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Quality of a Life of the Patient after total hip Arthroplasty
Obertová, Denisa ; Pečenková, Jaroslava (advisor) ; Šponer, Pavel (referee) ; Filková, Zuzana (referee)
Author's first name and surname: Obertová Denisa Institution: Charles University in Prague, Faculty of Medicine in Hradec Králové The Title of the thesis: Quality of a life of the patient after total hip arthroplasty Supervisor: Jaroslava Pečenková Number of pages: 100 Number of attachment: 3 The year of presentation: 2011 Keywords: quality of a life, arthrosis, hip joint, total arthroplasty, rehabilitation This Bachelor work is devoted to the problems of quality of a life after total hip arthroplasty. The theoretical part introduces the quality of a life of patiens and a total hip arthroplasty. The empirici part compares preoperative period of patiens with postoperative one, separately men and women. questionnaire method, 22 question, 70 respondents Souhlasím, aby práce byla půjčována ke studijním účelům a byla citována dle platných norem.
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Educational program for clients of home parenteral nutrition
Nováková, Alena ; Vachková, Eva (advisor) ; Vaňková, Dana (referee) ; Rybářová, Marie (referee)
The bachelor's thesis deals about the education of home parenteral nutrition. Generally, the theoretical part provides a comprehensive overview of education in nursing and parenteral nutrition and gives its specifications in the home environment. The empirical part refers to the possible problems relating to the nurse and the patient, which were solved by questionnaire. Based on the delivered data I have prepared proposal of an educational program for clients on home parenteral nutrition.
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Significance of MLL gene aberrations in patients with acute myeloid leukemia
Šárová, Iveta
In acute myeloid leukemia (AML), predominantly in AML M5a, the most frequent recurrent aberration of chromosome 11 involves region 11q23. Molecular breakpoint studies of several translocations involving chromosomal band 11q23 led to the detection of a gene that was named MLL (myeloid/lymphoid leukemia). This gene is important for the proper HOX gene expression during ontogenesis and hematopoiesis. Chromosomal aberrations affecting the MLL gene occur in 5 - 10 % of AML cases and are very variable. Since that time, more than 70 different translocation partners of the MLL gene have been described. Aberrations of the MLL gene are associated with an aggresive type of the disease and its detection is needed for the treatment decision. Therefore, we investigated the occurrence of MLL abnormalities in bone marrow cells of the 66 newly diagnosed AML patients, using conventional cytogenetic and fluorescence in situ hybridization (FISH) analyses with a commercially available MLL Break Apart Rearrangement probe (Abbott VYSIS). Out of the 66 patients, we proved MLL abnormalities in 9 (13,6%): 5 (7,6%) showed translocation of MLL gene, in 3 (4,5%) we detected MLL gene amplification without any evidence of rearrangement and in 1 (1,5%) pacient only an extra copy of the MLL gene. The FISH results were verified by...
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Local metabolism of glucocorticoids in female Prague hereditary hypertriglyceridemic rats
Klusoňová, Petra ; Pácha, Jiří (advisor) ; Kopecký, Jan (referee) ; Haluzík, Martin (referee)
11-hydroxysteroid dehydrogenase (11HSD1) is an oxidoreductase which catalyzes conversion of inactive 11-oxo steroid derivatives into active 11-hydroxy forms. 11HSD1 elevates intracellular level of active glucocorticoid (GC) hormones: cortisol in human tissues and corticosterone in rodents, therefore local level of active GCs can be set independently from systemic secretion driven by hypothalamo-pituitary-adrenal axis (HPA axis). Chronic systemic excess of GCs results in development of Cushing's syndrome which is characterised by central obesity and other metabolic disturbances. Despite normal serum levels of GCs, the patients with idiopathic obesity also develop metabolic syndrome. It was suggested that GCs could be elevated locally in target tissues due to enhanced 11HSD1 activity. This hypothesis was confirmed in transgenic rodent models. Prague hereditary hypertriglyceridemic (HHTg) rats represent a non-obese model of metabolic syndrome without genetic manipulations or specific mutations. The strain was bred by cross-mating of Wistar rat individuals with elevated serum levels of triglycerides (TGs). The strain exhibit hypertriglyceridemia and hypertension. When kept on high carbohydrate diet HHTg rats exhibit alterations in glucose homeostasis. Since there are no data that would describe...
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The influence of some factors on renal impairment in AA amyloidosis
Potyšová, Zuzana ; Ryšavá, Romana (advisor) ; Monhart, Václav (referee) ; Horák, Pavel (referee)
Introduction: Available data suggest an association between presence of secondary (AA) amyloidosis and MCP-1 (monocyte chemoatracttant protein-1) and MIP-1alpha (macrophage inflammatory protein-1 alpha) genes polymorphisms. Some studies have also shown an impact of polymorphisms in exon 3 of SAA 1 (serum amyloid A 1) gene on the incidence of AA amyloidosis in different populations. Methods: The incidence of single genotypes MCP-1, MIP-1alpha and SAA 1 genes was investigated. Serum levels of SAA, MCP-1 and MIP-1alpha were measured and potential relation between serum levels and genotypes were analyzed. All examinations were performed in patients with AA amyloidosis (43), rheumatoid arthritis (RA) without amyloidosis and healthy control group (100). Results: Significantly more frequent occurrence of 1.1/1.1 genotype in SAA 1 was recorded in AA amyloidosis group compared to RA group as well as in control group (p<0,001). No statistically significant differences in distribution of another genotypes were found. Distribution of neither 1.1/1.1 genotype nor another ones did not vary among RA group and control group. No significant difference in distribution of another examined genotypes was recorded among all three groups. Serum concentrations of SAA were statistically significantly higher in AA amyloidosis group...
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Intestinal transplantation on an experimental model.
Oliverius, Martin ; Adamec, Miloš (advisor) ; Gürlich, Robert (referee) ; Kala, Zdeněk (referee)
Intestinal transplantation represents a life-saving procedure for patients with an intestinal failure. An experiment on pigs was carried out during the preparation part of a clinical project in the Czech Republic. The main aim of the experiment was to successfully master the transplant surgery technique (i.e. small bowel harvesting, its preservation, followed by the transplantation). Another goal was to decide on the optimal immunosuppressive regime. Immunosuppression was based on tacrolimus monotherapy or its combination with sirolimus. A graft biopsy still remains the most reliable method for the diagnosis of an acute cellular rejection. In an attempt to find a suitable noninvasive humoral marker of the acute cellular rejection, we examined the correlation between plasma citrulin level and the acute rejection. The plasmatic level of proinflamatory and antiinflamatory cytokines was investigated as another potential marker of the rejection. We succeeded in standardizing the technique of intestinal transplantation. Connecting the graft to aorta and inferior vena cava is simpler and safer than connecting it to the portomesenteric vessel bed due to fewer subsequent complications. Both immunosuppressive regimes seem to be equally effective in preventing the acute cellular rejection. Histopathological...
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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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Chemokines and their receptors in pathogenesis of interstitial lung diseases
Šterclová, Martina ; Stříž, Ilja (advisor) ; Posová, Helena (referee) ; Musil, Jaromír (referee)
Sarcoidosis and extrinsic allergic alveolitis (EAA) are granulomatous lung diseases with predominantly Th1 immune response. In this prospective study, we analyzed the expression of chemokine receptors CXCR2, CXCR3 and CCR3 on bronchoalveolar lavage fluid (BALF) CD4 T-cells of patients either with EAA or sarcoidosis. We investigated the correlation of chemokine receptors expression, lymphocyte and neutrophil counts in BALF and high resolution tomography (HRCT) pattern. Thirteen sarcoidosis and 6 EAA patients were enrolled in the study. The expression of chemokine receptors on BALF CD4 T cells were analysed by flow cytometry. HRCT scoring system according to Kazerooni EA. was used for evaluation of the disease extent. We have found positive correlation between BALF CD4 T-cells CXCR3 expression and HRCT alveolar score in EAA patiens (p<0.01). CXCR2 expression on BALF CD4 T-cells and interstitial HRCT score did not show a correlation either in the EAA or the sarcoidosis group. Positive correlation between CCR3 expression on CD4+ T cells and HRCT interstitial score was proven in the EAA group (p<0.05). We conclude, that Th2 predominant immune response may play an important role in chronic EAA pathogenesis. The role of chemokine receptors in the pathogenesis of EAA and sarcoidosis should be presumed and investigated.
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Quality of life in patients with coronary artery disease after percutaneous coronary intervention treatment
Melkovičová, Stanislava ; Štefančíková, Mariana (advisor) ; Votroubková, Michaela (referee) ; Hodač, Martin (referee)
Key words: quality of life, assessment of quality of life, coronary artery disease, percutaneous coronary intervention Bachelor's thesis is focused on assessment of quality of life in 50 patients with chronic coronary artery disease after receiving percutaneous coronary intervention treatment. Risk factors, signs, diagnostic techniques, treatment and prevention were mentioned. Practical part of the thesis is based on questionnaire survey. The objectives are to evaluate the quality of life in patients with chronic coronary artery disease before treatment and assess the effect of treatment on further quality of life in these patients. Patients' compliance of preventive interventions and important differencies between both sexes were measured as well.
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