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Atherosclerosis and cadiovascular risk in selected rheumatic diseases
Oreská, Sabína ; Tomčík, Michal (advisor) ; Horák, Pavel (referee) ; Soukup, Tomáš (referee)
Cardiovascular (CV) diseases due to atherosclerosis are the leading cause of morbidity and mortality worldwide. CV risk in rheumatic patients is caused by both traditional and non- traditional risk factors associated with autoimmune diseases. Unlike the relatively more prevalent rheumatic disease, there is a lack of evidence on CV risk in rare rheumatic diseases. The aim of this study was to evaluate the CV risk in 90 patients with idiopathic inflammatory myopathies (IIM), compared to 180 healthy controls (HC) with similar age and gender distribution, without clinically manifested CV diseases. The results of this cross-sectional cohort study showed a significantly higher prevalence of traditional risk factors as well as of subclinical atherosclerosis in IIM compared to HC. In comparison to carotid ultrasonography, SCORE, SCORE2, and modified SCORE was proved to underestimate the CV risk, while SCORE2 appeared to be the most accurate. The most severe CV risk profile was observed in patients with statin-induced necrotizing myopathy. Overall, higher CV risk in IIM was associated with higher age, disease activity, body composition parameters, and higher blood pressure values. We confirmed a higher CV risk as well as a higher prevalence of traditional risk factors in patients with IIM compared to the...
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Prevalence and severity of sexual dysfunctions in patients with selected rheumatic diseases and the effect of specialized physiotherapeutic intervention on the sexual health of these patients
Heřmánková, Barbora ; Tomčík, Michal (advisor) ; Horák, Pavel (referee) ; Suchý, David (referee)
Introduction: Rare rheumatic diseases, such as systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM), are severe autoimmune diseases characterized by multiorgan involvement and often significant functional impairment that are chronic and progressive in nature. Severe clinical manifestations of SSc and IIM are often associated with significant deterioration of all aspects of quality of life, including sexual function. Only a low number of studies have addressed sexual health in patients with SSc and IIM, which are limited by small sample size, the use of non-standardized scales, or poor methodological quality. In addition, none of the studies evaluated pelvic floor function and its relationship to sexual function in patients with these diseases. Objectives: The aim of this work was a cross-sectional evaluation of the prevalence and severity of sexual dysfunction and pelvic floor dysfunction in women and men with SSc and IIM compared to sex-/age-matched healthy controls (HC). Furthermore, we aimed to evaluate the association between sexual dysfunction/pelvic floor dysfunction and disease-related features. Finally, our goal within the pilot project was to evaluate the effect of an 8-week physiotherapy program on sexual function in women with SSc and IIM. Methods: This work consists of...
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Body composition in patients with idiopathic inflammatory myopathies
Mareček, Ondřej ; Česák, Petr (advisor) ; Kinkorová, Ivana (referee)
Title: Body composition in patients with idiopatic inflammatory myopathies Objectives: The aim of this study was to compare selected parameters of body composition in patients with idiopathic inflammatory myopathies (IIM) with age- and sex-matched healthy controls (HC). Another objective was to evaluate the effect of selected clinical parameters in patients with IIM on the detectedvariability of the parameters of body composition and on physical activity of patients. Methods: The research sample consisted of 84 individuals (54 IIM, 30 HC). In anthropometry, we measured: body height (cm), weight (kg) and BMI (kg/m2 ). Using bioelectrical impedance analysis BIA 2000-M we obtained values: total body water (TBW in%), muscle mass (LBM in kg), body fat (BF in%) cell mass of lean body mass (BCM of FFM in%), and the proportion of extracellular/intracellular matrix (ECM/BCM). Using Lunar series iDXA we obtained values: muscle mass (LBM in kg), body fat (BF in %), bone mineral density (BMD in g/cm3 ), and visceral fat (Visceral in kg). To these measured values we added a questionnaire on physical activity Human Acitvity Profile (HAP). Statistics: T-test, Mann Whitney U test, Cohen's d, and Partialeta-squared. Results: Selected values (mean ± SD): body height: IIM 164.7 ± 9.1 cm, HC 170.3 ± 7 cm; body weight:...
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Relation of Soluble Factors of Immune System to Fenotype of Idiopathic Inflammatory Myopathies
Klein, Martin ; Vencovský, Jiří (advisor) ; Hrnčíř, Zbyněk (referee) ; Horák, Pavel (referee)
Introduction: Idiopathic inflammatory myopathies (myositis, IIM) are heterogeneous group of rare autoimmune systemic diseases, characterized particularly by proximal skeletal muscle weakness. Heretogeneity of myositis is based on different pathogenetic mechanisms which may be reflected by variable imunophenotypic response in individual subtypes. Objectives: The aim of this work was to explore the associations and influence of soluble factors of immune system in patient's sera on phenotypic characteristics and subtypes of IIM, to describe their expression in inflammed muscle tissue and study their eventual role in pathogenesis by analysis of effect on immune and muscle cells in vitro. Results: We have described prevalence and characteristics of joint involvement in myositis patients and its significant association with anti-Jo-1 autoantibody. Further we confirmed the relation of anti-HMGCR antibody to immune mediated necrotizing myopathy, its tight relation to statins and recent increase in incidence. We showed inverse association of IFNα serum levels with muscle activity detected on MRI. Clinical activity positively correlated with IFN type-I pathway activation in patients with dermatomyositis. We also show positive correlation of resistin levels and clinical activity and correlation of activity...
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The effect of physical activity interventions on the course and activity of selected rheumatic diseases
Špiritović, Maja ; Tomčík, Michal (advisor) ; Horák, Pavel (referee) ; Soukup, Tomáš (referee)
Introduction: This work focused on two rare rheumatic diseases systemic sclerosis (SSc) and idiopathic inflammatory myopathies (IIM). Skin and musculoskeletal involvement in patients with SSc leads to disability and loss of functional abilities of an individual. Chronic inflammation of the muscles, subsequent muscle atrophy and permanent muscle damage in patients with IIM are the cause of a decrease in muscle strength and endurance. Moreover, both diseases also affect internal organs and manifest often with impaired lung and heart function. All of these involvements in both diseases lead to a decrease in the quality of life of patients. The data on efficacy of non-pharmacological care in SSc and IIM are very limited due to the heterogeneity of the studied interventions and/or outcomes. However, due to limitations in pharmacological therapy, non-pharmacological interventions could help bring patients back into their everyday life and improve their quality of life. Objectives: The main objective of this project was to evaluate the impact of physical intervention on disease course and activity in a substantial number of SSc and IIM patients, with the aim of minimizing the limitations of available studies, thereby improving the quality and reliability of the obtained results. Methods: This is a...
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BAFF (B-cell Activating Factor of the TNF Family) in patients with idiopathic inflammatory myopathieswith respect to autoantibody profile.
Kryštůfková, Olga ; Vencovský, Jiří (advisor) ; Tlaskalová - Hogenová, Helena (referee) ; Blažíčková, Stanislava (referee)
The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of chronic muscle diseases with frequent extramuscular organ involvement that contributes to serious prognosis. The presence of autoantibodies and composition of muscle infiltrates both support autoimmune nature of the disease and pathogenic role of B lymphocytes. Besides the traditional diagnostic subgroups, autoantibody characterised phenotype subsets have been identified with presumed similar pathogenic mechanisms. The best known is the antisynthetase syndrome which is characterised by presence of myositis, antisynthetase autoantibodies (with anti-Jo-1 being the most frequent), interstitial lung disease and other extramuscular manifestations. BAFF (B cell-Activating Factor of the TNF Family) is a key factor in B cell homeostasis modulation. In high levels, it allows survival of autoreactive B cell clones and thus participates in the pathogenesis of autoimmune diseases. Its expression is induced by type I interferons (IFN-1). The aim of the PhD thesis was to explore the role of BAFF in pathogenesis of IIMs by analysis of its serum levels, the receptors for BAFF in muscle tissue, their associations to IFN-1 and expression of BAFF gene mRNA transcription variants in peripheral blood cells. Further aspect was to study a possible...
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Sexual dysfunction and pelvic floor dysfunction in patients with systemic rheumatic diseases
Heřmánková, Barbora ; Špiritović, Maja (advisor) ; Nováková, Tereza (referee)
Title: Sexual Dysfunction and Pelvic Floor Dysfunction in Patients with Systemic Rheumatic Diseases Objectives: To assess sexual functions, quality of life and pelvic floor function in female patients with Systemic Sclerosis (SSc) and Idiopathic Inflammatory Myopathies (IIM) compared to age-/sex-matched healthy controls (HC). Methods: In total, 41 women with SSc (mean age: 50.9, disease duration: 5.8 years), who fulfilled the ACR/EULAR 2013 classification criteria for SSc, 41 healthy controls (mean age: 50.9) without rheumatic diseases, 22 women with IIM [mean age: 55.1, disease duration: 7.9 years, dermatomyositis (DM, 8)/ polymyositis (PM, 10)/ necrotizing myopathy (IMNM, 3)/ inclusion body myositis (IBM, 1)], who fulfilled the Bohan/Peter 1975 diagnostic criteria for DM/PM, and 22 healthy controls (mean age: 55.1 years) filled in 12 well-established and validated questionnaires assessing sexual function/quality of life, pelvic floor function, fatigue, physical activity and depression. Results: Compared to HC, patients with SSc and IIM had significantly higher prevalence and greater severity of sexual dysfunction (FSFI, BISF-W: in all subscales as well as total scores), dysfunction of pelvic floor (PISQ-12), and worse sexual quality of life (SQoL-F). Worse scores in SSc patients were associated...
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Relation of Soluble Factors of Immune System to Fenotype of Idiopathic Inflammatory Myopathies
Klein, Martin ; Vencovský, Jiří (advisor) ; Hrnčíř, Zbyněk (referee) ; Horák, Pavel (referee)
Introduction: Idiopathic inflammatory myopathies (myositis, IIM) are heterogeneous group of rare autoimmune systemic diseases, characterized particularly by proximal skeletal muscle weakness. Heretogeneity of myositis is based on different pathogenetic mechanisms which may be reflected by variable imunophenotypic response in individual subtypes. Objectives: The aim of this work was to explore the associations and influence of soluble factors of immune system in patient's sera on phenotypic characteristics and subtypes of IIM, to describe their expression in inflammed muscle tissue and study their eventual role in pathogenesis by analysis of effect on immune and muscle cells in vitro. Results: We have described prevalence and characteristics of joint involvement in myositis patients and its significant association with anti-Jo-1 autoantibody. Further we confirmed the relation of anti-HMGCR antibody to immune mediated necrotizing myopathy, its tight relation to statins and recent increase in incidence. We showed inverse association of IFNα serum levels with muscle activity detected on MRI. Clinical activity positively correlated with IFN type-I pathway activation in patients with dermatomyositis. We also show positive correlation of resistin levels and clinical activity and correlation of activity...
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Body composition in patients with idiopathic inflammatory myopathies
Mareček, Ondřej ; Česák, Petr (advisor) ; Kinkorová, Ivana (referee)
Title: Body composition in patients with idiopatic inflammatory myopathies Objectives: The aim of this study was to compare selected parameters of body composition in patients with idiopathic inflammatory myopathies (IIM) with age- and sex-matched healthy controls (HC). Another objective was to evaluate the effect of selected clinical parameters in patients with IIM on the detectedvariability of the parameters of body composition and on physical activity of patients. Methods: The research sample consisted of 84 individuals (54 IIM, 30 HC). In anthropometry, we measured: body height (cm), weight (kg) and BMI (kg/m2 ). Using bioelectrical impedance analysis BIA 2000-M we obtained values: total body water (TBW in%), muscle mass (LBM in kg), body fat (BF in%) cell mass of lean body mass (BCM of FFM in%), and the proportion of extracellular/intracellular matrix (ECM/BCM). Using Lunar series iDXA we obtained values: muscle mass (LBM in kg), body fat (BF in %), bone mineral density (BMD in g/cm3 ), and visceral fat (Visceral in kg). To these measured values we added a questionnaire on physical activity Human Acitvity Profile (HAP). Statistics: T-test, Mann Whitney U test, Cohen's d, and Partialeta-squared. Results: Selected values (mean ± SD): body height: IIM 164.7 ± 9.1 cm, HC 170.3 ± 7 cm; body weight:...
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Case report physiotherapy care of a patient with dermatomyositis
Rožcová, Eva ; Vomáčková, Helena (advisor) ; Jarošová, Hana (referee)
Author: Eva Rožcová Title of the thesis: Case report physiotherapy care of a patient with dermatomyositis. Summary: The goal is to become familiar with the diagnosis of dermatomyositis and develop case report of a patient with this diagnosis. The work is divided into general and special. General section discusses the theoretical knowledge of the disease, the etiology, clinical manifestations diagnosis to treatment. In the special case report formed part falls historical data initial examination and determining the therapeutic plan. After running therapeutic units is done output examination with evaluation of the effect therapy. Keywords: idiopathic inflammatory myopathies, dermatomyositis, physiotherapy
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