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The Effect of Selected Drugs on Bone Metabolism
Karešová, Iva ; Palička, Vladimír (advisor) ; Bayer, Milan (referee) ; Horák, Pavel (referee)
With an aging population and increasing life expectancy, osteoporosis represents a major global health problem. Currently it is estimated that more than 200 million people suffer from osteoporosis. Fractures due to osteoporosis are the major cause of morbidity and mortality in the elderly (Compston et al., 2019). A large body of evidence suggests an association between AEDs and bone abnormalities. The prevalence of osteoporosis and osteopenia in long-term treated epileptics is high. More than 50% of patients with epilepsy have low bone mineral density (BMD) (Ko et al., 2020). The aim of the dissertation was to evaluate the effect of orchidectomy and the effect of selected new antiepileptic drugs (zonisamide, gabapentin, pregabalin, levetiracetam) on bone metabolism in young Wistar rats. The negative effect on bone tissue after rat orchidectomy was confirmed after 12 weeks. Orchidectomy led to a statistically significant reduction in BMD and had a negative effect on the biomechanical properties of bones. Our results confirm that young rats after orchidectomy can be considered a suitable animal model for the study of osteopenia. After 12 weeks of administration of new antiepileptic drugs (zonisamide, gabapentin, pregabalin, levetiracetam), there was no statistically significant effect on BMD in...
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Indicators of systemic inflammation in spontaneous and instrumental delivery. Influence on neonatal concentrations of inflammatory markers.
Šibíková, Michaela ; Janota, Jan (advisor) ; Bayer, Milan (referee) ; Straňák, Zbyněk (referee)
8 ABSTRACT The inflammatory process, associated with endothelium activation, is one of the possible mechanisms of the initiation of spontaneous delivery. The mode of delivery may affect the concentrations of inflammatory molecules and microvesicles produced by endothelial cells. These biomarkes might be used to detect neonatal pathologies. The aim of our study was to assess endothelial biomarkers in cord and neonatal blood following different modes of delivery: i.e. spontaneus vaginal delivery and elective cesarean section. The study group consisted of neonates and their mothers after uncomplicated pregnancy and spontaneous vaginal delivery (spontaneous group) and after elective caesarean section (elective group). The patient samples were taken from the cord blood and from the peripheral venous blood of the newborns between 48- 72 hours of life. Soluble biomarkers were measured using a multiplex immunoassay based on the Luminex® xMAP platform. The concentration of microvesicles and surface antigen-specific microvesicles was determined by flow cytometry. We found significantly increased concentrations of cord blood soluble endothelial markers and cell-membrane derived endothelium specific microvesicles after spontaneous vaginal delivery compared to elective cesarean section. Irrespective of the delivery mode...
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Low Cardiac Output in Extremely Low Gestation Age Neonates and Intraventricular Haemorrhage
Miletín, Jan ; Straňák, Zbyněk (advisor) ; Bayer, Milan (referee) ; Zoban, Petr (referee)
This thesis is a commented monothematic collection of nine publications addressing cardiovascular assessment in preterm and term infants with a special focus on the immediate postnatal period. At the beginning, it provides a literature review of different modalities of Cardiac Output (CO) measurements in neonates, pathophysiology of Peri-intraventricular Haemorrhage (PIVH) in preterm infants and short review of the neonatal transition with some notes on role of the Patent Ductus Arteriosus (PDA). The main thesis is then divided into three logical parts. In the first and the main part, CO measurement possibilities in the neonatal period are reviewed and published with bioreactance identified as a novel emerging method of continuous CO assessment. The second study of this part is a prospective, observational cohort study in infants with a birth weight of less than 1250g. The CO was measured by bioreactance between 6 and 48 hours of age. Infants with PIVH and/or Necrotising Enterocolitis (NEC) had significantly lower CO compared to infants without these complications on day one of life. This low CO was then followed by a significant increase on day two of life. The third study is a prospective observational cohort study in near term and term infants undergoing Therapeutic Hypothermia (TH) for...
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The importance of tissue oxygenation changes in monochorionic twins for predicting severe neonatal morbidity
Korček, Peter ; Straňák, Zbyněk (advisor) ; Bayer, Milan (referee) ; Janota, Jan (referee)
Despite improvements in perinatal outcome in recent decades, multiple pregnancies are associated with increased risk of complications including preterm birth, fetal growth restriction (FGR) and twin-twin transfusion syndrome (TTTS). Fetal circulatory disturbances and immature cerebral vasculature increase the risk for serious perinatal injury and adverse neurodevelopmental outcome in multiple births. Cerebral oxygenation (crSO2) monitoring using near-infrared spectroscopy (NIRS) is increasingly used in high-risk infants. However, limited data are available in twin preterm infants with respect to cerebral tissue perfusion. The aim of this project was to measure crSO2 using NIRS in preterm monochorionic and dichorionic twins during the first 72 hours of life and find out correlation between underlying fetal conditions and crSO2 development. We divided the study population into 4 subgroups based on major fetal pathology: donor (1) and recipient (2) monochorionic twins (with TTTS), selective FGR infants (3) and twins without fetal compromise (4). We observed significant variation in crSO2 among the subgroups using mixed model analysis. The recipient twins exhibited the lowest crSO2 throughout the study period, whereas the FGR and donor twins presented with the highest values. Nevertheless, we found no...
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Thyroid Gland in Newborn
Krylová, Kateřina ; Bayer, Milan (advisor) ; Al Taji, Eva (referee) ; Hrstková, Hana (referee)
THYROID GLAND IN NEWBORN MUDr. Kateřina Krylová SUMMARY Normal thyroid gland function during pregnancy and in newborns is a basic condition for normal growth, development and neurologic status during childhood and adulthood. The thyroid function can be influenced by external factors (mainly iodine supplementation and maternal thyroid diseases) and by anatomic and functional development of the fetal thyroid gland. Thyroid gland begins to form from third to twelfth gestational week and fetal thyroid hormones are detectable after 12 weeks of gestation. Fetus is fully dependent on maternal thyroid hormones during the first half of pregnancy and on maternal iodine supplementation during the whole course of pregnancy. The Czech Republic is considered a country with sufficient iodine supply in the general population although pregnant women are a population group in risk of iodine deficiency. Maternal thyroid diseases and iodine deficiency can lead to more prominent disability in newborns with congenital hypothyroidism even when treated in time. The functioning screening of congenital hypothyroidism and timely treatment is effective protection of affected newborns. One part of the management of these newborns is causal diagnosis of the congenital hypothyroidism. We are able to distinguish between morphologic...
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