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Case study of physiotherapy treatment of a patient with the diagnosis multiple sclerosis.
Valková, Barbora ; Novotná, Irena (advisor) ; Křížková, Štěpánka (referee)
Title: Case study of physiotherapy treatment of a patient with the diagnosis multiple sclerosis. Goals of assignment: Goal of common part of assignment was through study specialized literature regarding multiple sclerosis and it is etiology, prevalence of disease, diagnostic, types of treatment methods and procedures of physiotherapy. In special part was goal processing patient's casuistry his illness, application theoretical skills methods of physiotherapy and follow - up effect executed therapy. Methodology of assignment: Bachelor assignment is concentrated on physiotherapeutic treatment of patient with multiple sclerosis. In common part is described briefly anatomy and kinesiology which is pertinent to illness. In characterization of illness I deal with the probably etiology prevalence, individual types of illness, clinical image and factors which can affect illness. I devote my attention to diagnostic, prognosis and treatment. The treatment is divides into pharmacological, alternative and physiotherapeutic ones. The special part is written in the form of casuistry of patient with diagnosis multiple sclerosis. After the incoming kineziological assessment, long - term and short - term, therapeutic plan, process of single therapeutic units which include goal of the therapeutic unit, suggestion of...
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Caring for a patient with a disease of systemic connective tissue.
BAUEROVÁ, Eliška
The aim of this Bachelor Thesis is to find out what are the specifics of nursing care of a patient suffering from systemic connective tissue disease, and the specific needs of the patient. These goals were met by qualitative research.The data collection technique was semi-structured interviews with patients with systemic lupus erythematosus.This disease is one of the most prominent representatives of the group of systemic connective tissue diseases.The research part of the Bachelor Thesis has revealed how the disease started in patients, what the symptoms are now, what is the impact on the patient's psyche, the family approach to the illness, and also how the patients were hospitalized.These responses identified the specifics of nursing care of patients with systemic connective tissue disease.This specificity lies primarily in the focus of the nursing staff on the patient's pain, his or her tolerance to it and assessment. The research also reveals that the nurse should focus on assessing the patient's mobility and also on areas where the patient needs to be educated.Patients with this disease have a number of specific needs that the nurse should focus on.This is primarily the need to be painless. These patients also need enough sleep and rest. For the patients it is also important to avoid stressful situations, because stress often invokes and worsens symptoms of the illness.In addition, it has been found that the illness brings a number of constraints to patients' lives that patients need to learn to live with.It has also been found how much are the nurses informed about the disease according to the patients responses.In some departments, the nurses do know the issue of the disease, and in some other departments the nurses are not informed about it on sucha high level.This bachelor thesis could raise awareness of this disease among healthcare professionals and also improve the quality of care for patients with this disease.
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Autoimmune and lymphoproliferative diseases: associations and common mechanisms
Dobiášová, Alena ; Daňková, Pavlína (advisor) ; Hušáková, Markéta (referee)
Autoimmune and lymphoproliferative diseases share some etiologic mechanisms. The origin of the diseases is complicated process that involves an accumulation of hereditary and somatic mutations in a hematopoetic cell, which thanks to changed activity overcomes different growth and survival control checkpoints. Such mutations are for example those located in genes coding for transcription factors, apoptotic signaling molecules, costimulatory molecules and secreted exctracellular molecules. All these molecules influence the balance between survival and programmed cell death. Their dysregulated expression enables the cell to overcome defensive mechanisms of the immune system. Therefore, autoimmune and malignant cells are able to survive though, under usual circumstances, they would be selected. The main aim of this work is to shed the light on the influence of the dysregulated expression of the particular molecules on the origin of autoimmune and lymphoproliferative diseases. Key words: autoimmune ilnesess, lymphoproliferative diseases, etiology, AIRE, c-MYC, TP53, FOXP3, Fas, PTEN, Bim, CTLA-4, CD5, CD30, CD40/CD40L, BAFF, α-taxilin, IL- 10.
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HLA complex and association with autoimmune diseases
Karasová, Alexandra ; Slavčev, Antonij (advisor) ; Šírová, Milada (referee)
Autoimmune diseases are serious and sometimes life-threatening disorders that affect approximately 5 % of the world population and therefore represent a major socio-medical problem. The HLA complex is the best studied part of the human genome that encodes the HLA antigens, whose function is to present peptides to immune system (T-lymphocytes). During the study of the HLA complex it has been found that certain HLA antigens are strongly associated with the occurence of autoimmune diseases, despite the great progress in clarifying disease etiopathogenesis the mechanism of these associations is, however, not fully explained. Sometimes the association of autoimmune disease with the HLA complex is very strong, such as in ankylosing spondylitis or celiac disease, while in other diseases the association is relatively weak, suggesting a role of other genetic and / or environmental factors. The aim of this work is to briefly explain the structure and function of the HLA complex and its association with some severe autoimmune diseases.
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Dendritic cells and autoimmune diseases with a view to type 1 diabetes mellitus
Chrástová, Iveta ; Štechová, Kateřina (advisor) ; Krulová, Magdaléna (referee)
Dendritic cells (DC) are professional antigen-presenting cells (APC) that play an essential role in the induction of immune responses. DCs develop from CD34+ hematopoietic stem cells in bone marrow and their role is uptake, processing and presentation of antigens to T cells. DCs can be divided into two distinct subset of cells, myeloid a plasmacytoid DCs. Myeloid DCs (mDC) develop from hematopoietic cells in the presence of GM-CSF and TNF-α or from monocytes in the culture with GM-CSF and IL-4, then with CD40L they mature and produce a large number of IL-12, which is important in driving CD4+ T cell to type Th1. The development of pDC is CD40L and IL-3 dependent and Flt3-L supports this process as well. The essential role of pDC is that they secrete a large amounts of type I IFN in the responses to viruses and so they maintain the antiviral stage. To recognize the viruses pDC express Toll-like receptors 7/9. DCs have on the surface also other groups of receptors, e.g. C-type lectin-like receptors, RIG-I-like receptors and NOD-like receptors. They play the role in the various diseases, mostly autoimmune diseases, in which the immune system recognizes self tissues and activates against them the immune response. Dendritic cells function is that they are competent to activate T cells, in the most cases...
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Th17 lymphocytes and autoimmunity diseases with the intention of diabetes 1. type
Labiková, Jana ; Procházková, Jana (referee) ; Štechová, Kateřina (advisor)
Th17 cells were recently identified as a cell source of IL-17. They turned up to be a T cell lineage independent of previously described Th1 and Th2. The differentiation of naive CD4+ T cells towards Th17 requires the combination of TGFβ (a cytokine essential for the development of anti-inflammatory regulatory T cells) plus IL-6 or IL-21. IL-23 is required for in vivo function and phenotype maintenance of Th17. STAT3 and RORγt were identified as pivotal transcription factors in Th17 differentiation program. Th17 proved to have pro- inflammatory effects and are characterized by the production of IL-17A, IL-17F and IL-22 - cytokines implicated in host defense against certain extracellular pathogens. The cytokine products of Th17 cells act on wide range of cell types. They induce cytokines, chemokines and metalloproteinases and they also mediate neutrophil recruitment and production of antimicrobial peptides. Autoreactive Th17 are highly pathogenic and the production of IL-17 has been detected in several autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, psoriasis, Crohn's disease and type 1 diabetes. These diseases were thought to be mediated by Th1 cells, but it is becoming increasingly clear that the regulation of autoimmunity is influenced at least in some diseases by Th17 cells as well.
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The Mechanism of Pathogenesis of Experimental Autoimmune Uveitis and Possilbilities of Their Regulation
Klímová, Aneta ; Heissigerová, Jarmila (advisor) ; Pitrová, Šárka (referee) ; Holáň, Vladimír (referee)
Introduction:Uveitis in an ocular inflammation affecting mostly people of working age. Uveitis is responsible for severe visual impairment despite of expanding new therapeutics. The animal models of uveitis were established, because the wide clinical variability of uveitis limits the studies in human medicine. The goal our project was to establish a reproducible model of experimental autoimmune uveitis in Czech Republic, and further on this model to observe the frequency of CD3+ and F4/80+ cells in retina, to assess the influence of microbial environment on intensity of intraocular inflammation and to test the therapeutical possibilities. Material and methods: The C57BL/6J mice were immunized by retinal antigen (IRBP 1-20, interphotoreceptor retinoid binding protein), enhanced by complete Freund's adjuvant and pertussis toxin and mild posterior autoimmune uveitis was induced. The mice were bred in conventional and germ-free (gnotobiotic) conditions. The uveitis intensity was evaluated in vivo biomicroscopically and post mortem histologically on hematoxylin eosin stained sections according to the standard protocol. The histological eye specimen were analyzed also by imunohistochemisty and by flow cytometry. Each experiment was performed for 35 days. The conventional mice with uveitis were treated...
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Specifics of work of nurses in the centers of biological treatment.
MENCLOVÁ, Šárka
Specifics of the Work of a Nurse in Biological Therapy Centres? The bachelor thesis was written in theoretical form with the aim to map the problems of biological therapy. The method of research and analysis of the available present sources related to the topic was applied to the thesis elaboration. Biological therapy represents a new type of treatment trying to create such a compound that is capable of targeted immune system suppressing or strengthening to influence a pathological process in an ill or impaired organism as accurate as possible. Because of high costs the treatment by biological preparations had to be concentrated to centres. Quality teams of people that are able to assess effectively for which patient the therapy is suitable and safe work at the centres. Patient registers enable efficient treatment and long-term monitoring of medical safety. Attention is also paid to equipment and environment of the centres. The chapter Specifics of Nurse Work focuses on professional knowledge and skills of a nurse in biological therapy application. The main task of a nurse is to provide complex, individual holistic nursing care based on quality verbal and non-verbal communication and educational activity. The next part deals with the individual spheres of medicine with the best experience with biological therapy. In gastroenterology, where idiopathic intestine inflammations of Crohn?s disease and ulcerous colitis are treated by means of TNF-? blocking substances, the substances are administered in the form of infusion or subcutaneously. Nurses thus have to be aware of treatment process, treatment principle and side effects linked to the therapy. Excellent results are achieved with biological therapy in the rheumatology centre in treatment of rheumatoid arthritis, ankylosing spondylitis also known as Bechterew's disease, psoriatic arthritis and juvenile idiopathic arthritis. ATTRA Registry, which is one of the most important tools for patient monitoring from the beginning of the therapy, is also mentioned here. The work of nurses in the oncology centre focuses on monitoring the side effects linked to the therapy. Side effects linked to biological therapy are more specific than those in cytostatic therapy. It thus depends on nurse?s observation skills, her ability to decide what symptoms should be focused on during the therapy and ability to respond to them in timely manners. The last centre analysed in the thesis is the dermatology centre, where they have experience with therapy of a chronic disease called psoriasis vulgaris. The information provided from the available data has shown us that although the therapy is highly costly, its purposeful application is economically effective at least thanks to the fact that timely commencement of therapy enables patient life quality improvement without possible disability. Although the therapy is not able to cure the patients completely, its main goal is to slow down the disease prognosis and to free the patients from the pains linked to the disease.
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Complex Treatment of Patients with Bechterew´s Syndrome
ARCIMOVIČOVÁ, Petra
The bachelor thesis titled "Complex Treatment of Patients with Bechterew´s Syndrome" suggests therapeutic possibilities of the disease. Bechterew´s syndrome is a frequent topic of scientific papers but the complexity of treatment is not always considered. A major part of the theoretical section presents the disease with its signs and symptoms, and also discusses the much debated causes, the progression and phases of the disease. The thesis focuses on the psychosomatic approach; it discusses potential influences and other factors, specifically genetic and antigen factors, a potential connection with bacterial diseases, the function of intestinal microflora and its relation to dietary habits. Another important topic is influence of specific personality traits, as well as the implication of the patient´s social interactions in the early childhood on the behaviour in an adult age. The research results in five examinations of patients with Bechterew´s syndrome including personal history, kinesiology examination and a two-hour interview with each patient. The data are qualitatively analyzed. There are two research questions: the first explores which physical, psychological, social and spiritual factors may improve the disease; the second looks into factors which may aggravate it. On the one hand, in the majority of cases the most important factors seem to be the diet, physical activity, specific personality traits and faith in God. On the other hand, the diversity of patients - interviews with patients taking place in a spa, a rehabilitation centre, at home - leads to very different personal opinions and feelings. The last interview, number 6, offers a homeopathic point of view. In spite of the fact that the research sample is relatively small, the research data are very useful, even though no definite conclusions can be made. The thesis may contribute to the knowledge of health workers specializing in the treatment of Bechterew´s syndrome and to the training of physical therapists.
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