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Comparison of Costs for Treatment of Proximal Femoral Fractures
Železo, Eduard ; Lešetický, Ondřej (advisor) ; Mlčák, Jan (referee)
Due to the demographic development osteopoorosis is an increasing serious medical and economical problem today in developed industrial countries including Czech republic. Fractures of the proximal femur in the elderly are one of the manifestations of the illness. Within the context of the pharmacological prevention we must consider carefully its contribution in comparison with costs of the fracture treatment in the hospital. This graduation theses deals with evaluation of expenses on the surgical treatment of these fractures and expenses on the pharmacological prevention using Fosamax. This comparison is made in economic situation in Czech republic in the end of the first decade of 21. century
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Work of a nurse in an osteology out-patient ward
KAŠPAROVÁ, Iveta
Osteoporosis is defined as a metabolic system bone disease, which is characterised by reduced content of bone matter. This disease is considered the most frequent disease. Osteology departments are mostly visited by older clients, but younger clients are nowadays not exceptional either. The nurse plays an important role in the osteology outpatient department / clinic. In addition to nurse duties such as administrative or treatment work, the nurse should be able to communicate, listen, or possibly give advice to clients. Thus she becomes a consultant, assistant as well as a defence counsel. The thesis was aimed to determine the nurse job specification in an osteology outpatient clinic. The research was carried out using the qualitative method and data were collected from semi-structured interviews with 7 respondents in selected osteology outpatient clinics, of which 5 nurses are from the osteology outpatient clinic in České Budějovice and the remaining two nurses are from the osteology outpatient clinic in Prague. The interviews were consequently processed into case reports. Those case reports became the basis for evaluation of the results sorted in categorization tables. The most significant results of the research proved that nurses must only be trained in a specialized course if their job sheet includes densitometric examination. This densitometric examination, or sampling of biological material for bone markers and education with respect to application of medication using a fosteon pen are ranked amongst special activities not performed in other special outpatient departments. Some osteology nurses confirmed that their job sheet also includes to educate clients, most often verbally, and provide reference materials or practical demonstration. This bachelor thesis can primarily be used for nurses who are interested to work in an osteology outpatient department in the future.
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The influence of physiotherapy on patients with osteoporosis
REJŽKOVÁ, Olga
The theoretical part poses challange of osteoporosis as a disease that is in the limelight in recent years. Since it is a disease that causes bone rarefaction and bone stock loss was part of the work devoted to themes of microscopic and macroscopic structure of bone, bone formation and development, factors affecting growth and bone remodeling. Furthermore, the theoretical part describes the different types of osteoporosis, defines the causes and risk factors of disease, informs about modern methods and treatment procedures and establishes important principles for prevention. This work also focuses on the diagnosis of disease, particularly it is centred on the clinical and X-ray studies, osteodensitometry and laboratory tests which are currently the most frequently used methods of diagnosis. The examination procedures were discribed in detail in section operating methodology of research that were later used in the actual researches. They were especially densitometry imaging method that was used to determine bone density, followed by laboratory tests by means of them were detected samples of blood levels for substances that affect bone metabolism. To evaluate muscle strength and shortened muscle groups are used methods by prof. MUDr.Vladimir Janda, DrSc. Furthermore, the assessment of spine development, character and poise along with examination of stability were evaluated according to Romberg. The invertigate was composed of four patients. Two of them were involved in regular physiotherapeutic exercises, the other two were treated only with medicaments.
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Human nutrition like part of prevention in osteoporosis and osteomalacia
BRABCOVÁ, Markéta
The purpose of this baccalaureate work is to study deseases related to osteoporosis and osteomalacia. It describes the composition of the bones, historical occurrence of osteoporosis, the characteristics of the osteoporosis and osteomalacia, as well as the differences between these osseous diseases. Furthermore, the present work focuses on the prevention of osteoporosis from the nutrition point of view. It analyses the influence of mineral substances, vitamins and hormons on the formation of bones. Osteoporosis is an old disease. Women suffering from osteoporosis can be seen already on some Chinese and Greek paintings. Premature osteoporosis has been noticed also in skeletal residues of young women steming from the 3rd - 5th centuries A.D. In such young women, the osteoporosis was due to consumption of bread containing a higher portion of phytate which bonds calcium. Within the whole group of osseous metabolic osteopathias, the osteomalacia is the least frequent one. It can be found also in developing countries like India and Pakistan, but also in Muslim minorities living in the United Kingdom. It originates in the shortage of vitamin D. The purpose of this work was to find out to which extent the human nutrition influences bone diseases. A bone is never a finished product, it is subject to a continuous process of creation and destruction. Osteoporosis is a result . In aging individuals, the destruction of bones predominates over the creation of new ones, the total osseous substance decreases as such and there is an excessive decrease in all bone components - minerals, especially in calcium. This is why calcium reserves in bones are so important. The level of sexual hormons as well can cause an accelerated decrease in osseous substance. We refer here to the so-called menopausal osteoporosis which occurs in women. In men, it occurs at a later age and has a milder course. Osteomalacia is originated by a malfunction of the mineralisation of bones. There is a sufficient quantity of osseous substance, however, what is missing are minerals. A good mineralisation of bones requires enough vitamin D, calcium, phosphorus, magnesium and trace elements boron and fluorine. Osteoporosis and osteomalacia are, in the last years, an increasingly serious problem in the developed countries, as a consequence of the increasing life expectancy. The treatment of osteoporosis and osteomalacia is very expensive, and this is why so much emphasis is placed in their prevention. Prevention measures should be commenced as soon as possible, because lack of calcium in the infant food and in the nutrition of young people causes health problems and is the inception stage of osteoporosis. The most important preventive measure is a sufficient supply of calcium and vitamin D. Other measures are physical training and exercises, staying in the sun, a sufficient supply of minerals - magnesium, phosphorus, fluorine and vitamins, especially vitamins C, K and B12 from the daily food. A negative effect on the bones is caused by excessive consumption of proteins and caffeine, which leads to calciuria. A nutrition rich in fruits and vegetables increases the alkalinity of the environment, which reduces the calciuria.
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Effect of static and dynamic load in the treatment of osteoporosis in women in klimakterium
CHLUBNA, Ondřej
In the theoretical part I summarized theoretical knowledge related to this problematics. I described the anatomy, the function of a bone and the principals of its remodelation. I also summarized the pathogenesis od osteoporosis, its demonstrations, diagnostics possibilities and treatments focused on movement therapy. Besides this I elaborated on the possibilities of substitution therapy and tratment with osteocalcin. I also summarized the effects and possible sources of minerals and vitamin D. Since they are closely related on the metabolism and related ilnesses. At the conclusion of the theoretical part I elaborated on the investigation methods used in physiotherapy which even I was using in my research in order to assess the course of the therapy. In the practical part of the bachelor´s work I used the qualitative research method. I worked up the results thereof by the form of casusistics. I conducted the research at the outpatient rehabilitation facility at Policlinic Jih MEDIPONT s.r.o. The tested set of this research consisted of two patiens. The first one suffered from the form of osteoporosis abut on osteopeny and had no physical problems related to this ilness. In this patinent I chose a dynamic kind of physical burden. The second on had a little higher degree of osteoporosis and she came to the rehabilitation because of her backache, which was likely the consequence of this illness. This patient undergone static exercise. The aim of the work was to assess which of these attitudes is going to have a bigger influence in the progression if the ilness. However, the results of both patients show similar success of both attitudes. Therefore there is no difference in terms for which kind of physical facility we decided and according to my opininon it is even suitable to combine both.
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Bolesti zad jako civilizační onemocnění z pohledu fyzioterapie
KREJČOVÁ, Miluše
This work tell about problems with back pain and informations of patients. Look at the treraphy process and physiotherapist ´s effect with theraphy movement body and work with people mention then they can come to know what is right and what is wrong moving of ordinary day for their movement system. The main destination is preventation of the back pain. Know the right and wrong movement and movement´s habit is main of the preventation of the back pain and the best preventationly precaution is keeping this. Know of theory is mainstay of good therapy. The main destination of this work is getting better and describe to during and a cause the rise of back pain. The destinations were determine with help qualitative research presentation in this work.
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Osteoporosis - radiologic aspects
DAŠEK, Oldřich
OSTEOPOROSIS is a serious generalised bone disease which results in their increased fragility. It appears in the highest rate at older age. Goal Getting familiar with osteoporosis and comparing radiation doses of patients in case of kyphoplastics and vertebroplastics. Comparison of doses on different equipment and among different methods. Effort to cut down doses for both a patient and attending staff on the performance. Methodology In 2007, care was given to 46 patients in our station using percutaneous vertebroplastics and kyphoplastics. An angiographic set (Siemens - axiom artis) and a mobile C-arm (Ziehm - exposcope 8000) were used to navigate the action for 30 and 16 patients, respectively. The measured doses were assessed for the patients, average doses for vertebroplastics and for kyphoplastics were calculated, and these were compared one against the other. We also assessed the dose in relation to the number of treated vertebra for a single patient and anatomical zones of position of these vertebrae. And finally, we determined the average doses for the instruments and compared them one against the other. Results The lowest doses have been achieved in treating vertebral bodies of TH spine, and the highest value appeared in the performance when three vertebrae have been treated together. The results from comparison of the average dose on both instruments show that the average dose of a patient navigated with the angiographic set is by some 55 % lower against patients with the C-arm used. The value measured for kyphoplastics is by some 50 % lower than for vertebroplastics. Conclusion The results of the study show that kyphoplastics is more desirable concerning the dose, but the economic view is against, as well that it suits rather to acute fractures. The benefit of this work is the comparison of the doses for the surgeries on two types of instruments. We have shown that the selection of the suitable instrument can have impact of the resulting dose for the patient, as well the dose for attending staff. In our case, the effect was up to 55%. The outcome will be the effort to perform the maximum of these actions using the angiographic set and to minimise the total dose.
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Osteoporosis - analysis of hazard factors and health-social consequences on postclimacterial women in Klatovy region
ŠANTOROVÁ, Markéta
The topic of bachelor thesis is Osteoporosis-Analysis of Risky Factors and Health and Social Consequences with a View to Postmenopausal Women in the Region of Klatovy. Osteoporosis is the disease of body ´s bones, which is characterized by the decrease in bone minerals amount, the decrease in bone density and the change of bone micro architecture. The consequence of these changes is the lowered quality of bone tissue and the higher risk of fractures. Generally, we can divide risky factors into three large groups: factors which can not be influenced by a patient alone (age, sex, genetic influences, geographical influences and climate conditions), which are given in advance and it is not possible to change them; further the factors which can be partly influenced by various measures, for example dietary, regime and medical measures. The last group comprises factors which can be directly influenced by an affected person, and thus only dependant on his or her will and decision (input of calcium into an organism, the influence of a diet, mobility, and bad habits). In the theoretical part the definitions associated with the title of bachelor thesis are explained: etiopathogenesis of osteoporosis, risk factors, clinical picture of this disease, examination of patients with osteoporosis, prevention and treatment of osteoporosis, further anatomy, the structure and function of a bone, and last but not least climacterium and post menopause. For the practical part of bachelor thesis the method of data collection in the form of a questionnaire was chosen. Two questionnaires were created, of which the first comprised 17 closed questions; the second comprised 17 closed questions and 1 open question. The data was collected in the period from June 2007 to June 2008. First, 100 questionnaires were distributed; their rate of return was 100%. After the evaluation of osteoporosis measurements, 66 questionnaires were distributed to women, in which osteoporosis or osteopeny was found; and the rate of return was 60 questionnaires. The research group was the women after menopause from the age of 45 to 80 from the region of Klatovy. The hypothesis no. 1, that the women with significant osteoporosis had 3 or more risk factors, proved, since 15 women with significant osteoporosis mentioned 3 and more risk factors. The hypothesis no. 2, that most women, in which osteoporosis or osteopeny was found by examination, would change their present lifestyle and eating habits, proved, since out of 60 questioned women who suffer from this disease 54 changed their present lifestyles. Thy hypothesis no. 3, that at least one fifth of women with the diagnosis of osteoporosis suffered some of typical fractures, is true, since out of 15 patients who have osteoporosis, 13 mentioned the fracture already in the first questionnaire, 5 women in the second questionnaire (the fracture since the last measurement). The aim of the thesis was to find out the range of osteoporosis occurrence in measured group, the analysis of risk factors, health and social impacts and consequences in a year monitoring. This aim was achieved. The thesis can be used to prevent and eliminate risk factors which can be influenced; on the basis of analysis of risk factors and life style, cultural appeal on healthy women and already ill patients will occur. Better informedness of women is the basic presumption for the prevention of osteoporosis.
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The measure information about the osteoporosis problems by women at the age below forty years
KRÝDLOVÁ, Michaela
Abstract Osteoporosis is a skeletal disease, a disease of the bones of the body, which is characterized by a lowered amount of skeletal minerals, decrease of bone density and a changed microstructure of the bones. The effect of these changes is a lowered quality of skeletal tissues and an elevated risk of bone fractures. This risk, being very high, is directly threatening to the patient. Anybody can suffer from osteoporosis, but there are certain groups, much more at risk. The group most often affected by osteoporosis, are women in post-climacteric period of life, i.e. several years past their climacterium. The main factors causing this disease are age, gender, genetics, lack of physical activity, malnourishment, use of harmful substances (smoking, coffee, alcohol), use of some medications, certain endocrinological diseases and diseases of the digestive system, etc. Fundamental significance for prevention and treatment is an adjustment of life-style with sufficient physical activity, correct nutrition, avoiding of harmful substances such as smoking, alcohol and coffee. Regular use of vitamins and minerals as well as regular check-ups may help to prevent the disease. For this study a questionnaire was chosen for data collecting. The questionnaire created for this work included 17 closed and 8 semi-open questions. The total number of 120 questionnaires were distributed, of these 113 were returned, of which 12 were excluded for incompletelesness. The recovery of questionnaires was calculated to 84.2%. The researched group included 101 women between ages 18{--}40 from České Budějovice. The aim of the bachelor work has been accomplished. Hypothesis H1 was proved and H2 disproved. The results will be used as a basis for a seminar about problems with osteoporosis and its prevention intended for non-professionals.
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