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Importance of trombophilic mutations in clinical genetic.
Vavrušková, Klára ; Kuklík, Miloslav (advisor) ; Černá, Marie (referee)
Trombophilia means an increased disposition to creation of trombs. Health complication incurred as a consequence of hypercoagulation can be very serious. When a trombophilic mutation is found at a patient, it brings necassity of thrombosis - control in risk situations (e.g. pregnancy, operation) for the rest of the patient's life. There were filed 300 people (206 women and 94 men) with trombophilic mutations into my study of clinical signification of trombophilic mutations. These people were examinated in years 2008 - 2010. Most of positive medical findings - 266 people, were recorded in the area of MTHFR (C677T i A1298C) mutations. There were less findings in the field of FV Leiden and FII prothrombin mutations. Multipath trombophilic mutations were found at 99 patients. I accordance with foreign literature, our results advert to clinical consequences of trombophilic mutations like: repeated spontanious aborts, cerebrovascular akcident (CA), ischaemic heart disease (IHD), thrombosis, flebothrombosis, pulmonary embolism, varicose veins, aseptic necrosis of hip bone, arterial sclerosis and aortic stenosis. Mutations MTHFR C677T and MTHFR A1298C we found mainly at patients with CA, IM and IHD. Leiden mutation was most often found at patients with thrombosis, flebothrombosis and pulmonary embolism. We...
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Anticoagulant therapy focusing on patients with atrial fibrillation
VANÍČKOVÁ, Martina
Thrombosis has recently become a widely discussed issue due to an increasing number of cases and problematic treatment. Once developed, thrombosis cannot be cured completely. Currently used anticoagulant treatment is limited to avoid complications such a hemorrhage or stroke. INR value checks (Quick tests) and monitoring covering at least 70% of the treatment period within the therapeutic range are necessary (2-3), but could be rather difficult to maintain in some patients. So-called new anticoagulants could prove themselves as an appropriate solution.
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Examination of D-dimer in patients from the district Jindřichův Hradec
PROCHÁZKOVÁ, Veronika
Investigation of level (concentration) of d-dimer in the plasma is used to capture several pathological conditions. The most common is venous thrombosis and pulmonary embolism. Just thrombosis is diagnosed in 71 patients out of 100 000 inhabitants per year, pulmonary embolism in the same population in 69 inhabitants. Thanks to determine levels of d-dimer we can also determine the risk thrombophilia, a tendency to thrombosis. Thrombosis is the third most common pathological condition after myocardial infarction and stroke. Another states we can diagnose are undoubtedly disseminated intravascular coagulation, tumors, acute coronary syndromes, inflammatory disease. Increased level of d-dimer is found in pregnancy. My main objectives were to: 1. Acquisition of method for the examination of d-dimer, which is used in the Hospital Jindřichův Hradec, a.s. the Department of Haematology and Blood Transfusion, during one month. 2. Processing of at least 30 samples. D-dimer is one of the fission products of fibrin. It occurs in fibrinolysis, which was preceded by a sequence of reactions coagulation cascade. Its presence in the blood shows a fibrinolytic activity in the vascular system. Its level is increased after trauma or surgery. People taking hormonal therapy may suffer from increased coagulation and subsequently induced fibrinolysis. I deal in the tehoretical part of my thesis what is d-dimer, when arises. I mentioned also the coagulation cascade, which precedes the fibrinolysis. I focused on the main thrombotic condition in which the levels of d-dimer increased, from what causes these conditions arise, how they can be diagnosed. I was considering which diseases can develope because of thrombotic states and thrombophilia, what the symptoms are. In this section there is also the types of thrombotic conditions treatment, material, conditions of work with it, the types of hematological examination, the possibility of establishing d-dimer and preparation of antibodies. The practical part describes the receiption of material, its preparation for analysis, analysis, description of the apparatus, required reagents, the principle of work. I worked in the Department of Haematology and Blood Transfusion in the Hospital in Jindřichův Hradec. It was allowed to me to examine 100 patient samples, in most of the outpatient department of the hospital. I worked on the automatic coagulation analyzer ACL Elite Pro and I examined the levels of d-dimer. The latex-enhanced method is used to determine the d-dimer in routine practice in Jindřichův Hradec. D-dimer contained in the plasma forms a complex with the monoclonal antibody, which is bound to the latex particle. The principle of measurement is immunoturbidimetry, at 405 nm. The light beam is absorbed on the immune complexes and decrease of the transmitted light intensity, which passed through the reaction cell with a sample to be analyzed, is measured. I processed the measured values of d-dimer in tables and graphs using a computer program to separate part of the thesis. I divided the results according to gender, cut-off value of d-dimer used in hospital in Jindřichův Hradec, according to risk age of 45. I created graphs and tables and I evaluated the research. Increased level of d-dimer was showed in 56 patients, while the proportion of men and women was the same. I did not notice dependence on increased concentration with increasing age. Unconfirmed of two hypotheses may be due to the fact that I investigated samples from a small group of patients who were diagnosed with a pathological condition. Increased concentrations of d-dimer are most often caused by lifestyle and heredity. By working in the laboratory I have developed latex-agglutination d-dimer determination in plasma.
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Prevention of deep Venous Thrombosis in nursing Care
CHMELÍKOVÁ, Hana
Annotation: Deep vein thrombosis is created by blood flow slowdown that is caused by non-sufficient movement and also by the lack of fluids. Furthermore there are changes in blood clotting where the tendency for thrombosis can highly occur and the third mechanism of the deep vein thrombosis is the damage of vein endolets, e.g. inflammation or injury. The most frequent deep vein thrombosis affects lower limbs. The prevention in nursing care consists of application of low molecular heparin, bandages of lower limbs and very frequent mobilization of a client, his/her hydration etc. The topic of my bachelor wok is the ?Prevention of deep vein thrombosis in nursing care?. I focused on what steps and precautions do the nurses apply at a client within the prevention of deep vein thrombosis. If the clients know influenced factors of the deep vein thrombosis and whether they follow the rules of the prevention in the home care. The topic was processed on the basis of specific articles together with the special articles and internet sources. The qualitative research was made on the basis of interview which contains two parts. The first research file was created by the clients of the department of internal medicine and the second research sample were nurses working for the internal department. The data were collected at both research files by deep interview. The client ´s interviews were made into two phases. The research questions were answered on the base of questions which were later rewrote for further clarification together with the answers of the respondents which were rewrote in the date category of the research investigation. It is possible to say that out of the results of the research the nurse apply sufficient methods and steps for the prevention of deep vein thrombosis at clients who have such high risk of deep vein thrombosis. The influenced factors of the cause of the deep vein thrombosis are known mainly by clients who are aware of such illness and they have ever come across with it. The clients are fully advised by a nurse and by a doctor about the steps of prevention of the deep vein thrombosis in the home care and they try to follow them.
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