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Complex Evaluation of Immune Defects in Patients with Chronic Lymphocytic Leukemia
Vodárek, Pavel ; Belada, David (advisor) ; Doubek, Michael (referee) ; Papajík, Tomáš (referee)
Complex evaluation of immune defects in patients with chronic lymphocytic leukemia MUDr. Pavel Vodárek Abstract of dissertation thesis Chronic lymphocytic leukemia (CLL) is associated with significant combined immunodeficiency. Amongst most important immune defects are hypogammaglobulinemia and changes in relative and absolute counts of different lymphocyte populations and subsets. As consequence of these changes, there can be higher frequency of infections and progression of CLL itself. The impact of chemoimmunotherapy (CIT) on immunoglobulin (Ig) levels and lymphocyte populations has not been extensively studied. In this dissertation thesis, we analysed Ig levels and lymphocyte populations (using flow cytometry) in 45 patients with indolent untreated CLL and 90 patients with progressive disease indicated for treatment. In 58 patients, we evaluated the impact of first-line CIT. For lymphocyte populations' analysis, we had also cohort of 34 healthy controls. Patients with progressive disease had significantly lower levels of all Ig classes and subclasses than patients with inactive disease: IgG, median 6.96 vs. 9.86 g/l, p=0.0001; IgA, median 0.63 vs. 1.53 g/l, p<0.0001; IgM, median 0.36 vs. 0.57 g/l, p=0.0035. After treatment, median IgA increased from 0.59 g/l to 0.74 g/l (p=0.0031). Other Ig classes and...
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Monogenic susceptibility to infectious pathogens
Bloomfield, Markéta ; Šedivá, Anna (advisor) ; Koziar Vašáková, Martina (referee) ; Litzman, Jiří (referee)
(ENG) The modern approach to studies of monogenic inborn errors of immunity, driven by unprecedented advances of genetic tools, opens vast undiscovered areas of immune system components and functions. In particular, the diseases with striking clinical phenotypes with normal or near normal baseline immunophenotype, such as disorders of innate and intrinsic immunity with susceptibility to single pathogen, provide a unique window into the host-pathogen interactions. This thesis covers various novel aspects of immunopathology, genetics and clinical facets behind some such diseases, namely chronic mucocutaneous candidiasis due to hypermorphic (gain-of-function, GOF) STAT1 mutations, which hamper Th17-associated immune activities, and Mendelian susceptibility to mycobacterial diseases (MSMD) due to impairment of IL-12, IL-23/IFNγ signalling pathway. Moreover, it contributes to the mounting evidence that IL- 6 signalling is non-redundant in anti-staphylococcal immunity. Finally, it explores the novel Paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS- TS) as a single pathogen-driven life-threatening immunopathology, which most likely develops due to individual, yet unknown, genetic predisposition. The findings presented in this thesis were in several cases translated...
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Nurse's knowlege how to care for peripheral or central catheter
Fialová, Denisa ; Tomová, Šárka (advisor) ; Nikodemová, Hana (referee)
One of the basic skills of nursing staff is the knowledge of how to care for venous catheters. It is one of the important aspects of the care process. The aim of this work was to compare two different treatment units. III. Chirurgickou kliniku 1 LF UK a FN Motol and Interní kliniku 2 LF UK a FN Motol. The research was planned at I. Chirurgická klinika 2. LF UK a FN Motol, but I didn't receive an answer with an agreement. The next goal was to compare which clinic has a richer experience. To find out, whether the intensive care unit has higher quality care compared to the standard unit. The theoretical part describes different options for how a venous catheter gets inserted. There are introduced kinds of venous catheters, that are available nowadays. They have also mentioned their benefits for patients. Venous catheters may be divided based on the duration they can remain in the human body. In this chapter, there are described convenient locations for inserting, indications, contraindications, and correct techniques of how to care for the venous catheters. In the empirical part, there is the research of my own design included. It contains graphs and tabular protocol with results. The questionnaires were distributed among employers of mentioned clinics. The results of this research point out that...
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Use of barrier nursing care techniques in outpatient services
ŠAFÁŘOVÁ, Marie
This bachelor's thesis is about using barrier nursing care techniques in outpatient services. The first part describes the present situation, which includes single techniques of barrier nursing care, namely mechanical washing of hands, using personal protective equipment, disinfection, sterilization, and manipulation with used medical materials. The next part of the thesis is about applicable legal norms which are related to these issues. The thesis also has a part about the role of the nurse in outpatient services and the nursing process. The separate chapter is also devoted to nosocomial infections. In the second part are definitions of three targets. The first is to find out which types of protective equipment are used by nurses in outpatient services. The second target is to find out how nurses use hand hygiene techniques and the third is to find out which way nurses are manipulating used medical materials. The third part describes research methods. For qualitative research, the investigation was by deliberately selecting seven outpatient services in the territory of the capital city of Prague. The data collection technique is a semi-structured interview and participatory observation of a nurse working in outpatient services. The research was focused on the use of protective equipment, hand hygiene by nurses, and manipulation of used medical supplies. The fourth part contains the results of the research investigation, which are analyzed in the subsequent discussion, which provides a comparison of current legislation, literature, and results from practice. The conclusion of this thesis is that some techniques of barrier nursing care, namely proper hand hygiene, use of protective equipment, and compliance with some legislative standards in the field of prevention of the risk of infection, are not yet so included in the automatism of nurses working in outpatient services. The output of this thesis is a draft of a workshop on the topic of the thesis, especially hand hygiene and prevention of infection transmission.
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Spontánní regrese rakoviny
RADOVÁ, Lenka
The main goal of this thesis is to find and gather documented cases of spontaneous cancer regression without targeted therapy. Based on the case studies, this thesis aims to categorize individual cases and explain spontaneous regression at the immunological level. According to the findings, we will attempt to evaluate whether the observed cases of cancer regression would find experimental or clinical use.
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Epidemické modely s vakcinací a behaviorálními změnami
LUNGA, Petr
Compartmental models used in mathematical epidemiology were studied in order to learn about basic principles of those models and to create new ones. First two chapters are about basic SIR model, it's history and analysis. Next chapters then contain models with behavioral changes and vaccination. Models were illustrated by simulations created in the software AnyLogic.
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The care of a patient with prosthetic joint infection
BLÁHOVÁ, Zdeňka
This diploma thesis deals with the care of a patient with an infected endoprosthesis. It focuses mainly on how these patients are informed about the prevention of an infected endoprosthesis, how they evaluate the care of nurses and how are they manage the treatment of an infected joint replacement. The theoretical part of the thesis, deals with the description of the terms of infection and joint replacement infection. It also deals with the classification, diagnosis and treatment of infected endoprostheses. The next chapter focuses on the role of the nurse in the care of patient with infected endoprosthesis. It describes the prevention of creation of an infected endoprosthesis, nursing care and nursing diagnoses in a patient with an infected endoprosthesis. Three goals were set: Firstly to determine the level of awareness about the prevention of postoperative complications in patients with infected endoprostheses. Secondaly to find out how patients with infected endoprostheses evaluate the care of nurses. Third goal was to find out how patients manage the treatment of an infected joint replacement. The research part was processed using a qualitative research survey. The research was carried out using semi-structured interviews, which were then analyzed using the pencil and paper method. The interview was created from 23 questions, which were then divided into three categories. The research part raised an awernees that most respondents were given information about postoperative infectious complications by a doctor. The doctor devotes enough time and space to the respondents during the information and explains everything to them sufficiently and clearly. Another finding was that the vast majority of respondents were sufficiently informed about the need to undergo an examination at the dentist, or possibly undergo another professional examination. Furthermore, it was found out that general nurses do not sufficiently inform patients about antiseptic shower and preparation of the operating field, even though these activities can greatly influence the development of an infected endoprosthesis. In contrast, there have been found out that nurses are providing sufficient information to patients on how to care for a scar and the symptoms that may signal the presence of an infection. The interviews pointed out, how the respondents evaluate the care of nurses during hospitalization. The respondents were especially satisfied with the professional approach of the nurses, quality communication with the nurses during hospitalization and protection of intimacy, during general hygiene. It showed that all respondents trust the abilities of nurses and doctors in this hospital. It was also found out how the respondents manage the treatment of the infected joint replacement. The vast majority of patients that had been interviewed managed the treatment period very hard. The most difficult for the respondents during this period were restricted movement, inability to take care of themselves, pain and poor mental health during treatment. Lastly, it was found out what the result of the treatment was from the patient's point of view. Most respondents have been satisfied with the outcome of the treatment. The majority of respondents provided information that the results of the treatment of an infected endoprosthesis did not significantly affect their quality of life and that they can walk without any support.
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Selected nursing services in the context of Evidence Based Nursing
KRATOCHVÍLOVÁ, Gabriela
The thesis deals with the issue of selected nursing processes in the context of Evidence Based Nursing. The process in question is the care of central venous entry and peripherally placed central entry in relation to the incidence and prevention of central line associated infections. One of the aims of this paper is to map and analyse information on central line entry care. Other objectives are to determine which central line entry care is most effective in relation to infection incidence and to provide an overview of the interventions provided in central line care that are absolutely necessary and essential. The thesis is divided into several chapters which are structured around Evidence Based Nursing. The chapter describing the current state of the art outlines Evidence Based Nursing, invasive admissions and catheter infection. Chapters dealing with the education of general nurses in relation to central line nursing competency are presented, the area of infection and its prevention, the site and method of central line insertion, the type and characteristics of the central line catheter, dressing and draping techniques, disinfection, and the issue of flushing and needleless entry are discussed. The last chapter reviews education, care training and training in the care of central venous accesses. The information sources were searched from all over the Word in scientific databases. Several recommendations for practice have been established based on the development of this thesis. The thesis can be used as educational material and be an inspiration in the issues of different practices and education in this field.
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Newborn Care Safety from Mothers' Perspective
HIPPMANNOVÁ, Sonja
Current Status: The need of safety and security is one of the basic needs of a newborn. The nurses' role is to assess the level of education need in a newborn baby care and educate the mother accordingly, using a suitable method. The aim of the research was to assess the level of knowledge of mothers in a newborn care safety in home environment. Methodology: The study used quantitative method of research, using the technique of non-standardized survey. The selection of the respondents was intentional. The focus group were mothers of physiological newborns (N=300), that gave birth in Hospital in Jablonec nad Nisou between 15.11. 2020 and 30.1.2021. Results: Approximately half of the respondents (52 %) claimed that the benefit of postpartum bonding between a mother and her newborn is promotion of creation of breast milk. Only 45 % of respondents claimed that they wash their hands longer than 30 seconds and less than 1/5 of all respondents follow all six steps of proper hand washing. Less than half of the respondents (45 %) consider sleeping position on stomach or side of a newborn as a risk factor of SIDS. More than half of the respondents (60 %) knew how to resuscitate a newborn. The share of mothers in age category between 18-25 who answered wrong questions asking about CPR of a newborn was statistically significantly greater (p = 0,035) than share of mothers in higher age category. Respondents whose postpartum hospitalization lasted more than 72 hours claimed greater satisfaction with education in breast care statistically significantly more often (p = 0,029) than mothers hospitalized for shorter time. Respondents with primary level of education answered wrong questions asking about manipulation with a baby on a changing table statistically significantly more often (p = 0,046) than mothers with higher levels of education. Mothers having a fourth baby answered correctly question if blisters are a symptom of omphalitis, statistically significantly more often than mothers with less children (p = 0,014). Conclusion and Utilisation in Practice: Based on results of the research was created educational material "At Home with a Newborn Baby. A Few Handy Tips".
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Functional and pathological changes in the stomach of hosts infected with gastric cryptosporidia
MARKOVÁ, Marie
The aim of this study was to observe and record the effect of infection with gastric species of the genus Cryptosporidium on the gastric characteristics of their hosts. The species Cryptosporidium proliferans was used for a series of experimental infections, and three types of model hosts - BALB/c mice, C57Bl6 mice and multimammate mice (Mastomys coucha) - were used as experimental animals. Oocysts were detected in the faeces of infected animals by standard parasitological, specific staining and molecular methods and the course of infection and pathogenicity of the Cryptosporidium species were described. Groups of animals comprising of 1-3 animals were humanely euthanized at seven-day intervals up to 70 days after infection. C. proliferans was found to have a direct effect on pH change in selected host types, with an increase in pH at the peak of infection and, depending on the host type, either an increase until the end of the experiment or, in the case of self-healing, a gradual return to physiological values. Pathological changes of the gastric mucosa during the course of the infection were recorded by histological methods, which were its thickening and increased mucus production, as well as the presence of inflammatory infiltrates and the intensity of the infection, to varying degrees across the selected hosts and the course of the infection. We found that even with short-term infection in BALB/c and C57Bl6 mice, there is both mucosal enlargement and thickening, although the pathological changes in these types of mice are not as extensive as in multimammate mice, which do not self-heal.
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