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Genetic background of liver cirrhosis complications
Šenkeříková, Renáta ; Špičák, Julius (advisor) ; Brůha, Radan (referee) ; Husová, Libuše (referee)
Liver cirrhosis represents the end stage of most chronic liver diseases. The course of the disease and its complications can be significantly influenced by host genetic factors and the severity of portal hypertension (PH). The aim of the study was to describe the role of genetic factors influencing the progression and complications of liver disease and to determine the role of non-invasive assessment of the stage of liver fibrosis and severity of PH and their correlation with portosystemic gradient (HVPG) measurements. We first focused on the role of allelic variants in TLR4 signalling pathway genes in the risk of occurrence of severe bacterial infections in patients with advanced liver cirrhosis, liver transplant (LT) candidates. We found that the TNFA c.-238G/A promoter variant significantly reduced the risk of bacterial infections and was associated with a decreased mortality rate. We further investigated the role of the variant G allele in PNPLA3 gene in the progression of chronic liver failure and the need for LT in patients with liver cirrhosis due to HCV infection. As a result, we found that the carriage of the variant G allele led to a faster progression of chronic liver failure and the need for LT at a younger age. Third, we investigated whether the efficacy of triple combination treatment...
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Metabolic effects of bile lipids
Žížalová, Kateřina ; Leníček, Martin (advisor) ; Jirsa, Milan (referee) ; Dvořák, Karel (referee)
Bile acids act as important fat emulsifiers in the human body. However, it is increasingly becoming apparent that they also play a role as important signalling molecules. Bile acids are a relatively heterogeneous group differing also in their metabolic effects. Their individual proportion in the body is highly variable and strongly influenced by the composition of the microbiome. The importance of individual bile acids is not yet well enough described to be fully exploited in clinical practice. For this reason, the determination of bile acids by enzymatic methods seems to be considered sufficient in most departments. Another and more reliable option is the increasingly widespread use of liquid chromatography-tandem mass spectrometry (LC-MS/MS). The aim of my work was to test the reliability of the enzymatic method and to introduce a method for the determination of bile acids, including the measurement of such atypical ones for example microbial conjugates and keto- and isoderivatives. Moreover, I aimed to test sample preparation for the measurement of 7α-hydroxy-4-cholesten-3-one, the bile acid biosynthesis marker. We used these methods to investigate the changes in bile acid composition changes in iron overload rats. In this rat model of genetically determined disorders of iron metabolism, bile...
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A Case study of Physiotherapy on a Patient after Liver Transplantation
Hettiaratchi, Lukas ; Kučerová, Ilona (advisor) ; Sárazová, Daniela (referee)
Title: A Case Study of Physiotherapy on a Patient after Liver Transplantation Author: Lukas Hettiaratchi Objectives: The purpose of this work is to review in-depth theory concerning liver transplantations along with the rehabilitation process that entails it. Moreover, create an adequate case study of a patient after liver transplantation. Methods: This work is divided into two sections, the theoretical part, and the special part. The first part consists of information gathered through scientific literature, it includes the anatomy, physiology and pathophysiology of the liver. Furthermore, it dives into the specifics of liver transplantations and recommended physiotherapy. The second section exhibits a complete case study of early post-operative physiotherapy on a patient after liver transplantation. The case study was conducted during a month of clinical practice at Institut Klinické a Experimentální Medicíny (IKEM) from the 10/01/2022 - 04/02/2022. Results: The patient significantly progressed throughout the physiotherapeutic care. Their overall physical condition improved, that led to the ability of independent verticalization and gait. Keywords: Liver, transplantation, alcohol liver disease, portal hypertension, ascites, physiotherapy
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Case study of physiotherapy treatment of a patient after multivisceral transplantation
Plíhalová, Kateřina ; Stupková, Michaela (advisor) ; Jančařík, Vít (referee)
Autor: Kateřina Plíhalová Title: Case study of physiotherapy treatment of a patient after multivisceral transplantation Objective: The aim of this thesis is a summary of theoretical knowledge of a multivisceral transplantation and a case study of physiotherapy treatment of a patient, who underwent a transplantation of five visceral organs. Methods: The thesis is divided into two parts - general (theoretical) and special (practical). Theoretical part is based on the research of professional literature and summarises the basic information about the problems of liver diseases and about the management of their terminal phases using a multivisceral transplantation. Practical part documents the process of rehabilitation of the patient after multivisceral transplantation during the continuous physiotherapy internship. Results: The therapy reached the best results in the area of better overall condition of the patient, muscle strength improvement and reduction of edema in lower extremities. The final effect of the therapy was noted both subjectively and objectively. Key words: cirrhosis of the liver, portal hypertension, multivisceral transplantation, physiotherapy
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