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Optimization of personal costs in context with the optimization of personel procuration at the change of an entrepreneur of a dialysis centre
Lupoměská, Ivana ; Trpišovský, Milan (advisor) ; Dusilová Sulková, Sylvie (referee)
The submitted theses deals with a process of optimization of personal costs connected with a change of an entrepreneur of a dialysis centre. Specifically it deals with creation of a proposal and an accomplishment of changes which relate directly with the said proposal and which will be introduced into practice. The first theoretical part deals with a concept of strategic planning, from which management of human resources arises and which defines a theroretical frame of human resources management in the organization. Next part describes the initial state at the change of an entrepreneur of a dialysis centre and analysis of personel procuration that is needed for the dialysis centre operation. The outcome of this work is a proposal on an optimization of an organization of a schedule of patients'shifts and saving of personal costs resulting from this. Key words: strategic planning, management of human resources, chronic illness of kidneys, dialysis care, dialysis centre, optimization.
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Infectious complications in chronic renal failure
Kielberger, Lukáš ; Eiselt, Jaromír (advisor) ; Dusilová Sulková, Sylvie (referee) ; Matoušovic, Karel (referee)
INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complications in chronic kidney disease population is presented. The other part of this work presents results of our research dealing with pharmacoeconomical aspects of cytomegalovirus infection and finally our results in the field of influenza vaccination. The Aim of the first presented work was to evaluate the cost impact of four different strategies for prevention of cytomegalovirus infection after renal transplantation. We provide post hoc analysis of 2 randomized studies performed in our department and calculating direct CMV-related expenses using valacyclovir prophylaxis, ganciclovir prophylaxis, preemptive vlaganciclovir treatment and deferred therapy. To simulate ihe impact of varying prices of prharmacotherapy or diagnostic procedures, a sensitivity analysis was performed. With respect to our results, valacyclovir...
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Ethical context of resource allocation with regard to the possibilities and limits of chronic dialysis treatment
Dingová Šliková, Martina ; Jedličková, Anetta (advisor) ; Dusilová Sulková, Sylvie (referee) ; Rosina, Jozef (referee)
The main theme of the dissertation work are allocations of sources in regular dialysis treatment in ethical context. The aim of the work is detection, description and understanding to ethical problems forming in context with questionable allocation of sources in regular dialysis treatment. The theoretical part of the work is concentrated on mapping above mentioned problems from various point of view. By the help of analysis of pertinent literature it is referred to historical determination and social-economic context of difficult allocation of rare sources in health service, which subsequently caused development of specific ethical problems in clinical practice of dialysis treatment. Above mentioned ethical problems are discussed chronologically, namely from the first using of a dialysis device up to now, when this therapy is considered to be a standard clinical method. The practical part of the work contains results of high-quality research, the aim of which was to explore the experience of respondents with allocation of resources in regular dialysis treatment and so in ethical context. The dates for the research were obtained by the help of expert dialogues, the method of interpretative phenomenological analysis was used to the analysis of dates. The results of the research is the interpretation...
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Association Between Echocardiogrtaphic Markers and Glomerular and Tubular Kidney Functions in Cardiologic Patients
Opatrný, Jan ; Matoušovic, Karel (advisor) ; Dusilová Sulková, Sylvie (referee) ; Pařenica, Jiří (referee)
A close relation between the kidneys and the heart functions is a long lasting clinical experience. In the second half of the XXth century, many studies documented a role of the kidneys in blood pressure regulation. Since the beginning of the XXI century, many findings have highlighted a role of a damaged kidney function as a risk factor for the heart injury. A close link between the heart and kidney functions is mediated by many common pathophysiologic mechanisms. It is surprising, that terms cardio-renal and renocardiac syndromes have got in a common awareness of clinicians only in the last 15 years. Some links between echocardiopgraphic signs of the systolic and diastolic heart dysfunction and the glomerular kidney function has already been described. Relations between the cardiorenal syndrome and echocardiographic findings versus the renal concentrating capacity are unknown. It is well established, that even mild renal insufficiency increases the mortality risk in ischemic heart disease patients. A question arises, if only a transient decrease of the renal function influences a mortality risk in ischemic heart disease patients. The aim of our study was to find out: A) The associations between the echocardiographic signs of systolic and diastolic heart dysfunction, the eGFR and the kidney...
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Markers influencing the course of IgA nephropathy.
Neprašová, Michaela ; Maixnerová, Dita (advisor) ; Dusilová Sulková, Sylvie (referee) ; Rychlík, Ivan (referee)
IgA nephropathy (IgAN) is the most common primary glomerulonephritis worldwide with a very severe prognosis, causing kidney failure in up to 50 % of patients in a period of 30 years. For the diagnosis of IgAN it is necessary to perform a renal biopsy, this is an invasive examination that carries number of risks for the patients (the most common is bleeding and others). The aim of our work was to identify markers that could facilitate diagnosis and might help in determining the disease activity with an estimate of prognosis and consequently optimal use of effective therapy. In the pilot project on 19 patients with different types of glomerulonephritides (IgAN, diabetic nephropathy, membranous glomerulonephritis, lupus nephritis, ANCA associated vasculitis) and 19 healthy subjects we demonstrated a panel of 7 biomarkers (8-hydroxyguanosine, dodecanal, leukotriene C4, alpha1-antitrypsin, heparan sulfate , IgA-uromodulin, Gd-IgA1) that were able to completely differentiate patients with IgAN from other types of glomerulonephritides or healthy controls. In a group of 93 Czech patients with IgAN we confirmed the influence of clinical factors (PU, HT, eGFR) on the progression of renal function. Using LDA and logistic regression modelling we found that serum Gd-IgA1 (native without pre-treatment with...
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Infectious complications in chronic renal failure
Kielberger, Lukáš ; Eiselt, Jaromír (advisor) ; Dusilová Sulková, Sylvie (referee) ; Matoušovic, Karel (referee)
INFECTIOUS COMPLICATIONS IN CHRONIC RENAL FAILURE Infections represent a serious problem in chronic kidney disease (cohort and they are) associated with signifficant morbidity and mortality. The thesis originated in the nephrology division of the Department of Internal Medicine I., Charles University Teaching Hospital and Medical Faculty in Pilsen, an institution with a long standing research activity in the field. In the theoretical part of this work, a general summary of infectious complications in chronic kidney disease population is presented. The other part of this work presents results of our research dealing with pharmacoeconomical aspects of cytomegalovirus infection and finally our results in the field of influenza vaccination. The Aim of the first presented work was to evaluate the cost impact of four different strategies for prevention of cytomegalovirus infection after renal transplantation. We provide post hoc analysis of 2 randomized studies performed in our department and calculating direct CMV-related expenses using valacyclovir prophylaxis, ganciclovir prophylaxis, preemptive vlaganciclovir treatment and deferred therapy. To simulate ihe impact of varying prices of prharmacotherapy or diagnostic procedures, a sensitivity analysis was performed. With respect to our results, valacyclovir...
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Optimization of personal costs in context with the optimization of personel procuration at the change of an entrepreneur of a dialysis centre
Lupoměská, Ivana ; Trpišovský, Milan (advisor) ; Dusilová Sulková, Sylvie (referee)
The submitted theses deals with a process of optimization of personal costs connected with a change of an entrepreneur of a dialysis centre. Specifically it deals with creation of a proposal and an accomplishment of changes which relate directly with the said proposal and which will be introduced into practice. The first theoretical part deals with a concept of strategic planning, from which management of human resources arises and which defines a theroretical frame of human resources management in the organization. Next part describes the initial state at the change of an entrepreneur of a dialysis centre and analysis of personel procuration that is needed for the dialysis centre operation. The outcome of this work is a proposal on an optimization of an organization of a schedule of patients'shifts and saving of personal costs resulting from this. Key words: strategic planning, management of human resources, chronic illness of kidneys, dialysis care, dialysis centre, optimization.
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