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Atresia of gastrointestinal tract and possibilities of physiotherapeutic intervention
Zdobnická, Barbora ; Šonská, Kristýna (advisor) ; Štefanová, Petra (referee)
This bachelor thesis deals with atresia of the gastrointestinal tract and possibilities of physiotherapeutic intervention. The thesis is presented in the form of a review with a case study. The review part contains information about the development and anatomy of the parts of the gastrointestinal tract that are most often affected by atresia. The classification, diagnosis and surgical treatment options of individual atresia are also mentioned. The options of physiotherapy intervention include scar treatment, respiratory physiotherapy, physical therapy, basal stimulation and orofacial stimulation. The practical part of the bachelor thesis is presented in the form of a case study of a patient after gastrointestinal atresia surgery. The content includes the examination before and after the therapy in the physiotherapist's ambulance and the follow-up after 2 months of regular therapy. The positive effects of physiotherapy are documented by photodocumentation and by using the Alberta Infant Motor Scale to evaluate motor development. The practical part also includes an educational handout for parents about the implementation of respiratory physiotherapy after discharge from hospital, which will be subsequently used in the Department of Paediatric Surgery at FN Motol.
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Optimization of biologic therapy in children with inflammatory bowel disease (IBD) using modern biomarkers
Ohem, Jan ; Bronský, Jiří (advisor) ; Kotaška, Karel (referee) ; Bajerová, Kateřina (referee)
Optimization of biologic therapy in children with inflammatory bowel disease (IBD) using modern biomarkers Abstract to thesis Study programme: Biochemistry and Pathobiochemistry Introduction: In adults, infliximab (IFX) levels correlate with disease activity and antibodies to IFX (ATIs) predict treatment failure. We aimed to determine the association of IFX levels and ATIs with disease activity in paediatric population. Methods: This study was performed as a prospective observational study. We prospectively collected blood, stool, and clinical data from 65 patients (age 10.5-15.1 years) with Crohn's disease (CD) before IFX administration, and measured IFX trough levels, ATIs, and faecal calprotectin levels (CPT). We used multivariate analysis to identify the predictors of IFX levels. IFX and ATIs levels were meassured using ELISA. Results: Lower levels of IFX were associated with ATIs positivity (OR [odds ratio] 0.027, CI [confidence interval] 0.009-0.077). Higher C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR) and CPT levels were found in patients with lower IFX levels. The optimal combination of specificity (50%) and sensitivity (74%) for disease activity was calculated for IFX levels ≥ 1.1 µg/ml using CRP level < 5 mg/l as a marker of laboratory remission. In a model that used CPT ≤...
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Hyperbaric oxygen therapy in intensive care
MIČKA, Lukáš
The theoretical part of work named: "Hyperbaric oxygenotherapy in intensive care" consists of chapters releated to hyperbaroxia as a method, the hyperbaric chambers and hyperbaric oxygen. For its practical part there were created 7 targets regarding intensive care. The main purpose was an investigation of experience with effects, complications and negative consequences of the therapy. A research was also released to the part of therapeutic and nursing interventions. After that we focused on specifications of work with a child in hyperbaria and specification of hyperbaric equipment. We studied also prevention against nosocomial infection and factors which could increase a risk of stress and cause making errors by staff. To fill the target it was released a quality research investigation based on indiviual semi-structured interview. The interview included 16 questions which were answered by doctors and nurses from hyperbaric clinic in Kladno and Ostrava. To complete the studies, data analysis were used from 9 patients treated in the chamber. According the results it was comfirmed that using of this method makes visible a health profile in case of some types after each exposition. The Hyperbaroxy is considered as a safe and there are not serious complications caused by treatment for the respondents. Intervention HBO in acute care is not so different from that one in ICU. The only diference is a space condition. Specific premedication and nursing in case of the child till the age of 10 years is solved by special paediatric nurse. To release HBO therapy - it is necessary for the clinic to have a special respirator and medical ventilator for hyperbaric conditions. It was confirmed a complete sterility of hyperbaric spaces caused by keeping hygienic plan in a hospital. Factors which are increasing a risk as a stress and error exist, nevertheless keeping prevention steps by staff minimalize them. The bachelor thesis should be used as an information based on a basic inquiry about treatment, education and efficiency of the treatment in the hyperbaric chamber. That can be used by patiens thinking about care with hyperbaric oxygen as well as a future medical and nursing staff studying medical or nonmedical health branches.
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