This thesis describes coping in pacients with chronic musculoskeletal pain. It focuses especially on the cognitive evaluation of pain and coping strategies. Furthermore it deals with the emotional changes in chronic pain. The theoretical part consists of the development of access to pain and the overview of some current knowledge of biological and psychosocial determinant of pain. Emphasis is placed on a holistic, biopsychosocial approach to the issue. Empirical part consists of research aimed at assesing the important factors that contribute to cope life with pain, as in terms of personal dispositions of an individual, so in terms of environmental influence. The main aim of the research is to identity the most used coping strategies and to assess their effectiveness. Keywords: chronic disease, chronic pain, coping resources, coping strategies

2. Abstract Adaptation to chronic hypoxia is in addition to ischemic preconditioning one of the two known cardioprotective mechanisms. The precise molecular basis of these processes is still not fully explained. There are some studies that suggest the possible involvement of the adenosinergic signaling system in this adaptation. In this work, we focused on the characterization of the adenosinergic system in the myocardium of rats adapted to two regimens of chronic hypoxia - a protective continuous normobaric hypoxia (CNH) and non-protective intermittent hypoxia (INH/R, 23 h hypoxia and 1 h normoxia). Initially, we compared the total amount of adenosine receptors in samples from different groups of adapted animals. We discovered changes mainly at A2B receptor, which increased at CNH and declined in INH/R. This result suggests the possible involvement of A2B receptors in cardioprotection afforded by adaptation to chronic hypoxia. Furthermore, we investigated the distribution of various types of adenosine receptors and transporters in the plasma membrane of cardiac cells. We observed that A2A and A3 localize in membrane microdomains together with membrane enzyme CD73 that produces adenosine in the extracellular space by degrading AMP. A1 and A2B receptors similarly as nucleoside transporters ENT1, ENT2 and...

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Stela Pavlíčková Supervisor: PharmDr. Ludmila Melicharová Title of diploma thesis: Pain therapy with focus on pacients with oncological disease Pain therapy is a part of the oncological illnesses complex treatment. This therapy doesn't solve the cause of cancer, but significantly increase patient's quality of life during oncological treatment, even in the terminal stage. The main target of this work is to give basic information about pain treatment, focusing on the oncological pain, and elaborate a review of pharmacological groups and individual substances most used in oncological pain treatment. Basic pillar of the cancer pain treatment is pharmacotherapy, which goes out of the WHO three-grade analgesic ladder. Basic therapy is made of nonopioid analgesics. In case that they aren't enough, we can add weak opioids, which can be replaced by strong opioids afterwards. Analgesics are usually used repeatedly and often in combinations. Dosage interval depends on pharmacological properties, dosage form and patient condition. Well controlled pain phases are usually interrupted by very strong, cruel pain episodes, which are called break-through pain. Very strong pain, fully or partially...

The role of lipids and ROS in cardioprotective mechanism of chronic hypoxia Cardiovascular diseases, mainly ischemic heart disease is one of the most frequently cause of morbidity and mortality in developed countries. Therefore effective protection of the heart against ischemia and reperfusion injury is the crucial aim of experimental and clinical cardiology. One of the main streams of cardiovascular research is looking for possibilities of natural heart resistance augmentation. Adaptation to chronic hypoxia is one possibility how to protect the heart against ischemia-reperfusion injury. Chronic hypoxia increases resistance of the myocardium to acute deficiency of oxygen leading to vetricular arrythmias, postischemic contractile dysfunction and necrotic changes in the tissue. Recently, it has been shown that reactive oxygen species (ROS) play an important role in the cardioprotective mechanism of chronic hypoxia. It is known that oxidative stress has a harmful effect in acute ischemia-reperfusion however ROS generated during the adaptation to hypobaric intermittent chronic hypoxia play a role in the induction of cardioprotection. In this study, we demonstrated that adaptation of adult rats to chronic hypoxia increased the activity and protein abundance of manganese superoxide dismutase (MnSOD) in the...

This diploma thesis summarizes recent knowledge about body scheme, spatial orientation and their change in context of chronic pain. The purpose of this work is to find out if chronic pain negatively affects the body scheme and spatial orientation. The thesis includes a comparative analysis of experimental measurements between the patients with Failed Back Surgery Syndrome and healthy control group. The analysis compares tasks based on spatial orientation and body scheme tests. Results show the patients' group having lower results in body scheme related tests, showing a noticeable disparity compared to the control group's test scores. These results were further supported by portion of spatial orientation based tasks, where patients' group again performed at significantly lower level than the control group. In conclusion, our thesis, along with other academic works, states that there is a correlation between chronic pain, disrupted body scheme and spatial orientation. However, at the present time it could not be determined whether the pain precedes the effect of disrupted body scheme or vice versa. Powered by TCPDF (www.tcpdf.org)

Aim: The aim of this thesis is both evaluate a somatognosis quality and consider rate of personality dimensions in patients with FBSS. Methods: 30 patients with FBSS and 25 probands of healthy control group were examinated in laboratory of spatial cognition called Blue Velvet Arena. They underwent spatial navigation task and body scheme tests. We made comparative analysis of these measurements between groups. We evaluated personality dimensions in patients group, by using NEO personality inventory and Petrie test. Finally we consider relationships of these variables and another related factors. Results: Signicant difference between patient's group and control group was found both in spatial navigation task and body scheme tests. In spatial navigation task control group had lower results compared to the patient's group. In body scheme tests was found reverse results. We found high correlation of body scheme with age, pain duration and activity level. There was high percentage of underestimating probands and probands with high score of conscientiousness. Error rate (judgement out of tolerance zone) was higher in patient's group compared to the control group. Conclusions: Our results states that patients with FBSS have lower quality of somatognosis in light of body scheme. We hypothesise, that body...

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical sciences Student: Veronika Krčmářová Supervisor of master thesis: PharmDr. Miroslav Kovařík Ph.D. Title of master thesis: Resting energy expenditure in patients with chronic obstructive pulmonary disease II The aim of this study was to compare the resting energy expenditure (REE) and nutritional substrate utilization among patients with chronic obstructive pulmonary disease (COPD) and control group. Previous studies have confirmed increased values of REE in COPD patients. On the basis of the increase of this parameter there was a loss of lean and muscle mass. The utilization of nutritional substrates in patients with COPD is not yet known. Our study by a total of 20 patients includes 11 patients with COPD, and 9 from the control group . The age of patients ranged from 55 to 71 years. Each patient was examined once. We determined the value of REE by indirect calorimetry and utilization of nutritional substrates. According to our results, there was an increase in REE in 82 % of patients with COPD, while only 33 % of patients from the control group was hypermetabolic. Comparing the results of REE between groups we observed REE increase by about 20 % in patients with COPD compared with the control...

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Student: Lucie Sehnalová Supervisor of master thesis: PharmDr. Miroslav Kovařík Ph.D. Title of master thesis: Determination of body composition by bioelectrical impedance method in patients with chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is one of the top leading causes of death and its morbidity and mortality worldwide is still increasing. Besides the respiratory symptoms there are often developed alterations in metabolism and body composition in COPD patients. Clinically important are mainly malnutrition and skeletal muscle protein loss. Especially if the respiratory muscles are affected, the lung function is negatively influenced. The main aim of this study was to compare the body composition between 15 patients with COPD 3rd and 4th stage and 9 patients of control group without respiratory impairment and comparable anthropometric characteristics (age, body height and weight). By means of bioelectrical impedance analysis we determined the composition of main body compartments. In patients with COPD was the mean amount of lean tissue of body weight (rel LTM) 47.2 ± 8.4 %, amount of fat mass (rel Fat) 37.8 ± 6.4 % and mean overhydration (OH) 0.31...

1 Abstract Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Student: Martin Jenšík Supervisor of master thesis: PharmDr. Miroslav Kovařík Ph.D. Title of master thesis: Resting energy expenditure in patients with chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is step by step moving ahead in public and scientific interest due to its fast rising in mortality rate. Contemporary studies observed a phenomena that patients with COPD have increased resting energy expenditure (REE) that leads to loss of fat free mass and total weight. Our goal was to confirm or disprove this hypothesis. Our research ran in Department of research and development at University hospital Hradec Králové. In our study participated 30 patients, 26 men and 4 women, mean age 67 ± 8 let. Every patient was once examined after twelve-hour fasting. We determined REE and substrate utilization by method of indirect calorimetry. We confirmed increased REE from the average value of REE - 122 ± 14 % predicted by Harris - Benedict equation. None patient was hypometabolic, 7 were normometabolic and 23 hypermetabolic. Substrate utilization did not differ contrary to physiological values. Furthermore we discovered correlation among fat mass, fat free mass,...

Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Biological and Medical Sciences Student: Barbora Malinová Supervisor of Diploma thesis: PharmDr. Miroslav Kovařík Ph.D. Title of diploma thesis: Densitometric determination of body composition in patients with chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in 2004 according to the WHO Global Burden of Disease Project and its morbidity and mortality worldwide is still increasing. Besides the lung function impairment, there are often described changes in body composition in COPD patients e.g. the skeletal muscle protein loss. The main aim of the study was determining the body composition by DEXA in patients diagnosed with COPD and comparing them with physiological values or studies dealing with this issue. On each patient was performed one examination, patients were coming after twelve-hour fasting. Average age was 66 ± 8 years. The amount of fat-free mass was not reduced. There was not therefore a loss of muscle tissue due to COPD. When evaluating total fat, we find that men have more fat than normal levels. This is also indicated by BMI that has been in the majority in the range of overweight and obesity. We did not confirm the link between COPD...