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Physiotherapy for Stroke Patients in Chronic Stage Using the Methods of the Neurophysiological Basis
HANZALOVÁ, Jitka
The topic of the thesis is the physiotherapy based on neurophysiological methods for chronical stage stroke patients. The stroke is a lesion of a part of the brain tissue which develops suddenly from lack of blood perfusion in the area. The clinical manifestation of stroke can differ widely depending mainly on localization, extent, graveness and duration of the reduced blood perfusion or encephalorragia. This results in need of special rehabilitation programme made for each patient individually. The main principle of physiotherapy based on neurophysiological methods is prospering from plasticity of the neural tissue which is preserved in spite of severe injury of the brain. These methods influence control mechanisms in central nervous system by activation of various neural receptors. This therapy affects the patient complexly, it is not aimed at analytic muscle training. The purpose of this thesis was to prove and to evaluate the significance of the neurophysiological methods based physiotherapy for chronical stage stroke patients. The thesis consists of theoretical part and practical part. The theoretical part resumes information on the stroke, its risk factors, complications, consequences etc. The next part briefly describes some of the neurophysiological methods which can be used for the stroke rehabilitation. These particular methods were then utilized in the practical part during physiotherapy sessions with concrete patients. The theoretical part also informs about other means of complex rehabilitation which can be used for treating chronical stage stroke patients. The practical part records physiotherapeutical treatment with the patients. In the practical part of the thesis qualitative research method was used and following methodics: anamnesis, entering examination, special examination by Chedoke for hemiplegia scoring, the records of each therapy session and evaluating the effect of the therapy, which show that physiotherapy for stroke patients is meaningful in chronical stage as well and that the methods and concepts used are suitable. The thesis may serve as a source of information for healthcare professionals and other people taking part in care of the chronic stage stroke patient.
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Problems of renal tumours in patiens with terminal stadium of renal failure
Ürge, Tomáš ; Hora, Milan (advisor) ; Novák, Jaroslav (referee) ; Zachoval, Roman (referee) ; Morávek, Petr (referee)
Objective: Risk of renal carcinoma is minimal 10 x higher in group of patients in terminal stadium of renal failure (end stage kidney disease - ESKD). We have only some information about chromosomal changes in renal tubules, from which rise renal carcinoma, and about pathogenesis of renal carcinoma, which seems to be different from carcinoma in common population. Aim of the study: In clinical part we valorize characteristic signs of renal carcinoma in ESKD by using of statistic methods. In experimental part we can explain pathogenesis of this carcinoma by analysis of selective chromosomal aberations. Material, methods: In 2000 - 2007 were 184 patients with ESKD in care of transplant centre and nephrologic ambulation of Faculty hospital Plze_. In 15 patients we diagnose renal carcinoma. In this group we valorize: age, gender, causation of renal failure and dialysis duration. Age, gender and type of renal carcinoma we confront with carcinoma in common population. In experimental part we valorize numerical aberations in chromosome 7, 17 and Y of tubular epithelium using fluorescent hybridization in situ (FISH). Results: We have 15 patients in average age 55.7 ± 11.5 years, long of during dialyzation was 78 ± 54 months. We do not find dependence between causation of renal failure and genesis of renal...
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Application of selected conceptual nursing models on client with huntington's disease
Běhounek, Jan ; Židovská, Jana (advisor) ; Jirkovský, Daniel (referee) ; Jarošová, Darja (referee)
Bachelor thesis discourse possibilities of the usage of conceptual nursing models. Gordon's model is applied on client with Huntington's disease diagnosed in different stages of the disease. Johnson's model is presented on sample case reports. The focus of the thesis is a numeric representation of certain differences that the application of the Gordon's model bears. Namely - different level of cooperation and self sufficiency of patients with same primary diagnose. Surveyed sample included 5 men diagnosed with Huntington's disease, each in one of the five described stages of the disease. Two of them were receiving outpatient care, three of them were hospitalized in psychiatry clinic. Research study - The state of nursing documentation in Czech Republic, or more precisely - experience with practical application of mentioned concepts. The sample size included 108 healthcare providing institutions from Czech Republic, or more precisely opinion of head nursing representatives of these institutions.
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The dichotomic view on man in the chronic stage of the aphasia
Vondrášková, Dana ; Voldřichová, Michaela (referee) ; Housarová, Blanka (advisor)
The topic of this thesis is the life of people with aphasia, mainly in the chronic stage and the life of their partners. The introduction of the theoretical section of the thesis deals with the definitions of health and disease with emphasis on the medical, psychological and sociological perspectives. The theoretical section is based on the. wider concept of chronic disease. This thesis focuses on the quality of life of people with chronic aphasia that reflects many areas of everyday life. The emphasis is, first of all, put on family environment and friends. The practical section presents research focused on a two-sided view of the same disorder. How this disorder is perceived by a person with chronic aphasia and by his or her partner. The outcome of this thesis is the evaluation of the answers observed during the recorded discussions in each research area. Conclusions should provide a reflection on the life of the patients with chronic aphasia and their partners in all spheres of their lives.
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Feeding artery of vascular accesses for hemodialysis: model of arterial adaptation to high blood flow
Tuka, Vladimír ; Malík, Jan (advisor) ; Vízek, Martin (referee) ; Zicha, Josef (referee)
Background: Arteries adapt their diameter to changing haemodynamic conditions to maintain constant wall shear stress, the force generated by flowing blood on endothelial cells. The feeding artery of haemodialysis vascular accesses is a human model of arterial adaptation to chronically high blood flow and thus to high wall shear stress. The process of arterial adaptation is endothelium dependent. Endothelial dysfunction related to End-Stage Renal Failure, diabetes mellitus, dyslipidemia may impair also the dilatation of the feeding artery of vascular accesses. First the review of the literature presents in three parts different aspects of arterial adaptation: 1) arterial adaptation with focusing on the role of haemodynamic factors, 2) the influence of end-stage renal disease on arterial adaptation, 3) feeding artery of vascular accesses as a model of arterial response to chronic increase in blood flow. Methods: We examined the feeding artery of radial and brachial polytetrafluoroethylene grafts shortly after and one and two years after access creation. We used duplex ultrasonography to obtain internal diameter and blood velocity in the feeding arteries. We calculated wall shear rate as 4 x blood velocity / internal diameter and used it as approximation of wall shear stress. Results: In the first study we...
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Periodontal Disease of Dogs
Škutová, Šárka ; Barták, Miroslav (advisor) ; Olekšáková, Tereza (referee)
Periodontal disease (PD) affects periodontium and thanks to its prevalence it is considered to be one of the most occurred diseases in small animals and even in human. The uppermost etiological agens presents bacterial plaque. Bacterial plaque strongly accumulate if it is not eliminated and it might be the cause of development of gingivitis or even periodontitis over time.
The anatomy itself is relatively large, since the oral cavity is comprised of many kinds of tissues and a detailed description thereof would cover 70 pages at least. That is why the main aim of this work was to attempt to select the most basic information only.
Due to dividing of anatomical structures into bones, soft tissues, salivary glands and teeth, the individual components of supporting apparatus (periodontium) are not described in chapter called ,,periodontium,,. Here is explained its purpose and a description and function of periodontal ligament, which has not been included above. Particular attention was paid to the teeth. Determining the type and the number of individual teeth, the knowledge of their structure and the number of roots, all of that is important when it comes to a tooth extraction. The knowledge of tooth marking, dental formulas, identification systems and odontogenesis itself is equally important.
As for each disease, the etiology is the essential part for understanding the formation of disease. Bacterial plaque, which adheres to enamel of teeth is regarded (as already mentioned) as initial etiological agens. It can mineralize in tartar in varying degrees depending on every individual subject (animal). There are involved other risk factors at onset of the disease such as age, breed, number and line-up of the teeth, their pathology, diet, but also some diseases.
PD can be classified in two basic forms (gingivitis, periodontitis). Gum inflammation, or gingivitis, is often denoted as initial and totally reversible stage of disease. It is possible that there may not be present any symptoms or just slight redness at the beginning. Later stage leads to swelling, pain and significant bleeding, whereas it can manifest in periodontitis if therapy is absent.
Periodontitis affects the entire periodontium and it is often called as an irreversible stage. Although thanks to guided tissue and bone regeneration it is possible to achieve at least slight improvement these days. In most patients disease passes into chronic form, causes them not only pain during eating, but may also result in various systemic diseases. A special form which affects younger individuals is called ,,juvenile periodontitis,,. Diagnosis is primarily based on the medical history and examination of the oral cavity. Tartar index, gingivitis index, grades of tooth mobility and other parameters, which helps to determine the extension of disease and stage can be obtained using the intraoral radiographic, visual examination and measurement by periodontal probe. All collected information can be used to devise recommended therapy.
The sole therapy depends on the state of the patient and the requirements of the owner. It consists of several steps. The essence is especially removal of any deposits of bacterial plaque and tartar, correction of teeth pathologies (smoothing rough surfaces) and tissues pathologies to eventual tooth extraction. As part of the therapy may also be chosen application of antibiotics and other preparations supporting wound healing. Many specialists have been developing new treatments over the past 10 years, but most of them are still not fully finished. These include the development of vaccines, photodynamic therapy, or guided tissue and bone regeneration, which were already mentioned.
An integral part of therapy is home dental care. Without consistent home care there is a high probability of relapse.
An important weapon against the rise of PD are various preventive measures. The most effective method of prevention is probably regular tooth brushing using a brush and a special paste made for animals. However, many owners prefer to avoid this method. They rather elect to feed dry diets, dental treats and other products which help to reduce the amount of plaque and tartar. Another option is a professional teeth cleaning performed by a veterinarian.
A survey via questionnaire consisted of 16 questions, which were aimed at awareness of the disease, age, sex, breed, size, diet, preparations which help to control amount of plaque and tartar, systemic diseases and especially the presence of PD, age at first hit by disease, the circumstances of diagnosis, stage, treatment and relapse.
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Beast of prey herpesvirus infections
Zabranská, Dominika ; Karlasová, Barbora (advisor) ; Rozinek, Jiří (referee)
Viruses are a very heterogeneous group of microorganisms, which in many characteristics is different from bacteria. In 1957 André M. Lwoff formulated a general virus definition. Virus´s genome is the most important part of the virus from a biological point of view. Virus´s genomes can be divided in two groups according to their properties - DNA viruses and RNA viruses. General strategies of viral replication are very similar and they consist of several stages, which may be different in an order and duration. In 1973 International Committee on Taxonomy of Viruses was established, it has been still working as a primary source of information regarding the latest taxonomy of viruses. The name "herpesvirus" is derived from the word creeping (lat. herpes). Herpesviruses are large enveloped DNA viruses with two complementary strands. Replication of the virus takes place in a cell´s nucleus. A characteristic feature of the herpesvirus disease is a lifelong latent phase of the infection. Serious infection stages are observed primarily at young animals, fetuses, immunocompromised patients or as an associated disease in the course of other infections. Canid herpesvirus 1 and Felid herpesvirus 1 are classified in the genus Varicellovirus, in the subfamily Alphaherpesviridae and the family Herpesviridae.
Canid herpesvirus 1 (CaHV1) is a virus infecting mainly genital and respiratory parts; in a lesser extent it also causes eye diseases. It causes death mainly to newborn puppies. CaHV1 is a very demanding in terms of temperature and it can be killed by common disinfectants. It may be transmitted in several ways, including transplacental transmission from mother to fetus. The virus is ubiquitous with worldwide distribution. Since 2003 a vaccine for pregnant females has been available. The host range is generally limited to the family Canidae.
Felid herpesvirus 1 (FHV1) infects domestic and wild felines from the family Felidae. It is relatively unstable in the external environment, very sensitive to common disinfectants and high temperatures. Placental transmission from mother to fetus has not been confirmed. FHV1 is mostly excreted in the eye, nasal or oral secretions. The virus mainly infects the respiratory tract, conjunctiva and corneal epithelium. FHV1 is one of the most frequent and important viral pathogens of domestic cats throughout the world. Serious infection stages are observed primarily at kittens or debilitated animals. Several types of commercial vaccines against Felid herpesvirus 1 are available on the market.
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Stress and stress of emergency workers with the potential result of the/ burnout syndrome - the possibility of early diagnosis, treatment and prevention
Šeblová, Jana ; Kebza, Vladimír (advisor) ; Pokorný, Jiří (referee) ; Pokorný, Jan (referee)
The study was divided into 3 phases: the first stage was to create a simple and easy to use method to diagnose early signs of burnout and a sample of emergency services workers from the Czech Republic this methodology to verify and create a basis for future standardization. Furthermore, to determine the extent of exposure predefined risk factors (such indicators have been selected mass transport accident deaths of young people, treatment of burn trauma, death or severe injury collaborator) and his own threat level, associated with their work. The last of the surveyed areas were sources of stress and sources of satisfaction associated with the profession, as seen by the workers themselves. In the second part of the study should be developed in conjunction with the management of emergency services in place preventive programs and some programs, crisis intervention into practice. The third phase of the study should examine whether these support services affect the incidence of psychological manifestations of burnout and may help to reduce the psychological burden in terms of emergency services.
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