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Effectiveness and safety of biological therapy in inflammatory rheumatic diseases
Nekvindová, Lucie ; Závada, Jakub (advisor) ; Hendl, Jan (referee) ; Hrnčíř, Zbyněk (referee)
This thesis focuses on evaluating the effectiveness and safety of biological/targeted treatment in chronic inflammatory rheumatic diseases based on data from the ATTRA registry. The introductory chapters of the thesis give an overview of three rheumatic diseases - rheumatoid arthritis (RA), psoriatic arthritis (PsA) and axial spondyloarthritis (axSpA), characterising clinical manifestation, diagnosis, therapeutical options and current treatment guidelines. The work also contains a brief summary of information about planning, creating and maintaining a clinical registry and characterises specifics related to the analysis of registry data. The practical part of the thesis was aimed at two research questions. Recently, a treat-to-target (T2T) strategy was established for RA, PsA and axSpA. Studies from daily clinical practice concerning the advantage of following T2T over usual care are still lacking. Thus, the first goal of the thesis was to evaluate whether following a treat to target strategy after not reaching low disease activity within the first six months leads to a higher chance of meeting the treatment target at the twelve-month visit. Our second goal in the thesis was to evaluate the association between therapeutic response (achieving remission and drug retention) and patients'...
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Epidemiological aspects of inflammatory rheumatic diseases and diffusional diseases of binding tissue.
Hánová, Petra ; Pavelka, Karel (advisor) ; Bencko, Vladimír (referee) ; Horák, Pavel (referee)
v anglickém jazyce Introduction: No information was known about frequency of common inflammatory disorders in rheumatology in the Czech Republic. Aims of the study: To estimate the standardized annual incidence (INC) and point prevalence (PREV) of six diseases (rheumatoid arthritis-RA, juvenile idiopathic arthritis-JIA, gout, psoriatic arthritis-PsA, ankylosing spondylitis-AS, reactive arthritis-ReA) in a population-based study in two regions of the Czech Republic (CR). Methods: INC: Incident cases were registered on condition that the definite diagnosis was confirmed according to existing classification criteria during the study period. PREV was studied on the basis of identification of established diagnoses at a time point. Crude rates were standardized for age and sex. Results: Both INC and PREV are shown per 100.000 inhabitants. RA INC:31 (95%CI 20-42), PREV:610 (95%CI 561-658). Gout-INC:41 (95%CI 28-53), PREV:300 (95% CI 266-334). JIA-INC: 13 (95% CI 1-20), PREV:140 (95%CI 117-280). PsA-INC:3,6 (95% CI 1-8), PREV:49 (95%CI 40-60). AS-INC:6 (95% CI 3-11), PREV:94 (95% CI 94-109). ReA-INC:9 (95% CI 6-15), PREV:91 (95% CI 78-106). Conclusion: This is the first population-based study estimating annual incidence and prevalence rates of the most common rheumatological disorders in the Czech...
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Immunogenetic and hormonal markers of predisposition to systemic rheumatic diseases particularly systemic lupus erythematosus
Fojtíková, Markéta ; Pavelka, Karel (advisor) ; Hrnčíř, Zbyněk (referee) ; Rovenský, Jozef (referee)
Fojtikova 2011 INTRODUCTION: Several factors like genetic susceptibility is required for systemic rheumatic diseases development. Immunomodulatory PRL effect supports autoimmunity. AIMS: 1. To detect the immunogenetic background (alleles HLA class I, II and microsatellite polymorphism of the transmembrane part exon 5 of MIC-A gene) of SLE and PsA. 2. To detect PRL serum and synovial fluid with regard to clinical and laboratory RA activity. 3. To find the role of the functional polymorphism -1149G/T SNP PRL of extrapituitary promoter of PRL gene in SLE, RA, PsA, SSc and inflammatory myopathies development. METHODS: Genetic analyses of pateints with SLE (n=156), RA (n=173), PsA (n=100), SSc (n=75), PM (n=47) a DM (n=68) and 123 healthy individuals: PCR-SSP (HLA clase I and II), PCR-fragment analysis (MIC-A) a PCR-RFLP (-1149 G/T SNP PRL). In 29 RA a 26 OA PRL serum and synovial fluid concentrations were detected using immunoradiometric assay. RESULTS: 1. The allele HLA-DRB1*03 (pc=0.008; OR 2.5) and haplotype HLA-DRB1*03-DQB1*0201 (pc <0.001; OR 4.54) were determined as risk immunogenetic markers for SLE in Czech population. In SLE versus controls allele MIC-A5.1 was increased (pc =0.005; OR 1.88). MIC-A5.1 together with HLA-DRB1*03 increases the risk for SLE development, pc <0.000001; OR 9.71....
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Nursing care of patients with psoriatic arthritis.
KNEISSLOVÁ, Dagmar
The main task of this thesis is to assess the specifics of nursing care of patients with psoriatic arthritis. Two research questions are specified in relation to this aim: What are the specific needs of patients with psoriatic arthritis? What problems do the patients with psoriatic arthritis have while performing everyday activities? The research part of this bachelor thesis was compiled using the qualitative research method, implemented in the form of a semi-structured interview. The research sample consisted of 6 informants, who were diagnosed with psoriatic arthritis. The whole interview was composed of 33 questions, while some of them included complementary sub-questions. The interview was divided into basic categorization facts and the actual interview. The whole interview was recorded on mobile phone using the audio recording application. Subsequently, the interviews were transcribed into printed form and processed using the "pencil and paper" open coding technique. The survey results are divided into the following categories: physical health, self-sufficiency and psychosocial needs. The results of this thesis provide a perspective on the problems of psoriatic arthritis from the patients' point of view. The acquired thesis results can be used as educational material for students in the medical field or serve general nurses providing nursing care to patients with psoriatic arthritis.
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Epidemiological aspects of inflammatory rheumatic diseases and diffusional diseases of binding tissue.
Hánová, Petra ; Pavelka, Karel (advisor) ; Bencko, Vladimír (referee) ; Horák, Pavel (referee)
v anglickém jazyce Introduction: No information was known about frequency of common inflammatory disorders in rheumatology in the Czech Republic. Aims of the study: To estimate the standardized annual incidence (INC) and point prevalence (PREV) of six diseases (rheumatoid arthritis-RA, juvenile idiopathic arthritis-JIA, gout, psoriatic arthritis-PsA, ankylosing spondylitis-AS, reactive arthritis-ReA) in a population-based study in two regions of the Czech Republic (CR). Methods: INC: Incident cases were registered on condition that the definite diagnosis was confirmed according to existing classification criteria during the study period. PREV was studied on the basis of identification of established diagnoses at a time point. Crude rates were standardized for age and sex. Results: Both INC and PREV are shown per 100.000 inhabitants. RA INC:31 (95%CI 20-42), PREV:610 (95%CI 561-658). Gout-INC:41 (95%CI 28-53), PREV:300 (95% CI 266-334). JIA-INC: 13 (95% CI 1-20), PREV:140 (95%CI 117-280). PsA-INC:3,6 (95% CI 1-8), PREV:49 (95%CI 40-60). AS-INC:6 (95% CI 3-11), PREV:94 (95% CI 94-109). ReA-INC:9 (95% CI 6-15), PREV:91 (95% CI 78-106). Conclusion: This is the first population-based study estimating annual incidence and prevalence rates of the most common rheumatological disorders in the Czech...
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Problems of the Patient with Psoriasis and his Integration to the Society
Vaňková, Lucie ; Hošťálková, Monika (advisor) ; Marková, Eva (referee)
The bachelor work is dealing with the problems of patients, afflicted with psoriasis.In the first half of the teoretical part I am fixing on the description of the anatomy and physiology of the skin.The second half of the theoretical part makes clear, what actually psoriasis yields, what is its history, how manifests, what is the posssibility of diagnostics, what types of psoriasis we can meet in the practice, which are the possibilities of the treatment and why is important education of the diseased person,the family and the society.In several chapters I describe,which is the fall-out on the psychical and physical disposition of the patient. Last but not least I am joining on the chapter about the integrating of persons with psoriasis to the society.The empirical part is fixed on the life and stories of the people who did not choose this disease wilfully, however it guides them for the big part of their life. There was used the probe of the qualitative investigation with the technique of the half structured dialogue.The dialogues were recorded and subsequently analyzed by the help of the method of stationary theory.The principal aim is to find out,in what social spheres people with psoriasis have most often problems. The talks are made with the chosen patients, with their families, friends and with general...
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Immunogenetic and hormonal markers of predisposition to systemic rheumatic diseases particularly systemic lupus erythematosus
Fojtíková, Markéta ; Pavelka, Karel (advisor) ; Hrnčíř, Zbyněk (referee) ; Rovenský, Jozef (referee)
Fojtikova 2011 INTRODUCTION: Several factors like genetic susceptibility is required for systemic rheumatic diseases development. Immunomodulatory PRL effect supports autoimmunity. AIMS: 1. To detect the immunogenetic background (alleles HLA class I, II and microsatellite polymorphism of the transmembrane part exon 5 of MIC-A gene) of SLE and PsA. 2. To detect PRL serum and synovial fluid with regard to clinical and laboratory RA activity. 3. To find the role of the functional polymorphism -1149G/T SNP PRL of extrapituitary promoter of PRL gene in SLE, RA, PsA, SSc and inflammatory myopathies development. METHODS: Genetic analyses of pateints with SLE (n=156), RA (n=173), PsA (n=100), SSc (n=75), PM (n=47) a DM (n=68) and 123 healthy individuals: PCR-SSP (HLA clase I and II), PCR-fragment analysis (MIC-A) a PCR-RFLP (-1149 G/T SNP PRL). In 29 RA a 26 OA PRL serum and synovial fluid concentrations were detected using immunoradiometric assay. RESULTS: 1. The allele HLA-DRB1*03 (pc=0.008; OR 2.5) and haplotype HLA-DRB1*03-DQB1*0201 (pc <0.001; OR 4.54) were determined as risk immunogenetic markers for SLE in Czech population. In SLE versus controls allele MIC-A5.1 was increased (pc =0.005; OR 1.88). MIC-A5.1 together with HLA-DRB1*03 increases the risk for SLE development, pc <0.000001; OR 9.71....
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Possibilities of physiotherapy methods of psoriatic arthritis
DROBNÁ, Martina
This bachelor thesis deals with the problems of psoriatic arthritis, which has chronic evolution among most cases and can lead to articular deformities in patients. This disease has an unclear pathogenesis conditioned by genetic, external and immunologic factors. It affects above all patients with type I psoriasis with emerging symptoms such as swellings with articular pains, morning stiffness and overall fatigue. PsA often shows positive antigen HLA B27, without presence of rheumatoid nodules and negative rheumatoid factor (Štolfa, 2012). PsA causes both physical handicap in patients and substantial disturbance of their social and psychical life. The thesis is divided into theoretical and practical part. The theoretical part briefly outlines the anatomy of skin as well as structure and function of joints. Onward it describes psoriasis, its forms and methods of treatment. The next chapter explains the term arthritis and presents RA as an example. It is followed by detailed description of PsA, definition of the disease, its causes and occurrence, clinical picture and some therapy possibilities. In the practical part, the method of qualitative research was used, with participation of three female patients suffering from PsA. Therapy was initiated by input kinesiologic analysis, including specific examinations such as goniometric examinations of joints, grasp examinations, muscle palpation examinations and others. Patient appointments were held regularly each week for a period of eight-week therapy. On each appointment, previously applied therapy was consulted, exercises were repeated, possibly uncertainties were clarified. Each therapy lasted about 45 minutes, during which hypertonic muscles along with trigger points were relaxed according to specific patient issues. In the last session, output kinesiologic analysis was done and patients were informed about the importance of adhering to regimen measures. The results of the research clearly show overall posture improvement in all patients. A very substantial indicator of therapy success is noticeable reduction of swellings and pain, and hand function improvement. The therapy also focused on adjustment of faulty breathing stereotype manifesting itself with upper type, thereby causing overexertion of cervical spine muscles and frequent headaches. Strong emphasis was also put on activation of the transverse arch, which was collapsed in all patients. This bachelor thesis can be used in clinical practice of physiotherapists or as an educational material for patients.
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Creation of a center for patients with rheumatoid arthritis and psoriatic arthritis
ŠTOKROVÁ, Veronika
The name of this bachelor thesis is: Establishing a centre for people suffering from rheumatoid and psoriatic arthritis. Rheumatoid arthritis is a chronic, system, inflammatory illness of joints that results in destructions and deformities of joints. It is a characteristic feature of this illness symmetrically that it affects more joints at the same time, which are, in the majority of cases, small joints. Psoriatic arthritis is an inflammatory illness of joints which is accompanied by psoriasis. Psoriatic arthritis affects mainly distal interphalangeal joints of the hands, which makes it basically different from the rheumatoid arthritis. The thesis is divided into two parts. The theoretical part dealt with rheumatoid and psoriatic arthritis, priority needs of people suffering from these troubles, and a possible centre for these patients. The empirical part of my thesis was compiled in the form of qualitative research. The technique of collecting data was a semi-structured interview, which was conducted with 8 respondents suffering from rheumatoid and psoriatic arthritis, and 5 nurses working at rheumatologic surgeries. The interviews with the particular respondents and nurses were processed into case histories. The most interesting data were processed in the form of categorising tables. The thesis aimed at the following: to find out whether people suffering from these diseases are interested in establishing a centre for clients suffering from rheumatoid and psoriatic arthritis, to underline the benefits of such a centre for people suffering from rheumatoid and psoriatic arthritis, to underline possibilities of activities held at the centre for people suffering from rheumatoid and psoriatic arthritis, and to underline possibilities of involving nurses at the centre for people suffering from rheumatoid and psoriatic arthritis. We posed the following research questions: How much are people suffering from rheumatoid and psoriatic arthritis interested in establishing the centre? What do people suffering from rheumatoid and psoriatic arthritis view the benefits of the centre in? What are the possibilities of involving nurses at the centre for people suffering from rheumatoid and psoriatic arthritis? Which activities can be realised at the centre? The results of the research examination show that people suffering from rheumatoid and psoriatic arthritis are interested in establishing a centre. They view the benefits of the centre especially in seeing and testing compensation aids, and another benefit for them would be attending expert seminars held by a physician in cooperation with a nurse or, under circumstances, with students. The nurse in the centre would deal with the education, and another possible activity could be holding seminars or cooperation with a physician in basic examinations. The activities that can be realised in the centre are exercises under professional supervision of a physiotherapist, visiting a physician, testing compensation aids or making use of professional advice by an occupational therapist. The results of my bachelor thesis can serve as a foundation for creating a centre for people suffering from rheumatoid and psoriatic arthritis.
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