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Comparative analysis of the effect on disease-modifying drugs and biological therapy in functional ability in patients with rheumatoid arthritis.
Sýkorová, Veronika ; Vomáčková, Helena (advisor) ; Nováková, Tereza (referee)
Autor: Bc. Veronika Sýkorová Title: Comparative analysis of the effect on disease-modifying drugs and biological therapy in functional ability in patients with rheumatoid arthritis. Objective: The aim of the thesis is to compare the effect of disease-modifying drugs and biological therapy on quality of life using the disability index, which is achieved by evaluating the HAQ, grip strength the small muscles of the hand, which is tested a hand dynamometer and standing stability, which is detected by measuring on stabilometric platform. Methods: This is a pilot study using subjective and objective examination. Stabilometric and dynamometric examination and the Czech version of the Stanford Health Assessment Questionnaire validated by Rheumatology Institute in Prague 2010 were used to the analysis. Evaluation of the collected data was done using two-way analysis of variance with repetition. Results: Biological therapy and disease-modifying antirheumatic drugs have significant impact on quality of life, the strength of the small muscles of the hand and standing stability in patients with rheumatoid arthritis. Disease-modifying antirheumatic drugs have reached significant results than the biological therapy in quality of life, forces the small muscles of the right hand and standing stability. Biological...
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Adverse events of biologic therapy in psoriasis
Marques, Emanuel Carvalheiro ; Paluch, Zoltán (advisor) ; Kančeva, Radmila (referee) ; Farghali, Hassan (referee)
1 Adverse events of biologic therapy in psoriasis Abstract This doctoral thesis focuses on psoriasis vulgaris and its therapy, especially biologic agents and their safety profiles. The objectives of this research were to identify prognostic factors of severe psoriasis, compare the safety profiles of different therapy types (topical compounds, non-biologic systemic agents and biologic agents) and those of biologic agents themselves (adalimumab, etarnecept, infliximab, secukinumab, ustekinumab). A total of 289 psoriatic patients were followed up for 30 months; these were divided into 3 groups according to therapy type. Comorbidities, epidemiological parameters, and rates of adverse events were compared between the three groups and, also, between each of the 5 biologic agents, and the data were statistically analysed. It was concluded that psoriasis severity is directly related to an increased risk of cardiovascular disease, depression, hyperuricemia, and nonspecific noninfectious liver disease. Male gender, increased height, early age at disease onset, viral upper respiratory infections and periods of hormonal changes seem to be prognostic of higher levels of psoriasis severity. When comparing therapy types, biologic agents were the most effective therapies; however, they were associated with higher rates of...
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Longitudinal observation of parameters of dymanic postural stability on patients with sclerosis multiplex in terms of biological treatment
Krčíková, Barbora ; Vomáčková, Helena (advisor) ; Maršáková, Kateřina (referee)
Author: Bc. Barbora Krčíková Supervisor: PhDr. Helena Vomáčková, Ph.D. Title: Longitudinal observation of parameters of dymanic postural stability on patients with sclerosis multiplex in terms of biological treatment Objectives: The aim of this thesis is to describe the postural movement behaviour (independent of therapeutic intervention) in patients with multiple sclerosis referred for biological treatment. Methods: The study used longitudinal monitoring of fatigue and quality of walking in probands (n=2, female, ages 24 and 52) using the Multiple Fatigue Impact Scale (MFIS) and the Multiple Sclerosis Walking Scale-12 (MSWS-12) questionnaires, Longitudinal follow-up of changes in selected parameters of dynamic postural stability obtained on the NeuroCom SMART EquiTest System (Limits of Stability) and longitudinal follow-up of mobility tests using the T25FW (Timed 25 Foot Walk), 6MWT (6-minute Walk Test) and 5STS (5-repetition sit-to-stand test). Testing was conducted in the Applied Kinesiology Laboratory of the Department of Physiotherapy, UK FTVS. Each proband was asked to complete subjective questionnaires at each measurement, after which measurements were performed on the NeuroCom SMART EquiTest System using 7 protocols - Sensory Organization Test, Motor Control Test, Adaptation Test, Weight...
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Principles of complex physiotherapy in a patient with multiple sclerosis in the context of the clinical course of the disease
HODÁČOVÁ, Barbora
The topic of the bachelor's thesis is the principles of complex physiotherapy of a patient with multiple sclerosis in the context of the clinical course of the disease. The aim of the thesis was to provide a comprehensive view of the given disease, from diagnosis to treatment, where I focused on the possibilities of therapy on a neurophysiological basis. Multiple sclerosis is a chronic autoimmune disease for which there is currently still no causal treatment. As patients are often without clinical symptoms in the first years after diagnosis, they have the idea that they do not need to rush into long-term treatment. However, it has been proven that the only prevention of permanent neurological impairment is early diagnosis and almost immediate initiation of treatment, an integral part of which is physiotherapy. Together with pharmacotherapy and regimen measures, they give patients the opportunity to maintain a quality life. The practical part of this work was processed as qualitative research in the form of three case studies. More than one method of obtaining purposeful data has been used, the first was an analysis of the entire medical documentation, followed by an interview with the patient and taking a complete medical history, and finally a kinesiological examination was carried out. To evaluate the results of the four-month therapy an output kinesiology analysis was performed, which was compared with the input. From the results of the research, it was evident that therapies based on neurophysiology have the greatest impact in rehabilitation care. Since all three patients had difficulty with standing titubation, the therapy was partly directed at balance training using sensorimotor stimulation. Patients rated subjectively this concept as the most beneficial. Since the therapy was focused on all clinical symptoms comprehensively, the patients took away not only the possibilities of new exercise, but they got also educated about the correct movement stereotypes during normal daily activities in order to improve the overall state of health. The bachelor's thesis can serve as an inspiration for physiotherapists, what can be used in patients with multiple sclerosis and how to proceed in rehabilitation.
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Effect of biological treatment on functional ability and mobility of patients with ankylosing spondylitis
Hušková, Barbora ; Pavelka, Karel (advisor) ; Smolíková, Libuše (referee)
CHARLES UNIVERSITY IN PRAGUE 2ND FACULTY OF MEDICINE Department of Rehabilitation and Sport Medicine Barbora Hušková The influence of biological treatment on functional ability and mobility of patients with ankylosing spondylitis bachelor thesis Prague 2012 Abstract This thesis is primarily a literature search of knowledge about ankylosing spondylitis (AS), supplemented by two case studies of specific patients. The theoretic part describes the characteristics of AS as the main representative of spondylarthritides, including its diagnosis and testing methods. It also contains an overview of current approaches and strategies of a treatment. It focuses on biological treatment with TNF-α blockers. The practical part of the thesis illustrates the findings on the example of a patient with AS treated with biological therapy. It evaluates the subjective feelings in response to treatment and compares the results of treatment with standard therapy (i.e., without biological treatment) on another patient under otherwise similar conditions.
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Effect Multiple Sclerosis on activities of daily living
Němečková, Jana ; Nikodemová, Hana (advisor) ; Křivková, Jana (referee)
Bibliografický záznam NĚMEČKOVÁ, Jana. Vliv roztroušené sklerózy na aktivity denního života. Praha: Univerzita Karlova, 2. Lékařská fakulta, Ústav ošetřovatelství, 2016. 87 s., přílohy. Vedoucí bakalářské práce PhDr. Hana Nikodemová Abstract In my Bachelor thesis I examine the impact of Multiple sclerosis on a daily life activities. The intention is to present an overview of knowledge of the disease itself and map its impact on the activities of a normal day. The work is divided into theoretical and practical part. The introduction of the theoretical part is devoted to reasons of my decision to describe this topic, I define the aim of the work and the working hypotheses, subsequently there is described the disease itself in tabular form by each areas, such as the characteristics of the disease, duration of disease, diagnosis, treatment etc. Then I pay attention to daily life activities and needs of the patient. In the practical part is performed quantitative research through a questionnaire survey of patients from a specialized center for the treatment of demyelinating diseases in the Department of Neurology at the Motol University Hospital. The obtained data are presented in tabular and graphical reports. Keywords multiple sclerosis , activities of daily living, the impact of disease, attack, human needs
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Multiple Sclerosis: Corticoid and Biological Therapy, Importance of Pedagogy in Rehabilitation
Rosová, Anna ; Ehler, Edvard (advisor) ; Pavlasová, Lenka (referee)
The submitted thesis deals with the theme of a neurodegenerative autoimmune disease, the sclerosis multiplex. Although this serious disease has become an object of intensive research in recent decades and there is an inexhaustible quantity of literature available, we haven't yet fully identified the causes of this disease as well as we haven't found such kind of effective treatment that would lead to the permanent recovery of patients. I focused my interest on two main spheres: first, the description and comparison of practices in terms of pharmacotherapy giving priority to its benefits to patients, second, the view of another important but not always appreciated part of therapy, physiotherapy or rehabilitation; the main point is studying of processes and actions from the pedagogical point of view.
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Změny střevního mikrobiomu u pacietů s idiotypickými střevními záněty léčenými pomocí anti-TNF-α
Damašková, Dagmar ; Mrázek, Jakub (advisor) ; Drbal, Karel (referee)
English Abstract Crohn's disease together with ulcerative colitis, is a type of inflammatory bowel disease (IBD) with increasing incidence and prevalence in developed countries. IBD is an immunologically mediated multifactorial disease and it's mechanism of action is still unknown. Current well- established treatment targets the inflammation with corticosteroids and immunosuppressive drugs. Apart from the intestinal inflammation, which is the primary target of the treatment, patients are characteristically afflicted with intestinal dysbiosis. Therefore, possible interventions might be an adjuvant or biological therapy. Adjuvant therapy directly aims the microbiota with probiotics, whereas the target of biological therapy is TNF-α, a pro- inflammatory cytokine excessively secreted by macrophages. The aim of this thesis is to evaluate intestinal microbiota composition changes in IBD patients with regard to courses of adjuvant and biological therapy. Bacterial diversity was analyzed using three different DNA extraction techniques. Rapid beat beating + column (RBB+C) was chosen for analyzing patient samples, as it showed the highest DNA yield and the highest DNA purity. Primarily the bacterial diversity was analyzed using degradation gradient gel electrophoresis (DGGE) with subsequent sequencing of bands of...
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Intercellular interactions in malignant melanoma
Nedvědová, Tereza ; Dvořánková, Barbora (advisor) ; Brábek, Jan (referee)
Melanomas are one of the most aggressive types of tumours, with increasing incidence, high mortality and high potential to metastasize to a variety of diverse locations. The aim of this thesis was to study the tumour as a complex structure consisting not only of tumour cells but also of tumour stroma. Stromal cells play a major role in cancer biology. This is well documented for example in squamous cell epithelium tumours of the head and neck. Similar mechanisms can be expected to occur in melanomas. In the first experiment, we simulated the conditions in vivo during the metastatic process and studied the influence of non-adhesive environment both with and without the influence of stromal fibroblasts. The presented data demonstrates a change of tumour cells' phenotype leading to increased plasticity of the melanoma cells in these conditions. It also indicates the crucial role of stromal fibroblasts in interactions with melanoma cells. Cancer cell lines show variability in their behaviour, which is in accordance with well-known melanoma heterogeneity in clinical practice. The previous experiments in our laboratory indicate that cancer associated fibroblasts are able to influence the phenotype of a tumour cell line and this effect is based on a tumour type-unspecific mechanism. In the second part of...
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Case study of physiotherapy treatment of a patient with rheumatoid arthritis
Dostálová, Barbora ; Kozáková, Alena (advisor) ; Jarošová, Hana (referee)
Title: Case study of physiotherapy treatment of a patient with rheumatoid arthritis Aims: The main goal of my thesis was to use knowledge gained during studies of physiotherapy in a practical case of a patient treatment and to get feedback of the therapy that was used. The therapy included: an investigation, a proposal of the therapy, a procedure for the therapy and an evaluation of the effect of the therapy. Methods: The first part of my thesis is focused on the theoretical issue of rheumatoid arthritis. The main topic of this part is a clinical picture through which rheumatoid arthritis can come out. I also focused on arthral and non-arthral, neurological, symptoms. At the end of the thesis the physical therapy is discussed. The second part includes the actual diagnosis elaboration of a case study of physiotherapy treatment of a patient with rheumatoid arthritis. It was created during my practice in the Institute of Rheumatology in Prague, from 11th January until 21st January. The part includes an entry investigation, a short-term and a long-term therapy schedule, therapeutic units, an output investigation and an efficiency of the used therapy. The main aim of the therapy was to reduce pain and to restore the strength of muscles and the latitude of joints Results: With a high support of a medical...
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