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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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Preparation of patient prior to application intravenous of contrast medium in relation to the prevention of renal failure
PUCHOLTOVÁ, Lenka
The topic of the bachelor thesis is the patient preparation prior to intravenous contrast in relation to the prevention of renal failure. The theoretical part deals with the anatomy and physiology of the kidney, provides information about the contrast media of their properties, uses and side effects. At the end of the theoretical part describes the contrast medium-induced nephropathy. In the practical part I focused on finding out what is the incidence of contrast nephropathy in individuals with normal creatinine levels depending on the amount of contrast agent and the preparation of the patient. I obtained the data from the hospital information system Masaryk Hospital Townsville. The database contained a set of hospitalized patients in the years 2009 - 2011, which were performed CT examinations associated with the administration of iodinated contrast media. Part of the personal data of patients, the tests used, the type and amount of contrast agent and creatinine values. Since creatinine values were available for all patients, the final database was created from 938 patients with baseline of normal creatinine levels before the examination for which they may be level <than 130 mmol/l. The final group of patients was analyzed according to the defined aims and statistically processed. Hypothesis of this study: the incidence of contrast nephropathy in individuals with normal creatinine levels depending on the amount of contrast agent as a suitable preparation of patients prior to administration of iodinated contrast material does not exceed 10% - was confirmed. In the investigated group of patients was proved preventive effect of patient preparation before the test - hydration. A higher incidence of CN was observed in the group of patients whose preparation has taken place.
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Epidemiology (epidemiologic research) of burn injuries in children.
Eichlová, Lenka ; Tokarik, Monika (advisor)
EPIDEMIOLOGY ( EPIDEMIOLOGIC RESEARCH) OF BURN INJURIES IN CHILDREN Lenka Eichlová Supervisor: MUDr. Monika Tokarik Background: Burn injury belongs to main cause of morbidity and mortality in children. More than 100 000 people sustain flash burn every year, 40% of them forms children. Near minimus insider babies into two years come to scorch mostly owing second men. Cardinal cause of thermic injury off elderly is by personal endeavour. Burns differ by mechanism, range, depth and localization. An age is other crucial factor determinants prognosis of patient. And just therefore children's burns are very specific disbranch of medicine. Object: I tried to created a labour, in which I elaborate statistical data of newly hospitalized patiens on clinic of burns in FNKV behind the year 2008. Patients: The set contained 373 newly hospitalized patiens. I have divided them according to age, sex, mechanism of scorch, range, depths and localization of scorch. Further I followed longitude of hospitalization, way of applied therapy and occurence of complications. Results: Predomination of burns is in boyhood (65%). The highest occurence of burns is in the group at the age of 0-2. The most frequent reason of burn in this group is caused by scalding hot liquid and further contact with hot body. In a group of 4-15 years old,...
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Treatment of recurrent chronic wound.
Nagyová, Lucie ; Šimkovič, Dušan (referee) ; Semecký, Vladimír (advisor)
Lucie Nagyová Treatment of recurrent chronic wound Diplomová práce Univerzita Karlova v Praze, Farmaceutická fakulta v Hradci Králové Studijní obor: Farmacie The aim of this work is understanding to recurrent chronic wound healing processes, with a view to chronic diabetic foot ulcer (DFU) and ways of its treatment. The purpose is to find, how treatment of chronic DFU is conducted in current clinical practise and then compare this finding with theory. We chose a group of twenty patiens incidentally, and we made a brief analysis of chronic DFU treatment based on information taken from patients' health reports. We found that the treatment is combinated and mostly local with using wild range of wound contact layers. The contact layer and the way of treatment are chosen individually, according to a type of a defect and a patient's health state. New ways of treatment targeted to molecular levels of healing wound are not used in current clinical practise because majority of patients can not afford this too expensive therapy. Because of that thorough education of patients is necessary.
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Knee Ankle Foot Orthosis with Hydraulic Knee
Vávra, Jan ; Robenek, Dětřich (referee) ; Koutný, Daniel (advisor)
This master thesis deals with the engineering design of a knee-ankle orthosis and subsequent implementation of a functional sample. The subject of the first part of the thesis is the design of internal shape of the shell on the basis of the patient's leg using CAD software. The second part deals with the design of the hydraulic knee. The knee joint with hydraulic controlled bending enables easier movement for patients who are not able to bring up stairs and uneven surfaces than existing joints. In the implementation was used SolidWorks 2012 and Geomagic Studio 12.
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The use of comet assay for the estimation of DNA damage during the anticancer chemotherapy.
Voříšková, Jana ; Kovařík, Miroslav (advisor) ; Pávek, Petr (referee)
We have monitored the DNA damage induced by tumor chemotherapy. The combination of platin derivate (cis-platine or carboplatin) and another chemotherapy agent (gemcitabin, paclitaxel or vinorelbin) was applied to patients with lung carcinoma. The whole chemotherapy includes 4 cycles. We have monitored the DNA damage in peripheral blood lymphocytes through the first and the third cycle of chemotherapy and 3 weeks after the last cycle of chemotherapy. For detection we have used comet assay which seems to be accurate and reliable method. Lymphocytes were isolated from whole blood through the medium LSM lymfocyte and then were processed by the alkaline version of the single cell gel electrophoresis. We have analysed single strand breaks (SSB) and interstrand cross links (ICL). For the measurement of ICL isolated lymphocytes were incubated in the presence of 200 µM of styrene oxide (SO) to degrade the DNA by inducing strand breaks. Incubation of peripheral blood lymphocytes with 200 µM SO leads to the formation of comets. If ICLs are present in the DNA, the alkaline unwinding of DNA is blocked and the % of DNA in tail is reduced. Comets were stained with ethidium bromide and then analyzed by the software LUCIA Comet Assay. The damage of DNA caused by SSB before the chemotherapy was relatively low and...
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Bone metabolism, infection and ischemia in diabetic foot syndrome
Bém, Robert ; Jirkovská, Alexandra (advisor) ; Štěpán, Jan (referee) ; Broulík, Petr (referee)
The diabetic foot (DF) is one of the most frequent late complications of diabetes, which often leads to limb amputation and effects the quality of life in patients with diabetes. Ischaemia and infection play important role in pathogenesis of DF. One form of DF is Charcot neuroosteoarthropathy (CNO), defined as a noninfectious destruction of bones and joints in the foot due to diabetic neuropathy. The subject of the dissertation thesis was divided into 3 parts: bone metabolism and CNO, ischaemia and infection in DF and new methods in the treatment of DF. (...) In the third study, new quantitative scintigraphic parameters for assessment of CNO activity were defined and confirmed their satisfactory correlation with other parameters of CNO activity. In fourth and fifth study,good reproducibility was verified and efficiency of power spectral analysis of heart rate variability as a new method for diagnosis of autonomic neuropathy in patients with CNO. Sixth study refered to rare causes of atypical localization of CNO in the knee joint. Ischaemia and infection in DF were resolved in one study. In multivariate analysis of seventh study we approved, that risk factors for difficulty healing after minor amputation of the foot were low level of transcutaneous oxygen tension and high level of C-reactive protein before...
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Unruptured intracranial aneurysms : Does the risk of endovascular treatment outweigh natural history?
Beneš, Vladimír ; Stejskal, Lubor (advisor) ; Haninec, Pavel (referee) ; Janoušková, Ladislava (referee)
Summary: Background: The management of unruptured intracranial aneurysms (UIAs) remains controversial. The international study of UIAs (ISUIA) found low rates of rupture and appreciable treatment risks, which can be interpreted that many UIAs should not be treated. Results of endovascular coiling of 131 patients with UIAs are presented along with a risk-benefit analysis based on patient and aneurysm characteristics. Patients and methods: From December 1996 to September 2005, 131 patients (93 women and 38 men, mean age 51 years) with 151 UIAs were treated using detachable coil embolisation. Data on procedural complications, patient and aneurysm characteristics, clinical and radiological follow-up were entered into a prospectively collected database. A risk-benefit analysis was performed. Results: Endovascular treatment was successful in 145 (96%) aneurysms. One aneurysm ruptured intraoperatively with a fatal outcome. Ten thromboembolic events occurred, leaving one patient moderately disabled. The combined morbidity and mortality rate at 6 months per patient is 1,5% (95% confidence interval: 0,07 - 5,7%). Risk-benefit analysis comparing these data with published natural history suggests that treatment with low complication rates can be offered to most patients with UIAs. Conclusion: UIAs can be coiled with...
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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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