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Opioids and neuroprotection: the role of glial cells
Honc, Ondřej ; Novotný, Jiří (advisor) ; Kováčová, Ľubica (referee)
High energy deamand and insulation via the blood-bain barrier are the main reasons for neuronal sensitivity to oxygen or energy deficiency. Even short or mild periods of hypoxia/ischemia (H/I) could fataly impact the CNS enviroment. The area on the edge of the tissue affected by H/I and adjacent unaffected tissue is called the penumbra. Here, we can observe additional H/I related processes - gliosis allied with sterile inflammation and censecutive apoptosis. Opioid receptors attenuate H/I impact on CNS in both acute and consecutive phases. In acute phases, opioid receptors regulate ion homeostasis and attenuate glutamate toxicity; in consecutive phases, lower gliosis manifestation. Both these actions have significant neuroprotective effects. Ability of opioid receptor to lower sterile inflammation in CNS could be used in a series of neurodegenerative diseases, eg. Alzheimer disease or amyotrophic lateral screlosis. Glial cells participate on ion homeostasis, glutamate uptake, and production of antiinflammatory substances; one can, therefore, assume that a significant part of neuroprotective effects of OR is related to glial cells. The opioid system and its signaling pathways has not been fully elucidated yet. I present global overview of this phenomenon and describe some recent findings regarding...
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Design of Pilot Clinical Trial of Treatment of Hepatitis C in Polyvalent Problem Drug Users with Pharmacological Substitution of Opioids and Methamphetamine (HCV-PPDUSOM)
Oktábec, Zbyněk ; Gabrhelík, Roman (advisor) ; Minařík, Jakub (referee)
Charles University in Prague First Faculty of Medicine Study programme: Specialization in Health Care Branch of Study: Addictology PharmDr. Bc. Zbyněk Oktábec, Ph.D. et Ph.D. Design of Pilot Clinical Trial of Treatment of Hepatitis C in Polyvalent Problem Drug Users with Pharmacological Substitution of Opioids and Methamphetamine (HCV-PPDUSOM) Master's Thesis Advisor: Mgr. Roman Gabrhelík, Ph.D. Prague, 2016 Abstract Hepatitis C is one of the most serious blood-borne complications of somatic health status of drug users. The HCV-positive injecting drug users are therefore directly indicated for the treatment of this type (and other types also) of hepatitis. Problematic adherence and treatment compliance is obvious in this group. Both foreign and domestic experiences show that stabilization of the use of illegal (and/or illegally acquired) substances is the essential part of the treatment of hepatitis. The interaction of the high quality treatment of somatic, psychosocial and add-on pharmacological care, including the substitution of illegal (and/or illegally acquired) drugs, leads to patient's increased compliance and adherence to HCV treatment. This diploma thesis is presenting both the theoretical frame and the study design of the pilot clinical trial of HCV treatment with the supportive substitution...
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Psychological aspects of pharmacological pain management in palliative care
Trefná, Klára ; Niederlová, Markéta (advisor) ; Šivicová, Gabriela (referee)
This thesis deals with the psychological phenomena that are associated with the pharmacological pain management in a context of palliative care. The issue involves patient himself, but also a caregiver and a medical staff. The theoretical part of this thesis deals with pain and pharmacological pain management from a psychological point of view and focuses on a problematic attitude toward opioids. This thesis is based on the latest scientific findings by Czech and international researchers. This thesis also includes a research plan, which deals with the psychological factors that affect the attitude toward opioids in Czech environment.
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Psychological aspects of pharmacological pain management in palliative care
Trefná, Klára ; Niederlová, Markéta (advisor) ; Fajtlová, Zuzana (referee)
This thesis deals with the psychological phenomena that are associated with the pharmacological pain management in a context of palliative care. The theoretical part of this thesis deals with pain and pharmacological pain management from a psychological point of view and emphasizes the role of the psychologist in this process. This thesis is based on the latest scientific findings by Czech and international researchers and focuses on the factors that affect the attitude toward opioids of doctors, patients and caregivers. This thesis also includes a research plan, which inquire the relationship between the quality of communication and attitude toward opioids of caregivers in the mobile palliative care. Powered by TCPDF (www.tcpdf.org)
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Opioids in caesarean section
Nosková, Pavlína ; Bláha, Jan (advisor) ; Málek, Jiří (referee) ; Vymazal, Tomáš (referee)
The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...
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Issue of substance abuse and school environment
Šmejkalová, Jaroslava ; Pokorný, Ladislav (advisor) ; Přibyl, Ivan (referee)
The thesis investigates the theoretical knowledge about the issue of addictive substances and personal experience with their use for pupils 6. and 8. classes of primary school and for students 2. and 4. year of the grammar school. In the first part of my work, I focused on the definition of basic concepts, the outline of the characters and the possible causes that lead to addiction to drugs, I presented the most commonly used drugs and identified the possibilities of drug prevention. The second part is devoted to a survey in the form of a questionnaire, which directly examines the knowledge and experience with the drug specific age groups of pupils and students. This work could be material for teachers who want to participate in the drug prevention.
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Socioeconomic status and criminal problems of problematic opioids and metamphetamine users
Zittová, Lucie ; Mravčík, Viktor (advisor) ; Nechanská, Blanka (referee)
of the thesis Introduction: This dissertation focuses on socioeconomic status and problems with law of problematic opioid and methamphetamine users. Long-term intensive use of drugs leads not only to health impacts, but also social such as the inability of financial autonomy, indebtedness, unemployment, failure to comply with the respective social roles, fiduciary social functioning, poor housing etc. Great number of users are influenced by the drug in situations such as interpersonal relationship, family functioning and partnerships, there is a change of social status, social isolation or exclusion. Effective interventions and service development should always start with a good knowledge of the situation and needs of the user, who claims the service. Claim: The goal of this thesis is finding socioeconomic status and criminal situation of problematic methamphetamine and opioids users consequently draw recommendations towards services that work with these clients. Methods: Cross-sectional questionnaire study was carried among clients who have started a treatment episode or contacted selected facility type such as a contact centre, psychiatric AT ambulance, therapeutic community, medium-term inpatient treatment or replacement therapy. Recruitment into the study took place from June 2015 until October...
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Addictology services in the capital city of Prague with a focus on substitution treatment
Janyška, Jakub ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
The thesis is devoted to the issue of addiction services with a focus on substitution treatment. Theoretical part focuses on presenting of susbstitution treatment, its history and description of the substitution substances and their effects on the human body. Describes the abuse of substitution treatment by problem drug users and tries to map out the various addiction treatment services with a focus on substitution treatment in Prague. The research section defines the attitude of society towards the establishment and functioning of Prague substitution centers. The thesis concludes with an overview of addiction services and substitution programs in the capital city of Prague. Powered by TCPDF (www.tcpdf.org)
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Secondary and tertiary drug abuse prevention
Havlovičová, Kristina ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
This bacelor work deals with the subjective perception of significance of substitution treatment by it's clients. It's aim is to find out, how the clients of this treatment perceive it's significance primarily in their lives. Out of the data gained from the research it is obvious that despite some negatives of the substitution treatment it's clients considers it to be very positive especially because it allows them to get involve in the society and to live the "normal life". Suprisingly, in comparison with the orientation of intact population the clients almost completely ignore the influence of substitution on their state of health and the risk of transer of infection diseases. Powered by TCPDF (www.tcpdf.org)
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Secondary and tertiary drug abuse prevention
Havlovičová, Kristina ; Šotolová, Eva (advisor) ; Mlčková, Marie (referee)
This bacelor work deals with the subjective perception of significance of substitution treatment by it's clients. It's aim is to find out, how the clients of this treatment perceive it's significance primarily in their lives. Out of the data gained from the research it is obvious that despite some negatives of the substitution treatment it's clients considers it to be very positive especially because it allows them to get involve in the society and to live the "normal life". Suprisingly, in comparison with the orientation of intact population the clients almost completely ignore the influence of substitution on their state of health and the risk of transer of infection diseases.
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