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Cognitive deficits in children with visual impairment and the possibilities oftheir early diagnosis
Štrofová, Helena ; Květoňová, Lea (advisor) ; Vítková, Marie (referee) ; Lopúchová, Jana (referee)
The dissertation entitled Cognitive deficits in children with visual impairment and the possibilities of their early diagnosis responds to the need for a tool for the early detection of visual impairment at the level of the visual apparatus in children with cognitive deficits for special pedagogues. The aim of the thesis is to design and verify the reliability and usability of a tool for the early detection of visual disorders at the level of the visual apparatus, which could be used by special pedagogues. Based on them, identify children with an indication for a complete ocular and orthoptic examination. The partial goals are to determine the coincidence of visual impairment with cognitive deficit, to compare the reliability of individual stereotests and to evaluate the practical use of the tool for special pedagogues. The theoretical starting points are current findings on the issue of cognitive processes and their deficits, the visual analyzer and its defects at all levels, with an emphasis on defects at the level of the visual apparatus and the relationship of cognitive deficits to visual disorder in childhood. The research part is based on a tool created to detect defects at the level of the visual apparatus for special pedagogues and to determine its reliability using the quantitative method...
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Depression in the elderly with focus on people with cognitive deficit
Věchetová, Gabriela ; Hrachovinová, Tamara (advisor) ; Šivicová, Gabriela (referee)
Depressive symptoms are very common among people with neurocognitive disorder. The comorbidity of both diseases and the overlap of their symptoms complicates correct diagnosis and thus also the initiation of a correct treatment. The instruments of depression measuring in seniors with a severe cognitive deficit are also a discussed issue. The subject of the theoretical part is to describe the issue of depression and cognitive disorders in the old age with a focus on Alzheimer's disease, which is the most common mental disorder in the elderly together with depression. The goal of the empirical part of the thesis is to research based on the interviews with seniors if the most frequently used method of depression measuring in the elderly, Geriatric Depression Scale (GDS), is a suitable measuring instrument also in seniors with a cognitive deficit and further examine how these seniors actually experience the individual mood qualities which are the subjects of items in GDS. Forty seniors with a various degree of cognitive deficit participated in the research. The study results showed that the questionnaire is usable for seniors with a mild cognitive impairment and mild dementia. To detect the border of the cognitive deficit, below which it is not suitable to use the depression measuring method GDS, a...
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Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline
Kalendová, Lucie ; Malík, Jan (advisor) ; Bednářová, Vladimíra (referee) ; Janečková, Jana (referee)
Cerebral hypoxia in chronic kidney disease and its relation to cognitive decline Dissertation abstract - MUDr. Lucie Kalendová Introduction: Patients with chronic kidney disease in need of regular hemodialysis treatment have high rates of cognitive impairment. In its multifactorial etiology, vascular changes, cerebral ischemia and hypoxia play a major role. In our work we first studied the association between low cerebral oxygenation and cognitive impairment in this population. Subsequently, we focused on one of the possible etiological factors in this association - the presence of a vascular shunt for hemodialysis. Methods: Chronic hemodialysis patients without overt cognitive impairment participated in the studies. We used a near-infrared spectroscopy (NIRS) device named INVOS for monitoring cerebral oxygenation (rSO2). Cognitive function was assessed with the Montreal Cognitive Assessment (MoCA). To assess the effect of vascular shunt, we performed an interventional study based on short-term ultrasound-confirmed manual compression with continuous monitoring of rSO2. Results: In 39 patients (49 % women, age 64 ± 14 years) we observed a significantly lower rSO2 in the subgroup presenting cognitive decline than in patients without this diagnosis (48 ± 9 vs. 57 ± 10; p = 0.01). The association remained...
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Cognitive and psychosocial sequelae following hypoxic brain injury.
Dostálová, Veronika ; Bezdíček, Ondřej (advisor) ; Šonka, Karel (referee) ; Feketeová, Eva (referee)
Cognitive and psychosocial sequelae following hypoxic brain injury Abstract in English Hypoxic brain injury leads to neuronal necrosis and to other cerebral changes which may affect psychosocial functioning. Although the pathophysiology of cerebral hypoxia is multifactorial, and it is not possible to reliably describe the unified clinical picture of hypoxia patients, the most commonly described psychosocial consequences of cerebral hypoxia are cognitive impairment, increased anxiety and depressive symptoms. The aim of the present study is to characterize cognitive functioning and psychosocial changes of the patients exposing mild intermittent cerebral hypoxia (=chronic form of hypoxia, model of obstructive sleep apnea diagnosed by neurologist) and patients after severe one-time cerebral hypoxia (=acute form of hypoxia, model of cardiac arrest diagnosed by cardiologist). Regardless of the different etiology of particular hypoxia forms described in the theoretical part of the thesis, both forms may lead to neuronal death. In the experimental part we test a hypothesis comparing healthy individuals to patients with acute or chronic form of hypoxia in cognitive performance or anxiety and depressive symptoms. We document a decreased cognitive performance and higher level of state anxiety in a group of patients...
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Effects of Neurotransmission-Modulating Multipotent Compounds in Pharmacological Animal Models of Cognitive Deficit
Chvojková, Markéta ; Valeš, Karel (advisor) ; Kuchař, Martin (referee) ; Rudá, Jana (referee)
In preclinical research on Alzheimer's disease pharmacotherapy, attention is paid to multipotent compounds, enabling intensification of the effect by targeting multiple pathophysiological mechanisms. The aim of the thesis was to assess the effect of multipotent compounds and combination therapy in models of cognitive deficit in the rat. The mechanism of action of the tested compounds was modulation of neurotransmitter systems. The aim of the first part of the study was to compare the effect of experimental monotherapy and combination therapy with an N-methyl-D-aspartate (NMDA) receptor antagonist and a γ-aminobutyric acid type A (GABAA) receptor positive modulator in the trimethyltin-induced model. Superiority of the combination therapy was proven by histological analysis of hippocampal neurodegeneration; however, it did not reach statistical significance in the cognitive test. The other part of the thesis focused on multipotent tacrine derivatives. We demonstrated a positive effect of 6- chlorotacrine-6-nitrobenzothiazole hybrid, as well as 6-chlorotacrine-L-tryptophan hybrid, acting as acetylcholinesterase inhibitors, in the scopolamine-induced model of cognitive deficit. Besides, we demonstrated a low risk of serious side effects of other tacrine derivatives acting as NMDA receptor antagonists....
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Treatment for Brain Arteriovenous Malformations
Bradáč, Ondřej ; Beneš, Vladimír (advisor) ; Haninec, Pavel (referee) ; Vaverka, Miroslav (referee)
Introduction: The surgical and endovascular results of the treatment of pial AVM provided at our Neurosurgical centre are presented. These results are supported by neuropsychological outcomes of subgroup of treated patients. Going by these results and by an overview of literary data on the efficacy and complications of each therapeutic modality, the optimal algorithm of indications is presented Cohort of patients: The main series comprises 222 patients aged 9 to 87 years treated in the years 1998 - 2013. The surgical group consists of 85 patients, 55 patients received solely endovascular treatment. Thirty-four patients were consulted and referred directly to the Radiosurgical unit. The remaining 48 were recommended to abide by the strategy of "watch and wait". A subgroup of 66 patients, who underwent treatment of AVM was neuro-psychologically tested at least two years after treatment using a battery of tests constructed specifically for this study. A control group consisted of 10 subjects without any neurological disease. Results: In the surgical group, serious complications were 3.5% at a 96.5% therapeutic efficacy. As for AVM treated with purely endovascular methods, serious procedural complications were seen in 5.5% of patients, with efficacy totalling 36.4%. One observed patient suffered...
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Cognitive and psychosocial sequelae following hypoxic brain injury.
Dostálová, Veronika ; Bezdíček, Ondřej (advisor) ; Šonka, Karel (referee) ; Feketeová, Eva (referee)
Cognitive and psychosocial sequelae following hypoxic brain injury Abstract in English Hypoxic brain injury leads to neuronal necrosis and to other cerebral changes which may affect psychosocial functioning. Although the pathophysiology of cerebral hypoxia is multifactorial, and it is not possible to reliably describe the unified clinical picture of hypoxia patients, the most commonly described psychosocial consequences of cerebral hypoxia are cognitive impairment, increased anxiety and depressive symptoms. The aim of the present study is to characterize cognitive functioning and psychosocial changes of the patients exposing mild intermittent cerebral hypoxia (=chronic form of hypoxia, model of obstructive sleep apnea diagnosed by neurologist) and patients after severe one-time cerebral hypoxia (=acute form of hypoxia, model of cardiac arrest diagnosed by cardiologist). Regardless of the different etiology of particular hypoxia forms described in the theoretical part of the thesis, both forms may lead to neuronal death. In the experimental part we test a hypothesis comparing healthy individuals to patients with acute or chronic form of hypoxia in cognitive performance or anxiety and depressive symptoms. We document a decreased cognitive performance and higher level of state anxiety in a group of patients...
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Functional consequences of perinatal hypoxia-ischemia in rat
Nováková, Eva ; Otáhal, Jakub (advisor) ; Riljak, Vladimír (referee)
Title: Functional consequences of perinatal hypoxia-ischemia in rat Objectives: The aim of this diploma thesis is to design a set of behavioral tests which provide an effective assessment of motor and cognitive-behavioural deficits in adults rats after experimental hypoxic-ischemic insult during the perinatal period (P7). Supposed benefit is to establish a model of motor and cognitive-behavioural abilities of individuals after this procedure. Methods: The present thesis has a theoretical-empirical character. The practical part describes how the experiment was performed. 32 long Evans Rats were randomly devided into two groups: experimental group (HIE) and control group (Ctrl). The method to produce hypoxic-ischemic brain damage in the 7 day-old rats consisted of right common carotid ligation followed by systemic hypoxia by the inhalation of 8% oxygen and 92% nitrogen. The adult animals (55-75 days old) were tested by the following list of behavioral tests: Bar holding test, Rotarod test, Ladder rung walking test, Reaching test, Open field test and Morris water maze test. Sigma Plot and Microsoft Excel 2010 were the programs used for statistical analysis. Results: Results of Open field test, Ladder rung walking test and Morris water maze test confirmed that hypoxic-ischemic insult affects the...
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Problematic Areas in the Everyday Life of Patients with Huntington's Disease. Subtitle: A Suggestion of Compensatory Strategies in Coping with Cognitive Impairment
Sýkorová, Jitka ; Zemánková, Zuzana (advisor) ; Sládková, Petra (referee)
This diploma thesis explores problematic areas of patients with Huntington's disease in their performance during activities of daily living (ADLs) from the perspective of patients and their caregivers. The aim of the research was also to assess a possible correlation between cognitive impairment and the patient's performance in ADL. Twenty-five patients with their caregivers met the selection criteria for the research. There were used standardized assessment methods available in Czech: the Montreal Cognitive Assessment (MoCA), the Canadian Occupational Performance Measure (COPM) and the questionnaire for caregivers called Bristol Activities of Daily Living Scale (BADLS-CZ). The statistical analyses consisted of methods of the nonparametric statistics, qualitative analysis was processed by data categorizing. Caregivers reported more problematic areas in ADLs which was significantly confirmed in the statistical hypothesis testing (p <0,05). A significant correlation was seen between the results of the questionnaire and the results of the MoCA assessment (rSp = -0,620; p <0,05). For various reasons, patients with Huntington's disease did not mention as many problematic areas in performing ADL as their caregivers. Therefore, it is appropriate in clinical practice to supplement the assessment of the patient's...
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Nursing care of a patient with iatrogenic perforation of oesophagus
Polívková, Helena ; Di Cara, Veronika (advisor) ; Hocková, Jana (referee)
The theme of the final thesis is the nursing process in a patient with iatrogenic perforation of the esophagus in the Department of Geriatric Medicine. I consider the chosen topic to be very interesting, but not too often presented from the viewpoint of a nurse and nursing. Based on a single patient case study, the objective was to analyze the care provided for a patient with iatrogenic perforation of the esophagus in the Department of Geriatric Medicine. Nursing care was focused on the care of a geriatric patient with an esophagostomy, mediastinal drain and cognitive deficits. Another goal was to demonstrate that even in the geriatric department, very good results can be achieved by providing a good patient care. The last objective was to compare the procedures provided by nursing care in the Czech Republic and abroad. In my final thesis, I used a case study method, implemented by a nursing case in a patient in the geriatric department and aftercare of a regional type medical facility. Information for the final thesis was drawn from Czech and foreign literature, own observation and provision of nursing care, interview with the patient and from its available documentation. Part of the information was obtained from an interview with the medical team that provided the care. I had the oral approval of...
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