|
|
Acquisition, Modeling and Signal Processing in Ultrasound Perfusion Imaging
Mézl, Martin ; Kozubek, Michal (referee) ; Flusser,, Jan (referee) ; Jiřík, Radovan (advisor)
This work deals with possibilities of ultrasound perfusion analysis for the absolute quantification of perfusion parameters. In the theoretical part of this work are discussed possibilities of using of the ultrasound contrast agents and approaches for the perfusion analysis. New methods for the perfusion analysis are suggested and tested in the practical part of this work. The methods are based on convolutional model in which the concentration of the contrast agent is modeled as aconvolution of the arterial input function and the tissue residual function. The feasibility of these methods for the absolute quantification of perfusion parameters is shown on data from phantom studies, simulations and also preclinical and clinical studies. The software for the whole process of the perfusion analysis was developed for using in hospitals.
|
|
|
Effect of enteral nutrition on the microbiota of children with Crohn's disease
Halbrštátová, Eliška ; Bunešová, Věra (advisor) ; Salmonová, Hana (referee)
Each year there are many facts being discovered, supporting the unexceptionable importance of intestinal microbiota on human health. One of these many fields of interest is the significant role of microbiota in inflammatory bowel diseases arising due to disruption to its balance. This bachelor thesis deals with one of the aforementioned inflammatory bowel diseases, namely Crohn's disease, whose occurrence increases not only in children, but in adults also. Because of the fact that there hasn't been discovered any effective drug yet, treatment is targeted on suppressing the inflammation, curtailment of the urgent phase and attaining long term symptomless period. One of treatment options is enteral nutrition, whose influence on microbiota will be investigated in this study. The research is focused on the influence of nutrition in children patients, which differs by its specifics from adult treatment.
Due to the difficulty of the study, from 50 originally classified patients, 15 children patients of Motol University Hospital were selected. Those were subjected to treatment by enteral nutrition for a period of 6 weeks, during which stool samples were taken. Fresh stool samples were used for cultivation and biochemical test.
Cultivated and quantified were the groups of gramnegative bacteria, coliform bacteria and Escherichia coli, total amount of anaerobic bacteria and bacteria of the genus Bifidobacterium, Lactobacillus and Enterococcus. Biochemical tests were further conducted, those were targeted on the detection and identification of the genus Bifidobacterium in the patient's stool. For identification, the commercial diagnostic system API ZYM was used. With the aim of promoting the conclusiveness of study, samples were preserved for the isolation of bacterial DNA and further research.
A review of the literature proved the fact that in Crohn's disease some of the beneficial bacterial groups are reduced, while, on the other side, quantity of some bacterial groups increases, which converts otherwise beneficial and ordinarily inhabiting groups of the intestinal microbiota to pathogenic ones. So enteral nutrition treatment should support increasing the number of reduced groups and the pathogenic ones should be reduced to benefit of reduced groups.
Summing up the results of our study comes to the conclusion, that expected increase bacteria of the genus Enterococcus a Lactobacillus was achieved, thus confirming efficiency of enteral nutrition treatment. On the contrary, the growth of the bacteria of the genus E. coli and the group of coliform bacteria, together with the downturn of bacteria of the genus Bifidobacterium, refutes the efficiency of enteral nutrition treatment.
|
|
|
Problems of Children Crohn's disease
TENKLOVÁ, Monika
Crohn's disease is a chronic inflammatory disease that affects the entire gastrointestinal tract in all its layers.The theoretical part deals with the characteristics of the disease, its causes, symptoms, complications, treatment and psychological aspects. It also touches on the needs of children and communication with a chronically ill child.At first, this work set out to achieve two goals: mapping the provision of nursing care to children with Crohn's disease in hospitals and determining the impact of Crohn's disease on the everyday life of a child. A third goal, gathering respondents' views on the possibilities of community nurses in collective institutions, was encountered during the research and was added.The empirical part was carried out using qualitative research method using semi-structured interviews both with health professionals working at pediatric wards, as well as children with Crohn's disease and their parents.Survey results show that children with Crohn's disease come in contact with health workers at various departments of health facilities. The most common early symptoms of Crohn's disease in children included abdominal pain, diarrhea with blood or mucus and failure to thrive. The most common areas affected were the gastrointestinal tract, the small intestine, the colon in one case and the rectum in another.Some workers did not know which tests or treatments their hospital prescribes to the children.They report pain as the main nursing challenge, but this did not reflect in nursing practice.In all departments, except one, there was no material on Crohn's disease, which would have been helpful to the workers.Interviews with children and parents, as well as with health workers confirmed that the disease has a socio-cultural impact on the child and those around it. The results of this diploma thesis were presented at three conferences and will be published.
|
|
|
Patients with chronic bowel disease and their lifestyles
FRANKOVÁ, Zuzana
The thesis deals with the lifestyle of patients with chronic intestinal disease. The theoretical part contains topics of theoretical knowledge essential to the orientation in the issue. It describes the principles of a healthy lifestyle, the issue of chronic intestinal disease, especially Crohn's disease and ulcerative colitis as a disease of clinical manifestations, from diagnosis to treatment. An important chapter of the theoretical part of the work are the impacts of IBD on lifestyle at chronically ill patients. The empirical part deals with the qualitative research. For datas collecting was chosen and used the method of questioning with narrative interview technique. Methodology of narrative interview was expanded to include specific methods of collection datas, the life curve method. The content of each interpretation is the final report that summarizes the observed facts associated with answers to research questions. Significant elements of the interviews are recorded in tables. The aim of the thesis was to find out in what areas and how the selected people with chronic intestinal diseases have changed their lifestyle. To provide information to the public about the limitations of patients with chronic intestinal diseases that directly affect their everyday lives. Finally to assist society tolerance to constraints of patients with chronic intestinal disease.
|
|
|
Nursing care by children on biological treatment for Crohn's disease
KOUBOVÁ, Marta
This bachelor's work with the title: Nursing care of children with the Crohn´s disease going through biological treatment concerns with the care specifics which are necessary for the child´s patient during biological treatment giving. The Crohn´s disease has been along with the ulcerous colitis called by omnibus term for idiopatic intestinal inflammation characterised also by the abbreviation IBD from the English Inflammatory Bowel Disease. It refers to chronic inflammatory intestinal disease which affects intestine segmentally with intestine mucous membrane hitting in total thickness and has been characterised by remise and relapse phases. In the treatment connection, the aim is life quality improvement not only at the children but also at the adults. In the curative scheme the biological treatment has a high therapeutic potential which is from the costs viewpoint applied at relatively small sample of patients. For this bachelor´s work objects fulfillment was qualitative research investigation. Within research investigation were two aims determined. First goal was finding if nurses know specifics of the nursing care of children with the Crohn´ s disease. Second goal was to find out if nurses know biological treatment giving principles. On the basis of mentioned bachelor´s work aims the explorative questions were set: Which knowledge do nurses have of care at the children with the Crohn´s disease going through biological treatment? How do nurses ensure specific nursing care of children with the Crohn´s disease going through biological treatment? Which principles do nurses consider important at the care of the Crohn´s disease children going through biological treatment? The empirical part of bachelor´s work was processed in the form of data qualitative analysis using semi-structured talks and participated hidden monitoring. The research file consisted of eight respondents who participate upon applications of biological treatment at children with the Crohn´s disease diagnostics. Respondents answerred on the basis of own knowledge and acquired experience. The conversations were processed using open coding technique method pencil and paper. The categories and codes were processed into thought maps representing also respondents answers. The research investigation was added by semi-structured talk with the child´s gastroenterologist ensuring the biological care. The hidden participated monitoring was other used method taken at the same research file during the biological treatment application with focus on nursing care. Under the bachelor´s work will be organized the course on the basis of theoretical part and acquired results in the children´s ward of the České Budějovice hospital with orientation on nurses applying biological treatment and also on nurses unknowing in this problems.
|
|
| |
|
|
Quality of life of patients with Crohn´s disease
RENDL, Lukáš
Theoretical foundation Crohn's disease is a chronical autoimmune disease categorized, together with ulcerative colitis, in the group of idiopatic intestinal inflammations. But in spite of this categorization, Crohn's disease may not be found only in the intestines but anywhere in the gastrointestinal tract. However, the intestinal localization is most frequent and is related with numerous manifestations like stomachake, diarrhoea, bloating, flatulence, belching, loss of weight, etc. The pathogenetic cause of those discomforts consists in disorder of autoimmunity, when the body starts producing antibodies against its own tissues. But the cause of start of that pathogenetic mechanism has not been clarified so far. Experts speak about influence of infections, food, psychosomatics, smoking, genetic perceptiveness, etc. The hope of the patients is pinned on the continuously improving treatment, culminating by biological preparations that have most influenced the health condition of those persons so far. But in spite of the modern therapy, all characteristics of the disease can have negative impact on the quality of life of the patients. Goal of the thesis The goal of this thesis consists in ascertaining the quality of life of Crohn's disease patients. Hypotheses H1: Crohn's disease patients have problems in physical area. H2: Crohn's disease patients have problems in psychic area. H3: Crohn's disease patients have problems in social area. Methodology The practical part of the thesis was implemented based on quantitative inquiry within the grant Project No. 120/2012/S ?Reflection of life quality in nursing?. Two standardized questionnaires were used for the inquiry: the WHOQOL-100 general questionnaire and the IBDQ specific questionnaire, distributed among Crohn's disease patients. Valid licence was bought for both questionnaires. The size of the research set was determined at 100 Crohn's disease patients, the Crohn's disease diagnosis being the only criterion for selection of the respondents. The distribution of the questionnaires among the respondents took place with the help of gastroenterological centres. Results All data obtained were statistically processed in the SASD (Statistical Analysis of Social Data) program. The results of the processing can be divided into three areas, by the three main hypotheses verified. The first area of results provided information on the problems confronted by Crohn's disease patients in physical area. Only one problem was confirmed here: the Crohn's disease patients feel fatigue. All the remaining problems under verification in this area were refused. The second area brought information on psychical problems of the patients. Similarly to the preceding case, only one problem troubling the Crohn's disease patients was found here: feeling of irritation. The occurrence of the remaining psychical problems under verification was not confirmed. The last area of results found out the problems of the patients in social area. The results were the most positive in this case, as none of the problems under verification in this area was confirmed. Based on all results stated above, the hypotheses were evaluated as follows: H1 Crohn's disease patients have problems in physical area - refused; H2 Crohn's disease patients have problems in psychic area - refused and H3 Crohn's disease patients have problems in social area - refused. Conclusion The thesis provides comprehensive view on the issue of quality of life of Crohn's disease patients. The results may be used particularly in the work of so called IBD nurses, endoscopic nurses, but also general nurses working with the patients. The thesis can be also used as study material or as foundation for further research.
|
|
|
Education clients in Crohn's disease.
HAVELKOVÁ, Martina
Crohn's disease is an unspecific inflammatory disease of the intestines, which affects people regardless of age or sex. The disease is lifelong, though it follows a cycle of calm periods (remissions) and inflammatory periods (relapses). The first symptoms usually arise between year 20 and 30. There is currently no known therapy which leads to a complete recovery, though successful therapy can induce the remission stage. This therapy enables patients to return to a relatively normal lifestyle, such as they lead before the onset of the disease. We performed quantitative research by distributing 100 questionnaires to general nurses. 71 of the returned questionnaires could be used for research. The thesis is further supported by qualitative research - an in-depth dialogue with five clients with Crohn's disease. The goals of the thesis were met. We defined two hypotheses. H1: Doctors educate clients about Crohn's disease more than nurses. H2: Clients are educated about Crohn's disease more often by means of printed educational materials than direct dialogue. Neither hypothesis was confirmed. Nurses educate clients according to their competence and in close cooperation with doctors, and education takes place by means of dialogue supported by printed materials. Two research questions were also defined: 1. Do you think that upon leaving the hospital you have sufficient information about Crohn's disease? 2. What form of education do you prefer? The research showed that most respondents consider themselves sufficiently informed about Crohn's disease before leaving hospital, and prefer dialogue before printed materials. My Bachelor's Thesis is designed so it can be used as a basis for education materials which will improve communication between patients and medical personnel with respect to information about Crohn's disease.
|
|
|
A client with non specific intestinal inflammations in community care
DOLEŽALOVÁ, Jana
Non specific intestinal inflammations, including Crohn´s disease and ulcerous colitis, belong to so called civilization diseases. Their cause is not completely clear. There is a common factor of both the diseases, that they attack mainly young people between 20 and 30 years of age. These diseases affect mainly physical, but also mental and social aspects of client´s lives. A client needs to have sufficient information on his/her disease and its treatment to be able to cooperate with medical staff actively and thus contribute to improvement of his/her health condition. A nurse plays an important role here as well. Nurse are those who are in permanent contact with a patient and patiens often ask them questions they would be embarrassed to ask a physician. Support of family and friends is also of great importace. Patient organizations that support and help patiens suffering from non specific intestine inflammations and also support their family members may also play an important role. The aim of the bachelor thesis is to find out how patiens with non specific intestine inflammations may benefit from patient associations, to find out how nurses participate in keeping the clients informed and to compile material for clients with non specific intestine inflammations. The qualitative research method was used in the practical part of the thesis. Data collection was performed by means of a semi-structured interwiew. The research sample consisted of selected clients with non specific intestine inflammations, members of IBD CROCODILE Club České Budějovice, participants of seminars of CroCus Patient Club České Budějovice and a civil association of patiens with idiopathic intestine inflammations in Prague. Case studies were elaborated upon interviews with the indiviual respondents. The case studies formed a base for categorization tables in which the most important research results were summarized. Apart from the set goals the research results showed problems the patiens and thein families have to cope with on daily basis. The disease has the most serious impact on their lives in the fields of nourishment, physical activities and travelling. The elaborated information material may be used in seminars of patient organizations, but also in classes at medical school. The research result might be published at specialized lectures and conferences.
|
|
|
Computed tomography of the intestinal tract, usage, advantages and disadvantages of this metod
SMOLÁKOVÁ, Eva
In presented essay author tries to offer comprehensive overview of possibilities of computer tomography (CT) in examination of the intestinal tract at her radiologic department. Introduction of Multidetector CT represents outstanding advance in spatial resolution in z - axis and accelerated data acquisition wihout increase of radiation dose. All these advantages of Multidetector CT project strongly onto examination of the intestines. At author´s department CT enterography and CT colonography replaced to the background classic methods as irrigoscopy and enteroclysis. The feasibility of assessment of the intestinal tract and other abdominal organs at the same time is the most significant contribution of this method. At our department we note progressive decrease of number of enteroclysis examinations since the year 2003. Limitations of this method are radiation exposure, intravenous application of iodine contrast medium and impossibility to obtain specimens for histologic examination. We expect, that future technologies will reduce some of these disadvantages.
|
guest ::
