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Palliative nursing care for a patient with pancreatic cancer
ŠAŠKOVÁ, Karolína
The bachelor's thesis, which is called Palliative nursing care for a patient with pancreatic cancer, is divided into two parts - for the theoretical and practical part. In the theoretical part, I deal with the definition of "palliative nursing care", its history, the difference between general and specialized palliative nursing care, the goals of palliative care are described, the role of the nurse is described, and the specifics of palliative nursing care are discussed. The second part of the theoretical part focuses on the definition of pancreatic cancer, etiology, risk factors, clinical picture, diagnosis and TNM classification. In the practical part of the bachelor's thesis, the results of qualitative research are presented, where I find answers to research questions that are important for the research goals. The aim of this work is to find out what are the specifics of nursing in the terminal stage, whether nurses make differences in nursing in certain stages of the disease, how they maintain mental health and whether they have the opportunity to fulfill the patient's spiritual wishes. The research is carried out through a semi-structured interview, which is conducted with the nurses of the internal medicine and oncology departments. The research shows that the specifics of palliative nursing care depend on the nurses' emotions, nursing care in certain stages of the disease is conditioned by the cooperation of the patient, and that mental hygiene is very important for nurses and its fulfillment is achieved through physical activities. Finally, it is found that the fulfillment of the patient's spiritual needs depends on the availability of the given need. This work provides readers with information regarding palliative nursing care for patients with pancreatic cancer in practice. It helps to understand the burden that nurses experience both psychologically and physically when caring for palliative patients. In addition, this information can offer nurses ideas and advice on maintaining mental health and possible changes in the approach to palliative care.
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Genetické aspekty melanomu
KOUDELKOVÁ, Kateřina
The aim of this diploma thesis is to summarize findings about the cellular, molecular and mainly genetic characteristics of malignant melanoma, which is one of the most harmful human malignancies with steadily increasing incidence in recent decades. Malignant melanoma is a highly complex disease in which a huge number of genes play a role. The experimental part is devoted to the detection of mutations in the CDKN2A and CDK4 genes and polymorphism C609T in the NQO1 gene in participants with melanoma or pancreatic cancer in the family.
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Peritoneal lavage cytology and biochemistry in cases of upper GI tumours
Hoskovec, David ; Antoš, František (advisor) ; Lischke, Robert (referee) ; Aujeský, René (referee)
Introduction: Intraperitoneal tumor seeding is a common form of recurrence after surgery for GI tumours. Early diagnosis and treatment may influence the course of disease. Hypothesis and objectives of the work The finding of free tumor cells and / or elevation of tumor markers in peritoneal fluid predicts intraperitoneal tumor recurrence. The results of these tests can be used to indicate HIPEC. Aim of this work is to determine the sensitivity and specificity of cytology and tumor markers levels and importance of these tests for early diagnosis and prognosis of recurrence. Another objective was to confirm the applicability of RT PCR for identification of free tumor cells. Patients and methods . Materials are sourced both during initial surgery (220 patients) and by the dispensary controls (25 patients). The peritoneal fluid was examined cytologically and biochemically too. 50 samples was exemined by RT PCR. Results Elevation of tumor markers or finding of free intraperitoneal tumor cells predicts recurrence. The prognosis of these patients corresponds to stage IV TNM classification, regardless of other parameters TNM. Low sensitivity of these tests (34% for cytology, 53% for tumor markers) does not allow its use as an indicator of HIPEC. Due to degradation of RNA we did not confirm the value of RT...
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Pancreatic Cancer Diagnosis
Bunganič, Bohuš ; Zavoral, Miroslav (advisor) ; Rejchrt, Stanislav (referee) ; Urban, Ondřej (referee)
Pancreatic cancer is a malignant disease with an unfavorable prognosis. Currently, the diagnosis of pancreatic cancer is based mainly on CT, MR and EUS imaging methods, because a reliable biomarker of pancreatic cancer is not available. It is considered a success in the current clinical practice if patients suitable for surgical resection can be selected, because in this group the overall survival is slightly better than in the group where surgery is not technically possible. In the first part, the presented dissertation focuses on testing of already established imaging diagnostic methods used in common practice, i.e. EUS and EUS FNA, as well as modern examination possibilities, such as contrast endosonography, and the comparison of the accuracy of the methods used. The dominant role of the EUS FNA was confirmed. In the next phase of the work, the methodological procedure of EUS FNA collection and the preprocessing of pancreatic tissue samples was tested with regard to the quantity and quality for epigenetic examination and further testing using the prognostic role of KRAS and miR-21. It has been suggested that cytological smears are the most suitable source of biological material for DNA and miRNA analysis, where non-tumor tissue contamination is low. Although the prognostic role of KRAS is...
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Signalling pathways in pancreatic cancer and its treatment by targeting of mitochondria
Ezrová, Zuzana ; Neužil, Jiří (advisor) ; Masařík, Michal (referee) ; Divoký, Vladimír (referee)
Pancreatic cancer is one of the deadliest types of malignant diseases. Asymptomatic early tumour stages, tumour heterogeneity, cancer cell plasticity and unusually dense pancreatic stroma are responsible for the poor prognosis attributed to late diagnosis and therapy resistance. Therefore, targeting of a pivotal element common for any cell type within the tumour, e.g. mitochondria, may bring significant improvement. In this work, we demonstrate mitochondrial targeting of metformin, an anti-diabetic drug associated with reduced risk of developing pancreatic cancer, substantially increases accumulation of the compound in mitochondria. In consequence, we show that mitochondrially targeted metformin, MitoMet, eliminates pancreatic cancer cells in more than 1000-fold lower concentration than used for its parental compound. Following interaction with respiratory complex I (CI), MitoMet inhibits mitochondrial respiration, activates AMP-activated protein kinase pathway and causes depolarization of mitochondrial membrane potential in pancreatic cancer cells. Moreover, MitoMet induces cell cycle arrest and apoptosis, which is partially mediated via increased level of reactive oxygen species (ROS), and suppresses pancreatic tumour growth in vivo. Interestingly, SMAD4-deficient pancreatic cancer cells manifest...
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Possibilties of Portal Vein Reconstruction During Surgical Treatment of Pancreatic Cancer - Experiment on a Large Animal
Pálek, Richard ; Liška, Václav (advisor) ; Ryska, Miroslav (referee) ; Loveček, Martin (referee)
Possibilities of Portal Vein Reconstruction during Surgical Treatment of Pancreatic Cancer - Experiment on a Large Animal Introduction: Pancreatic cancer is a fatal malignancy that is known as one of the leading causes of cancer mortality worldwide. The only potentially curative treatment is radical surgical resection. Because of the lack of early symptoms, the diagnosis is usually made in advanced stages of the disease. In the majority of patients, the tumor is already locally advanced or it has distant metastases at the time of diagnosis. Pancreatic cancer tends to infiltrate the portal vein (PV) or the superior mesenteric vein (SMV). Nowadays, resection of infiltrated parts of PV/SMV is recommended in specialized centers. There are several established techniques of PV/SMV reconstruction. The use of allogeneic venous grafts seems to be a method with minimal risk of adverse effects but there is only limited experience with these grafts. The optimal anatomical origin of allogeneic venous grafts for PV/SMV reconstruction remains unknown. Aims: The aim of this experiment was to compare two types of allogeneic venous grafts used for PV reconstruction in a large animal model of pancreatico- duodenectomy. These grafts were harvested from the systemic venous system (inferior caval vein grafts - IVC grafts) and...
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The importance of biosynthetic and catabolic pathway of cholesterol in inflammatory and tumor diseases
Leníček, Martin ; Vítek, Libor (advisor) ; Haluzík, Martin (referee) ; Mareček, Zdeněk (referee)
This thesis focuses on the importance of intermediate products of biosynthetic and catabolic pathway of cholesterol. The aim of the first part of the thesis is mainly to investigate, whether statins (HMG- CoA reductase inhibitors) possess antitumor properties and to compare the differences in antitumor potential of individual statins. The other part of the thesis aims at the utilization of 7α-hydroxycholest-4-en-3-one (C4), a promising marker of cholesterol 7α-monooxygenase (CYP7A1) activity and bile acid malabsorption. We demonstrated antitumor effect of statins on an experimental model of pancreatic cancer. Individual statins, however, differed significantly in their efficacy, depending on their physico-chemical properties. Our data suggests, that the most likely (but not the only) mechanism of antitumor effect of statins is decreased prenylation of signaling proteins, especially Ras protooncogene. We set up a reliable method for measurement of C4, which facilitated our research in CYP7A1 regulation. We demonstrated, that promoter polymorphism -203A>C might affect CYP7A1 activity, that diurnal variability of CYP7A1 activity might be triggered by insulin, and that insulin resistance in patients with non-alcoholic fatty liver disease impedes the feedback regulation of CYP7A1, which may lead to disease...
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Glutathione and glutathione-dependent enzymes in various pathophysiological states.
Kodydková, Jana
Backround: Oxidative stress (OS) has been implicated in pathogenesis of human disorders such as depressive disorder, sepsis, cardiovascular disease, acute and chronic pancreatitis, and cancer. Increased OS is result of imbalance between increased reactive oxygen and nitrogen species (RONS) production and / or insufficient activity of antioxidant defence system. Antioxidant system, which is composed of antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidases (GPX), glutathione reductase (GR) and non- enzymatic antioxidant reduced glutathione (GSH) plays an important role in the protection of cells against enhanced OS. The aim of this study was to assess the OS markers and antioxidant enzymes in different pathophysiological states. Materials and methods: Activities of erythrocyte glutathione peroxidase (GPX1), GR and concentration of GSH as well as levels of OS markers were analysed in six different pathophysiologic states. These parameters were measured in 35 women with depressive disorder (DD), 40 patients with metabolic syndrome (MetS), 30 septic patients (S) followed up in the course of sepsis; 15 non-septic critically ill patients (NC), 13 patients with acute pancreatitis (AP), 50 with chronic pancreatitis (CP) and 50 patients with pancreatic cancer (PC), compared to...
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Resting energy expenditure and nutritional intake in patients with pancreatic cancer before elective pancreatectomy
Heniková, Marina ; Gojda, Jan (advisor) ; Urbánek, Miroslav (referee)
Aims: The aim of this work was to determine whether a increased resting energy expenditure contributes to the nutritional risk for patients with pancreatic cancer. What the variability of resting energy expenditure is and whether it predicts weight loss. Another aim was to verify that lower protein-energy intake also has an impact on weight loss. Methods: Data for the diploma thesis were obtained from the project "Pancreatic Cancer: Metabolic Derangements Associated With Insulin Resistance", which takes place at the Department of Clinical Physiology of Metabolism at 2nd Department of internal medicine in the University Hospital Královské Vinohrady. The project includes 40 - 50 patients with pancreatic tumor resection per year. Data were collected from the beginning of December 2019 until the end of April 2020. The project is funded by the grant AZV NV19-01-00101. 10 consecutive patients (4 women and 6 men) with pancreatic cancer who had a complete dataset for analysis were selected for the research set for the diploma thesis. The patients underwent anthropometric examination, blood tests were taken, and indirect calorimetry was performed. Results: The first part of the research was focused on anthropometric parameters, parameters of nutritional status and the presence of cancer cachexia. The second...
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