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Diagnosis and therapy of Helicobacter pylori infection
POSPÍŠILOVÁ, Michaela
H pylori is a Gram-negative, microaerophilic rod-shaped moving bacterium, notorious for its urease production. It colonizes gastric mucosa and always leads to chronic gastritis, which may result in the development of other serious diseases, such as gastroduodenal ulcer disease and gastric adenocarcinoma. In 1994, H pylori was classified as a category 1 carcinogen. H pylori infection can be tested for invasively and noninvasively. The invasive methods include cultivation, histological examination and a rapid urease test. Noninvasive options are the carbon urea breath test, a stool antigen (HpSA) test and a blood antibody test. H pylori is sensitive to betalactam antibiotics. These should therefore be the essential part of the treatment; the instances of resistance are rare. Should the patient be allergic to betalactam antibiotics, nitroimidazoles can be used instead. H pylori is also sensitive to macrolides. The objective of my bachelor thesis was to acquire practical knowledge necessary for the correct processing of stool and serum samples in laboratory practice. I also intended to describe current trends in diagnosis and treatment of H pylori infection, together with the infection rates depending on age, sex and the season of the year. The findings were discussed in the context of relevant academic literature. Finally, I monitored the ways in which gastroduodenal ulcer disease caused by H pylori infection is diagnosed and treated by gastroenterologists in České Budějovice. The collection of the data for quantitative research was carried out between 1 January 2012 and 31 December 2012 in the microbiological laboratory Synlab czech s.r.o. in České Budějovice, which covers the whole of the South Bohemian Region. The samples were supplied mostly, but not exclusively, by GPs, and two methods of medical examination (euroSCREEN HP and EIA Helicobacter MONO IgG) were used. EuroSCREEN HP is based on the stool antigen (HpSA) detection, EIA Helicobacter MONO IgG is an immunoenzymatic method detecting IgG antibodies against H pylori in human serum or plasma. The data for qualitative research were collected in gastroenterologic ambulances in České Budějovice. Guided semi-structured interviews were carried out with one doctor in each ambulance. The acquired data were then processed as case studies and used to obtain categorization tables. The quantitative research confirmed all three hypotheses subject to evaluation. Higher age groups were found to have higher infections rates. However, no effect of either sex or the season of the year on the infection rates was registered. The qualitative research showed that gastroduodenal ulcer disease is most frequently diagnosed by České Budějovice gastroenterologists by the means of a biopsy check during gastroscopy. The samples are then sent to a microbiological laboratory for cultivation, histological examination and a rapid urease test. H pylori infection is usually treated by the standard triple therapy: amoxicillin, clarithromycin and a proton pump inhibitor. In case of hypersensitivity to betalactam antibiotics clarithromycin, a proton pump inhibitor and metronidazole are used instead. Occassional resistance to metronidazole and clarithromycin was reported. In these situations, cultivation is carried out in order to determine the sensitivity to antibiotics. The effects of the eradication treatment are evaluated by the means of a biopsy check during gastroscopy 6-8 weeks after its application. The samples are analysed in a microbiological laboratory. Some gastroenterologists also use a stool antigen (HpSA) test.
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Current problems of zoonoses in the Czech Republic and the risks associated with them
SOUMAROVÁ, Michaela
Both wild and domestic animals can be the source of severe infections, such as the viral, bacterial, fungal, and parasitic human infections, that are called zoonoses. Zoonoses are infections being transmitted naturally among the animals and people in a direct or indirect way. Currently there are more than 200 known zoonoses. Within the Czech Republic, the most frequent zoonotic diseases are campylobacteriosis, salmonellosis, listeriosis, Lyme disease, tick-borne meningoencephalitis, tularemia, ornithosis, toxoplasmosis, and leptospirosis. Some zoonoses have already been eradicated from our territory (brucellosis, rabies). Immunosuppressed individuals belong to the main vulnerability group. Due to the changes of climate conditions and travelling to exotic countries, the diseases previously unrecognized in our conditions occur. Actual problem is represented by the increasing resistance of microorganisms to antibiotics. Monitoring is a tool for the assessment of zoonoses and their prevalence and sources, as well as for the determining the level of their risks. In the Czech Republic monitoring is provided by the veterinary administration.
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The Costs Analysis of Colorectal Cancer.
Bednářová, Martina ; Lešetický, Ondřej (advisor) ; Břehovský, Miroslav (referee)
The topic of this dissertation paper is the evaluation and comparison of costs related to the treatment of colorectal cancer in a sample of therapeutically significant groups of patients who were treated in the hospitals in Jindrichuv Hradec and Ceske Budejovice. Particular groups differ by the type of treatment used in this case and it is possible to distinguish patients with initial, advanced and most advanced stages of the illness.
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Life with pulmonary hypertension observed in the IKEM, Prague
KLOPOTOVÁ, Michaela
This undergraduate work deals with the issue of pulmonary hypertension monitored in clients at the Institute of Clinical and Experimental Medicine (IKEM) in Prague. The theoretical portion deals with the comprehensive issue of pulmonary hypertension {--} its aetiology, pathogenesis, pathophysiology, epidemiology, classification, clinical picture, examination methods, therapy and prognosis. It also covers its health and social aspect, which is further divided into its health and social impact. The health and social aspect is divided into health and illness, health support, prevention and quality of life. The health impact focuses on nutrition, physical activity, natural medications, colds and depression. The social aspect explores the social effects on health, illness and social benefits for clients with pulmonary hypertension. The practical portion of this work presents the results from a quantitative questionnaire carried out with clients monitored at IKEM Prague between 1 July 2008 and 28 February 2009. The purpose of the questionnaire was to establish whether patients with pulmonary hypertension often suffer from depression, whether the illness affects their health and social status and whether clients have sufficient information about pulmonary hypertension. The results show that the objectives were fulfilled. It has been proved that clients with pulmonary hypertension suffer from depression, their health and social status is also affected by the illness and most of them have sufficient information about pulmonary hypertension. This work can serve as a well-arranged source of information for different cardiology departments that deal with pulmonary hypertension. I am sure that the clients themselves would like to see the results of this work, let alone the Association of Pulmonary Hypertension Patients. This association follows not only specialized literature, but also the quality of life of and benefits for people with pulmonary hypertension.
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Incidence of Blood-Born and Sexually Transmitted Infectious Diseases with Focus on HBV and HCV in the Central Bohemia Region.
VELEKOVÁ, Petra
Viral hepatitides B and C are among the most widespread and at the same time most serious blood-born and sexually transmitted infectious diseases. The World Health Organisation considers the incidence of both infections to be an epidemic and, according to its estimates, there are 2 billion of people infected by hepatitis B virus and over 170 million of people infected by hepatitis C virus worldwide. Viral hepatitides B and C are diseases infecting the liver frequently becoming chronic and presenting a major factor in hepatocellular carcinoma development. Acute hepatitis C allegedly develops into chronic condition in approximately 85 % of CASE, and around one third of chronic hepatitis C patiens develop cirrhosis and many of them a liver carcinoma. There is a direct correlation between the incidence of acute hepatitis B developing into a chronic condition and possibly leading to cirrhosis or a hepatocellular carcinoma and the patientś age, it is indicated at 90 {--} 95 % in neonates, at 25 {--} 50 % in 1 to 5-year-olds, at 5 {--} 10 % in older children and adults. These diseases also have considerable socioeconomic impacts. Vaccination has been the most effective preventive measure agains viral hepatitis B, so far, no effective vaccine has been found for hepatitis C virus. The fundamental precautions against both types of viral hepatis consist in non-specific prevention related to the means of transmission of infection, namely avoiding contact with blood and other body fluids of any infected person. Both hepatitis B and C are most frequently trasmitted parenterally, by means of sexual intercourse, vertical transmission is less common. Before the introduction of screening tests for blood donors, viral hepatitides B and C were most frequently transferred via blood transfusion. At present, intravenous administration of illicit drugs presents a major risk factor due to sharing needles, syringes and other instruments among users. The theoretical part of the thesis summarizes present day knowledge on viral hepatitides B and C. The practical part focuses on the incidence and means of transmission of viral hepatitis B and viral hepatitis C in the Central Bohemia Region within a 10-year period. I also aimed to examine viral hepatitides B and C transmission risks awareness, and safe-sex rules observation among a selected group of the Central Bohemia population.
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Public awareness of drug problems in České Budějovice district
KOZLOVÁ, Lucie
ABSTRACT Addictive drugs are all around us and they have become a part of our lives. The issue of drug abuse is of critical importance, global, and difficult to solve. Typically, drugs are categorized as tolerated or not tolerated by society, and more or less risky. It is vital, therefore, to know the attitude of public to the issue. Lots of drug abuse causes have already been revealed, just like the reasons why some users develop addiction while others do not. In all probability the abuse of drugs or the addiction development cannot be put down to a single background factor. Everything will depend on personality traits of the individual, on his or her environmental conditions, and on specific effects of the drug. Since I take much interest in these issues, I have chosen for my thesis the subject of Public awareness of drug abuse issues in the District of České Budějovice. I investigated what people knew about drug abuse at the District where I live; their opinions of drug abuse; whether they believed that drug abuse deteriorated social position of an individual; whether they believed it boosted the rate of crime; if people were informed about facilities assisting recovery from drug addiction within the District of České Budějovice; and, last but not least, whether they suspected what drugs could come in their way here. The thesis aimed to examine what people knew about the drug abuse issues in the České Budějovice District. This objective has been met. Fifty three percent of respondents were found well informed on the subject, while the remaining 47% lacked the information. The survey was to prove or disprove hypothesis that the public was unaware of organizations providing help to drug addicts - the hypothesis was not confirmed since 51% of respondents were informed about the relevant organizations and 49% were not. Another hypothesis predicted that the public could not tell the illegal drugs from the legal ones - it was not confirmed as the public was found sufficiently informed. The hypotheses expecting the public to believe that drug abuse drives crime and deteriorates the addict's social position were confirmed by the bulk of respondents living in the District of České Budějovice. Ninety nine percent of the respondents believed the drug abuse pushed up the crime rate and 95% were of the opinion that it affected the addict's social position. As follows from the survey, the public in the České Budějovice District was relatively well informed of the drug abuse issues, though the differences encountered between awareness and unawareness of the subject were just minor. I intend to release the thesis as an information source for the general public(in the form of brochures, internet publications or periodicals); moreover, I want to offer the results to organizations engaged in the drug abuse treatment and to students of the University of South Bohemia to serve as training material. The public will find a wealth of important drug-related information in the paper, while the addiction treating organizations will be prompted to fill the gaps still existing in information available to the general public.
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Ecological and epidemiological aspects of tick-borne encephalitis
GREGOROVÁ, Eva
Tick-borne encephalitis (TBE) virus is endemic in many countries in central, eastern and northern Europe. Nowadays its importance rises because of its increasing incidence. This study focuses on characterization of tick-borne encephalitis virus, its host and human disease caused by this pathogen and efficacy of available vaccines. Furthermore, an evaluation of climatic changes and their influence on TBE incidence is discussed.
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Education and Training in Medical Informatics, Statistics and Epidemiology, at the EuroMISE Center
Zvárová, Jana ; Hanzlíček, Petr ; Peleška, Jan ; Štefek, Martin ; Švejda, David ; Tomečková, Marie ; Zvára Jr., Karel ; Choura, Michal ; Gula, Pavel
In the paper we show the different activities of the EuroMISE Center in the field of medical informatics, statistics and epidemiology education and training. The development of these activities has started within TEMPUS-PHARE project and is continuing with the support of IT EDUCTRA (Fourth Framework Programme) project. New approaches using Internet and new developed programmes are described.
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Incidence and prevalence of a disease in a district hospital over 3 years.
Matoušů, Barbora ; Střítecký, Rudolf (advisor) ; Lešetický, Ondřej (referee)
Branches of science such as epidemiology, clinical epidemiology, statistics and various statistical methods are by ground for activity of epidemiological-manager indicators. Incidence and prevalence are numbered among epidemiological-manager indicators. In condition of hospital Pelhřimov are these indicators written, analyzed and predicated for department of hospitalized in years 2005 -- 2007. At the same time is appraised use of capacities department of hospitalized, is made analyse and estimation of most often treated diagnosis and is watched progress their average time of treatment. The watching indicators are by one of series others records for manager decision-making by control of hospital.
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