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Importance of trombophilic mutations in clinical genetic.
Vavrušková, Klára ; Kuklík, Miloslav (advisor) ; Černá, Marie (referee)
Trombophilia means an increased disposition to creation of trombs. Health complication incurred as a consequence of hypercoagulation can be very serious. When a trombophilic mutation is found at a patient, it brings necassity of thrombosis - control in risk situations (e.g. pregnancy, operation) for the rest of the patient's life. There were filed 300 people (206 women and 94 men) with trombophilic mutations into my study of clinical signification of trombophilic mutations. These people were examinated in years 2008 - 2010. Most of positive medical findings - 266 people, were recorded in the area of MTHFR (C677T i A1298C) mutations. There were less findings in the field of FV Leiden and FII prothrombin mutations. Multipath trombophilic mutations were found at 99 patients. I accordance with foreign literature, our results advert to clinical consequences of trombophilic mutations like: repeated spontanious aborts, cerebrovascular akcident (CA), ischaemic heart disease (IHD), thrombosis, flebothrombosis, pulmonary embolism, varicose veins, aseptic necrosis of hip bone, arterial sclerosis and aortic stenosis. Mutations MTHFR C677T and MTHFR A1298C we found mainly at patients with CA, IM and IHD. Leiden mutation was most often found at patients with thrombosis, flebothrombosis and pulmonary embolism. We...
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Bleeding after cardiac surgery. Importance of fibrinolysis in off-pump versus on-pump coronary artery bypass surgery
Jareš, Martin ; Vaněk, Tomáš (advisor) ; Dominik, Jan (referee) ; Málek, Jiří (referee) ; Nečas, Emanuel (referee)
The aim of our two prospective randomized studies was to evaluate and compare haemostatic effects of fibrinolytic inhibitors in patients undergoing off-pump coronary artery bypass surgery (OPCAB). The first study evaluated efficacy of tranexamic acid vs. placebo, the second one compared effects of tranexamic acid vs. aprotinin vs. placebo. In addition, the risk of per operative myocardial ischemia and trombotic events was assessed. In the first study postoperative bleeding was significantly lower in the tranexamic acid group compared with the control group. We observed two postoperative myocardial infarctions (one in each group) and any cerebrovacular event or pulmonary embolism. In the second study we conclude that both tranexamic acid and aprotinin significantly reduce the postoperative blood loss in OPCAB patients, and the efficacy of tranexamic acid and aprotinin, respectively, seems to be quite similar. We did not observe any statistically significant difference in the need for allogenic transfusion, although the total number of re-transfused patients was the highest in placebo group. Treated groups did not demonstrate postoperative increase in mean levels of myocardial enzymes, compared with placebo group. Significantly higher mean values of D-dimer were found in placebo group 24 h...
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Gene expression analysis in patients with myelodysplastic syndrome
Vašíková, Alžběta ; Votavová, Hana (advisor) ; Neuwirtová, Radana (referee) ; Jarošová, Marie (referee)
Myelodysplastic syndrome (MDS) is a clonal disorder affecting maturation and differentiation of hematopoietic stem cells. MDS is characterized by ineffective hematopoiesis resulting in peripheral blood cytopenia in at least one lineage, and increased risk of development of acute myeloid leukemia (AML). This disorder mostly affects the elderly, with the incidence of 10-50/100000 people per year. Heterogeneity of MDS is further underlined by the presence of both idiopathic primary and secondary therapy-related forms, which arise from accumulation of mutational events induced by cytotoxic therapy (exposure to alkylating agents or after therapy with topoisomerase II inhibitors). In this thesis, we focused on determination of differential gene expression between MDS patients and control subjects using different microarray platforms. Using nylon membranes, we detected 4 genes (ERCC1, FLT1, NME4, PCNA) with increasing expression pattern in advanced MDS stages, which correlated with disease progression. Their strong up- regulation was also observed in patients with de novo AML, suggesting their involvement in the leukemic transformation of MDS. Comparison of gene expression profiles of early and advanced MDS obtained by Agilent microarrays resulted in the set of differentially expressed genes, which might...
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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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Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to the presence of a chronic bronchitis phenotype
Koblížek, Vladimír ; Salajka, František (advisor) ; Skřičková, Jana (referee) ; Marel, Miloslav (referee)
AJ Impairment of nasal mucociliary clearance in former smokers with stable chronic obstructive pulmonary disease relates to presence of a chronic bronchitis phenotype Background: Associations between nasal and bronchial impairment have been repeatedly described in chronic obstructive pulmonary disease (COPD) whereas nasal mucociliary clearance (MCC) in COPD patients is not yet fully understood. We studied nasal MCC parameters in COPD patients and compared them with healthy adults (HA) and with cystic fibrosis (CF) patients with compromised MCC. Methodology: Pilot study of seventeen COPD patients without exacerbation; all of them were examined to investigate and compare nasal and bronchial ciliary beat frequency (CBF) and ciliary beat pattern. Main observational study of 98 COPD ex-smokers and subjects from control groups (15 CF and 39 HA) evaluated for nasal MCC time (NMCCt) and by digital video microscopy of nasal mucosa recording ciliary beat frequency (CBF) and ciliary beat pattern (index of ciliary dyskinesia). Results: It was found no difference in mean ciliary beat frequencies between nasal (6.0 Hz ± 1.3) and bronchial (5.9 ± 1.3) mucosa (p = 0.427). We found medium association in degree of ciliary dyskinesia (κ = 0.733). In the main observational study: the NMCCt was decreased in HA (575...
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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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Nutritional support for cancer patients
Petrovová, Hana ; Těšínský, Pavel (advisor)
According to the report of the Institute of Health Information and Statistics , published in 2007 which processes the results of 2005 , the incidence of malignant neoplasms in the Czech Republic in the long term increasing incidence . The most common Malignant tumors are basal cell carcinoma , although mostly for its specificity from other classifications set aside . Of the more serious diagnoses are among the most frequent malignancy colorectal neoplasm , trachea and lung cancer in women and in men the prostate. In 2005 in the Czech Republic reported over seventy thousand malignant neoplasms and neoplasms in situ (1) . Weight loss may be as the first sign of malignant disease and may occur later in the course . frequency weighting loss and malnutrition occurs in 31-78 % of oncology patients Depending on the location, type and stage of the disease . The most commonly occurs in gastrointestinal cancer and lung cancer ( 2 ) . For some patients as a result cancer develops cachexia. Causes of weight loss in cancer patients are numerous and Currently , it is clear that far yet know all . Generally causes divided into three major groups : physiological disorders caused by abnormalities interactions tumor - host ( changes in metabolism , anorexia) and finally consequences anticancer treatments ( both chemo - Radio...
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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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Nonparametric estimations in survival analysis
Svoboda, Martin ; Malá, Ivana (advisor) ; Tomášek, Ladislav (referee)
This work introduces nonparametric models which are used in time to event data analysis. It is focused on applying these methods in medicine where it is called survival analysis. The basic techniques and problems, which can appear in survival analysis, are presented and explained here. The Kaplan -- Meier estimator of survival function is discussed in the main part. This is the most frequented method used for estimating the survival function in patients who have undergone a specific treatment. The Kaplan -- Meier estimator is also a common device in the statistical packets. In addition to estimation of survival function, the estimation of hazard function and cumulative hazard function is presented. The hazard function shows the intensity of an individual experiencing the particular event in a short time period. Special problems occur when analyzing time to event data. A distinctive feature, often present in such data, is known as censoring. That is the situation when the individual does not experience the event of interest at the time of study. The thesis covers also an empiric part, where the results of an analysis of patients with the larynx carcinoma diagnosis are shown. These patients were treated in a hospital located in České Budějovice. This analysis is based on a theory presented in the previous chapters.
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