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Allooimmunosensitization in left ventricular assist device recipients and impact on post-transplantation outcome
Urban, Marián ; Netuka, Ivan (advisor) ; Ošťádal, Petr (referee) ; Mrázek, František (referee)
Background: In recent years mechanical circulatory assist devices became an established option in bridging patients with refractory heart failure to heart transplantation. One of the alleged limitations of mechanical devices is a high degree of antibody production with possible deleterious effect on subsequent heart transplantation outcome. Aim: The main goal of this study is to assess the role of antibodies on the outcome of surgical treatment of patients with end- stage heart failure. Method: Firstly, we present a literature review on the current state of knowledge of possible immunologic mechanisms involved in antibody production in left ventricular assist device (LVAD) recipients, new methods of antibody detection, desensitization strategies and overview of published evidence assessing the impact of sensitization on post-transplantation outcome. In the experimental part of our study we prospectively evaluated the presence of anti-Angiotensin II Type 1 Receptor (AT1R) antibodies in 83 Heart Mate II (HMII) recipients who were implanted at our institution between 2008 and 2012 and survived the first 60 days. On-device survival and device malfunction, major infection, major bleeding and neurologic dysfunction were compared between antibody positive and antibody negative recipients. Out of a total...
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Laboratory diagnostics of micrometastases in breast cancer patients
Mikulová, Veronika ; Zima, Tomáš (advisor) ; Svoboda, Marek (referee) ; Průša, Richard (referee)
Introduction: The presence of circulating tumor cells (CTC) in the peripheral blood has been associated with worse prognosis and early relapse in breast cancer patients. CTC determination in the peripheral blood has been considered as a liquid biopsy. The aim of this project was to analyze the presence of CTC followed by their molecular characterization with the potential use not only as a new biomarker for real-time monitoring of therapy efficacy but also as a suitable tool for patient's stratification and individualization of treatment for breast cancer. Methods: A total of 54 patients with diagnosed early breast cancer were enrolled into a prospective study. Ten millilitres of peripheral blood were sequentially collected to test for the presence and characterization of CTC during the follow-up of patients. CTC isolation and detection was performed by AdnaTest BreastCancer™ (AdnaGen AG, Germany), which is based on the detection of EpCAM, HER2 and MUC1 specific transcripts in enriched CTC- lysates. cDNA from isolated CTC has been further used for newly optimized qPCR assays for breast tumor and therapy resistance associated genes: TOP1, TOP2A, CSTD, ST6GAL, KRT19 and reference gene actin. qPCR results have been analyzed by Genex software (MultiD Analysis). Results: 195 blood samples have been...
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Intracranial Aneurysms - Treatment Options and Natural Course. Safety and Efficacy of Treatment Strategies for Posterior Inferior Cerebellar Artery Aneurysms.
Petr, Ondřej ; Beneš, Vladimír (advisor) ; Haninec, Pavel (referee) ; Přibáň, Vladimír (referee)
BACKGROUND: Posterior inferior cerebellar artery (PICA) aneurysms are an uncommon, heterogeneous group of aneurysms with poorer neurological outcomes compared to other intracranial aneurysms. At first, as part A, we conducted a systematic review of the literature to evaluate the safety and efficacy of treatment strategies for PICA-aneurysms. Subsequently, as part B, we performed a multicenter retrospective study to analyze the outcome in a large series of patients treated with contemporary microsurgical and endovascular techniques. METHODS: For the meta-analysis, a systematic search of Medline, EMBASE, Scopus and Web of Science was done for studies published through November 2015. We included studies that described treatment of PICA-aneurysms with ≥10 patients. Random-effects meta-analysis was used to pool the following outcomes: complete occlusion, technical success, periprocedural morbidity/mortality, stroke rates, aneurysm recurrence/rebleed, CN-palsies rates, and long-term neurological morbidity/mortality. As the second part, aiming to report the current trends and results in treatment strategies for PICA-aneurysms, records of 94 patients treated for PICA-aneurysms between 2000 and 2015 at 3 large referral neurovascular centers were retrospectively reviewed. RESULTS: In the meta-analysis, we...
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Specifics of nursing care of devotees of Hinduism at the nursing unit
HAPATYKOVÁ, Jitka
The aim of this work was to investigate specific aspects of care at a nursing unit when treating Hindu worshippers. To achieve this objective four research questions were selected. This thesis was divided into theoretical and practical part. In the first half of the theoretical part the basic elements of Hinduism, its history, directions and expansion to the Czech Republic, but also the customs, rituals and lifestyle of its worshippers were described. The second half of the theoretical part was focused on multicultural and transcultural approaches that are very important in nursing care for patients/clients of different beliefs. In the empirical part of the work the very investigation using qualitative research method was performed. This took the form of semi-standardized interview. The interview contained 40 questions which were further extended with additional questions to get the most detailed information. In the last part of the empirical part we summarized the results in a discussion. With our research survey we answered all the research questions. It was found that the respondents are not satisfied with the Czech health care system, especially with the availability of health care. The respondents said that they did not like long order times for medical procedures and tests. They were bothered with full waiting rooms at the doctors. From the results related to the second question it was found that, despite some negative experience, the respondents are rather positive about the hospitalization in the Czech Republic. Mainly, the respondents did not like the hospital environment. The answer to the third research question was given to us by another group of questions focused on nursing care. The experience with nursing care was both positive and negative. Although respondents often expected different behavior from nurses than was really encountered, the results of our survey showed that the respondents are satisfied with nursing care. None of these outcomes relates to their religious beliefs. The last group of questions gave us the answers to the fourth research question. We investigated the specifics in the treatment of Hindu worshippers in the field of nutrition, hygiene, religious belief and prayers during hospitalization, leisure time spending during hospitalization, dying and death. In the field of nutrition we noticed certain specifics. Hindus are vegetarians and lacto vegetarians who regulate their diet according to strict religious rules. Hospital food does not respond to their rules, therefore they let their food be brought from their friends. Further specifics resulted from the issues relating to religion and prayers. Hindu worshippers perform their prayers each day even during hospitalization. Hindu prayers may be performed by whispering or mutedly, lying in bed, therefore they do not require any special prayer room. Their prayers are quiet and do not disturb anyone. That closely relates to the answers to questions about the specifics of leisure time spending during hospitalization which the Hindu worshippers mostly spend by activities associated with belief. In their free time they mostly listen to spiritual music, read sacred texts and perform prayers. In the field of dying and death we have not discovered any specifics. Only in the understanding of death. For the Hindu worshippers, death is seen as a new beginning, so they are looking forward to it and getting ready for it for all their life. Hindus believe that, after death, they are born again in a new body. With our survey we were able to answer all the research questions and thus achieve the aim of the thesis, which was to find out what the specifics in the treatment of Hindu worshippers at a nursing unit are. Based on the results of the research, information material for nurses was developed, in which the specifics of treatment of Hindu worshippers are described.
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The Need for Nonpharmacological Pain Relief in Rheumatoid Arthritis Patients
BOUKALOVÁ, Naděžda
This diploma thesis called "Need of non-pharmacology pain relieving for patients afflicted by Arthritis rheumatic" has been created as a next step of a previous pilot research. Respondents of the previous investigation expressed their interest in non-pharmacology pain relieving. It is very important to relief pain caused by Arthritis rheumatic as chronic disease in balance manner by usage of both approaches pharmacology and non-pharmacology. The goal of this study has been to investigate possibilities of non-pharmacology pain relieving among patients afflicted by Arthritis rheumatic and how these patients cooperate with nurses. The research comprises following goals: 1. Ascertain, whether patients afflicted by Arthritis rheumatic prefer pharmacology to non-pharmacology pain relieving. 2 Ascertain, which method of non-pharmacology pain relieving is mostly used. 3 Ascertain the interest of patients to relief pain by usage of non-pharmacology methods. 4 Ascertain the nurses' influence on the non-pharmacology pain relieving. The theoretical part is focused on pathophysiology of the disease, the issue of chronic pain and quality of patient life. The second, empirical part, is dedicated not only to actions of the investigation itself, but also its characteristics and results. There were issued 130 questionnairs for qualitative analisis. 102 of 130 questionairs has been retrieved and filled in properlly. Data from questionairs was compiled and hypotheses were tested by usage of Chi-squared test. 3 hypotheses have been built: H1 Patients afflicted by Arthritis rheumatic prefer pharmacology pain relieving to non-pharmacology. This hypothesis H1 was affirmed only for patients in acute stage of Arthritis rheumatic. H2 Patients afflicted by Arthritis rheumatic prefer thermotherapy to rehabilitation when considering non-pharmacology pain relieving. This hypothesis H2 was not confirmed due to low number of respondents. H3 Patients achieved higher education degree express higher interest in non-farmacology pain relieving. Higher education degree of patients has only impact on method in acute stage of Arthritis rheumatic. Qualitative investigation was carried out by half-structured interview with 7 respondents working on inpatient department and also outpatient department. Several statements could be concluded out of qualitative investigation: Nurses have been persistently educating by passive or active participation on various seminars or congresses. They have been trying to convey information about non-pharmacology treatment to their patients. They cobnsider non-pharmacology treatment as a indiscerptible part of a treatment. Investigation results will ne provided to all collaborative departments to support improvement in cooperation between nurses and patients.
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Cost Analysis of the Treatment of Prostate Cancer
Plánka, Martin ; Lešetický, Ondřej (advisor) ; Mlčák, Jan (referee)
This diploma thesis deals with prostate cancer, contains informations about this affection and in the practical part I deal with costs, which are used on treatment for prostate cancer. The theoretical part presents prostate cancer, its symptoms, risky factors and diagnostic. Furthermore introduces treatment methodes of prostate cancer, its classifying and insertion to stages. In the theoretical part are calculated costs on the individual modalities of prostate cancer treatment. These costs are compared with datas received from Hospital in Jihlava during the treatment of this affection. In the end sumarise costs of this treatment and analyse propriety of punctual screening of illness.
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Analýza finančních toků spojených se zdravotnictvím a spokojenost pacientů se zdravotní péčí poskytovanou v soukromě vlastněných nemocnicích v České republice
Supová, Aneta ; Štěrbová, Ludmila (advisor)
This Master Thesis focuses on the structure of health related financial flows and patient satisfaction with privately owned hospitals in the Czech Republic. The main aim was to provide a general overview of health care system in the Czech Republic, to describe how the health care system is financed, and to find out if patients hospitalized in privately owned hospitals are more satisfied with the care provided in this type of hospitals. Having analyzed the major statistical reports from the WHO, EU, and the Institution of Health Information and Statistics of the Czech Republic, the theoretical part provided a comprehensive summary of health care, health financial flows, and pricing of health treatments. The practical part, on the other hand, shows distribution of health costs among differently aged people in the form of contribution/expenditure ratio. Finally, the results of the questionnaires conducted among patients in privately owned hospitals enabled to conclude that patients in the Czech Republic are still not fully aware of the difference between privately and publically owned hospitals.
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Scanning thermal microscopy of thermoelectric pulsed laser deposited nanostructures
Vaniš, Jan ; Zelinka, Jiří ; Zeipl, Radek ; Jelínek, Miroslav ; Kocourek, Tomáš ; Remsa, Jan ; Navrátil, Jiří
New materials with high possible figure of merit ZT are of high interest as a promising candidates for thermoelectric applications such as energy harvesting. Miniaturization of such systems tends toward developing of the suitable characterization method with nanometer resolution ability. In our contribution, we present the development and experimental results of a simple scanning probe microscopy method for the relative thermal conductivity characterization. The possibility of the setup is demonstrated on the set of different thin thermoelectric layers grown from hot pressed targets by pulsed laser deposition on the reference Si substrate. All the measurements were performed on the commercial Veeco Multimode scanning AFM/STM microscope with home developed controller and by using PicoCal Inc. bolometer probes with tungsten resistive path. All the experiments were done in the air at the ambient condition. Additional sample treatment for the measurement will be also briefly described
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Effect of a cultivar and thermal treatment of seeds in selected vegetables at early growth phase on the sensitivity to infection by important fungal pathogens
Novotný, Čeněk ; Koudela, M. ; Svobodová, Kateřina ; Nedorost, L. ; Aust, R. ; Kocourek, F.
The methodology is focused on the effect of selected factors on the development of important vegetable illnesses: Alternaria brassicicola dark leaf spot of cabbage, A. dauci carrot leaf blight, and Botrytis aclada onion neck rot and Peronospora destructor onion downy mildew. In the case of A. brassicicola, A. dauci and B. aclada, the plants in a defined stage of development were infected by the strains of fungal phytopathogens originating from acknowledged collections. In the case of P. destructor the plants were infected by a fungal strain obtained from a field plant culture massively affected by this phytopathogen. The effect of the cultivar used and of the seed thermal treatment on the development of the above given phytopathogens was investigated. It was found that, in the case of the cultivars used, the interpretation of the results had to include the factor of the cultivar´s earliness that was important with respect to the resistance to the fungal pathogens.
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Yellow rust protection on the wheat
Hanzalová, Alena ; Bartoš, Pavel
Heavy incidence of yellow rust in the years 2014 and 2015 has proved high deleterious effects of this rust. For this reason this publication deals with yellow rust on wheat. Rusts on wheat cause losses every year. In the years of an epidemic yield can be decreased by more than a half. Epidemics of stem rust and yellow rust occur in irregular intervals. Leaf rust causes damage every year particularly in central and southern part of Moravia. Chemical control limits yield losses, however in the case of heavy rust incidence this control particularly on susceptible cultivars is not sufficient. Repeated chemical treatments increase the costs and are limited by phytosanitary regulations. Economic and ecologic rust control consists in resistance breeding and growing resistant cultivars. Knowledge of virulence in the rust poppulation and suitable sources of resistance are prerequisites for successful resistance breeding. This publication presents a summary of data from literature on the yellow rust on wheat. Data on resistance of the grown cultivars and possibilities of the chemical control are included.
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