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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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Determination and diagnostics of beta-hemolytics streptococcus in clinical microbiology
VOŘÍŠKOVÁ, Martina
The genus of Streptococcus includes gram-positive catalase of negative coccus, which rank into pairs and chains and their colonies are also sometimes very small in enriched soils. Most of species are selectively anaerobic. This genus includes a large number of species with different significance for people ´s disorders, and also the species significant for veterinary medicine. Beta-hemolytic or pyogenic Streptococci important in human medicine include first of all streptococci of A and B group. Streptococcus pyogenes (A group) is the cause of either localised purulent infections, or invasive and toxic diseases, and also late consequences of these infections. The carrying of beta-hemolytic streptococci of B group (Streptococcus agalactiae) is significant especially in pregnant women because it can threaten the mother and the newborn as well. They are the most important causers of newborn meningitis and sepsis. The aim of the thesis is to find out information of determination and detection methods concerning beta-hemolytic streptococci. It is necessary to devote our attention to each streptococcus and determine its type by cultivation, eventually by further supplementary methods. The main role in diagnostics is played by classical cultivation in common (blood agar) or special enriched soils. Each microbiological laboratory chooses its own laboratory procedures. The use of cultivation for capture of beta-hemolytic streptococci and determination of their types by PYR test (for the proof of A group streptococci) and latex agglutination (for confirmation of other groups) seem to be the most convenient. CAMP-test is still the most frequently used method for the proof of group B streptococci. For exclusion of later consequences the assessment of anti-streptolysin O (ASLO) or antideoxyribonuclasis B (ADNB) in serum are often used. All beta-hemolytic streptococci must be regarded as important pathogens namely in whatever locality, that is why the knowledge of basic and special laboratory methods which lead to identification of particular types of these streptococci is very important for clinical microbiology and the treatment of patients.
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