|
|
Investigation of thyroid disorder in pregnancy and reference intervals in evaluation of maternal thyroid function
Springer, Drahomíra ; Zima, Tomáš (advisor) ; Průša, Richard (referee) ; Zamrazil, Václav (referee)
The importance of maternal thyroxine for the development of the fetus brain early in pregnancy has received increasing acceptance. It has more recently become evident that maternal hypothyroxinemia results in the birth of children with decreased mental and psychomotor development. In our group of 7,530 women in 9-11 week of pregnancy were determined TSH, anti TPOAb and FT4. For evaluation of results was necessary to set reference intervals for pregnant women. The TSH reference interval was determined to be 0.06 - 3.67 mU/l and for FT4 9.8 - 23.43 pmol/l was used. The limit for anti-TPO positivity was determined to be 143 kU/l. A raised concentration of TSH was found in 5.14% of women; and a suppression of TSH was found in 2.90% of women and 11.5% of pregnant women were found positive. Serum concentrations of FT4 were lower in TPOAb positive as compared to TPOAb negative women and differences of FT4 in euthyroid women with suppressed, normal and elevated TSH were found. (...) In Czech Republic, case finding screening is able to disclose only about 20% of asymptomatic mild or deep hypothyroidism or women with positive anti TPO in pregnancy. Foreign study report 70% of these high-risk pregnant women, consequently is evident need of general screening of pregnancy thyroid failure in Czech Republic. Moreover the...
|
|
|
Effect of latent toxoplasmosis on the thyroid function during pregnancy
Procházková, Lucie ; Kaňková, Šárka (advisor) ; Springer, Drahomíra (referee)
While several past studies dealt with the effects of latent toxoplasmosis on the function of the thyroid gland and on the pregnancy separately, the former one with varied results, this work combines the two areas together with goals to determine whether the latent toxoplasmosis affects levels of antibodies against thyroid peroxidase (TPO) in the 1st trimester of pregnancy, to analyze the effect of toxoplasmosis on the levels of the thyrotrophic hormone and to learn whether the interactions between latent toxoplasmosis and autoimmune thyropathies affect conception, foetal development, length of pregnancy and mode of delivery in childbirth. The work follows on the recent years' discoveries of our laboratory that showed the latent toxoplasmosis to affect both the course of pregnancy and the prenatal development of a child. It also takes up directly on a screening of autoimmune thyropathies in pregnant women conducted in years 2006 to 2009 in General University Hospital. The retrospective study comprised of 1434 pregnant women who underwent serological examination as a part of the 1st trimester screening and whose serum was subsequently examined for toxoplasmosis. The data set obtained from medical databases contained results of serological screening of the mothers, ultrasound examination of the...
|
|
|
Progression of thyroid diseases in women with thyroid gland disorder diagnosed during pregnancy
Krejčová, Simona ; Springer, Drahomíra (advisor) ; Límanová, Zdeňka (referee)
Diploma thesis is based on a four-year study the goal which was to demonstrate on a group of pregnant and postpartum women the frequency and severity of thyroid disease in pregnancy and after childbirth, and thus support the introduction of screening of function thyreidopathias into normal practice within screening for congenital defects in first trimester of pregnancy. In 3937 sera from women in the 10th - 12 week of pregnancy were, with informed consent of pregnant, determined TSH and anti TPO, in the case of FT4 deviation. Of the total number of examined 6,4 % had TSH higher than 4,00 mIU/l, 4,2 % with TSH less than 0,1 mIU/l and 12,4 % of women with positive anti TPO antibodies. 552 women were recommended visiting endocrinology. 106 pregnant women came to be endocrinologically tested to Third Internal Clinic of VFN and 1st LF UK which is the equivalent to 19,2 % of all positive hits and 2,7 % of all investigated over the period. Only 56 women (52,8 %), came for subsequent checks in which the monitoring of the disease continued. After the endocrinologic examination in pregnancy 60,4 % of women was diagnosed with subclinical hypothyroidism. This subclinical form developed in 39 % of women into an overt hypothyroidism 24 - 30 months after childbirth. Overall, the disease progressed in 41.1% of women....
|
|
|
Preoperative Diagnostic Methods in Prostate Cancer
Dolejšová, Olga ; Hora, Milan (advisor) ; Záleský, Miroslav (referee) ; Springer, Drahomíra (referee)
Preoperative diagnostic methods in prostate cancer Introduction: At present, the most attention in prostate cancer is focused on tumor markers and imagining methods, especially magnetic resonance and fusion methods in order to accurately identify carcinoma deposits and predict the biological behavior of the tumor. Accurate diagnosis allows choosing optimal therapeutic procedure. Aim: The aim of the study is to evaluate how preoperative diagnostic methods can help in designing an optimal treatment in a patient with prostate cancer. The main objective is to evaluate the use of the Prostate Health Index (PHI) in differentiating low-risk carcinoma from aggressive cancer. Another goal of the thesis is the use of imaging methods. I focused on the 3T magnetic resonance imaging in assessing invasion beyond the prostate and in high risk patiens on a new method of fusion magnetic resonance imaging and positron emission tomography for prediction of nodal involvement. Methodology: A total of 320 patients who underwent preoperative diagnosis using our investigated methods (PHI, MRI, choline PET / MRI) and subsequently radical prostatectomy were enrolled in the study. It allowed us to retrospectively assess these diagnostic tests. The PSA, % fPSA, -2proPSA, and PHI results overall were evaluated by statistical...
|
|
|
Preoperative Diagnostic Methods in Prostate Cancer
Dolejšová, Olga ; Hora, Milan (advisor) ; Záleský, Miroslav (referee) ; Springer, Drahomíra (referee)
Preoperative diagnostic methods in prostate cancer Introduction: At present, the most attention in prostate cancer is focused on tumor markers and imagining methods, especially magnetic resonance and fusion methods in order to accurately identify carcinoma deposits and predict the biological behavior of the tumor. Accurate diagnosis allows choosing optimal therapeutic procedure. Aim: The aim of the study is to evaluate how preoperative diagnostic methods can help in designing an optimal treatment in a patient with prostate cancer. The main objective is to evaluate the use of the Prostate Health Index (PHI) in differentiating low-risk carcinoma from aggressive cancer. Another goal of the thesis is the use of imaging methods. I focused on the 3T magnetic resonance imaging in assessing invasion beyond the prostate and in high risk patiens on a new method of fusion magnetic resonance imaging and positron emission tomography for prediction of nodal involvement. Methodology: A total of 320 patients who underwent preoperative diagnosis using our investigated methods (PHI, MRI, choline PET / MRI) and subsequently radical prostatectomy were enrolled in the study. It allowed us to retrospectively assess these diagnostic tests. The PSA, % fPSA, -2proPSA, and PHI results overall were evaluated by statistical...
|
|
|
Standardization of dynamic tests of hypocorticali
Žánová, Magdalena ; Springer, Drahomíra (advisor) ; Kosák, Mikuláš (referee)
During this thesis - Standardisation of hypocortisolism dynamic testing - levels of hormones used when diagnosing adrenal cortex diseases were immunoanalytically determined. Examination of a control group of 66 healthy people from 19 to 68 years of age was a part of the grant project. This group underwent an insulin tolerance test (ITT) and it was confirmed that level of hypoglycaemia does not depend on age. Hypoglycaemia is partially dependent on body mass index in cases when a person's BMI is over 30. Salivary cortisol levels during the ITT reached its maximum levels at 90 minutes while serum cortisol levels were at their highest at 60 minutes. Usage of saliva during this stress test is very limited and it is possible only when using sufficiently sensitive immunoanalytical methods. An insulin stress test retains the gold standard test for the hypothalamic-pituitary-adrenal (HPA) axis examination. Substitution of a high-dose synacthen test (HDST) using 250 µg of Synacthen was considered in order to lower body burden. A LDST when 1 µg of Synacthen is used seem to be suitable. In this case, 98.5 % of tested people previously marked healthy by the HDST were found healthy at cut-off values of 500 nmol/l. Evaluation of aldosterone and renin levels measured in basal samples of particular stress tests showed...
|
|
|
Effect of latent toxoplasmosis on the thyroid function during pregnancy
Procházková, Lucie ; Kaňková, Šárka (advisor) ; Springer, Drahomíra (referee)
While several past studies dealt with the effects of latent toxoplasmosis on the function of the thyroid gland and on the pregnancy separately, the former one with varied results, this work combines the two areas together with goals to determine whether the latent toxoplasmosis affects levels of antibodies against thyroid peroxidase (TPO) in the 1st trimester of pregnancy, to analyze the effect of toxoplasmosis on the levels of the thyrotrophic hormone and to learn whether the interactions between latent toxoplasmosis and autoimmune thyropathies affect conception, foetal development, length of pregnancy and mode of delivery in childbirth. The work follows on the recent years' discoveries of our laboratory that showed the latent toxoplasmosis to affect both the course of pregnancy and the prenatal development of a child. It also takes up directly on a screening of autoimmune thyropathies in pregnant women conducted in years 2006 to 2009 in General University Hospital. The retrospective study comprised of 1434 pregnant women who underwent serological examination as a part of the 1st trimester screening and whose serum was subsequently examined for toxoplasmosis. The data set obtained from medical databases contained results of serological screening of the mothers, ultrasound examination of the...
|
|
|
The influence of veno-arterial extracorporeal membrane oxygenation (VA ECMO) on antibiotic concentrations in a animal model
Havelková, Kristýna ; Springer, Drahomíra (advisor) ; Pokorná, Pavla (referee)
In July, August and December was conducted a pilot project investigating the availability of antibiotics to the lungs on the model of piglets treated with VA ECMO. In the study were collected and processed samples from the pulmonary artery, artery, ECMO and BAL. To determine the analytes there were used different analyzers that are capable of conducting the investigation. Most analyzers use the detection limit from the manufacturer. The measured values were lower than those limits, it was important to determine whether they are relevant and therefore usable for further statistical processing. Data from this project was evaluated using the newly calculated limits of detection. Of the total group of 12 piglets all successfully completed the project, 2 of them suffered a pulmonary edema. It was concluded that the use of VA ECMO, despite the apparent reduction in pulmonary flow, does not reduce the concentration of vancomycin, gentamicin or amikacin in pulmonary artery and within one hour after administration of antibiotics can be detected in the tracheal aspirate. .
|
|
|
Total two-year evaluation (2009 - 2010)of pilot project examination of thyroid gland function in group of pregnant women
Řehoř, Jiří ; Springer, Drahomíra (advisor) ; Límanová, Zdeňka (referee)
In the years 2009 and 2010 the pilot project investigating the function of the thyroid gland took place in 13 cities of the Czech Republic. In the context of the screening of congenital developmental defects the levels of TSH, FT4 and anti-TPO in serum were by women in the first trimester of pregnancy investigated, after signing informed consent. For the determination of analytes there were different analyzers used, which laboratories possess and are able to carry out the necessary examinations. Most of analyzers the reference intervals for TSH, FT4 and anti-TPO has set up from the manufacturer. These reference intervals are suitable for the normal population, neither less for pregnant women. Data from this project was evaluated using the newly calculated reference intervals for pregnant women, which are for the group of investigated women much more appropriate. From the total file of 3,484 pregnant women, it was thanks to these new reference intervals captured about 100 pregnant women with increased levels of TSH more, than in the use of reference intervals of producers. The comparison of reference intervals from the manufacturer with the newly calculated reference intervals for pregnant women managed to surface FT4 to find out about 126 more women below the surface of the new reference interval, than...
|
|
| |
guest ::
RSS feed.