Case study of ortho-prosthetic care of a patient with a diagnosis of transtibial amputation

vi Abstract Title: Case study of ortho-prosthetic care of a patient with the diagnosis of transtibial amputation Objectives: The main goal of this bachelor's thesis is to process a case report of a patient with a detailed description of the production and application of a prosthetic device. Another goal is to process basic theoretical knowledge about anatomy, amputations and prosthetics of the lower limbs with a focus on transtibial prostheses. Methods: The bachelor's thesis is divided into a theoretical and a practical part. The theoretical part summarizes basic knowledge regarding anatomy, amputations and transtibial prosthetics of the lower limbs. The practical part contains a case study of a diabetic patient with the diagnosis of lower leg amputation, which consists of a description of their medical history, measurement taking and the process of manufacturing a prosthetic device. Results: The case report was prepared as part of my professional training at Protetika s.r.o. The result of the work is the creation of a new prosthetic device that will help the patient in his daily life and improve it. Keywords: amputation, prosthesis, transtibial, case reportv Abstrakt Název: Kazuistika ortoticko-protetické péče o pacienta s diagnózou amputace bérce Cíle: Hlavním cílem této bakalářské práce je zpracování kazuistiky pacienta s detailním popisem výroby a aplikace protetické pomůcky. Dalším cílem je zpracování základních teoretických poznatků o anatomii, amputacích a protetice dolních končetin se zaměřením na transtibiální protézy. Metody: Bakalářská práce je rozdělena na část teoretickou a část praktickou. Teoretická část shrnuje základní poznatky týkající se anatomie, amputací a transtibiální protetiky dolních končetin. Praktická část obsahuje kazuistiku diabetického pacienta s diagnózou amputace bérce, která se skládá z popisu anamnézy, odebírání měrných podkladů a procesu výroby protetické pomůcky. Výsledky: Kazuistika byla zpracována v rámci plnění mé odborné praxe ve společnosti Protetika s.r.o. Výsledkem práce je zhotovená nová protetická pomůcka, která pomůže pacientovi v jeho každodenním životě a zkvalitní jej. Klíčová slova: amputace, protéza, transtibiální, kazuistikaKatedra fyzioterapieDepartment of PhysiotherapyFaculty of Physical Education and SportFakulta tělesné výchovy a sport

The possibilities of bone densitometry and monitoring occurrence of osteoporosis at the past populations.

Ochorenie osteoporózou je dnes celosvetovým problémom. Otázkou ale zostáva, či osteoporózou trpeli i ľudia minulých populácii alebo je zvýšený výskyt osteoporózy následok dnešnej doby. Doby, keď sú ľudia nedostatočne vystavení slnečnému žiareniu, a tak nedostatku vitamínu D, doby, keď životný štýl sa nezhoduje s pojmom zdravý životný štýl. Cieľom práce bolo zistiť, či pochované osoby na Mikulčickom hradisku majú pokles kostnej hmoty, ktorý ukazuje, či v ich živote figurovala osteoporóza. Hodnoty kostnej hmoty sa získavali pomocou denzitometrického merania, merali sa kosti päty a štvrtý lumbálny stavec. Práca nadväzovala na štúdiu, pri ktorej sa denzitometricky merali kosti stehenné. To znamená, že jednej osobe, ak to bolo možné z hľadiska zachovalosti, sa zmerali kosti stehenné, kosti päty a štvrtý lumbálny stavec. Ďalším cieľom práce bolo zistiť, či hodnoty z jednotlivých meraní majú na sebe signifikatnú závislosť a či by bolo možné z meranie jednej oblasti usúdiť niečo o meranných hodnotách z oblasti druhé, nakoľko najväčším problémom archeologického materiálu je práve zachovalosť a kompletnosť skúmaného materiálu. Ďalej má práca metodický prínos, prináša presný popis merania kosti päty v prístroji Lunar PIXI určený pre meranie kosti päty u živých pacientov a taktiež prináša možnosť merania...Nowadays, disease of osteoporosis is worldwide problem. The question is whether osteoporosis affected people of past populations or increasing of osteoporosis is result of todayś time. Time, when people don't have enough of solar radiation and vitamin D, time when lifestyle does not match with the term healthy lifestyle. The goal of this work was to determine whether the buried persons at fort in Mikulčice had less of bone mass which indicates whether osteoporosis figured in their lives. The values of bone mass were obtained by densitometric measurements. The heel bones and fourth lumbar vertebras were measured. The work continued on a study in which femoral bones were measured. It means, if it was possible in terms of preservation, femoral bones, heel bones and fourth lumbar vertebras were measured in one person. Another goal of this work was to determine whether the values of the individual measurements show a significantly dependence on each other and whether would be possible to infer something about measure of one area from measurement of second area since the biggest problem of archaeological material is preservation and completeness of the material. The work has also a methodological contribution. The work provides precise description of measurement of the heel bones by using Lunar PIXI...Department of Anthropology and Human GeneticsKatedra antropologie a genetiky člověkaFaculty of SciencePřírodovědecká fakult

Testing various imaging methods in assessment of hyoid bone fractures

In the field of forensic anthropology, the hyoid bone provides important evidence on victim’s biological profile (e.g., sex or age at death) and on potential foul play, because in addition to accidental (e.g., traffic accidents, medical-rescue interventions), and self-inflicted traumas (e.g., hanging), hyoid fractures have been vastly documented in assaulted injuries (e.g., manual or ligature strangulations). Still, an unbiased diagnosis of perimortem damage can be problematic as hyoid fractures frequently occur postmortem when a laryngeal region is being harvested and examined at autopsy. The aims of the present study was to explore characteristics of peri- and post-mortem fractures in hyoid bones by a variety of available examination techniques. The studied material consisted of selected fractured hyoid bones with documented demographic profiles and mechanisms of damage. Characteristics of the observed fractures (e.g., hyoid shape, fracture angle and surface characteristics of the fracture line) were assessed on a macroscopic level using traditional and advanced approaches (macro-photography, 3D laser scanning). Furthemore, micro-CT, RTG and SEM imaging methods were employed to examine damaged regions on a microscopic level. Special attention was given to the distinctions between peri- and post-mortem fractures by observing the cortical bone microstructure (as viewed on raw CT images, and generated 3D digital models) as the bone tissue properties are believed to reflect the mechanism of damage substantially. The acquired results provide an important insight into potentials and limitations of currently available imaging techniques employable in the course of assessing hyoid bone fractures in the framework of physical and forensic anthropology

The assessment of the semicircular canals and cochlea of the human bony labyrinth using imaging techniques

The human bony labyrinth is an inner ear structure located inside the pyramid of the temporal bone that encloses the organs of sound perception and balance. As one of the most resistant skeletal elements in human body, the pyramid is frequently uncovered in a good state of preservation. Until recently, research of the human bony labyrinth had been restricted exclusively to irreversibly invasive techniques. Due to this invasiveness, literature on morphological variation has been scarce and many questions regarding population, age or sex-related differences are yet to be answered. The studied sample of pyramids originated from Dětkovice - Za zahradama Site (Czech Republic) dated to 1000’s and 1100’s A.D. All elements were examined using an X-ray Carestream Xtreme device and a cone-beam CT unit. In digital X-ray images, linear distance of the semicircular canals and cochlear diameter were measured in ImageJ program. CT images were first processed to generate 3D digital models, which were subsequently studied using a newly established PC-aided approach employing measuring functionalities available in GOM Inspect program. Altogether 39 variables were proposed in order to describe shape and size variation in the semicircular canals. Acquired measurements were confronted and tested against individual's demographic data determined based on corresponding skeletal elements and burial attributes. The results showed small to none sex-related and body side-specific differences. Still, statistically significant differences were shown between sub-adults and adults. They were particularly evident in size variables of the lumens of the lateral and posterior semicircular canal, where larger values for adults were provided. This indicates a widening of the canals during growth by the resorption in the vicinity of the canals. The acquired results contribute to our comprehension of the development of inner ear structures and demonstrate the potential of the employment of non-invasive approaches when examining human skeletal remains

Bats and Caves: Activity and Ecology of Bats Wintering in Caves

Temperate regions of the world undergo a marked range of seasonal variation, most becoming extremely cold during the winter. Bats are the only group of vertebrates that have successfully exploited caves as permanent shelter. Although bats may use caves throughout all year, their most important role in ecology of temperate bats is as hibernacula. Here, we summarize various aspects of bat hibernation ecology, including variation in flight activity at the cave entrance; patterns of bat hibernation behaviour; site selection in hibernacula, including the importance of temperature during hibernation; and level of bat movement activity inside the cave. In addition, we review present knowledge on white‐nose syndrome, one of the most important threats to cave‐dwelling bats

Quercetin-induced changes in femoral bone microstructure of adult male rabbits

Flavonoids are a group of plant metabolites with antioxidant effects. One of the most abundant flavonoids in the human diet is quercetin. It is found widely in fruits, vegetables and has a lot of beneficial effects on human health. Quercetin has a positive pharmacological effect on bone metabolism and it prevents the organism against bone loss. However, its impact on the size of basic structural units of the compact bone is still unknown. Therefore, the aim of present study was to investigate the impact of the quercetin on femoral bone microstructure in 5-month-old male rabbits. Five rabbits of Californian broiler line were randomly divided into two groups. In the experimental group (E group; n=3), animals were intramuscularly injected with quercetin at dose 1000 μg.kg-1 body weight (bw) for 90 days, 3 times per week. Two rabbits without quercetin administration served as a control group (C group). According to our results, intramuscular application of quercetin had an insignificant effect on cortical bone thickness in male rabbits. In these rabbits, changes in qualitative histological characteristics were present in the middle part of the compacta, where primary vascular longitudinal bone tissue was present and expanded there from the periosteum. Also, a lower number of secondary osteons was found in these animals. From the histomorphometrical point of view, significantly decreased sizes of primary osteons' vascular canals and secondary osteons (p <0.05) were found in rabbits administered by quercetin. Our findings indicate that subchronic administration of quercetin at the dose used in our study had considerable impact on both qualitative and quantitative histological characteristics of the compact bone in adult male rabbits

Use of germline genetic variability for prediction of chemoresistance and prognosis of breast cancer patients

The aim of our study was to set up a panel for targeted sequencing of chemoresistance genes and the main transcription factors driving their expression and to evaluate their predictive and prognostic value in breast cancer patients. Coding and regulatory regions of 509 genes, selected from PharmGKB and Phenopedia, were sequenced using massive parallel sequencing in blood DNA from 105 breast cancer patients in the testing phase. In total, 18,245 variants were identified of which 2565 were novel variants (without rs number in dbSNP build 150) in the testing phase. Variants with major allele frequency over 0.05 were further prioritized for validation phase based on a newly developed decision tree. Using emerging in silico tools and pharmacogenomic databases for functional predictions and associations with response to cytotoxic therapy or disease-free survival of patients, 55 putative variants were identified and used for validation in 805 patients with clinical follow up using KASP™ technology. In conclusion, associations of rs2227291, rs2293194, and rs4376673 (located in ATP7A, KCNAB1, and DFFB genes, respectively) with response to neoadjuvant cytotoxic therapy and rs1801160 in DPYD with disease-free survival of patients treated with cytotoxic drugs were validated and should be further functionally characterized. © 2018 by the authors. Licensee MDPI, Basel, Switzerland.Czech Medical Council [15-25618A]; Charles University [GAUK 1776218

The role of vitamin D in relation to bone disease.

In recent years vitamin D is at the forefront of scientific research because of its huge impact on human health. Vitamin D plays pivotal roles in metabolism of bones by regulation of their mineralization and building. Dysfunction or deficiency of vitamin D can lead to occurrence of many diseases like osteoporosis, rickets and osteomalacia. In the archeological studies of my bachelor's essay I have mentioned that deficiency of vitamin D was also found in last human population. There is no difference in present. In March in 2010 was published 59 % of people are affected by deficiency of vitamin D and 25 % from them are affected by acute deficiency of vitamin D (Gilsanz et al., 2010). Deficiency of vitamin D is typically for people who don't expose for the Sun and eat poor food for vitamin D, for women after menopause and for people afflicted with failure of kidney, liver, intestine absorption and hyperparathyroidism. Deficiency of vitamin D is the most critical for children because of disrupting their growing of cartilages, bones and teeth. Bones begin soft, fragile and usually are deformed by weight of body. Disease with these symptoms is known like rickets. In adults deficiency of vitamin D can cause bad accumulation of calcium in bones and so bones are demineralized, thin, soft and easy to deform...