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Problems of the Patient with Psoriasis and his Integration to the Society
Vaňková, Lucie ; Hošťálková, Monika (advisor) ; Marková, Eva (referee)
The bachelor work is dealing with the problems of patients, afflicted with psoriasis.In the first half of the teoretical part I am fixing on the description of the anatomy and physiology of the skin.The second half of the theoretical part makes clear, what actually psoriasis yields, what is its history, how manifests, what is the posssibility of diagnostics, what types of psoriasis we can meet in the practice, which are the possibilities of the treatment and why is important education of the diseased person,the family and the society.In several chapters I describe,which is the fall-out on the psychical and physical disposition of the patient. Last but not least I am joining on the chapter about the integrating of persons with psoriasis to the society.The empirical part is fixed on the life and stories of the people who did not choose this disease wilfully, however it guides them for the big part of their life. There was used the probe of the qualitative investigation with the technique of the half structured dialogue.The dialogues were recorded and subsequently analyzed by the help of the method of stationary theory.The principal aim is to find out,in what social spheres people with psoriasis have most often problems. The talks are made with the chosen patients, with their families, friends and with general...
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Importance of HSD17B1 gene amplification in breast cancer
MAŠOVÁ, Michaela
Breast cancer is the most common female tumour disease. Although, the incidence is constantly growing, mortality of this disease is decreasing. However, there are still occurrences, where the conventional therapy failed. One of the important therapeutic attribute is hormone dependence of breast cancer and status of growth factor receptor HER2 (Her-2/neu, c-erbB-2). Treatment of the breast cancer with higher expression of estrogene or progesterone receptors (ER or PR) could be targeted-into blockade of these receptors or in the case of HER2 we could blockade it´s function with monoclonal antibody trastuzumab or lapatinib. Because of aggression of HER2 positive tumour cells, this subtype of breast cancer belonged to the group of patients with the worst prognosis. Thanks to targeted (biological) therapy belongs this patients into the group with the best treatable breast cancer today. However, in some of the hormone-dependent breast cancer cases the treatment fails. One of the reasons could be the product of HSD17B1 gene that is involved in metabolism of these hormones. Moreover, this gene is localized on chromosome 17 (like HER2 gen) and therefore it´s aberration could be suspected. Because the FISH probe for HSD17B1 gene is not commercially available, we prepared it by using transgenic E. coli bacterial clones. The specifity was checked on chromosomal spreads. In this presented thesis, we investigated 50 patient´s breast cancer samples by using fluorescent in situ hybridization to determine the status of HSD17B1 gene. Amplification of the gene could be important in the treatment of breast cancer and in resistance to antihormonal therapy. Next, we tried to check, if the status of HSD17B1 gene could be dependent on status of HER2 gene or if it correlates for example with patient´s age at time of diagnosis etc. Although, the statistical important correlations were not found, it seems, that HSD17B1 gene is lightly increased in some cases. In the next phase the study will be extended of another patient samples and the clinical dates and analysis in relation to HSD17B1 will be done. This is a pilot project. The main goal was to prepare HSD17B1 gene probe intended for commercialization and check the probe on the set of patients with breast cancer.
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Specifics of work of nurses in the centers of biological treatment.
MENCLOVÁ, Šárka
Specifics of the Work of a Nurse in Biological Therapy Centres? The bachelor thesis was written in theoretical form with the aim to map the problems of biological therapy. The method of research and analysis of the available present sources related to the topic was applied to the thesis elaboration. Biological therapy represents a new type of treatment trying to create such a compound that is capable of targeted immune system suppressing or strengthening to influence a pathological process in an ill or impaired organism as accurate as possible. Because of high costs the treatment by biological preparations had to be concentrated to centres. Quality teams of people that are able to assess effectively for which patient the therapy is suitable and safe work at the centres. Patient registers enable efficient treatment and long-term monitoring of medical safety. Attention is also paid to equipment and environment of the centres. The chapter Specifics of Nurse Work focuses on professional knowledge and skills of a nurse in biological therapy application. The main task of a nurse is to provide complex, individual holistic nursing care based on quality verbal and non-verbal communication and educational activity. The next part deals with the individual spheres of medicine with the best experience with biological therapy. In gastroenterology, where idiopathic intestine inflammations of Crohn?s disease and ulcerous colitis are treated by means of TNF-? blocking substances, the substances are administered in the form of infusion or subcutaneously. Nurses thus have to be aware of treatment process, treatment principle and side effects linked to the therapy. Excellent results are achieved with biological therapy in the rheumatology centre in treatment of rheumatoid arthritis, ankylosing spondylitis also known as Bechterew's disease, psoriatic arthritis and juvenile idiopathic arthritis. ATTRA Registry, which is one of the most important tools for patient monitoring from the beginning of the therapy, is also mentioned here. The work of nurses in the oncology centre focuses on monitoring the side effects linked to the therapy. Side effects linked to biological therapy are more specific than those in cytostatic therapy. It thus depends on nurse?s observation skills, her ability to decide what symptoms should be focused on during the therapy and ability to respond to them in timely manners. The last centre analysed in the thesis is the dermatology centre, where they have experience with therapy of a chronic disease called psoriasis vulgaris. The information provided from the available data has shown us that although the therapy is highly costly, its purposeful application is economically effective at least thanks to the fact that timely commencement of therapy enables patient life quality improvement without possible disability. Although the therapy is not able to cure the patients completely, its main goal is to slow down the disease prognosis and to free the patients from the pains linked to the disease.
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Difficult to treat asthma in adults from the nurse´s point view
LAHODOVÁ, Danka
Summary The quality of life of patients with bronchial asthma is influenced by severe everyday difficulties, including nocturnal symptoms, limitation of physical activities or a more frequent hospitalization. Therefore, it is necessary that the medical staff take special care and individual approach to the patients with difficult treatable asthma. Objective 1: Find out limitations in customary daily activities of the patients with severe asthma. Patients stated that they are restricted in their customary daily activities including sport activities. Objective 2: Find out the nurse?s participation in the care for asthmatics. The objective was achieved; the nurse takes part in the care of patients with difficult treatable asthma from the first visit in the ambulance. She makes the first contact with patients, assists the doctors, takes examination material, carries out certain examinations or helps out with them and takes part in the nursing care. Objective 3: Find out the role of a nurse during biological treatment of patients with difficult treatable asthma. Essential is to make a relationship between the nurse and the patient, to educate the patient, to reeducate him and to provide nursing care. According to these objectives we have put three research questions. The first question is: ?In what customary daily activities is the patient with asthma restricted?? During the research interviews we discovered that the most difficult period for the patients was, when they had to leave their jobs because of the disease. Furthermore, clients stated that they handle daily activities at their own pace and it always depends on their current health. Patients try to keep their condition by doing leisure sport activities. The second question is ?How does the nurse engage family in the care of an asthmatic?? From the interviews we found out that family engages in the care when breathing problems occur and the patient is not able to deal with it on his own. Family ensures the feeling of patient?s safety. The nurse provides family with information on how to avoid asthmatic fits, how to help during the fit and where to find this information. Patients with difficult treatable asthma and their families have to be provided with appropriate information. It results from our research that family accompanies the patient very rarely during the visits in the ambulance for the treatment of difficult treatable asthma, only in case of health impairment. Clients visit the ambulance mostly on their own without any companions. Question 3 is ?What is the nurse?s role during the biological treatment of the patient with difficult treatable asthma?? We discovered that nurse?s role starts with educating the patient in order to abide by the rules of treatment regime and with assessing individual needs of the patient. She teaches him how to change the behavior due to the disease, responsibility for his health and helps him to deal with limitation which the disease brings. Moreover, the nurse is the bearer of the nursing care, applies the biological treatment. It is important to gain trust and build cooperation with the patient.
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