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Nursing Childcare during Chemotherapeutic Treatment
CIMBÁLNÍKOVÁ, Eva
Current status: Children oncology is a field which has become an important part of medicine and thanks to its development it is possible to heal up to 80% of children oncological patients. In the children oncology, we can meet many kinds of cancer such as Hematopoietic Tissue tumors, Lymphomas and Central nervous system tumors. Children are usually cured using chemotherapy which has not only therapeutically effects, but also unwanted symptoms which decrease the quality of patient lives and can be even dangerous for children. Main aim of my bachelor thesis is to describe the core principles of the nursing childcare during chemotherapy and to set the basic rules concerning the right vein entry care as well as the principles of the right application of medicinal products through venous inlets. Another task is to describe the principles of manipulation with cytostatic and to demonstrate the key role of the nurse during the application of chemotherapy. Methodology: To process this bachelor thesis and to achieve the set aims a qualitative research examination was done while using the technique of secondary analysis of relevant resources. This research included looking for the information concerning the problem in the professional and scientific publications as well as gaining the experience during the internship in the Department of Pediatric Oncology in the Faculty Hospital Brno Results: This thesis describes key principles of the nursing childcare during chemotherapy focused mainly on the possible problems related side effects of cytostatic. The main task of the nurse is to watch a possible occurrence of these effects and to provide a careful nursing care. The nurse must always adapt the care to the current health condition and needs of the patient. Each child is individual and reacts differently to the cure. It is necessary during the chemotherapy to prevent from a possible infection by a very careful barrier nursing care. The task of the nurse is also to provide children and parents with a psychological support, to educate about the treatment regime in her competence, to ensure the safe cytostatic use while watching their effect and possible complications as well as to take a complex care of venous inlets. The thesis also finds out the right rules of the safe manipulations with cytostatic. The main rule during each manipulation is to protect your own health by using the protective equipment such as special Nitrile gloves, oral veils etc. and to work according to the rules of the safe manipulation with cytostatic which are available in each oncological department. Conclusions: This research work is treated as a theoretical overview work and its main benefit is presenting the theoretical knowledge about the oncology nursing childcare while describing a very important part of the nurse taking care of children oncological patients. The nurse must have a lot of both theoretical and practical knowledge which she uses during the nursing care. The results of this research should provide both professional and lay public enough information about the children oncology.
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Study on potentiaion of pharmacological efficiencies of ellipticine
Vranová, Iveta ; Mrázová, Barbora (referee) ; Stiborová, Marie (advisor)
Cytotoxic chemotherapy offers tool for clinical treatment of neoplasia. One of the drugs suitable for chemotherapy is ellipticine. Ellipticine is an alkaloid, which has significant antineoplastic properties. It acts as a DNA intercalator, inhibitor of topoisomerase II and forms also covalent DNA adducts mediated by cytochrome P450 and/or peroxidases. Oxidation of ellipticine by CYP (CYP3A4, CYP1A1/2, CYP2C9, CYP1B1) provides several metabolites (7-hydroxyellipticine, 9-hydroxyellipticine, 12-hydroxyellipticine, 13- hydroxyellipticine, and ellipticine N2 -oxide). Metabolites 12-hydroxyellipticine and 13- hydroxyellipticine, formed by CYP3A4, are responsible for formation of two major DNA adducts. Two carbenium ions, ellipticine-13-ylium and ellipticine-12-ylium were proposed as a reactive species binding to DNA. The main metabolites generated by peroxidases are the ellipticine dimer and ellipticine N2 -oxide, which provide the same carbenium ions and same DNA adducts. Modern chemotherapy uses targeting for higher selectivity for malignant cells and lower cytotoxicity for normal cells. Ellipticine-conjugates and his derivates (N-(2-hydroxypropyl)methakrylamid-ellipticine conjugates, vasoactive intestinal peptide-ellipticine conjugates and human serum albumin-ellipticine conjugates) and epidermal...
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Metody eliminace virů u meruněk a broskvoní
Fronková, Hana
This work describes methods of virus elimimination for obtaining virus-free plant material of peaches and apricots. Four methods of elimination were chosen, apical meristem isolation, thermotherapy, chemotherapy and cryotherapy. In this work, four economical singificant viruses are described, which can infect peaches and apricots. This work describes botanical characteristic above-mentioned fruit species and importance of their planting in the area of the Czech Republic.
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Nursing problems in patients undergoing chemotherapy with a focus on nutrition.
KULÍŠKOVÁ, Eva
Nutrition is very important for patients undergoing chemotherapy. Tumour-associated malnutrition often appears in them which can be caused both by the cancer disease, and the administration of cytostatics which have a lot of side effects influencing patient´s nutrition, such as the loss of appetite, vomiting, mucositis, but also diarrhoea and constipation. Depending on the seriousness of malnutrition, risks of complications of the anti-tumour therapy increase and the quality of patients´ life decreases. The loss of 5% of weight has an adverse effect on the long-term survival of the oncologically ill. The theoretical part of the thesis deals with the term of chemotherapy, methods of administration of cytostatics and their adverse effects. It further describes pathogenesis of tumour-associated malnutrition, a clinical picture, the role of a nurse in diagnostics and basic nutritional measures to be taken at the occurrence of adverse effects of cytostatics. The first goal was to determine the scope of nurses´ knowledge of the nutrition problems of patients undergoing chemotherapy. The second goal was to determine whether patients knew the possibilities for affecting adverse effects of chemotherapy by means of nutritional measures. The third goal was to determine whether nurses applying chemotherapy provided patients with information about nutritional measures which could influence adverse effects of chemotherapy. Four research questions were stated to meet the goals. The practical part of the Bachelor´s thesis contains results of the quality survey performed by means of an in-depth interview. The research investigation was carried out at the Masaryk Memorial Cancer Institute in Brno. The interviews were held in March 2013, with the consent of the Deputy for Nursing Care. Five nurses who apply chemotherapy and five patients who were receiving chemotherapy were asked for cooperation. Research question 1: ?Do nurses have necessary knowledge in the field of nutrition of patients undergoing chemotherapy?? The answers showed that nurses did not have complete knowledge of nutritional measures during chemotherapy. Their answers were usually brief and incomplete. All the nurses agreed that it was important to have correct knowledge in the field of nutrition during chemotherapy but only one of them stated that she would appreciate a training in this field. Research question 2: ?Do patients know the possibilities for influencing adverse effects of chemotherapy by nutrition?? Answers of patients were similar to those of nurses. Patients usually only knew basic measures; their knowledge can be assessed as insufficient in this field. Research question 3: ?Do nurses inform patients about the possibilities for nutrition during the application of chemotherapy?? Nurses and patients stated in agreement that the most frequent source of information is an educational brochure which only contained basic notes. The majority of patients stated they received sufficient information about nutrition, which did not correspond with their knowledge. Research question 4: ?Do patients know the possibilities where to obtain information about nutrition during chemotherapy?? The majority of respondents answered that they would look for the answers on the internet or they would ask a nurse at the ward. All of them answered in agreement the question ?What information resources do nurses recommend to patients?? they only hand over an information brochure and a contact to the ward. A possibility how to improve the knowledge of patients as well as nurses could be a wider content of educational documents on influencing adverse effects of chemotherapy, or higher knowledge of other sources of information such as internet links or the possibility to contact a nutrition therapist. Results of this thesis could be used as information documents which can help improve nursing care of patients undergoing chemotherapy.
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The incidence of microsporidium in hematological and oncological patients
DORAZILOVÁ, Veronika
Microsporidia are intracellular parasites belonging to the Fungi kingdom. There are about 1200 species of microsporidia in 150 genera, 14 species of microsporidia are the most important for human. Enterocytozoon bieneusi and Encephalitozoon intestinalis are the most common microsporidian, that cause infections in humans. Infectious stages of microspoidia are spores. They are oval shape and serve for host infection. Spore contains the polar tube, which is ejecting into cystoplasm of the host cell. The process is triggered by external conditions and release the content called sporoplasma into host cell. The development of microsporidia in the host follow, which includes two phases of development - merogony, which involves division of the plasmodium on meronts and sporogony, when individual cells become independent and after variol stages of development finishes by the spore formation. Microsporidiosis can be transmitted by fecal oral transmission: ingestion of contaminated water or poorly cooked meat. This type of transmission is called horizontal. The second type of transmission is vertical transmission (transplacental), which wasn´t been described in humans. Zoonotic transmission can be important, too. A person can be infected by microsporidiosis from various species of animals that were infected with different species of microsporidia. Patients with acquired primary immunodeficiency are the group at risk. Children, senior patients, travelers or patietns after transplantation can be infected, too. Microsporidia cause opportunistic infections for which is characteristic that accompany other primary diseases, such as AIDS, other viral or bacterial diseases and so on. The most common clinical manifestations include diarrhea, other symptoms are eye, lung or muscle problems. The aim of this work was determine the presence or absence four species of microsporidia, Encephalitozoon intestinalis, Encephalitozoon hellem, Encephalitozoon cuniculi and Enterocytozoo nbieneusi in faecal samples of hematology and oncology patients and compare the results with the results already described. I collected 45 stool samples during the period January 2012 - January 2013. Samples were collected in non-sterile cap bottles and processed in parasitological laboratory in AS CR in České Budějovice. Then I stained all samples by the calcofluor white and examined with the microscope Olmypus IX70. I was looking for oval bright blue-white spores of microsporidia. It was necessary to distinguished from yeasts. Another method was molecular diagnostics. I isolated DNA from all 45 samples using a commercial kit PSP Spin Stool DNA kit (INVITEK). During isolation spores were desintegrated and DNA suitable for further processing obtained. Then I performed polymerase chain reaction, a method using a rapid multiplication of DNA based on the principle of replication of nucleic acids. PCR was performed in thermocycler (BIO RAD, BIOER) for two hours. Amplification was carried out in 35 repetitive cycles of three basic steps - denaturation, hybridization and elongation. Gel electrophoresis was next step. There result was shown by electrophoresis transluminator, which was connected with a computer. According to the fragment length was determined whether one of the four above-mentioned species of microsporidia is present in the sample. DNA extraction from gel was next step, if presence of microsporidia was comfirmed. Then the purified DNA was send to sequencing to Korea and sequences were evaluated. Total nine DNA fragments were send to sequencing. Next analyses was last step. This was carried in out in the biological center of AS CR in České Budějovice. Phylogenetic analyses determined type of genotype. Presence of the species Encephalitozoon cuniculi, genotype II in one hematologic patient was confirmed. Also, presence of the species Enterocytozoon bieneusi, genotype D in two hematologic patients and six hematologic patients was confirmed.
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Radiotherapy of colorectal cancer
MAJERČÁKOVÁ, Iva
In agreement with WHO organisation is on record 940 000 new cases every year in the whole world, and one half of them die because of lateness. Consciousness of this disease is low, people think it{\crq}s insignificant and easily curable tumour. This diagnosis forms approximately 10 % of all registered malignant cancers and it is once of the most frequent causes death between tumours in the whole world. The Czech Republic rank among forefront in incidence and mortality in the Europe. Prevention this significant cancer is considerably deficient and uneconomical in the Czech Republic.
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Antiviral effect of ribavirin and acyclic nucleosid phosphonates against Turnip yellow mosaic virus.
MRÁZKOVÁ, Ivana
A new method was developed for testing antiviral compounds against plant viruses based on rapidly growing brassicas in vitro on liquid medium. While using ribavirin as a standard for comparison, phytotoxicity and ability of the acyclic nucleotide analogues(R)-PMPA, PMEA, PMEDAP, and (S)-HPMPC to eliminate ssRNA Turnip yellow mosaic virus (TYMV) were evaluated by this method. Double antibody sandwich ELISA was used for relative quantification of viral protein in plants. Ribavirin had the most powerful antiviral effect against TYMV. On the other hand, (R)-PMPA and PMEA had no antiviral effect and almost no phytotoxicity compared to the control. (S)-HPMPC and PMEDAP showed moderate antiviral effect, accompanied by higher phytotoxicity.
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Toxic effects of Radiotherapy for Female Patients over 60 Years of Age with Gynecological Tumors
POLODNOVÁ, Šárka
Cervical cancer and cancer within the body of the uterus are the most frequent cancers of the female reproductive organs, the incidence of which is on the rise. Every year, more than 1,000 new cases of cervical cancer are diagnosed in the Czech Republic, as well as 1,500 cases of endometrial cancer. Surgical treatment and external radiotherapy are used during therapy and, in some cases, it is combined with brachytherapy and chemotherapy. I focused on the early toxicity of radiotherapy, which can be a limiting factor for the completion of treatment, especially in older patients. The investigated sample consists of 100 female patients who were divided into 4 groups, according to age and the primary diagnosis of these patients. Each group consists of 25 women. Patients in the first group are represented in a group of those under 60 years of age with cervical cancer; the average age is 48 years. The second group consists of patients with the same diagnosis, but who are over 60 years of age; the average age is 66 years. The third group consists of patients who are under 60 years of age who have uterine cancer; the average age is 54 years. The 4th group consists of patients who are over 60 years of age with uterine cancer; the average age is 71 years. All patients were irradiated at the Oncological Clinic of České Budějovice Hospital. In my thesis, I compared the toxicity of radiotherapy in the group of younger patients with the group of the older patients. Hematological toxicity was more frequently identified in older patients, be it the malignant cervical cancer (76%) or the endometrial cancer (52%). In younger patients, hematological complications occurred less frequently (cervix {--} 52%, body of uterus {--} 24%). Serious grade 4 toxicity was identified in one patient over 60 years of age with separate pelvis radiotherapy for cervical cancer. Grade 3 toxicity was identified in one patient from the younger group and in one patient from the older group with combined treatment for cervical cancer. In regard to non-hematological complications, toxicity was more severe in older patients too. The incidence of diarrhea in the over 60-year-olds was 64% as opposed to 48% in the younger group. The stated hypothesis of higher toxicity of treatment for older patients was confirmed during my research.
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