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Innovation of minimally Invasive Procedures in Urology
Balík, Michal ; Pacovský, Jaroslav (advisor) ; Študent, Vladimír (referee) ; Záleský, Miroslav (referee)
Innovation of minimally invasive procedures in urology MUDr. Michal Balík Abstract Background Prophylactic administration of tranexamic acid reduces blood loss in procedures with a high risk of perioperative bleeding. There is good evidence for this published in cardiac surgery, orthopedics, and gynecology. However, in urology, papers have been published so far with ambivalent results in transurethral resection of the prostate, open radical prostatectomy, or radical cystectomy. No study to date has tested prophylactic administration of tranexamic acid at the beginning of robotic-assisted radical prostatectomy. Methods Based on the promising results of a pilot study that evaluated the effect of prophylactic tranexamic acid administration during robot-assisted radical prostatectomy on perioperative blood loss and the incidence and severity of complications, we performed the RARPEX study - a prospective, double-blind, randomized, placebo-controlled trial. Our aim was to confirm preliminary data in a sufficient cohort of patients with multiple surgeons. Results In the RARPEX study, we demonstrated a positive effect of prophylactic tranexamic acid administration during robotic-assisted radical prostatectomy on hemoglobin decline in all measurements. However, the difference between the groups did not reach the...
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Aspects of the testicular cancer from the affected patients point of view
Pásztorová, Lenka ; Pacovský, Jaroslav (advisor) ; Hadaš, Lubomír (referee)
Author: Lenka Pásztorová Institution: Ústav sociálního lékařství LF UK v Hradci Králové Oddělení ošetřovatelství Title: Aspects of the testicular cancer from the affected patiens point of view Supervisor: MUDr. Jaroslav Pacovský, Ph.D. Number of pages: 92 Number of attachments: 2 Year of defense: 2016 Keywords: testicular tumors, prevention, nursing care, education The Bachelor's thesis is focused on the testicular tumors. The main issues are population awareness and this disease prevention options knowledge. This work utilizes personal experiences of men affected with this disease. Theoretic part describes symptoms, risk factors, diagnostic procedures and therapy of testicular tumors. The main interest of this work is prevention and it offers suitable methods for early diagnosis. The role of a nurse in a nursing process, an optimal communication form and educational activities are designed as well. Possible patient's reactions of patient on the proclaimed severe diagnosis and the disease self-perception are presented. The empirical part presents results of the quantitative research with the questioners use. The aim of the study was deeper understanding of this diagnosis and to get more complex overview on it. The most important expected result is to create suitable information handout.
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DNA Methylation Changes as Potential Biomarkers in the Treatment of Bladder Cancer
Hušek, Petr ; Pacovský, Jaroslav (advisor) ; Študent, Vladimír (referee) ; Doležel, Jan (referee)
DNA methylation changes as potential biomarkers in the treatment of bladder cancer Introdution Bladder Cancer (BC) is the second most common malignancy of the urinary tract. BC has two categories. Approximately 75 % of patients with BC present with disease confined to the mucosa or submucosa (non muscle invasive bladder tumor - NMIBC). Carcinoma in situ (CIS) is a very specific subgroup of NMIBC, because it is not a papillary lesion but a flat tumor, which is why CIS can be missed in cystoscopy. CIS is always a high grade tumor. Without any treatment, approximately 54% of patients with CIS progressed to muscle- invasive or metastatic disease. The second category covers patients with muscle-invasive BC (MIBC). These patients have a higher prevalence of progression rates and higher cancer- specific mortality. Patients with NMIBC are indicated to transurethral tumor resection (TUR) alone or with adjuvant treatment (intravesical chemotherapy or intravesical Bacillus Calmette- Guérin - BCG immunotherapy). BCG is an attenuated mycobacterium developed as a vaccine for tuberculosis that has demonstrated antitumor activity in BC intravesical instillation, and significantly reduces the progression risk of high grade papillary lesion and CIS. The therapy of MIBC is radical cystectomy - hard mutilating surgery...
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DNA Methylation Changes as Potential Biomarkers in the Treatment of Bladder Cancer
Hušek, Petr ; Pacovský, Jaroslav (advisor) ; Študent, Vladimír (referee) ; Doležel, Jan (referee)
DNA methylation changes as potential biomarkers in the treatment of bladder cancer Introdution Bladder Cancer (BC) is the second most common malignancy of the urinary tract. BC has two categories. Approximately 75 % of patients with BC present with disease confined to the mucosa or submucosa (non muscle invasive bladder tumor - NMIBC). Carcinoma in situ (CIS) is a very specific subgroup of NMIBC, because it is not a papillary lesion but a flat tumor, which is why CIS can be missed in cystoscopy. CIS is always a high grade tumor. Without any treatment, approximately 54% of patients with CIS progressed to muscle- invasive or metastatic disease. The second category covers patients with muscle-invasive BC (MIBC). These patients have a higher prevalence of progression rates and higher cancer- specific mortality. Patients with NMIBC are indicated to transurethral tumor resection (TUR) alone or with adjuvant treatment (intravesical chemotherapy or intravesical Bacillus Calmette- Guérin - BCG immunotherapy). BCG is an attenuated mycobacterium developed as a vaccine for tuberculosis that has demonstrated antitumor activity in BC intravesical instillation, and significantly reduces the progression risk of high grade papillary lesion and CIS. The therapy of MIBC is radical cystectomy - hard mutilating surgery...
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Aspects of the testicular cancer from the affected patients point of view
Pásztorová, Lenka ; Pacovský, Jaroslav (advisor) ; Hadaš, Lubomír (referee)
Author: Lenka Pásztorová Institution: Ústav sociálního lékařství LF UK v Hradci Králové Oddělení ošetřovatelství Title: Aspects of the testicular cancer from the affected patiens point of view Supervisor: MUDr. Jaroslav Pacovský, Ph.D. Number of pages: 92 Number of attachments: 2 Year of defense: 2016 Keywords: testicular tumors, prevention, nursing care, education The Bachelor's thesis is focused on the testicular tumors. The main issues are population awareness and this disease prevention options knowledge. This work utilizes personal experiences of men affected with this disease. Theoretic part describes symptoms, risk factors, diagnostic procedures and therapy of testicular tumors. The main interest of this work is prevention and it offers suitable methods for early diagnosis. The role of a nurse in a nursing process, an optimal communication form and educational activities are designed as well. Possible patient's reactions of patient on the proclaimed severe diagnosis and the disease self-perception are presented. The empirical part presents results of the quantitative research with the questioners use. The aim of the study was deeper understanding of this diagnosis and to get more complex overview on it. The most important expected result is to create suitable information handout.
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Quality of life in adults with benign prostatic hyperplasia
Kroutilová, Petra ; Pacovský, Jaroslav (advisor) ; Mareš, Jiří (referee)
ANOTATION Author: Petra Kroutilová Institution: Institute of Social medicine Department of Nursing Charles University in Prague Medical Faculty of Hradec Králové Title of Thesis: The Quality of Life in Adults with benign Prostatic Hyperplasia Supervisor: Jaroslav Pacovský, M.D., Ph.D. Pages number: 99 Attachments number: 3 Year of Disputation: 2012 Key words: Quality of life, benigh prostatic hyperplasia, transurethral resection of the prostate, nursing care Bachelor's thesis presents problem of the benign prostatic hyperplasia (BPH) and its management. BPH disease drops down quality of life. The incidence of these problems increases and BPH needs correct diagnostics following by adequate therapy. This thesis is interesting for majority of men, even for younger of them, because the pathologic changes in the prostate can be found in men after the 30th year of age. Bachelor's thesis is focused on the quality of life just after the surgical management of BPH - Transurethral resection of the Prostate - TUR-P. The objective of this thesis is an evaluation of the factors with the deepest impact on BPH symptoms and complications. Moreover it evaluates patients' expectances of improvement or worsening and compares them with the post-operative reality even in time period.
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Nursing care of the patient with renal cancer
Zajícová, Kateřina ; Kutílková, Soňa (advisor) ; Pacovský, Jaroslav (referee)
Téma své bakalářské práce Ošetřovatelská péče o pacienta s diagnózou karcinom ledviny jsem si vybrala na základě skutečnosti, že karcinom ledviny patří k těm nejnebezpenějším nádorům a jeho incidence je největší právě v České republice. První příznaky nádoru často souvisejí až s metastázami, a skutečně účinná léčba, která by dokázala zvrátit nepříznivý osud nemocných s takto pokročilým onemocněním, nám stále chybí. Díky rozšířenému používání ultrazvuku se však v posledních letech zvýšil záchyt lokalizovaných forem nádoru, které mají při správné léčbě relativně dobrou prognózu. Ultrazvukové vyšetření je u nemocných často indikováno pro jiné potíže a nález karcinomu ledviny je pouze náhodný. A právě tato náhoda figuruje v případu pana M. S., který mi poskytl vzácné informace pro napsání této práce a souhlas s jejich uveřejněním. Bakalářská práce je rozdělena na dvě části: klinickou a ošetřovatelskou. V klinické části se zabývám anatomií a fyziologií ledvin. Následně uvádím základní informace o panu M. S., tzn. okolnosti jeho přijetí na urologickou kliniku k operačnímu řešení karcinomu ledviny, jeho stav při přijetí a vlastní průběh hospitalizace. Ošetřovatelská část je věnována problematice ošetřovatelské péče, která byla panu M. S. poskytována metodikou ošetřovatelského procesu. Model Marjory Gordonové se mi...
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Pathogenesis of the Lymphocele following the Kidney Transplantation
Pacovský, Jaroslav ; Navrátil, Pavel (advisor) ; Třeška, Vladislav (referee) ; Adamec, Miloš (referee)
The lymphocele is a surgical transplant complication resulting from lymphatic vessels injury. This injury is background of the lymphocele pathogenesis, no lymphocele cannot become into existence without this step. On the other hand, the all organ procurement and transplantation procedures are associated with any rate of this injury at all time. Our results present proteins as a very important factor influencing interstitial fluids transport. The colloid osmotic pressure of the proteins controls interstitial fluids flow even across the vessel walls. Lymph fluid flow is also under the osmotic pressure control. The proteins play serious role in the second phase post-transplant lymphocele pathogenesis. At first, proteins control return of the leaked lymph back into the lymphatic vessels. Finally, inflammatory proteins participate on development of the fibrous lymphocele capsule. Postoperative care for protein metabolism seems to be very important in the protection against the post-transplant lymphocele formation. Carefully metabolic care for patient after renal transplantation should help to decline risk of lymphocele. The knowledge of the pre-transplant protein level and its fractions is very useful for relevant estimation of the risk of the post-transplant lymphocele formation. Calculation of the...
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Changes of voiding regimen in patients before and after kidney transplantation
Škrancová, Kateřina ; Pacovský, Jaroslav (advisor) ; Navrátil, Pavel (referee) ; Švecová, Dagmar (referee)
Changes of voiding regimen in patients before and after kidney transplantation The purpose of my work is to find out, whether patients before kidney transplantation felt some kinds of voiding disorders taking into account their basic disease. I have focused the main part in my work into voiding disorders after kidney transplantation. In the theoretic part I have digestedly described kidney diseases that led to renal failure, treatment possibilities and related complications. Furthermore, my work is dealing with problems in patients with chronic disease generally, because dialyzed patients surely could be placed in this group. In the empirical part I tried to find out and characterize subjective perception of complaints with urination by a questionnaire investigation. I have used a standardized and modified questionnaire KHQ, in part, my own questionnaire to verify the condition of urination and diuresis before kidney transplantation. For my work I have choused patients, who had been oliguric or anuric before kidney transplantation. I got a 42 responders from the total 59 addressed patiens. The target of this inquiry was to find out whether patients can perceive the voiding changes and possible new problems with urination in everyday activities, personal relationships, emotions and in physical and...
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