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Ethicotherapy in Conception of Vladimír Vogeltanz
Laňková, Renata ; Klimešová, Anna (advisor) ; Sivek, Vojtěch (referee)
I wrote about ethicotheraphy because I'm interested in psychosomatic view of diseases in my work. In the first part I focused on a historical view of connection among body, soul and health. There are also chapters in which I introduced history of psychosomatic approach and ethicotheraphy generally with its methodical approach. In the second part I compared a relationships between the doctors with their patients and the ethicotherapists with their clients was compared, too. I described the ways of work in the ethicotheraphy and their clients and I mentioned a profit of disease. In the third part I wrote about a cancer in ethicotheraphy view. I wanted to show how difficult is to treat these disease all the other incidental difficulties. Powered by TCPDF (www.tcpdf.org)
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The hip fracture register, optimalization of hip hemiarthroplasty position
Skála - Rosenbaum, Jiří ; Bartoníček, Jan (advisor) ; Chomiak, Jiří (referee) ; Janeček, Miloš (referee)
The study examines the monocentric epidemiological data of patients with hip fractures from 1997-2007. Adult patients treated for hip fracture between the years 1997-2007 were included in the study. Retrospective statistical assessment of continually gathered data focused on epidemiology and demographics. The second part of the study was concerned on risk factors on protrusion of hemiarthroplasty into the acetabulum. The goal was to specify exact indication, proper operative technique and selection of the implant. The study involved 3 683 patients (2 678 women, 1 005 men). Patients older than 70 years accounted for 82 % of all cases. There was an increase in the number of hip fractures resulting in a significant increase in pertrochanteric fractures (AO-31A1+2) (p<0.001). The ratio of trochanteric to neck hip fractures increased from 0.99 to 1.53. Continual monitoring of patients with hip fracture offers data which allows comparisons between regions and countries. The importace of a continual increase in the number of hip fractures has its importance in macroeconomical planning in traumatology. Hemiarthroplasty was conversed to total hip arthroplasty in 12 patients in our department. The indication, time period to conversion and hemiarthroplasty position were retrospectively assessed. The direction of...
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Chamber music - development of musicality and creativity
Klinecká, Magdalena ; Tomášek, Jiří (advisor) ; Palkovská, Jana (referee)
This work treats of chamber music in several points of view. First, it deals with chamber music in itself; second, with its relation to the interpret; third, with its reference to the audience. Concerning the relation between the interpret and chamber music, we recognize different stages and levels of its prosecution - by children, pupils, amateurs and professional musicians. Further, we detect the impact of chamber music on a person listening to it. We find the positive influence of that music on diseased or handicapped people. We get knowledge of various competitions for chamber ensembles. In the end we acquaint with playing chamber music within my "initial" family and with an extract from arrangement of folksongs for children.
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Molecular factors of artherogenesis in chronic kidney disease with experimental model of chronic inhibition of Nitric Oxide Synthesis and its Effect of HMG-CoA reductase inhibitoin
Lecian, Dalibor ; Matouš, Bohuslav (advisor) ; Tesař, Vladimír (referee) ; Zadražil, Josef (referee)
The experimental part of the thesis covered the markers involved in nitric oxide deficiency model in rats. The analogue of arginine N-nitro- L -arginine-methyl ester ( L -NAME) was used. L -NAME administration resulted in sustained elevation of BP, decreased GFR, and in higher albuminuria compared to control animals. The administration of hypolipidemic drug - atorvastatin to Wistar rats was studied. The statin used caused lower albuminuria and prevented decreases in GFR in L -NAME rats without having an impact on hypertension. CAV1 protein expression was similar in all groups of rats. In contrast, VEGF expression and RhoA activity was increased in L -NAME-treated animals, and normalized with coadministration of atorvastatin. Clinical part of the thesis focused on the analysis of markers of oxidative stress in obese and non-obese patients with CKD and after kidney transplantation. The patients with CKD had elevated serum concentrations of AGEs, sRAGE and ADMA with the maximal concentrations of AGEs in the patients on hemodialysis. The successful kidney transplantation decreases the AGEs, sRAGE and ADMA concentrations but not to normal value according to general population. Patients with obesity exhibited lower concentrations of sRAGE in CKD as a protective factor for cardiovascular disease. Concentrations of...
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The endocrine function of adipose tissue and its importance for initiation and development of insulin resistance and diabetes
Haluzík, Michal ; Schreiber, Vratislav (advisor) ; Marešová, Dana (referee) ; Šeda, Ondřej (referee)
Endocrine production of adipose tissue is a very complex process affected by numerous endogenous and exogenous stimuli. Peroxisome proliferator-activated receptors-alpha (PPAR-) are important modulators of metabolic processes which can also affect endocrine function of adipose tissue. Recently, numerous novel factors produced by adipose tissue with important metabolic effects were identified. Some of them can directly bind PPAR receptors. One of the examples of these factors is fatty acid binding protein 4 (FABP4) which can directly bind PPAR receptors and indirectly modify its activation by changing availability of endogenous PPAR ligands -free fatty acids. We hypothesized that the mechanism of action of PPAR receptors to metabolic processes may partially lie in their complex interaction with adipose tissue-derived hormones. The unraveling of these interactions may have important consequences in finding approaches to treat patients with type 2 diabetes mellitus. (...) In summary, our data show an important role for the interplay of PPAR activation and endocrine function of adipose tissue in metabolic regulations which may have important clinical consequences.
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Toxicity of chemoradiotherapy in patients older 60 years with rectum cancer
BABOROVÁ, Monika
The Czech Republic belongs to countries with high incidence of rectal cancer . Annually, 2600 cases of rectal tumors are detected. In the Czech Republic the rectal cancer is the second most frequent tumor disease in men and women. Mortality is also high, it is the cause of more than 4000 deaths per year. The treatment of particular malignant tumors combines radiotherapy and chemotherapy. The reason for combining radiotherapy with chemotherapy is the enhanced treating effect on the tumor tissue while adverse effects on healthy tissues are still bearable. The administration of appropriate cytostatics may potentiate the effect of the combined treatment. The method of concomitant chemoradiotherapy leads to better therapeutic effects in patients. However, the combined treatment is more toxic both for the tumor and the patient´s healthy tissues in areas affected by both the curative methods.
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Precaution of catarct surgery complication: Intraoperative Floppy Iris Syndrome
Damdinragchaa, Selenge ; Ernest, Jan (advisor)
Billowing iris syndrome ( Intraoperative floppy iris syndrome , IFIS ) is a condition that predisposes to the formation of perioperative complications during surgery cataracts. The syndrome is characterized by insufficient mydriasis before surgery, constriction of the pupil during surgery , inability to extend her stretching, unusual elasticity of the pupillary margin and surging and billowing iris with tendencies to prolapse . The syndrome was first detected in 2005 patients treated for prostatic hyperplasia treated with α1 blocker tamsulosin ( Flomax , Omnic ) . Following a worldwide three-year research demonstrates that IFIS may be adversely effect and other α1 -blockers , such as antihypertensives , antipsychotics and antidepressants . It turns out that the best prevention of complications during cataract surgery field IFIS is especially well collected by pharmacological history ophthalmologist and close collaboration with urologists and other specialists. good awareness allows you to get time to select another operating procedure
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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