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Comparison of methods of ECLIA and ELISA in determining the beta-CrossLaps
KOŽANTOVÁ, Jana
Osteoporosis is a very old disease affecting a large majority of population. Its occurrence rate has been growing permanently. It is a systemic disease of bones for which the decrease in bone mass, i.e. of inorganic as well as organic bone part is characteristic. Typical symptoms are osteoporotic fractures. To perform an in time diagnostics of the disease, it is necessary to execute the necessary examinations. One of them is also the laboratory determination of markers of bone resorption and new creation for finding out the state of bone metabolism. The target of my bachelor thesis was to find out the level of the bone resorption marker (beta-CrossLaps) by means of ELISA and ECLIA methods on the same serum from patients with the diagnosed osteoporosis and to process statistically the results. In the next part I dealt with the structure and functions of bones. Then I focused on markers of bone formation and resorption. Finally I mentioned the bone metabolism and its control mechanisms. I concentrated mainly on the metabolism of calcium, D vitamin, parathormone and calcitonin. I carried out the practical part of my bachelor's thesis in the accredited private laboratory STAFILA, spol. s r. o. in České Budějovice. The procedure of my work followed the standard operating procedure of the laboratory. In the research, in total 66 serums of patients with osteoporosis were analysed by me. At first, I determined the concentration by beta-CrossLaps method based on the principle of sandwich ELISA on the appliance NexGen Four from TestLine company. Then I analysed the same samples on the automatic analyser IDS-iSYS from IDS company, this time by ECLIA method. Both appliances on which the determination was executed, principles of both methods, applied analytic sets and the procedures of analysis are described in the methodical part. In the next part of my bachelor's thesis, the results of my measuring are stated. At first I entered the concentrations beta-CrossLaps in ng/ml measured by both methods into the table and for the respective samples I stated the sex and years of birth of individual patients. Moreover I prepared a graph illustrating the share of men and women of various age categories in my research. The second graph shows the differences in values of beta-CrossLaps concentrations between both methods. Resulting concentrations were subject to regression analysis. I applied linear regression and Grubbs test for finding out the outlying values excluded from the further statistical processing. I performed Passing-Bablok regression based on the remaining values. As a result of regression equation and 95% CI of the slope B and intercept A, the proportional error of measuring was rejected but on the contrary, the systematic error was confirmed. Correlation coefficient R = 0,97 shows a very good linear dependency between both methods. It turned out by practice in the laboratory that the evaluation of concentrations beta-CrossLaps from the same patients on various appliances may show partially different values. I worked at two different analysers, each of them was based on another principle, with a different sensitivity and calibration. All of this could have the influence on the resulting concentration of individual samples. The advantage of automatic analyser IDS-iSYS is a quicker determination. Moreover it is possible to perform on this apparatus all the possible examination concerning the bone metabolism from D vitamin, parathormone, osteocalcin up to bone markers. It is advantage for the patients with osteoporosis as well as with other metabolic skeleton diseases. It follows from this that all the necessary examinations may be carried out on one apparatus.
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Risk factors for osteoporosis - knowledge and behavior of adolescent girls
KVASNÍKOVÁ, Martina
The thesis deals with the theme of risk factors for osteoporosis, knowledge and behavior of adolescent girls. The theoretical part of the thesis is divided into four chapters. The first chapter deals with the anatomy and physiology of bone. The second chapter discusses general information about osteoporosis. The third chapter summarizesthe prevention of osteoporosis and in the fourth chapter describes the treatment of osteoporosis. In the practical part of thesis was used method quantitative research. The target group consisted of 100 adolescent girls in the age range of 15-17 years of grammar school and vocational school in the České Budějovice. The girls were interviewed using a questionnaire, which consisted of questions related to osteoporosis. In thesis were determined two main objectives. The first of them was to map the knowledge of adolescent girls in the prevention of osteoporosis. The second objective is concerned with mapping the behavior of adolescent girls in the prevention of osteoporosis. The first research question dealt with by what kind of knowledge adolescent girls in the prevention of osteoporosis. The second research question was focused on the behavior of adolescent girls in the prevention of osteoporosis. According to the questionnaires can be concluded that the majority of respondents are not sufficiently informed about osteoporosis, but I find girls that basic information about the disease they have. Questionnaires filled in by teenage girls from the first and second years of grammer school and vocational school, therefore, the results are compared with one another. The survey shows that respondents from vocational school awareness of osteoporosis do not. Girls from grammer school have heard about this disease, but they can´t define it. The reason for this ignorance is that girls (from grammer school and from vocational school) have never been informed about osteoporosis. This fact mention the majority of the respondent girls. In most cases in the families of the respondents there is not osteoporosis or the girls do not know. On the following questions in the questioannarire girl (from both schools) have marked mostly option "not know". It were a questions whether sex hormones protects to some extent against osteoporosis. Furthermore, for which persons osteoporosis frequently occurs, whether the osteoporosis relate with calcium and vitamin D, or not. Schoolgirl from grammer school and vocational school mostly said that they consume milk and milk products several times a day or once a day. Of the 100 respondents sonly 18 girls said that do not drink alcohol. A total of 55 female students do not smoke and 23 female students smoke. The number of girl who smoke from vocational school is more than number of girls from grammer school. Schoolgirls of grammer school correctly think that physical activity can affect osteoporosis, the respondents of vocational school hold a different opinion. All of the girls regularly do sports, except for the two girls who do not purposefully movement. Based on the information from the questionnaire it would be appropriate that the teenager girls should be more informed about osteoporosis. There are several variations, such as educational material prepared for teenage girls or classes in school or self studying. Very important is the prevention of osteoporosis. The important role have a adequate nutrition and physical activity. Therefore, it is necessary to increase the knowledge of adolescent girls about the disease, so they can avoid.
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The role of a nurse in prevention of injuries with women patients with osteoporosis aiming at women in menopause
ŽAMBOCHOVÁ, Pavla
Injury rate among seniors has been increasing rapidly in the Czech Republic recently. Women in menopause with osteoporosis diagnosed form a large group. These are so called low-energy injuries, which are closely linked to increased mortality among old people. This issue is not only related to healthcare, but also to social and economic spheres. Proper education in prevention of injury occurrence in women with this diagnosis is one of the key means leading to reduction of the number of osteoporotic fractures. The Code of Ethics of the International Council of Nurses points out the obligation of a nurse to take responsibility in prevention sphere. The theoretical part of the thesis deals with characteristics of the menopause period, development of osteoporosis, the most frequent osteoporosis related injuries prevention, and an outline of social and economic impact of the injury rate. The practical part deals with a research performed on patients of the orthopaedic outpatient department of the Tábor Hospital. Six women with diagnosed osteoporosis in menopause were chosen. The main goal of the work was to find out what role a nurse from an orthopaedic outpatient department plays in prevention of injuries in women with osteoporosis, whether patients are aware of injury prevention possibilities, which form of provision of such information is best appreciated by the patients and whether the patients apply their knowledge of prevention to practice. A qualitative research in the form of non-standardized interview with open questions prepared in advance was performed. The interviews were conducted individually with each patient. A framework analysis based on the results from the interviews was performed and category groups formed. Processing of the results revealed that the information on prevention of injury in osteoporosis provided to the patients by the orthopaedic outpatient department was poor. Nurses are involved in this prevention activity just marginally or not at all. Complex identification of the problem might be the topic of further research. It might be necessary to find out whether insufficient time, poor knowledge of the problem or indifferent attitude to the problem is the reason. On the other hand only some of the patients apply their obtained knowledge to practice. We can however conclude from the interviews that provision of general information on prevention and the risks of injuries might inspire women to modification of their present way of life. Organization of group lectures with the possibility to obtain printed complex data of this society-wide problem seems to be a suitable form of providing information.
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The physiotherapy in patients with compression fractures in the lumbar spine area
LUKŠAN, Filip
This bachelor?s thesis focuses on physiotherapy of patients with compression fractures of the lumbar spine. Compression fractures of lumbar vertebrae are caused by excessive dynamic pressure on the lumbar spine. These fractures come about both by reason of direct causes such as falls from heights or injuries from automotive accidents. Osteoporosis is another aspect. It is a generalized skeletal disease which causes bone mass degradation and is therefore an indirect cause of compression fractures of the lumbar vertebrae. Women over 70 years of age are the most frequent sufferers. The aim of this bachelor?s thesis is to map out physiotherapy methods used in patients with compression fractures of the lumbar vertebrae. The paper is divided into two major sections: theoretical and practical. The theoretical section describes the anatomical structures concerned, osteoporosis types and diagnostics, types and causes of lumbar vertebrae injuries and their mechanism. A further focus is diagnosing these injuries and potential treatments, i.e., conservative and surgical. Physiotherapeutic methodologies which may be use for these conditions are the topic of another chapter in the theoretical section. They include the Vojta method, sensorimotor stimulation, proprioceptive neuromuscular stimulation, spinal exercises, large ball exercises, dynamic neuromuscular stabilization, school of the back and physical therapy. Using these physiotherapeutic methodologies can result in a reduction in pain, support of the healing process and improvement of the functional stability of the lumbar vertebrae. A total of four probands were selected for the practical section and divided into two groups: patients immediately after a fracture and patients in whom the healing has been completed. All the patients were treated conservatively, i.e., using the Jewett brace. The first group consisted of two patients hospitalized in the České Budějovice, a.s. hospital. I took their history and carried out input and output kinesiology analyses. The therapy took 3?4 weeks. Using the methodologies mapped out in the theoretical section, I prepared my own physiotherapeutic procedure governing the entire therapy period. In these patients, the focus was put on positioning in bed, using the Jewett brace, the proper walking stereotype while using the brace, achievement of self-sufficiency and independence in daily activities along with strengthening the muscle corset. This therapy helped the patients transfer to home care in the shortest time possible. The second group consisted of two patients whose fractures have been healed but continued to suffer from pain in the lumbar region. Here too, I took their history and carried out the input and output kinesiology analyses. The therapy took 3?4 weeks. It focused on the activation of the deep muscle and strengthening the surface muscle using the methods of the lumbar spine dynamic stabilization, exercise on a large ball, proprioception and learning the principles of taking care of one?s back. The contribution made by this bachelor?s thesis lies in mapping out the methodologies to be used for these conditions and preparing the author?s own physiotherapeutic procedure for these issues.
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Kinesiotherapy in patiens with osteoporosis
BRAŠNIČKOVÁ, Jana
Abstract The theme of this bachelor's thesis is kinesiotherapy in patients with osteoporosis. Osteoporosis is the disease of metabolism which causes the density of bone mass, the bone becomes less firm and tough. This disease can be asymptomatic in the long term, but it causes many physical and mental problems later, which markedly get worse the quality of life. The first symptoms of osteoporosis are chronic backaches and fractures caused by minimal strain. These pains often raise feelings of depression, anxiety and fear. The preconditions of origin of osteoporosis are genetic but they are formed also from the early childhood, that's why it is very important to follow healthy lifestyle which includes sufficient calcium and vitamine D intake, activity, proper diet and avoiding toxic influences from the birth. Kinesiotherapy is one of the most important ways of preventive and medical care of patients who are endangered by osteoporosis or suffer by this disease. It is aimed at the improvement of motoric stereotypes, muscular strenght, mobility, coordination and activation of deep stabilizing system. It teaches proper breathing, lying, sitting, standing, lifting and carrying loads, forward bend and relaxation. World Health Organization considers this disease as one of the biggest health problems of mankind. Therefore I think it is important to pay attention to these issues. The first part of this bachelor's thesis is aimed at theoretic knowledge, divided into general and special part. The general part includes knowledge about structure and function of a bone, defines osteoporosis, deals with its classification, its clinical symptoms, its diagnosing and risk factors. Next there are described the possibilities of therapy, preventive measures and the impact of osteoporosis. In the special part there is introduced the definition of kinesiotherapy, its medical effect and general principles which is important to follow during kinesiotherapy procedure. It deals with possibilities of kinesiotherapy according to clinical phases and then describes particular kineziotherapy methods suitable for patients with osteoporosis. The aim of a theoretical part was to outline the possibilities of kinesiotherapy of patient with osteoporosis. The second part of this thesis is my research. For this part was chosen the method of qualitative research. It was done as case history including anamnestic data, initial and final kinesiological analysis, the progress of therapy, conclusion and long-term rehabilitation plan. The data were collected during the interviews with patients, by observing of them, sampling of anamnesis, kinesiological screening and the analysis of data from medical documentation. The research set was formed by two patients diagnosed with osteoporosis. The research was carried out in rehabilitation ward Poliklinika Jih in České Budějovice during four weeks. Exercising took place twice a week for 20-30 minutes. Soft tissue techniques, mobilisations, post isometric relaxation, stretching, fitness, breathing and relaxation exercising, elements training of the back, exercising with a big ball, proprioceptive neuromuscular facilitation, sensomotoric stimulation and the activation of deep stabilizing system. The aim of the research was to compile and realize the most effective kinesiotherapy procedures for chosen patients diagnosed with osteoporosis. The results show that the chosen kinesiotherapy methods influenced positively the condition of both patients. It is evident that their backache and posture are much better. They evaluate the therapy as positive and useful for their health. From the kinesiologic point of view it is evident the improvement in breathing stereotype, posture and reduction of some asymmetry and muscular unbalance which negatively influenced physical and mental aspects of patients.
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The testing of celiac disease in connection with osteoporosis
SLADKÁ, Romana
My Bachelor´s thesis deals with the examination of celiac disease in connection to osteoporosis. The aim of the thesis was to specify the level of antidotes against tissue transglutaminase in the class IgA and IgG in the serum with osteoporosis diagnosed patients, to interpret, based on the results of the study, possible link between osteoporosis and celiac disease as well as to compare the outcome with scientific data. I focused on the present knowledge of osteoporosis and celiac disease in the first part. As for celiac disease, I described its history and characteristics. I also paid attention to diagnostics of celiac disease with the assistance of laboratory serological tests ELISA. I mentioned the free-gluten diet treatment after that. As regards osteoporosis, I described its history, symptoms, forms, perils and complications which the disease causes. I conducted the methodical part of my work in the biochemical haematological laboratory Stafila where I work, with its seat in České Budějovice. As for measurements, I took them in the department of microbiology, where immunologic tests are also taken. I carried out the screening of celiac disease from serum, namely the determination of antidotes against tissue transglutaminase in the class IgA and IgG, with the aid of ELISA - a sandwich method. I took measurements with 58 osteoporosis diagnosed patients. I obtained the sera thanks to the supervisor of my thesis Mrs. Marie Ládová, who is at the head of an osteological outpatient department in České Budějovice. I stated the serological markers of celiac disease with the assistance of enzymatic immunoanalysis conducted on automatic analyzer Nexgen Four, which was provided by the firm Test-Line. I describe the analyzer, its specification, checking and calibration of the gadget together with determination checks in this part of the thesis. Additionally, there is described the principle of the method ELISA- sandwich, which is non-competitive enzymatic immunoanalysis. At the end of the section there is depicted the methodical procedure of my work, the preparation of working solutions and checks, the preparation and dilution of samples for analysis and working procedure for semiquantitative interpretation with positivity index and for quantitative interpretation U/ml. I continued with my own measurements. while respecting standard operations procedures of the laboratory Stafila, a limited liability company. The results of my measurements are processed in the third part of the thesis. The acquired results are given in a table: quantitative interpretation of the antidote against tTg IgA and IgG (U/ml) level in the sera of the osteoporosis diagnosed patients. Then I presented a graph interpreting the proportional relation of the antidote against tTg IgA and IgG levels in the sera of the osteoporosis diagnosed patients. There are included calibration graphs for tissue transglutaminase IgA and IgG and tables of the obtained data of checks for the methods in the results. 3 out of the 58 examined samples of osteoporotic patients were positive, they had the level of antibodies higher than 22 U/ml. One of the samples had marginal figures, which means it had the antidotes against tTg IgA an IgG between 18 and 22 U/ml. Positive results were found with patients born in 1976 and 1978. A patient born in 1962 appeared to have a marginal result. The acquired antidote figures against tissue transglutaminase in the class IgA and IgG are presented proportionally in the graph 1. 3 out of the 58 measured samples were positive, which represents 5%, and 1 sample was marginal, which is 2%. My analysis is based on the availability of the examined material and the potential of our laboratory. Celiac disease is an illness which was not paid much attention to in the past. Hypothesis about the link between osteoporosis and celiac disease has been proved.
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Calcium in foods and its importance for nutrition
POKORNÁ, Veronika
This bachelor's thesis deals with the calcium in food and its importance for the nutrition of students at second grade of primary school. The theoretical part discusses the general characteristics of calcium, especially the chemical, physical and biological significance of chemical compounds, the occurrence of calcium in water and nature. It is focused on the calcium content in foods of animal and vegetable origin. Finally, in the theoretical part, is outlined the importance of calcium for the human body, especially the intake, absorption, excretion and consequences of its insufficient income, for example hypocalcemia, osteoporosis and osteomalacia. Practical work is focused on findings to estimate the knowledge of students aged 12 to 15 years about calcium and consequently its consumption, occurrence in foods and the importance of nutrition, using a questionnaire. The results are evaluated and graphically presented.
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