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Low microbial diet after bone marrow transplantation
PALOUDOVÁ, Karolína
Bone marrow transplantation is a complex intervention in the human organism that requires a few pre- and post-operative regimen measures. Regime measures also include a low-microbial diet, which is indicated for a period of 3-6 months. This is a strict dietary measure, about which the patient should be informed by a nutritional therapist or attending doctor. Adherence to a low-microbial diet includes strict hygienic and technological requirements for food preparation, but also a very limited food selection. The theoretical part discusses the bone marrow transplantation, types of transplantation, the course of treatment and possible complications. Following on from the most common complications, another section is devoted to food-borne infections and other gastrointestinal problems. The final section focuses purely on the low microbial diet. Individual nutrients, procedures for the technological preparation of dishes and other options for nutritional care are detailed here. The practical part, which is carried out in the form of qualitative research, is divided into two parts. The first part is devoted to case reports, where the basic information and eating habits of the patients, obtained based on an interview, are mentioned. In the second part, the respondents' answers and their weekly meal records are evaluated. The research shows that all seven respondents followed a low-microbial diet for at least 100 days after the transplant. The analysis of the menus shows that most of them do not meet their daily energy needs. A big problem is the monotony of the menu, which can be caused by a diet, a limited choice of food, the disease itself, or lack of appetite. The work can raise awareness of this diet and, based on the booklet created, help people who have been indicated for a low-microbial diet.
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Growth in children after allogenic hematopoetic stem cell transplantation
Tomešová, Jitka ; Sedlak, Petr (advisor) ; Keslová, Petra (referee)
Nearly 80 % of child oncological patients survive treatment nowadays and live in adulthood. Therefore, one of the main current children's oncology task is not only to cure the patient but to assure the life after treatment in as highest quality as possible. Related to the quality of life is the adequate adult body height which is in these children after hematooncological treatment ussualy known as impaired. The aim of this diploma thesis was to specify the frequency and level of impaired final body height in children after hematopoietic stem cell transplantation, and find its relation to sex, diagnosis and age at the time of transplantation. Thesis criteria met 89 children (35 female), who recieved the hematopoietic stem cell transplantation between years 1989 and 2012 in University Hospital in Motol, Prague. Children were observed prospectively in Laboratory of Clinical Anthropology of the Pediatric Clinic of University Hospital in Motol since the date of their transplantation till they reach their final body height. Each survey consists of the measurement of body height and weight, BMI calculation, Tanner pubertal stages and bone age assessment by the TW3 method. These, completed by clinical data about diagnosis, growth hormone deficiency treatment, and menarche in girls, were compared to the...
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Growth in children after allogenic hematopoetic stem cell transplantation
Tomešová, Jitka ; Sedlak, Petr (advisor) ; Keslová, Petra (referee)
Nearly 80 % of child oncological patients survive treatment nowadays and live in adulthood. Therefore, one of the main current children's oncology task is not only to cure the patient but to assure the life after treatment in as highest quality as possible. Related to the quality of life is the adequate adult body height which is in these children after hematooncological treatment ussualy known as impaired. The aim of this diploma thesis was to specify the frequency and level of impaired final body height in children after hematopoietic stem cell transplantation, and find its relation to sex, diagnosis and age at the time of transplantation. Thesis criteria met 89 children (35 female), who recieved the hematopoietic stem cell transplantation between years 1989 and 2012 in University Hospital in Motol, Prague. Children were observed prospectively in Laboratory of Clinical Anthropology of the Pediatric Clinic of University Hospital in Motol since the date of their transplantation till they reach their final body height. Each survey consists of the measurement of body height and weight, BMI calculation, Tanner pubertal stages and bone age assessment by the TW3 method. These, completed by clinical data about diagnosis, growth hormone deficiency treatment, and menarche in girls, were compared to the...
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NURSING CARE OF PATIENTS WITH HEMATOLOGICAL MALIGNANCIES IN THE INTESIVE CARE UNIT
Dolinská, Michaela ; Hošťálková, Monika (advisor) ; Kukol, Václav (referee)
NURSING CARE OF PATIENTS WITH HEMATOLOGICAL MALIGNANCIES IN THE INTENSIVE CARE UNIT Michaela Dolinská, DiS. ABSTRACT Overall survival and quality of life of the patients with malignant diseases, especially with hematological malignancies, have improved significantly in the last years. Early diagnosis and aggressive treatment, including the hematopoietic stem cell (bone marrow) transplantation modality, have led to the increase survival rate of such patients. Simultaneously, these opportunities generate increasing number of individuals requiring the intensive care due to various complications of malignant disease and/or its treatment. This bachelor thesis is designed as theoretical-empirical study. The theoretical part provides the review and analysis of current literature and discusses particular specifics of nursing care of patients with hematological malignancies in the intensive care setting. Pancytopenia- associated immunosuppression and infection risk, the need of barrier-approach principles of nursing care will be described. Next, bleeding conditions and restricted transfusion politics, telling unfavorable information to the patients and their families and last but not least the palliative care principles are reviewed too. The empirical part of the thesis is processed as the qualitative research in...
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Transplantace kostní dřeně příjemcům s regenerující krvetvorbou: účinnost transplantace a stav regenerující kostní dřeně
Forgáčová, Katarína ; Nečas, Emanuel (advisor) ; Vávrová, Jiřina (referee) ; Hofer, Michal (referee)
Hematopoietic stem cells (HSCs) have the ability of both self-renewal and differentiation. After bone marrow damage, surviving host HSCs or transplanted donor HSCs are able to restore hematopoiesis and maintain it for a long time due to the self-renewal potential. HSCs reside in a specific microenvironment in the bone marrow, in stem cell niche, which supports their survival and controls their functioning. In this study, we investigated the impact of bone marrow damage induced by increasing doses of irradiation on engraftment efficiency of transplanted donor repopulating cells. Using the CD45.1/CD45.2 congenic mouse model, we developed a new approach enabling estimation of surviving HSCs in damaged hematopoietic tissue. Its principle is in measuring of the donor chimerism resulting from transplantation of a defined dose of normal congenic bone marrow cells. The transplanted donor cells contain repopulating cells, progenitors (STRCs) and HSCs (LTRCs) that give rise to blood cell production which proceeds in parallel with that present in the host hematopoietic tissue. We applied this approach to monitor spontaneous regeneration of repopulating cells, including HSCs, in mice irradiated with a sublethal dose of 6 Gy or by a lethal dose of 9 Gy and rescued by syngenic bone marrow cells. This was...
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Effect of the pretransplantation conditioning on the effectiveness of bone marrow transplantation in a mouse model
Renešová, Nicol ; Šefc, Luděk (advisor) ; Průcha, Miroslav (referee)
Hematologic malignancies are among the most often diagnosed forms of cancers. Treatment regimens often utilise various combination of cytostatic drugs and total body irradiation and subsequent transplantation of hematopoietic stem cells. One of the most common combinations includes ionising radiation with the antineoplastic alkylating agent cyclophosphamide. In this study we used congenic Ly5.2 and L5.1 mouse strains that express different isoforms of CD45 antigen to evaluate the effects of various time interval between cyclophosphamide and irradiation treatments on the viability of hematopoietic stem cells and their viability. This was done by competitive repopulation assay. The results revealed that level of engraftment and subsequent reconstitution of hematopoiesis can significantly vary and depend on the time interval between cyclophosphamide and total body irradiation administrations. The results indicate that patients with hematologic malignancies could possibly benefit from the treatment especially if they received transplants after being irradiated five or seven days after cyclophosphamide because at that time point their own stem cells would be least competitive. Key words: bone marrow transplantation, cyclophosphamide, chimerism, hematopoietic stem cells, ionising radiation
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Opportunistic parasites of the patients with transplants and other immunosupressed individuals
ZAJÍČKOVÁ, Petra
The main objective of this study was to establish the rate of occurrence of opportunistic parasites in patients with bone-marrow transplants. As a result of reduced immunity due to immunosuppresive therapy, these patients are more susceptible to multiple infections, in particular to infections caused by opportunistic parasites. The parasites were detected using MIFC sedimentation, staining according to Miláček-Vítovec and Calcofluor staining. These methods were used to investigate a total of 100 samples, of which 4 were positive for the presence of microporidia. The presence of microsporidia in the four samples was confirmed with polymerase chain reaction (PCR). Occurrence of other opportunistic parasites was not confirmed. Microsporidia were found in 7,4% of patients with bone-marrow transplants. This fact was rather surprising as the increasing number of patients with suppressed immunity is associated with increased occurrence of these opportunistic parasites as well. The results of this research might be used not only as educational material for the undergraduates of the Faculty of Health and Social studies, but also for the public concerned with this issue.
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