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Acquired Fibrinogen Deficiency in Severe Trauma Patients and its Early Detection
Škola, Josef ; Černý, Vladimír (advisor) ; Durila, Miroslav (referee) ; Blatný, Jan (referee)
UNIVERZITA KARLOVA Lékařská fakulta v Hradci Králové Acquired fibrinogen deficiency in severe trauma patients and its early detection Josef Škola Summary Doktorský studijní program Chirurgie Hradec Králové 2023 This thesis deals with developing and early diagnostics of acquired fibrinogen deficiency in patients with severe trauma. Fibrinogen is an essential glycoprotein of the coagulation system, which is converted by thrombin into insoluble fibrin, the fundamental component of a blood clot, in the final stage of blood coagulum formation. Trauma-induced coagulopathy is a complex disorder of blood coagulation resulting from extensive tissue damage, traumatic shock, activation of the sympathoadrenal system, dysregulation of fibrinolysis, as well as loss of coagulation factors through bleeding, consumption or dilution of remaining dilutions. Hypothermia, acidosis, hypocalcemia, or preexisting factors on the patient's side (e.g., anticoagulant or antiplatelet therapy) also contribute to impaired haemocoagulation. Acquired fibrinogen deficiency (hypofibrinogenemia) is vital in the early phase of trauma-induced coagulopathy. Fibrinogen is the first of the coagulation factors to achieve a clinically significant decrease in plasma concentration. Hypofibrinogenemia is associated with the magnitude of blood loss, the...
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Reportage photography and its informative value
Gorcovská, Laura ; Černý, Vladimír (advisor) ; Váša, Ondřej (referee)
Our thesis is dealing with case of reportage photography and medial sharing of our choosen visual image. We have choosen an image of syrian refugee Aylan Kurdi from 2015, whose photo is refering the problem of refugee crisis in Europe. The thesis is focused on semiotic approach of selected photographies, which are showing the same picture from different perspectives. In our case is perspective very important part of thesis, because these photographies are very questionable on ehtical principes. Therefore, we are also focused on the way, how the media deal with this issue. Our thesis points the signs of reportage photography and also monitor their changes, which depends on the medium, title, perex and composition of words completing photography.We are also focused on contextual framework of photography in choosen media. The secondary objective of our thesis is the comparision of results of analysis of selected picture published in individual selected media and comparision of differences in interpretation and photography context. Thesis is primaly based on theoretical concepts of Roland Bathers on specific visual sharing of selected media. Monitored indicators are the concepts of denotation, conotation and myth, while we are focused on connection between text and image and interpretation in selected...
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Evaluation of patient satisfaction with perioperative anesthetic care
Břízová, Pavla ; Černý, Vladimír (advisor) ; Mrákava, Vlastimil (referee)
The topic of this thesis is "Evaluation of patient satisfaction with perioperative anaesthesia care." The work is divided into theoretical and practical parts. The theoretical section describes the definition of satisfaction from multiple points of view and analyses factors affected satisfaction of patients and psychosocial needs that have a significant impact on the experience of the hospital care. The practical part deals with the questionnaire survey. The questionnaire is focused on the evaluation of patient satisfaction with perioperative anaesthesia care. Questionnaire results are statistically analysed. The aim of this work is to determine the level of satisfaction of patients in the preoperative and postoperative period.
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The Impact of Analgosedation on Heart Function
Omran, Nedal ; Černý, Vladimír (advisor) ; Vaněk, Tomáš (referee) ; Kieslichová, Eva (referee)
Introduction Nowadays, sedation has become an essential part of clinical practice. Despite this fact, we still lack data describing the exact impact of sedation on cardiac function. Objective The aim of this work is to compare the changes in cardiac function induced after sedation with midazolam or dexmedetomidine by magnetic resonance imaging (MRI). A total of 30 volunteers were randomized into two groups: 15 patients in the midazolam (MID) group and 15 patients in the dexmedetomidine (DEX) group. Each participant underwent a one session MRI imaging of the heart during and after sedation administration. The following parameters were recorded: right ventricular (Pul-vol) and left ventricular (Ao-vol) stroke volume, maximal blood flow velocity through the aortic (Ao-flow) and through the pulmonary valve (Pul-flow) during systole, and maximal blood flow velocity through the mitral valve during early (E-diast) and late diastole (L-diast). The monitor recorded mean blood pressure (MAP), pulse (P), and blood oxygen saturation (SpO2) at 5minute intervals. Results As for the parameters of ventricular systolic function dexmedetomidine decreased significantly Ao-vol (p = 0.006), Pul-vol (p = 0.003), Ao-flow (p = 0.048) and Pul-flow (p = 0.007). Midazolam also significantly decreased Ao-vol (p = 0.001), Pul-vol (p =...
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Hypotension after General Anesthesia Induction
Jor, Ondřej ; Černý, Vladimír (advisor) ; Vymazal, Tomáš (referee) ; Gál, Roman (referee)
Objectives: 1. To provide a comprehensive review of current state of art of hypotension after introduction to general anesthesia (GAIH) 2. Describe the epidemiology of GAIH 3. Critically evaluate the obtained information and compare them with literature Methods: Systematic literature review. Epidemiological data were obtained from a multicenter prospective cross-sectional observational study. Patients from five Czech Anesthesiology Departments of various sizes were included. Results: 661 patients were included in the study. Our results indicate a high incidence of GAIH (36.5%) from hypnotics to 10 minutes after ETI. In some patients (2.9 %) hypotension occurred in the entire observed interval. The highest incidence of GAIH was observed at 5 and 10 minutes after ETI. The risk of GAIH increases with age, the degree of decompensation of hypertension and the presence of type II diabetes mellitus. We have shown that the risk of GAIH increases with increasing dose of propofol. Conclusion: 1. The occurrence of hypotension affects the recovery of a patient undergoing surgery under general anesthesia (GA). An effect on perioperative mortality and morbidity has been demonstrated. The risk of organ damage increases with the severity and duration of hypotension. 2. GAIH is a common problem. Our work...
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Computed tomography in tissue characterization of the myocardium.
Černý, Vladimír ; Mašek, Martin (advisor) ; Malíková, Hana (referee) ; Zemánek, David (referee)
Introduction: Magnetic resonance (MR) represents still the gold standard in myocardial imaging. There are some studies suggesting that the computed tomography (CT) might be a valid alternative for some patients (especially the ones who are unable to undergo MR). Aims: We had two aims. Aim number 1: To evaluate the ability of CT in the evaluation of delayed contrast enhancement (DCE) in patients with dilated cardiomyopathy. Aim number 2: To assess the possibilities of CT originally performed for a different indication in myocardial tissue characterization. Methods: Part 1: We prospectively enrolled 17 patients with dilated cardiomyopathy. All the patients underwent both cardiac CT and cardiac MR. We compared the findings of DCE on CT with the findings of DCE on MR. Part 2: We retrospectively evaluated 96 patients who underwent both CT for any indication and cardiac MR. We compared the findings of a hypodense area in the myocardium with the findings of DCE on MR. Results: Part 1: CT detected DCE in 3 patients and MR detected DCE in 6 patients. The agreement between both modalities was in v 82% cases (kappa 0.56). The sensitivity and specificity of CT were 50% and 100%, respectively and the positive predictive value was 100%. In patients with positive findings on CT, the localization of DCE was almost...
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Reportage photography and its informative value
Gorcovská, Laura ; Černý, Vladimír (advisor) ; Váša, Ondřej (referee)
Our thesis is dealing with case of reportage photography and medial sharing of our choosen visual image. We have choosen an image of syrian refugee Aylan Kurdi from 2015, whose photo is refering the problem of refugee crisis in Europe. The thesis is focused on semiotic approach of selected photographies, which are showing the same picture from different perspectives. In our case is perspective very important part of thesis, because these photographies are very questionable on ehtical principes. Therefore, we are also focused on the way, how the media deal with this issue. Our thesis points the signs of reportage photography and also monitor their changes, which depends on the medium, title, perex and composition of words completing photography.We are also focused on contextual framework of photography in choosen media. The secondary objective of our thesis is the comparision of results of analysis of selected picture published in individual selected media and comparision of differences in interpretation and photography context. Thesis is primaly based on theoretical concepts of Roland Bathers on specific visual sharing of selected media. Monitored indicators are the concepts of denotation, conotation and myth, while we are focused on connection between text and image and interpretation in selected...
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Alternation of Glycocalyx in Critical Illness and during Major Surgery and Approaches for Glycocalyx Protection
Astapenko, David ; Černý, Vladimír (advisor) ; Cvachovec, Karel (referee) ; Adamus, Milan (referee)
Background: Glycocalyx represents a protective cellular coat on a sugar basis. It serves as a communication medium with outside environment. Glykokalyx also covers the inner apical surface of endothelial cells where it is called the endothelial glycocalyx (EG). Research from last decade declare its pivotal role in physiology and pathophysiology of microcirculation. EG is prone to be damaged in critical conditions but there are more questions than what we actually know about this complex structure. Also, there are new methods being developed for more precise description of EG condition. The aim: The aim of this thesis is to evaluate the level of contemporary evidence about EG and to evaluate methods of its assessment. To describe the condition of EG in experimental model of cardiac arrest (CA) in pig and in experimental model of iatrogenic hypernatremia in rabbit. To describe the influence of different types of anesthesia on EG in patients in perioperative care. To describe the dynamic changes of EG in patients in critical care. To evaluate response of EG to fluid challenge of 500 ml of normal saline in healthy volunteers and the response of EG to administration of lipid emulsion in patients in critical care. To describe the condition of EG in patients with dyslipidemia, with long term home parenteral...
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Manipulation in photography: Techniques of manipulation and their identification
Liprtová, Anna ; Černý, Vladimír (advisor) ; Fišerová, Michaela (referee)
Diploma thesis deals with the manipulation of the photography, especially journalism. To bring the reader into context work starts with the first creation and the history of photography, early examples of manipulation of analog photography and its techniques. The main part focuses on the specifics and characteristics of the digital era in relation to the photographs, handling technology in digital photography and the possibilities of detection. Thesis reflects manipulation of photographs on social networks and the prestigious photographic competitions and the question of objectivity. Considering how it is in the background handling adjustments with confidence in the photo and that picture can be adjusted to detect and effectively to defend against them. Due to the nature of the digital society and a number of factors that the creation and publishing of photographs accompanying the photo we have to think critically and understand its truth value as intersubjective.
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