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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Computer analysis of ultrasound images of thyroid nodules, focusing on their sonographic features and cytological findings.
Procházka, Antonín ; Smutek, Daniel (advisor) ; Rožánek, Martin (referee) ; Jiskra, Jan (referee)
Ultrasound imaging is one of the fundamental examinations of thyroid nodules, determining whether a patient undergoes a cytological examination, which is essential for the decision on a possible thyroid surgery. Unfortunately, the cytological examination has limited specificity and potential surgery carries risks. Therefore, other diagnostic methods are being sought with hope that they will be able to bring more certainty into diagnostics. One of the new methods is computer-aided diagnosis (CAD), which exhibits promising results using image analysis and machine learning. In this study, we present two somewhat similar, yet different, CAD approaches. The first approach is based on analysing entire nodules using a Segmentation Based Fractal Texture Analysis (SFTA) algorithm that splits the image into individual grayscale bands. Using this approach, we have achieved an accuracy of 92.4% using random forests (RF) and 95% using support vector machines (SVM) on a data set of 40 images evaluated by the cross-validation method. The second CAD approach is also based on the method of multiple image thresholding, but the difference is, that a larger number of predictors describing the binary texture are extracted from the individual grayscale bands. Furthermore, the analysis did not take place on whole nodules, but on...
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Thyroid autoimmunity and thyroid nodule elasticity - relation to thyroid nodule biological nature.
Krátký, Jan ; Jiskra, Jan (advisor) ; Gabalec, Filip (referee) ; Smutek, Daniel (referee)
Thyroid nodules represent a very common pathology. Using modern high-resolution ultrasound, nodules could be found in up to 68 % of patients. The most important task is the diagnosis of thyroid cancer which represents only about 5-15 % of nodules, however the incidence is still growing. Even with the use of a fine needle aspiration biopsy, it is not always possible to decide on the biological nature of the nodule. A significant proportion of such patients have to undergo thyroid surgery for diagnostic reason. Thyroid surgery is associated with risks to the patient and financial costs to the health-care system. In recent decades, the efforts to improve non-invasive diagnostics of thyroid nodules have been made. The thyroid elastography and thyroid autoimmunity are among the examined risk parameters. Using real-time strain elastography, thyroid carcinomas elasticity has been significantly reduced compared to benign thyroid nodules in our group of patients. The elastography of thyroid nodules can be used as a suitable complement to conventional sonographic examination. In our work, the combination of both methods (conventional ultrasound and elastography) increased the negative predictive value compared to both methods individually. The results of our work further indicate that, in case of absence of...
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Economic aspects of screening for thyroid disease in pregnancy and in women with fertility disorders
Bartáková, Jana ; Jiskra, Jan (advisor) ; Zamrazil, Václav (referee) ; Smutek, Daniel (referee)
The incidence of thyroid diseases in pregnancy in the Czech Republic reaches 10- 15%. Emphasis on early diagnosis and treatment is laid not only during pregnancy but also in the time preceding conception due to the impact of thyroid diseases on fertility, the course of pregnancy, birth and fetal development. The aim of the dissertation was to assess the effectiveness and economical aspects of screening for thyroid disease in pregnancy and in women with fertility disorders in the conditions of the Czech Republic. The dissertation consists of four published studies. The first study is a prospective cross-sectional study of 200 positively screened pregnant women. In the study we come to conclusion that pregnant women who are at high- and low-risk for thyroid disease have similar clinical and laboratory characteristics and screening, currently focused only on risk groups, is ineffective. The second study of 5 223 pregnant women is a case-control study. We find that the age of women over 30 cannot be regarded as a risk factor for thyroid disease in pregnancy, although addition this age criterion to the case-finding screening strategy improve its efficiency and ATA (American Thyroid Association) include it in their guideline 2011. The third publication is a retrospective cross-sectional study of 188...
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Origin of “rock cities”, pillars and cleft-conduits in kaolinite-bonded sandstone: New insight from study in sandstone quarry where landforms recently evolve
Bruthans, J. ; Soukup, J. ; Schweigstillová, Jana ; Vaculíková, J. ; Smutek, D. ; Mayo, A. L. ; Falteisek, L.
Based on measurements of relative erodibility, ambient and water-saturated tensile strength at natural and quarry exposures three distinct kinds of surfaces were distinguished (erodible sandstone, sub-vertical fracture surfaces and case hardened surfaces). Erosion proceeded along highly fractured zones.
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