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Major dietary mistakes in patients with primary aldosteronism and essential hypertension
Hampl, Petr ; Petrák, Ondřej (advisor) ; Krátká, Zuzana (referee)
Abstact Arterial hypertension is one of the most serious risk factors for cardiovascular complications in the form of stroke, heart failure, ischemic heart disease, and other manifestations of atherosclerosis. Damage caused by the disease increases over time due to asymptomatic course and interaction with other risk factors, especially dyslipidemia, insulin resistance, smoking habits, or obesity. These combinations of risk factors, together with hypertension, further multiply the overall cardiovascular risk of sufferers. Although arterial hypertension is influenced by pharmacological treatment and lifestyle modification, its high prevalence represents a serious health problem in both the Czech Republic and in other developed countries. This bachelor thesis aims to evaluate the eating habits of patients with essential hypertension, a multifactorial form of the disease without a specific causing cause, and of hypertonics with primary aldosteronism, which arises on the basis of autonomous overproduction of aldosterone. Although this form of disease has a specifically treatable cause, its course and organ complications are often more serious than those of essential hypertension. Dietary habits, together with adherence to other nonpharmacological measures, can largely moderate the manifestations of the disease...
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Prognosis in Ischemic Stroke Patients and Related Prognostic Faktors
Kielbergerová, Lenka ; Rohan, Vladimír (advisor) ; Holečková, Irena (referee) ; Petrák, Ondřej (referee)
Stroke is a significant cause of morbidity and mortality in the developed world. In the theoretical part of the thesis, we try to summarize the overall knowledge of stroke, the definitions and the general approach to the diagnosis and treatment, with a focus on ischemic stroke. Furthermore, the issue of acute phase treatment and secondary preventive treatment of ischemic stroke is reviewed and the modalities of the subsequent neurological deficit evaluation, the occurrence of mood disorders and the assessment of the quality of life of individuals after stroke are discussed. Our research aimed to assess the perspective of ischemic stroke patients admitted to the hospital. The first part is focusing on the mortality of patients with ischemic stroke in the period 2003-2019 in the Westbohemian region and its relation to secondary prevention. The second part aims to identify the main clinical and psychosocial factors affecting the quality of life of chronic stable post-stroke patients after their first in-life episode of stroke. The relation of poor quality of life indicators, mortality and conventional cardiovascular risk factors is prospectively assessed. The mortality of patients after first-in-life ischemic stroke hospitalization the years 2003- 2019 is higher compared to worldwide trends. In the...
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Salt intake by patients with primary hyperaldosteronism
Sahatciu, Mrika ; Petrák, Ondřej (advisor) ; Krátká, Zuzana (referee)
1 Abstract My bachelor's thesis focuses on the intake of table salt and other dietary approaches and habits in patients with primary aldosteronism, an extreme form of salt-sensitive hypertension. The theoretical part deals with the definition of the term and risk factors associated with primary aldosteronism, summarizes the diagnosis and treatment procedures especially dietary measures which are very important in the treatment. The practical part was based and developed using an anonymous questionnaire form. The questionnaire consisted of 66 questions ranging from sociodemographic to awareness, education, dietary habits and dietary preferences in relation to salt intake. The purpose of this study was thereby to determine the dietary habits and sodium chloride intake of patients with primary aldosteronism. The total number of patients who were approached was 15, mostly males which were 11 and females were 4. The diet was fairly regular, but with more than half prioritizing lunch and dinner rather than breakfast. When they had a higher intake of cold cuts, salty bars, chips compared to fruit and vegetables. Most of the patients were educated about salt restriction diet and diet in hypertension due to the characteristics of the cohort, but few of them actually follow it. And there were no efforts to limit salt...
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Improvement of quality, function and transplantation outcomes of pancreatic islets using RNA interference
Kosinová, Lucie ; Kříž, Jan (advisor) ; Štechová, Kateřina (referee) ; Petrák, Ondřej (referee)
Transplantation of insulin producing tissue is the only therapeutic method so far allowing type 1 diabetic patients to achieve long-term independence of insulin administration. Transplantation of isolated pancreatic islets (PI) into liver represents a safer but less effective alternative to whole-organ transplantation. This is caused by a significant loss of transplanted islets within a short time after transplantation due to the instant blood-mediated inflammatory reaction (IBMIR). This reaction is triggered by molecules of tissue factor, abundantly expressed on the surface of PI cells. Tissue factor activates directly the coagulation pathway leading to platelet aggregation, complement activation, and infiltration of islet graft by leukocytes which results in a destruction of up to 60 % of transplanted tissue, and a formation of ischemic areas of downstream lying liver tissue. Tissue factor also stimulates angiogenesis which makes it necessary for revascularization of PI after transplantation. Inhibition of tissue factor gene in isolated PI using RNA interference provides an opportunity for short-term suppression of tissue factor expression, leading to protection of PI in the early post-transplantation period without hindering the connection of capillaries to the recipient vascular system later...
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NaCl intake in the diet of patients with severe arterial hypertension
Křišťálová, Kateřina ; Petrák, Ondřej (advisor) ; Štrauch, Branislav (referee)
Arterial hypertension is a serious cardiovascular disease which has developed at around 2.5 million people in the Czech Republic. It is a civilization disease with progressive occurrence among the population of the Czech Republic. This bachelor thesis deals with the diet of the patients with the arterial hypertension with focus to the intake of the cooking salt in the food. Excessive amount of the cooking salt in the food is believed to be one of the main risk factors for the development of the arterial hypertension. The aim of this thesis is an evaluation of the particular dietary habits from the point of the nutritional therapy. Theoretical part of the thesis describes arterial hypertension its causes classification epidemiology diagnostics and last but not least its treatment. Practical part of the thesis is based on the anonymous questionnaire. Questionnaire is focused on the questions concerning basic demographic characteristics in the clinical treatment of hypertension and on the questions concerning non-pharmacological treatment i.e. nutrition (with focus on the cooking salt) and physical activity. The aim is to find out the quality of arterial hypertension patients' diet, their awareness of the proper diet, their adherence to the proper diet, whether patients avoid salty and improper food and their...
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Nursing Process for a Patient with Post-resuscitation Therapeutic Hypothermia after Acute Myocardial Infarction
Viktora, Jan ; Vytejčková, Renata (advisor) ; Petrák, Ondřej (referee)
The bachelor's thesis deals with acute cardiology, namely with casuistry of a patient after acute myocardial infarction with successful cardiopulmonary resuscitation in the field, artificial pulmonary ventilation and therapeutic hypothermia. The thesis wants to present the highly specialised and demanding nursing care of resuscitated patients from the nurse's point of view with the use of the most modern procedures and technology. The theoretical part of the thesis is divided to several chapters describing anatomy and physiology of the cardiac muscle, acute myocardial infarction, cardiopulmonary resuscitation and therapeutic hypothermia. The main focus of this part of the thesis is on the diagnosis of the acute coronary syndrom itself. The theoretical part describes in more detail therapeutic hypothermia and nursing care of patients after cardiopulmonary resuscitation. Very important chapter is also introduction of a patient on whom is concentrated the nursing care in the practical part of the thesis, and presentation of his hospitalization. The practical part deals with creating, planning and implementation of the nursing care by means of biomedical model and nursing process. The practical and theoretical part alike is divided to several chapters. The main one is focused on nursing anamnesis with...
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Metabolic and Genetic Factors of Vascular Ageing
Gelžinský, Július ; Mayer, Otto (advisor) ; Petrák, Ondřej (referee) ; Wohlfahrt, Peter (referee)
Arterial system is a system of vessels distributing blood. Ageing of arterial system leads to two distinct pathologies: atherosclerosis and arteriosclerosis - stiffening of arterial wall. These pathologies can coexist and interfere; however, they differ in their pathogenesis, location, scope and consequences. Progressive loss of elastic properties of large arteries is natural part of vascular ageing. It is directly responsible for several age dependent consequences, such as increase of central systolic pressure or prevalence of isolated systolic hypertension in the elderly. Clinically, central arteries stiffness manifests as aortic pulse wave velocity, which can be quantified, among other methods, using applanation tonometry. There is abundant evidence that aortic pulse wave velocity represents an independent predictor of cardiovascular mortality and morbidity. The most important mechanism in arterial stiffening is repeated mechanical damage which leads to fractures, fragmentation and thinning of elastin. Stiffening of large arteries can be accelerated by several other mechanisms, e.g. deposition of several substances (calcium, advanced glycation end-products, etc.), metabolic turnover of key elements of vascular extracellular matrix (collagen and elastin) or individual genetic susceptibility. In...
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The role adipose tissue in development of insulin resistance and other metabolic disorders in patients with pheochromocytoma
Klímová, Judita ; Petrák, Ondřej (advisor) ; Kříž, Jan (referee) ; Mlíková Seidlerová, Jitka (referee)
Pheochromocytoma and functional paraganglioma (PPGL) are rare neuroendocrine tumors characterized by catecholamines overproduction, which give a rise to disorders of glucose, lipid, and energy metabolism. The role of adipose tissue in these processes remains unclear. Our aim was to determine the gene expression profile in subcutaneous and visceral adipose tissue of patients with PPGL focusing on endocrine functions of adipose tissue, occurrence of brown (BAT) and beige adipose tissue (BeAT), all in connection with other measured metabolic and energy parameters and levels of circulating adipokines. We demonstrate signs of UCP1-dependent norepinephrine induced thermogenesis connected with overexpression of DIO2 in retroperitoneal VAT of PPGL and higher expression of key transcriptional factors of brown/beige adipogenesis, namely PPARGC1α, CEBPB and PRDM16. However, classic murine BAT or BeAT gene signature in VAT of PPGL was not detected. In subcutaneous adipose tissue (SAT) of PPGL we found signs of possible BeAT transformation, however without simultaneously undergoing UCP1-dependent thermogenesis. We also demonstrate that patients with PPGL have higher serum levels of FGF21 compared to healthy controls and these levels do not differ from obese patients. Furthermore, successful tumor removal...
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The Metabolic Determinants of Central Arterial Stiffness
Karnosová, Petra ; Mlíková Seidlerová, Jitka (advisor) ; Bernat, Ivo (referee) ; Petrák, Ondřej (referee)
This dissertation demonstrates not only the classic hemodynamic and metabolic cardiovascular (CV) risk factors affecting arterial rigidity but also the soluble receptor for advanced glycation end-products (sRAGE) was studied. The stiffening of central arteries may precede the onset of manifest atherosclerosis, thus being a potential target for early prevention of cardiovascular disease. The actual guidelines of Czech society for hypertension recommend the measurement of aortic pulse wave velocity (aPWV) in hypertensive patients. The AGEs/RAGE complex participates in various stages of atherosclerosis/arterial stiffening. The soluble form of RAGE probably acts as a decoy for RAGE ligands and it is a naturally occurring inhibitor of toxic impact caused by AGE-RAGE action. It is suggested to be a potential marker of further chronic disease. This dissertation focuses on four publications investigating CV risk factors in two different population cohorts. We studied a random general population sample and offspring of patients with premature coronary heart disease sample compared to controls. In the general population we demonstrated that aPWV increased linearly with the rising numbers of individual metabolic syndrome risk factors (p for trend 0,0001). The levels of sRAGE were significantly positively...
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Electrophoretic determination of rivaroxaban
Petrák, Ondřej ; Křížek, Tomáš (advisor) ; Kubíčková, Anna (referee)
Capillary electrophoresis is a method used in pharmaceutical analysis because of its low cost, speed and environmental friendliness. This diploma thesis deals with development of electrophoretic method for rivaroxaban determination. After several optimizations, a method suitable for rivaroxaban determination inside its dosage forms was developed. Optimizations involved change of background electrolyte's composition from aqueous solution of low molecular weight organic acids to non-aqueous solution of acetic acid and cetyltrimethylammoniumbromide in acetonitrile in multiple steps. Final conditions of analysis included background electrolyte composed of 1M acetic acid and 40mM cetyltrimethylammoniumbromide in acetonitrile, sample injection carried out hydrodynamically by pressure of 5,0 kPa for period of 3 s and subsequent insertion of separation voltage of 30,0 kV for entire duration of analysis. Capillary content was mobilized by pressure of 0,50 kPa for entire duration of analysis. With aforementioned optimizations a selective method for determination of dosage forms of rivaroxaban was obtained. This method provides limit of detection 0,0056 mg/ml and limit of quantification 0,019 mg/ml and is linear in 0,01 - 0,40 mg/ml range with a recovery of 93,2 %. Keywords capillary electrophoresis,...
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