|
|
Methods of Segmentation and Identification of Deformed Vertebrae in 3D CT Data of Oncological Patients
Jakubíček, Roman ; Flusser, Jan (referee) ; Kozubek, Michal (referee) ; Jan, Jiří (advisor)
In this doctoral thesis, the design of algorithms enabling the implementation of a fully automatic system for vertebrae segmentation in 3D computed tomography (CT) image data of possibly incomplete spines, in patients with bone metastases and vertebral compressions is presented. The proposed algorithm consists of several fundamental problems: spine detection and its axis determination, individual vertebra localization and identification (labeling), and finally, precise segmentation of vertebrae. The detection of the spine, specifically identifying its ends, and determining the course of the spinal canal, combines several advanced methods, including deep learning-based approaches. A novel growing circle method has been designed for tracing the spinal cord canal. Further, the innovative spatially variant filtering of brightness profiles along the spine axis leading to intervertebral disc localization has been proposed and implemented. The discs thus obtained are subsequently identified via comparing the tested vertebrae and model of vertebrae provided by a machine-learning process and optimized by dynamic programming. The final vertebrae segmentation is provided by the deformation of the complete-spine intensity model, utilizing a proposed multilevel registration technique. The complete proposed algorithm has been validated on testing databases, including also publicly available datasets. This way, it has been proven that the newly proposed algorithms provide results at least comparable to other author’s algorithms, and in some cases, even better. The main strengths of the algorithms lie in high reliability of the results and in the robustness to even strongly distorted vertebrae of oncological patients and to the occurrence of artifacts in data; moreover, they are capable of identifying the vertebra labels even in incomplete spinal CT scans. The strength is also in the complete automation of the processing and in its relatively low computational complexity enabling implementation on standard PC hardware. The system for fully automatic localization and labeling of distorted vertebrae in possibly incomplete spinal CT data is presented in this doctoral thesis. The design of algorithms enabling the implementation utilizes several novel approaches, which were presented at international conferences and published in the journal Jakubicek et al. (2020). Based on the results of the experimental validation, the proposed algorithms seem to be routinely usable and capable of providing fully acceptable input data (identified and precisely segmented vertebrae) as needed in the subsequent automatic spine bone lesion analysis.
|
|
|
Role of nurses in postoperative care in patients with lung cancer.
PLECEROVÁ, Jana
At present time the lung/ bronchial carcinoma is the most frequent malignant disease but not only in our country but worldwide. It is an insidious disease that at the beginning is asymptomatic (i.e. without clinical symptoms), however it has an extraordinary unfavourable prognosis. The lung/ bronchial carcinoma is painless disease therefore the sick people (adversely affected by lung/ bronchial carcinoma) do not suffer from any significant health trouble for very long time. In a later stage some of the patients realize the fact, that they are facing some health troubles. They find out that something go wrong as far as their health condition is concerned, the most frequent case is reported as breathlessness or difficulties in breathing in general. Their difficulties in breathing is frequently attributed to their weight, physical strain, stress, workload, work environment they work in. These patients usually make an appointment with the physician not sooner than they observe further manifestations of the illness which testifies to advanced stage of the illness, however. These symptoms often are the following: haemoptysis, rhonchus/hoarseness, chronic cough, dysphagia, pains, loss of weight. The lung carcinoma is frequently discovered on a random basis within a preoperative preparation for another surgical intervention i.e. the centre of lung carcinoma is identified when heart and lungs are X-rayed. The very sad moment of this disease (lung carcinoma) is the fact that overwhelming majority of the patients bring about this insidious illness or contract the illness themselves. The reason is smoking. Present youth regard smoking fashionable and modern. They feel and perceive smoking as their need to try something new and majority of them persist with smoking. They become smoking addict and only small percentage of them seek a help or assistance of an expert in making people give up smoking. In the past we encountered the diagnosis of lung carcinoma with the patients whose age fell in between 60 (sixty) and 70 (seventy). At present time the patients with such a diagnosis are rather younger. Their age fall within the interval 40 (forty) and 50 (fifty). I can express my belief that the public should be not only better informed but also keep informed about the life-threatening lung carcinoma, malignant lung tumour, ways and means of healing, primary and secondary prevention and help and assistance in making people to give up smoking. The public should be informed and be kept informed about risk factors that lead to the origin and development of this insidious disease. The media should do whatever possible to present statistics, research investigations dealing with the origin and development of lung carcinoma, case reports regarding patients with this diagnosis. Several years ago, there were cigarette packets provided with various pictures on them presenting risks of smoking as well as possible complications and troubles accompanied with smoking including lung carcinoma. Unfortunately, this campaign did not achieve such effect as it had been expected. This diploma work has been worked out by focusing on theory. Its goal is to present the problem of lung carcinoma, malignant lung tumours in the Czech Republic and in the world. The crucial area of the diploma work is devoted to the surgical therapy of the lung carcinoma, malignant lung tumours that is subject of permanent development and still brings new pieces of knowledge in the field of therapy of lung malignity. Another aim of this diploma work is to clarify, map out and visualize the position and role of nurses in postoperative care for the patients with lung carcinoma/ tumour. The conclusion of the diploma work focuses on specific questions and requirements of the palliative care and its models. This diploma work makes it possible to get an overall view of the specialized field of malignant lung tumours, their statistics, the numbers of which has been rising.
|
|
|
Problems of breakthrough pain in cancer patients
TOMŠÍČKOVÁ, Lenka
Objectives: The diploma thesis deals with the occurrence and treatment of breakthrough pain in patients treated for cancer. The role of the nurse is irreplaceable in the issue of breakthrough pain, because the competences of nurses include the recognition and satisfaction of needs, which includes the need for pain relief. The aim of the thesis was to find out the experience of nurses related to the care of patients with breakthrough pain. Then to further describe the experience of patients themselves with breakthrough pain and with the pain treatment with transmucosal administration of opioids. Methodology: A qualitative form of research was chosen to fulfill the objectives of the thesis. Obtaining information was ensured using the method of semi-structured interviews with fifteen nurses and case studies in five patients. For the case study, data were obtained from the medical records of the participating patients in combination with interviews with these patients and the nurses caring for these patients. The choice of suitable participants was chosen by deliberate sampling. The data obtained were then analysed using open coding, a method called "pencil and paper". Results: The research part shows that the treatment and overall nursing care of patients with breakthrough pain is very demanding. However, the participating nurses mention the fact that treatment is often managed through erudite doctors of the facility using various forms of treatment. The nurses also mention that the interventions they can use to relieve pain within their competencies are usually not sufficient in the area of breakthrough pain. This statement is supported by information obtained from the patients themselves. The results also show that physicians in the facilities where the interviewed nurses work prefer other forms of drugs to treat breakthrough pain to transmucosally administered opioids. At the same time, however, the case study revealed that the participating patients are satisfied with this treatment form of breakthrough pain, as evidenced by the answers of the patients themselves and nurses. The thesis also documents the finding that nurses are very important in evaluating the effectiveness of pain treatment or in education about the use or application of specific dosage forms. Contribution of the thesis: Information about breakthrough pain and experience with its treatment, which is dealt with in the theoretical and research part, can be a source of instruction for health professionals and lay people. The results also allow to create a comprehensive overview of the issue of breakthrough pain.
|
|
|
Methods of Segmentation and Identification of Deformed Vertebrae in 3D CT Data of Oncological Patients
Jakubíček, Roman ; Flusser, Jan (referee) ; Kozubek, Michal (referee) ; Jan, Jiří (advisor)
In this doctoral thesis, the design of algorithms enabling the implementation of a fully automatic system for vertebrae segmentation in 3D computed tomography (CT) image data of possibly incomplete spines, in patients with bone metastases and vertebral compressions is presented. The proposed algorithm consists of several fundamental problems: spine detection and its axis determination, individual vertebra localization and identification (labeling), and finally, precise segmentation of vertebrae. The detection of the spine, specifically identifying its ends, and determining the course of the spinal canal, combines several advanced methods, including deep learning-based approaches. A novel growing circle method has been designed for tracing the spinal cord canal. Further, the innovative spatially variant filtering of brightness profiles along the spine axis leading to intervertebral disc localization has been proposed and implemented. The discs thus obtained are subsequently identified via comparing the tested vertebrae and model of vertebrae provided by a machine-learning process and optimized by dynamic programming. The final vertebrae segmentation is provided by the deformation of the complete-spine intensity model, utilizing a proposed multilevel registration technique. The complete proposed algorithm has been validated on testing databases, including also publicly available datasets. This way, it has been proven that the newly proposed algorithms provide results at least comparable to other author’s algorithms, and in some cases, even better. The main strengths of the algorithms lie in high reliability of the results and in the robustness to even strongly distorted vertebrae of oncological patients and to the occurrence of artifacts in data; moreover, they are capable of identifying the vertebra labels even in incomplete spinal CT scans. The strength is also in the complete automation of the processing and in its relatively low computational complexity enabling implementation on standard PC hardware. The system for fully automatic localization and labeling of distorted vertebrae in possibly incomplete spinal CT data is presented in this doctoral thesis. The design of algorithms enabling the implementation utilizes several novel approaches, which were presented at international conferences and published in the journal Jakubicek et al. (2020). Based on the results of the experimental validation, the proposed algorithms seem to be routinely usable and capable of providing fully acceptable input data (identified and precisely segmented vertebrae) as needed in the subsequent automatic spine bone lesion analysis.
|
|
|
Fatigue in cancer patients
NEJEDLÁ, Gabriela
This bachelor thesis deals with the topic and problematics of the role, aspect and contribution of the proffesional nurses in the case of the oncology patient's fatigue.. The aim is To find out not only what are the possibilities of influencing the whole process of onkology patients' fatigue but how they are applied in practice as well. Furthermore the process of how is the cancer patients' fatigue documented and evaluated is also pointed out as well as the patients' perception of tiredness. In the practical part of the thesis was used qualitative research in the form of semi-structured interviews. The research group consisted of nine nurses and nine patients of selected oncology departments in the Czech hospitals. The choice of all the respondents was deliberate. The given interviews were processed by the open coding technique using pencil and paper. Nine categories were created during the process of evaluation of the interviews with nurses. Patient interviews were evaluated in seven categories. Some of the groups are divided into subcategories according to their specialization. The research shows that this - the whole process of fatigue is a symptom that is often neglected by nursing staff. The research also points out has shown that nurses do not follow up with assessing and recording fatigue in the patient's documentation as they should. They don´t carry out all possible interventions to affect fatigue. The results also showed that the majority of nurses do not educate the patients about the possibilities of affecting tiredness despite the fact that the nurse can influence not only the patient's physical condition but the psychological state as well by good nursing care, which is directly reflected in the level of patients' fatigue.
|
|
|
Výživa onkologických pacientů
Grossová, Lucie
The aim of the thesis was to create nutritional recommendations for patients with cancer and to develop sample menus for these patients. The first chapter is devoted to a general description of cancer. Also described herein are outer and genetic factors involved in the occurrence of cancer diseases. Other chapters deal with the evaluation of nutritional status of cancer patients and complications that may accompany patients with insufficient nutrition. The fourth chapter describes the possibilities of nutritional support for cancer patients. The last chapter includes nutrition recommendations and Nutriceutics selected which have a protective effect against some types of cancer.
|
|
|
Nutrition of oncology patients in palliative care
TICHÁ, Miroslava
Nutrition of oncological patients in palliative care is a serious global problem, and therefore, I decided to make a reseach and learn more about this problematics. Although treatment of cancer in this time has moved forward, cancer spread throughout the world in relatively high values. This work is divided into two parts, while in the theoretical part is described the way the disease spreads, what is the percent incdence, prevalence and mortality in the Czech Republic. Next, what symptoms are associated with this disease malnutrition, cachexia, nausea, and other. The most important part of this thesis is description of the nutritional recommendation, witch is specified for each patient individually associated in regards with enteral and parenteral nutrition, as proper nutrition can affect not only the physical needs, but also psychological and also improve the overall condition of the patient. The described care and its division is the last point in the theoretical part. The current way of eating of oncological patients in palliative care was the aim of the practical part of the thesis. My research questions are: 1. How does the disease affect the appetite of the patient in palliative care? and 2. Which component of the patients diet is deficient? The topic was processed in a way of qualitative reseach of 6 oncology patients at palliative department, I used interviews and questionnaires with patients and medical staff. I reviewed the menus in the program Nutriservis and the general condition of patients using a scale of most common symptoms. According to the results, the majority of patients ranged under the limits of standards, with protein energy malnutrition, which was caused by a lack of food rich in protein and also opioids medication which can affect appetite or symptoms associated with this disease.
|
|
|
Medical communications with oncological disease patients.
SLABOVÁ, Markéta
The aim of this thesis is to find out the current state of communication between paramedic and patients with cancer. This work created a manual which is going to be a hand book for nurses who encounter them selves with serious or incurable sick people. In this hand book can nurses find principles of communicaton with oncological patients. The theoretical part contains information about problematic of communication, types of communication or purpose of communication. It also contains issues of oncological diseases, their causes, diagnoses, treatment and an increase in the Czech Republic and in the South Bohemian Region. Theoretical part also deals with process of approach and communication with oncological patients and with posssibilities of care for incurable sick people. Empirical part is based on research of several issues which should accomplish two elected objectives. The research questions are answered using qualitative research through halfstructured interviews by nurses and oncological patients. Data were congregate during February and March 2016 in two South Bohemian hospitals. After the processing of interviews in Microsoft Office Word were created identification data of respondents and nurses. The objectives of bachelor thesis were approached witch qualitative research. The analysis of interviews was done by using categorization of data and subsequent encoding. Data analysis showed that patients are satisfied with the communication and attitude of medics. Nurses are against burnout syndrom very resistant.
|
|
|
The role of nurse in nutrition for cancer patients
KUBÁTOVÁ, Aneta
Thesis: The role of the nurse in the nutrition of cancer patients. Nutritional issues concerning cancer patients are often discussed in recent years and they are still a current theme of debates. The results from surveys of recent years show the seriousness of the situation and urge to its fast solution. The situation is not favourable: the nutritional care in oncology is still underestimated, even though it forms significant foundation for the general success of treatment
|
|
|
Needs of Oncology Patients in Ambulatory Care
CHOVANOVÁ, Martina
The number of people diagnosed with cancer is constantly rising. According to the World Health Organization (WHO), this disease will affect four times more people within the next ten years. Therefore it is advantageous to invest time and energy to identification of oncology patients' needs. Systematic evaluation and planned fulfillment of needs are the key element of modern nursing. One of the biggest challenges of the 21st century is proper classification of cancer treatment. However, this challenge is a tough one, which is confirmed by the fact that patients need to undergo a complex procedure including a correct diagnosis, surgical treatment and curative care together with supportive and palliative care. What is more, patients meet a number of specialists during this process. The aim of this Bachelor's thesis was to: 1) Identify the needs of oncology patients in ambulatory care. 2) Determine the possibilities of need satisfaction among patients. This objective consists of four research questions. Question 1: What are the specific needs of cancer patients in ambulatory care? Question 2: How can we achieve maximum fulfillment of their needs? Question 3: What are the relationships of oncology patients with patients suffering from the same or similar disease? Question 4: Where do patients get all the necessary information about their disease? The research was conducted by means of a qualitative survey consisting of interviews with cancer patients. The interviews took place from January to March 2015. The obtained data were then processed using the pen and paper method. Next, these data were entered into individual schemes. The research group consisted of eight oncology patients. The results will be used as a support text for establishing a social day care services in Chrudim.
|
guest ::
