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Vasculature models to study thrombolysis
Schildová, Veronika ; Ambrožová,, Gabriela (referee) ; Víteček, Jan (advisor)
The theoretical part of diploma thesis describes the cardiovascular system and focuses on hemostasis. This is a complex of events which maintain functional blood circulation. Hemostasis includes procoagulant processes responsible for elimination of bleeding as well as anticoagulant processes maintain blood fluidity. If there is an imbalance between procoagulation and anticoagulation, thromboembolic or bleeding diseases will occur. This work is focused on one of the most fatal diseases, ischemic stroke, and its treatment by thrombolytics. These are drugs that accelerate the degradation of the blood clot and the recanalization of the blood vessel. This thesis describes the comparison of the only thrombolytic approved for ischemic stroke – alteplase and its mutant tenecteplase. The experimental part is focused on various types of in vitro models to the study of thrombolysis. These are static model, microplate model, thrombus penetration into fibrin gel and sequestration. Such models are used to compare thrombolytics.
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In vitro study of thrombolytic resistance in ischemic stroke
Hložánková, Anna ; Raptová, Petra (referee) ; Víteček, Jan (advisor)
Ischemic stroke is one of the most common causes of mortality and permanent disability worldwide. The most frequently used therapeutic approach in stroke treatment is enzymatic thrombolysis using recombinant tissue plasminogen activator – alteplase. Although alteplase is currently the only clinically approved thrombolytic for the treatment of ischemic stroke, its efficacy is limited. These limitations can be caused by several factors, including the structure and mechanical properties of the clot. The theoretical part of this bachelor thesis is focused on ischemic stroke, its enzymatic therapy, and on the study of factors affecting thrombolytic efficacy. The practical part deals with in vitro preparation of structurally variable clots and the characterization of the effect of their structure on the efficacy of thrombolytic agents and the mechanical properties of clots.
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Use of thrombolytics in prehospital emergency care
OHNESORG, Adam
The topic of this bachelor thesis is the use of thrombolytics in pre-hospital care.The theoretical part is focused on the anatomy and physiology of the cardiovascular system. The work presents recent information on anticoagulants, antiaggregants and indications for thrombolysis in pre-hospital care.The practical part of the bachelor's thesis was processed through a qualitative investigation, where semi-structured interviews were used. 13 paramedics from the Karlovy Vary region were involved in the research. The aim of the research was to find out the level of awareness of the paramedics about the issue of thrombolysis in pre-hospital care and to detect practical and theoretical obstacles to its use. The research investigation took place in March 2023. Each informant underwent the interview voluntarily. The resulting data from the interviews were analyzed and coded in the thesis. Subsequently, the data was divided into categories and subcategories. Two research questions were set in the research investigation. The first question focused on the awareness of paramedics about the possibilities of using thrombolytics in pre-hospital care. The second research question addressed barriers to use from a paramedic perspective. Among the obstacles, paramedics also included the small number of cases that require the use of thrombolytics and the resulting limited experience of doctors and paramedics. The main indication for the administration of thrombolytics in pre-hospital care is sudden the use of thrombolysis in acute myocardial infarction is not practically used. Paramedics demonstrated a not good awareness of the indications for thrombolysis and the risks associated with its administration. Due to the very rare administration of thrombolysis in pre-hospital care, it is certainly appropriate to carry out regular training on this issue for both paramedics and EMS doctors.
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Complications of systemic thrombolysis in patients with stroke
Drbohlavová, Šárka ; Di Cara, Veronika (advisor) ; Kulhavá, Miluše (referee)
Strokes are one of the most serious diseases that often lead to permanent disability and in some cases even to death. Currently, widely available treatment by intravenous thrombolysis is recommended. The objectives of this diploma thesis are to analyse complications that may arise for patients with iCMP treated by intravenous system thrombolysis, to define the role of a nurse in ICU in terms of taking care of this group of patients, and to map all the factors influencing the result of the treatment. In order to obtain the data necessary, combined research method has been applied. The quantitative part was retrospectively evaluated based on SITS Registry data. The research part comprised of patients, to whom IVT was applied between January 2014 and December 2015. The subjects of the analysis were treatment complications, gender of patients treated by IVT, risk factors present, time data, and heaviness of the deficit before the treatment and after. Furthermore, we observed where is the patient released to after IVT and how many patients are able to stay in home environments three months after the treatment. Qualitative part of the investigation was evaluated based on half-structured interviews with the nurses working in ICUs for highly specialized care for patients with stroke. We observed their...
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Strokes and the protocol of a stroke for Emergency Medical Services of the South Bohemian Region
SCHWARTZ, Kamila
The topic of this thesis are the Stroke and the Protocol of a Stroke for Emergency Medical Services of the South Bohemian Region. The teoretical part of this thesis includes basic anathomy and pathophysiology facts of brain necessary for understanding of a cerebrovascular accident. Afterwards the chapters are focused on the CVA itself. First of all are described the definition and a basic division of Strokes. In the next chapter are described possible high-risk factors leading to an inception of a cerebrovascular accident. The following topic is the Clinical Picture of Ischemic and Hemorrhaging CVA, diagnostic method used in a hospital facility. The important chapter is the therapy of a cerebrovascular accident in a preliminary medical care, there is also described the Protocol of a Stroke and potential patient's aiming to an acute medical treatment. The two last chapters are focused on a hospital medical treatement and after-care. The intention of this thesis is the maping of theoretical knowledge and differences in application of the Protocol of a Stroke aplicated by paramedics and nurses working in the Emergency Medical Service of the South Bohemian Region. We also wanted to evaulate a cooperation with Stroke Centers that can help to get the patient to undergo a medical performance as fast as it is possible which is essential for the patient and improves many times a future quality of life. Practical part tooks place by the method of a qualitative research. There were used semi-structured interviews with paramedics and nurses employed by Emergency Medical Services of the South Boheminan Region. The interviews included twelve questions concerning theoretical knowledge about the Cerebrovascular Accident, knowledge of the Stroke Protocol and filling in of of it, evaulation of co-operation and a telephonic consultation with Stroke Centers in the South Bohemian Region. Furthermore there was led a semi-structured interview with the doctor of the Complex Cerebrovascular Centre in České Budějovice and with the doctor of the Stroke Centre in Písek. The interviews consited of five questions concerning primarily a frequency of occurrence of the Stroke Protocol during the submittig of the patient and the evaulation of the consultation of patient's condition using the Stroke Telephone. Transcribed interviews are the component of practical part. The evaulated answers were catalogued into the charts for a better arrangement and orientation.
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The Work of the Nurse at the Stroke Unit
BROŽÁKOVÁ, Žaneta
The theme of the Bachelor degree work ?The Work of the Nurse at the Stroke Unit? was chosen as it deals with the interesting issue of the development of neurology medical branch which is closely connected with building ictus stroke units. These new units provide for modern treatment and nursing care in particular to patients suffering from the acute vascular cerebral accident ? stroke (ictus). The development of these units also supposes higher requirements for nurses both in the sphere of the theoretical knowledge and the practical skills. The theoretical part of the work deals with the general issue of ictus in the form of symptoms, diagnostics and treatment. Further, it informs us about the organization of the cerebral-vascular care in the Czech Republic and nurses´ competences in the selected nursing performances. Next, there is described the intervention of the nurse at the acute reception of the patient suffering from ictus and particularly the complex nursing care at the ictus/stroke unit accompanied with nursing diagnoses which occur at the patient suffering from ictus. The aim of the work was to find out specific features of the nurse´s work at the ictus unit from the nurse´s point of view and to map out nurse´s knowledge at the ictus unit from the nurse´s point of view. To accomplish both aims there were answered research questions. VO1: What nursing procedure is specific for the work of the nurse at the ictus unit? VO2: What nursing diagnoses are specific for patients at the ictus unit? VO3: What knowledge is required form the nurses working at the ictus unit? VO4: How does the nurse gain necessary knowledge for the work at the ictus unit? The practical part of the work provides a lot of information on the work of the nurse at the ictus unit from the nurse´s point of view. This detailed information was found out by means of the research investigation, the qualitative method in the form of interviews with nurses at the selected ictus units. The results of the research work are used for the compilation of the nursing standard of the care for the patient suffering from ictus during thrombolytic therapy. This standard provides nurses complex information and helps the patient to get high-quality and safe nursing care.
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Investigative CT algorithms for the early diagnosis of ischemic brain lesions
VOHNOUTOVÁ, Markéta
Stroke is the second most often cause of death in the Czech Republic after heart attack. It is not to say that older people are afflicted in particular. In the last period of ten years there are more often cases of stroke and ictus for people at the age of 40. The aim of this bachelor work is processing of knowledge acquisition in summary. The main point of this work is to evaluate the asset of new software programmes of multidetector computed tomography during early diagnostic of sudden strokes. In part of Present state there are following terms described in detail. It is etiology, aethiopathogenesis, risk factors of stroke. The next part is centred on anatomy of brain vascular supply and computed tomography Nowadays, software programmes have been improved enough for early diagnostics of ischaemic brain lesion. It is caused with continual improvement of diagnostic imaging and its digitalization. In many medical fields it has been spoken about new field of imaging - digital radiography. The computed tomography represents star part in the diagnostics, scanning of non-enhanced brain is the first period of the diagnostics, this algorithm shows us if it concerns haemorrhage or non-haemorrhage centre, continuing perfusion of brain which represents chat percent of tissue is damaged forever and it is finished with diagnostic process Angiography. The following part is focused on processing of data acquisition from České Budějovice Hospital, Inc. and Masaryk Municipal Hospital in Jilemnice. In these hospitals there are the numbers of patients examined CT compared. My hypotesis is confirmed and I can say that usage of new software programmes for early diagnostic of sudden strokes reduces per cent of complications during their cure.
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