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Monitoring of biochemici markers of septic states
Brodská, Helena ; Kazda, Antonín (advisor) ; Zazula, Roman (referee) ; Průša, Richard (referee)
The topic of systemic inflammatory response is lately often discussed across the whole field of medicine. Early diagnosis and the following adequate therapy minimize the risks of the development of systemic inflammatory response syndrome (SIRS). Therefore there is a general urge to find an appropriate marker for diagnosing and monitoring of the development of SIRS. Each year new markers appear, markers that fill up the mosaic of a pathophysiological picture, but we still do not have a marker, that would fulfill the demands of specificity, sensitivity and availability. In the recent ten years, one of the most promising markers seems to be the PCT. (...) In two studies with patients in end states renal diseases (ESRD) the non infectious elevations appear as marker of severity of clinical state. In the last study we confirm the relationship between PCT and severity of clinical state and the antioxidative defence, respectively the plasmatic selenium level. In the above mentioned studies I would like to present the wide range of this marker, which in the meantime is one of the most used markers of the SIRS. I would like to stress the importance of a correct indication and of an accurate interpretation in accordance with all the other parameters, but most of all with the clinical state. PCT, being almost ten...
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Acid-base balance in peritoneal dialysis Patients: Stewart-Fencl Analysis
Klaboch, Jan ; Matoušovic, Karel (advisor) ; Kazda, Antonín (referee) ; Jabor, Antonín (referee)
Background: Evaluation of acid-base disorders using Stewart-Fencl principle is based on assessment of independent factors: strong ion difference (SID) and the concentration of non- volatile weak acids (Atot-). This approach allows for a more detailed evaluation of the cause of acid-base imbalance than the conventional bicarbonate-centered approach based on the Henderson-Hasselbalch principle. Studies with lactate-based peritoneal dialysis fluid (PDF) demonstrated an effect of peritoneal membrane transport characteristics on acid-base status. The "A" aim of our study was to assess acid-base disorders in peritoneal dialysis (PD) patients using both of these principles. The "T" aims were to determine whether or not peritoneal membrane transport characteristics, i.e., dialysate-to-plasma creatinine ratio (D/Pcreat) and creatinine mass transfer area coefficient (MTACcreat) have an effect on base influx when using a PDF with a combination of bicarbonate (bic-25mmol/L) and lactate (lac-15 mmol/L), and whether or not base influx differ between patients using icodextrin- or glucose-based PDF in night-time exchange. Methods: Two groups of patients with chronic renal failure treated with peritoneal dialysis "A" 17 patients and "T" 21 patients and group of healthy volunteers with normal renal function were...
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Acid-base balance in peritoneal dialysis Patients: Stewart-Fencl Analysis
Klaboch, Jan ; Matoušovic, Karel (advisor) ; Kazda, Antonín (referee) ; Jabor, Antonín (referee)
Background: Evaluation of acid-base disorders using Stewart-Fencl principle is based on assessment of independent factors: strong ion difference (SID) and the concentration of non- volatile weak acids (Atot-). This approach allows for a more detailed evaluation of the cause of acid-base imbalance than the conventional bicarbonate-centered approach based on the Henderson-Hasselbalch principle. Studies with lactate-based peritoneal dialysis fluid (PDF) demonstrated an effect of peritoneal membrane transport characteristics on acid-base status. The "A" aim of our study was to assess acid-base disorders in peritoneal dialysis (PD) patients using both of these principles. The "T" aims were to determine whether or not peritoneal membrane transport characteristics, i.e., dialysate-to-plasma creatinine ratio (D/Pcreat) and creatinine mass transfer area coefficient (MTACcreat) have an effect on base influx when using a PDF with a combination of bicarbonate (bic-25mmol/L) and lactate (lac-15 mmol/L), and whether or not base influx differ between patients using icodextrin- or glucose-based PDF in night-time exchange. Methods: Two groups of patients with chronic renal failure treated with peritoneal dialysis "A" 17 patients and "T" 21 patients and group of healthy volunteers with normal renal function were...
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Disturbances of effective osmolality in acute brain diseases
Špatenková, Věra ; Kazda, Antonín (advisor) ; Maňák, Jan (referee) ; Jabor, Antonín (referee)
Dysbalances of effective osmolality arc some of the most frequent and serious complications in neurointensive care. Their severity lies in brain oedema in hyponatraemia and dehydration of the brain in hypernatraemia. Due to the seriousness of dysnatraemia in acute brain diseases, timely and accurate diagnosis is necessary. Nowadays this is easily achieved through measuring and calculating renal function parameters. The aims of this study were 1) evaluation of hyponatraemia and hypernatraemia in acute brain diseases after establishing these renal parameters into clinical practice in our NNICU and 2) determining the significance ofNT-proBNP in differential diagnostics of hyponatraemia. Over a ten-year period, in a retrospective (1.1.1996 - 31.12.2000) and a prospective study (1.1.2001 - 31.12.2005) we evaluated all patients hospitalised in our NNICU with acute brain diseases, who had scrum sodium below 135 mmol/1 (collection hyponatraemia) or above 150 mmol/1 (collection hypernatraemia). The prospective part took place according to standard protocol for diagnosing hyponatraemia and hypernatraemia in the NNICU, which includes the measuring and calculating of renal function parameters. In the prospective study, assesment of NT-proBNP was carricd out on 40 patients with hyponatraemia. The control group consisted...
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Monitoring of biochemici markers of septic states
Brodská, Helena ; Kazda, Antonín (advisor) ; Zazula, Roman (referee) ; Průša, Richard (referee)
The topic of systemic inflammatory response is lately often discussed across the whole field of medicine. Early diagnosis and the following adequate therapy minimize the risks of the development of systemic inflammatory response syndrome (SIRS). Therefore there is a general urge to find an appropriate marker for diagnosing and monitoring of the development of SIRS. Each year new markers appear, markers that fill up the mosaic of a pathophysiological picture, but we still do not have a marker, that would fulfill the demands of specificity, sensitivity and availability. In the recent ten years, one of the most promising markers seems to be the PCT. (...) In two studies with patients in end states renal diseases (ESRD) the non infectious elevations appear as marker of severity of clinical state. In the last study we confirm the relationship between PCT and severity of clinical state and the antioxidative defence, respectively the plasmatic selenium level. In the above mentioned studies I would like to present the wide range of this marker, which in the meantime is one of the most used markers of the SIRS. I would like to stress the importance of a correct indication and of an accurate interpretation in accordance with all the other parameters, but most of all with the clinical state. PCT, being almost ten...
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Biochemical diagnosis and monitoring of disorders of renal functions in critically ill patients
Balík, Martin ; Kazda, Antonín (advisor) ; Tesař, Vladimír (referee) ; Schück, Otto (referee)
Aims: A systematic approach to renal function monitoring using information taken by means of renal function tests calculated from serum and urine specimen has not been comprehensively explored. The application of analysis of natriuretic peptides and low molecular weight proteins in diagnosis of advanced renal failure has not been tested in critical ill patients. The performance of continuous renal replacement therapy depends on adequate anticoagulation of the extracorporeal circuit. Prostacyclin as one of the newer agents has not been compared to citrate which may be considered a standart agent in many intensive care units. Changes of distribution volume of antibiotics have been a matter of debate in terms of dosage alteration but have not been assessed clinically at the bedside using other tools than a pharmacokinetic model. Methods: Establishing computer programme calculating various renal function tests allowed us to monitor the effects of diuretics, osmolality shifts, disorders of urine acidification and progression of renal insufficiency towards acute renal failure. Creating a functional model of acute renal failure serves as a tool for further studies on renal replacement therapy. A relationship between residual diuresis and levels of natriuretic peptides and cystatin C were studied before and...
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Corporate enterprises at the Continental and American legal system
Fischerová, Alena ; Boháček, Martin (advisor) ; Kazda, Antonín (referee)
The main goal of the thesis is to compare the legal regulations of the corporate enterprise in the selected countries of the Continental legal system and the corporations of the American legal system with the corporate enterprise acording to the Czech law. Considering the range of the work the focus will be concerned on stock-corporations of the Continental and American legal system. In the thesis there are briefly described the legal regulations of the Czech stock-corporations, followed by descriptions of the stock-corporations in the selected countries (France, Germany, Austria and USA) in more details. There are futher described both Continental and American legal systems, as well as their history, development, characteristic features including sources of law, which are the basis of the treatise on stock-corporations. Therefore, the primary goal is the basic description and afterwards a comparison of the particular legal regulations of the stock-corporations. Methodology of the work appears from the scientific comparative method.
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