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Comparative analysis of the effect on disease-modifying drugs and biological therapy in functional ability in patients with rheumatoid arthritis.
Sýkorová, Veronika ; Vomáčková, Helena (advisor) ; Nováková, Tereza (referee)
Autor: Bc. Veronika Sýkorová Title: Comparative analysis of the effect on disease-modifying drugs and biological therapy in functional ability in patients with rheumatoid arthritis. Objective: The aim of the thesis is to compare the effect of disease-modifying drugs and biological therapy on quality of life using the disability index, which is achieved by evaluating the HAQ, grip strength the small muscles of the hand, which is tested a hand dynamometer and standing stability, which is detected by measuring on stabilometric platform. Methods: This is a pilot study using subjective and objective examination. Stabilometric and dynamometric examination and the Czech version of the Stanford Health Assessment Questionnaire validated by Rheumatology Institute in Prague 2010 were used to the analysis. Evaluation of the collected data was done using two-way analysis of variance with repetition. Results: Biological therapy and disease-modifying antirheumatic drugs have significant impact on quality of life, the strength of the small muscles of the hand and standing stability in patients with rheumatoid arthritis. Disease-modifying antirheumatic drugs have reached significant results than the biological therapy in quality of life, forces the small muscles of the right hand and standing stability. Biological...
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Case study of physiotherapy care of a patient with rheumatoid arthritis and after hip replacement surgery
Páleníková, Vanda ; Pavlů, Dagmar (advisor) ; Jarošová, Hana (referee)
Title: Case study of physiotherapy care of a patient with rheumatoid arthritis and after hip replacement surgery Author: Vanda Páleníková Aim: Summary of theoretical knowledge, performing a kinesiological analysis, design treatment and monitoring of the patient during rheumatoid arthritis, and before and after right hip replacement surgery and subsequently summation effects by therapy. Methods and abstract: This thesis was created during professional practice, which was held at the Institute of Rheumatology in Prague from 14.1. 2013 to 8.2 2013. The thesis is divided into two parts - general and special. The first (general) part deals with the theoretical knowledge of rheumatic diseases, particularly rheumatoid arthritis and hip replacement surgery and methods of treatment, including physiotherapy practice. The second (special) case report describes a patient with rheumatoid arthritis before and after total hip replacement surgery, the design and the process of therapy and its evaluation. Result: The patient's condition was improved. After the operation has been modified posture and position in right hip joint. During therapy increased muscle strength and increase range of motion in the right hip joint. Key words: case study, rheumatoid arthritis, total hip replacement, surgery of rheumatic...
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Vliv fyzioterapie na rozvoj jemné motoriky ruky u pacientů s revmatoidní artritidou
MACHYNIAKOVÁ, Šárka
The subject of this thesis is mainly description of rheumatoid arthritis and physiotherapeutic possibilities of precisely developing hand motoring. The first objective was to describe the current possibilities of physiotherapy in patients with rheumatoid arthritis, which were appropriately applied based on individual kinesiological analyses. Second goal was to build an effective exercise unit for developing fine motor skills in the hands area, based on objective and subjective information obtained from probands at the time of the research. This thesis is divided into two parts. The first theoretical part described the disease itself, epidemiology, etiopathogenesis, clinical picture, elemental examination diagnosis, and detailed description of known types of therapy. Finally, I briefly described the anatomy and kinesiology of the upper limb plait. The second practical part I processed in the form of qualitative research. The research sample contained one man and two women aged 79 to 89. For all probands, I performed an initial kinesiological analysis, grip evaluation, and testing according to Jebsen - Taylor test. Based on the information gathered, I have set short-term goals and chosen appropriate physiotherapy methods to achieve these set goals. The practical part took place over three months. During this time, I visited patients once a week and adjusted the therapy as necessary. Finally, I performed an output kinesiological analysis, the results of which I compared with the input kinesiological analysis and performed an evaluation. Probands were advised to continue therapy by fulfilling the goals of the long-term rehabilitation plan. The information found indicates that regular therapy with appropriate exercise has a positive effect especially on increasing shoulder joint ranges, improving hand handling, pain relief, and overall psychological improvement of probands. This thesis can be used as educational material for healthcare professionals, medical students, the public, and especially for the sick or their loved ones.
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Case study of physiotherapeutic treatment of a patient with Rheumatoid arthritis after total hip replacement
Uhlíková, Barbora ; Žáková, Lenka (advisor) ; Vincová, Gabriela (referee)
Author: Barbora Uhlíková Supervisor: PhDr. Lenka Žáková, Ph.D. Title: Case study of physiotherapeutic treatment of a patient with Rheumatoid arthritis after total hip replacement Objectives: The aim of this thesis is the theoretical elaboration of information regarding the diagnosis and preparation of a case report of physiotherapeutic care in a patient diagnosed with rheumatoid arthritis with a condition after TEP of the hip joint. Methods: The theoretical part deals with the anatomy and kinesiology of the hip joint, information about rheumatoid arthritis and osteoarthritis, treatment options for osteoarthritis, hip arthroplasty and subsequent physiotherapy intervention after hip replacement. The special section includes initial kinesiological analysis, individual therapies, outcome kinesiological analysis and evaluation of the effect of physiotherapy intervention. The thesis also includes a comparison of the physiotherapy methods selected and used by me with the literature. All physiotherapeutic methods and procedures used during the therapy are within the framework of the Bc in Physiotherapy at UK FTVS. Results: During the physiotherapy intervention consisting of 9 sessions, the patient experienced several positive changes. The therapies were without complications. The results of the therapies...
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The role of TRP ion channels in rheumatoid arthritis pain
Havrilčáková, Gabriela ; Zímová, Lucie (advisor) ; Heleš, Mário (referee)
Rheumatoid arthritis is a disease that affects many people across the world. It is a chronic autoimune disease causing inflammation in joints. The inflammation affects joint lining and causes gradual damage to the joint cartilage. Main symptoms are swelling and pain, The perception of pain is closely related to a group of TRP receptors expressed on sensory neurons. The state of inflammation in the affected joints also has a significant influence on the pain accopanying rheumatoid arthritis, in which participate the cells of the joint lining - synovial fibroblasts. They express a subset of TRP receptors that play a key role in the pathophysiology of arthritis development as well. In relation to pain and inflammation, the most studied TRP receptors are TRPV1 and TRPA1. This bachelor thesis describes the findings on these two receptors in relation to pain in rheumatoid arthritis. However, it also describes the TRPC5 receptor, whose inhibiton has only recently been shown in a mouse model to leads to exacerbation of symptoms. The results discussed in this bachelor's thesis show, that pharmacological modulation of the activity of TRP receptors is a promising way of possible future treatment of rheumatoid arthritis, including its main symptom - pain. Key words: rheumatoid arthritis, transient receptor...
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Role of IL-34 in the pathogenesis of autoimmune rheumatic diseases
Reichlová, Petra ; Andrés Cerezo, Lucie (advisor) ; Brdička, Tomáš (referee)
Interleukin-34 (IL-34) is a cytokine described in 2008 using proteomic analysis. As IL-34 does not share any sequence similarity with other interleukins, it fell into the group so-called "orphan" cytokines. IL-34 binds to three receptors: CSF-1R, syndecan-1 and PTP-ζ. These interactions influence signal pathways which lead to proliferation, differenciation of monocytes or to an increased expression of other cytokines. Up-regulated expression of IL-34 has been observed in many autoimmune rheumatic diseases such as rheumatoid arthritis, systemic lupus erythematosus, Sjögrenʼs syndrome or systemic scleroderma. These findings indicate that IL- 34 may be involved in the pathogenesis of these diseases and may become one of the diagnostic markers or even the target of medical therapy in the future. Key words: interleukin-34, cytokine, autoimmune rheumatic diseases, rheumatoid arthritis, systemic scleroderma, systemic lupus erythematosus, Sjögrenʼs syndrome
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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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Selected aspects of methotrexate treatment in patients with rheumatoid arthritis
Hloch, Karel ; Pávek, Petr (advisor) ; Souček, Miroslav (referee) ; Tomčík, Michal (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Training Workplace Department of Social and Clinical Pharmacy Doctoral Degree Program Clinical and Social Pharmacy Candidate MSc. Karel Hloch Supervisor prof. PharmD. Petr Pávek, Ph.D. Advisor assoc. prof. MUDr. Tomáš Soukup, Ph.D.; PharmD. Martin Doseděl, Ph.D. Title of Doctoral Thesis: Selected aspects of methotrexate treatment in patients with rheumatoid arthritis Introduction and objectives Rheumatoid arthritis (RA) is an autoimmune disease typically connected with chronic inflammation of the joints, causing their swelling and pain. The prevalence of RA is about 1% in the general population. A crucial role in higher morbidity and mortality in RA patients has been associated with increased inflammatory activity. Methotrexate (MTX), a drug with immunosuppressive activity, is the most frequent drug of choice used in RA therapy. It seems that main anti-inflammatory effect is mediated via release of purine nucleoside adenosine. The status of patients with inflammatory diseases is influenced by activation of A2a and A3 adenosine receptors. High caffeine (adenosine receptor antagonist) consumption may therefore lead to alteration of MTX treatment efficacy. 1) The aim of first study was to determine whether RA patients who had discontinued...
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Case Study of Physiotherapeutic Care of a Patient with Rheumatoid Arthritis
Stehlíková, Alžběta ; Opatrná Novotná, Irena (advisor) ; Nováková, Tereza (referee)
Title: Case study of physiotherapeutic care of a patient with rheumatoid arthritis Objectives: The aim of this thesis is to elaborate case study of physiotherapeutic care of a patient with rheumatoid arthritis and to confirm the effect of chosen physiotherapeutic methods and procedures. Their effectiveness demonstrates the importance of a physiotherapist as part of an interdisciplinary team in comprehensive care. Methods: This thesis was based on a four-week internship at the Institute of Rheumatology in Prague in the period from January 10, 2022 to February 4, 2022 under the professional supervision of Mgr. Gabriela Vincová. The bachelor thesis consists of a general and a special part. The general part is focused on theoretical information about RA - it deals with its epidemiology, etiopathogenesis and clinical signs. Additionally, it includes diagnostics and differential diagnosis, evaluation of disease activity, course and prognosis, therapy and rehabilitation. The special part consists of a case study of physiotherapeutic care, including anamnesis, initial kinesiological assessment, short-term and long-term goals, design and course of therapy, final kinesiological assessment and evaluation of the effect of the therapy. Results: After eight therapies, the final kinesiological assessment was...
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The expression of interleukin 20 and its role in rheumatoid arthritis
Yadollahi, Benjamin ; Šenolt, Ladislav (advisor) ; Krulová, Magdaléna (referee)
Rheumatoid arthritis (RA) is a chronic autoimmune disease that is associated with formation of autoantibodies, activation of inflammatory cascade and up-regulation of several cytokines. These processes lead to persistent synovial inflammation, joint damage and systemic manifestations. The aim of this diploma thesis is to characterize the role of a novel cytokine interleukin-20 (IL-20) in the pathogenesis of RA and to investigate its involvement in different stages of the disease as a potential surrogate biomarker. In this work, several methods including Enzyme-Linked Immunosorbent Assay (ELISA), Immunohistochemistry and Real-Time quantitative Polymerase Chain Reaction (RT-qPCR) have been employed. We demonstrated increased expression of IL-20 in the synovial tissue of RA compared with control osteoarthritis (OA) patients. Along with the up-regulation at sites of inflammation, concentrations of IL-20 were higher in the synovial fluid compared with circulating levels of IL-20. Furthermore, serum and synovial fluid IL-20 levels significantly correlated with RA disease activity. Synthesis of IL-20 was significantly increased in peripheral blood mononuclear cells (PBMCs) and synovial fibroblasts upon stimulation with some TLR ligands and pro-inflammatory cytokines. Although not regulating PBMCs functions in...
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