascularisation. According those facts we would expect that the healing and scaring should involve intrinsic urethral mechanism. After reconstructive surgery Implants further increase scaring process. Methods: In our study we included patients with anterior compartment defect. We randomized patients into three interventional arms according the surgical approach and use of implants. Before and 3-5 month after the surgery we performed urodynamic studies and pelvic floor ultrasound examination, including Doppler for urethral perfusion assessment. Another early ultrasound scan was added forth day after surgery. We correlated ultrasound and urodynamic parameters. Results: We randomized 87 patients. We couldn't find any correlation between the morphologic changes and severity of incontinence. Methods for urethral perfusion assessment showed high inaccuracy...
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Phosphates containing food and their implications for osteoporosis
Šobáň, Jan ; Rambousková, Jolana (advisor) ; Černá, Milena (referee)
Phosphates containing food and their implications for osteoporosis Phosphates are salts of phosphoric acid resulting from the secession of three acidic hydrogen from it. Phosphates are found in natural foods such as nuts, legumes, cereals, meat and offal. Phosphorus is also being added to foods industrially for its' various chemical properties. From more than 1 500 "E's" I found 16 that contain phosphates and thus significantly increase the supply of phosphorus in the body. Usual daily intake of phosphorus is about 1 g. Increased intake of phosphorus forms an acidic environment in the kidney and calcium phosphate complexes, and thus leads to calcium removing from the body and bone demineralization. "E's" containing phosphates are frequently found in meat products, processed cheese, confectionery, bakery products, cola beverages, frozen and instant foods. Most commonly used additive is E-338 phosphoric acid. Osteoporosis is a systemic skeletal disease characterized by a small amount of bone mass and de- terioration of bone micro-architecture resulting in increased fragility and fracture risk. The Czech Republic declares to have 600 000 patients treated for osteoporosis.
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The influence od educational to maintenance of secondary prevention rules of myocardial infarction
ŠÍMOVÁ, Martina
This bachelor thesis deals with the effects of educational plans on the compliance with the principles of the secondary prevention of myocardial infarction. The theoretical background covers atherosclerosis, acute myocardial infarction, the secondary prevention of myocardial infarction and the educational process in nursing. Prior to elaborating the practical part of the thesis we had established two objectives. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. A qualitative form of research had been chosen for this thesis, semi-standardized interview in particular. The analysis of the data gained was subsequently carried out. Two objectives had been established in the thesis. Objective 1: To find out whether the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Through the analysis of the obtained data we found out that the patients educated without an educational plan are as knowledgeable as the patients educated through an educational plan. Objective 2: To compare whether the patients educated without an educational plan comply with the principles of the secondary prevention of myocardial infarction in the same way as the patients with an educational plan. Having compared the results we found out that the patients with an educational plan comply with the principles of the secondary prevention more consistently than the patients educated without an educational plan. The objectives of the thesis were met.
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The role of GH/IGF-1 axis components in the etiopathogenesis of metabolic disturbances in type 2 diabetes mellitus and acromegaly
Toušková, Věra ; Haluzík, Martin (advisor) ; Müllerová, Dana (referee) ; Saudek, František (referee)
(EN) GH/IGF-1 axis components (GH, growth hormone receptor (GH-R), IGF-1, IGF-1 receptor (IGF-1R), IGF-binding proteins (IGFBPs)) participate in the control of glucose metabolism, inflammatory processes as well as cell proliferation and differentiation, including adipocytes and monocytes. The aim of the present study was to evaluate the role of local mRNA expression of GH/IGF-1 axis components in subcutaneous adipose tissue (SCAT) and peripheral monocytes (PM) in the development of insulin resistance and differences of adipose tissue mass in following groups of patients: obese females with and without type 2 diabetes mellitus and subjects with active untreated acromegaly. A total number of 66 subjects were included in the study: obese females without type 2 diabetes mellitus (OB), obese females with type 2 diabetes mellitus (T2DM), acromegalic patients (AC) and healthy lean control subjects (C). T2DM underwent 2 weeks of very-low- calorie diet (VLCD - energy content 2500 kJ/day). According to our results we suggest that decreased mRNA expression of IGF-1, IGF-1R, IGFBP-2 and IGFBP-3 in adipose tissue of T2DM subjects may contribute to changes of fat differentiation capacity and the increased IGF-1R mRNA expression in peripheral monocytes in these patients may play a role in the regulation of...
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Smell of faraway, smell of flowers. Graphic casuistic of a client with psychotic diagnosis
SMETANOVÁ, Tereza
This bachelor paper talks about disease called schizophrenia. The theoretical part is focused on basic terminology, it's also touching slightly the dopamin theory and Wienbergers hypothesis. One chapter is dedicated to lexical semiotics in the graphical production of psychotic patients and other people connected with this problematics. There is also mentioned the art brut and patient art. The practical part is dedicated to a casuistry of a client, which is diagnosed with paranoid schizophrenia. The paper is using information from daily contact and work with the patient. There are mentioned arteterapeutical accesses and posibilities of work with schizophrenic clientele. The paper is going to try to analyse the process and developement of graphical output of the client based on her production. The secondary goal is to prove, that for the schizophrenic patient is really important to have the possibility of graphical utterance and good therapeutic relation with the therapist.
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BK-polyomavirus infection in patients after simultaneous pancreas and kidney transplantation
Mindlová, Martina ; Saudek, František (advisor) ; Forstová, Jitka (referee) ; Reischig, Tomáš (referee)
Introduction. The aim of the study was to introduce a new BKV PCR protocol in our centre and to verify its accuracy as well as to assess the prevalence, risk factors of BK virus replication, course of BKV infection and therapeutic approaches in simultaneous pancreas and kidney (SPK) recipients in order to design a screening protocol. Methods. The results analysed by both Affigene® and Transplantation Virology, Basel PCR protocols were compared. Thereafter 183 SPK patients were examined to assess the prevalence of BK viremia, viruria and BKVN and to identify the risk factors of BKV replication. The cases of retransplantation after a graft loss due to BKVN were retrospectively described. Results. 100 of results were analysed according to the Affigene ® and Transplantation Virology, Basel PCR protocols with the accordance of 95%, Rho = 0,946, 95% CI: 0.920 - 0.963, P<0,0001, Bland-Altman plot analyses: bias Basel PCR protocol/Affigene® BKV trender: -0,1 (mean) *±1.96 SD: -1,6 - 1,3] for both methods. Point-prevalence was assessed in 183 patients; Viruria found in 17,3 %, viremia in 3.8% of patients. High-level viruria >107 copies/mL detected in 3,7% of patiets, high-level virémia >104 in 1,6% of patients simultaneously with high-level viruria. BKVN was found in 0,5% of patients. Diabetes duration...
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Renal Biopsy in Diabetes, Comparison of Morphology and Clinical Symptoms
Kruntorád, Vít ; Rychlík, Ivan (advisor)
Diploma student work can bring many beneficial skills and useful knowledge. It mainly on him, how much is ready to put time, energy and creative potential. I managed to find the unique theme of work, I have also become a big challenge. The main motivation was Considering that the work has clear clinical meaning and perhaps even impact. Diabetes mellitus (DM) is a serious disease significantly changing the current life of the patient. Good control and treatment disease requires patient discipline in lifestyle and respect of medical schemes. However, even with goodcompensation diabetes may progress and reduce the quality of life affected. This is mainly on chronic complications specific for this disease - that is affected eye, kidney and polyneuropatické. The theme of this work is just one the most serious chronic komlikací diabetes and diabetic nephropathy. We tried to map the situation of kidney damage in diabetics, its dependence on selected clinical parameters and some prognostic parameters. The information that we have collected will be further used in the project of the Czech Society of Nephrology (CNS) within the Czech registry of renal biopsy (CRRB) - Renal biopsy in diabetic patients, survey results in 1999-2003, which isfinancially fully backed by the CNS. Is the exclusive property of CRRB CNS, the...
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