The general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives. The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Three types of long-term pain were classified and described among the 43 participants included, aged 33-82 years. These were central post-stroke pain, nociceptive, mainly shoulder pain, and tension-type headache. Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all pain groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about longterm pain, attention and understanding among the professionals, and continuity in the contacts. / On the day of the public defence the status of article III was: Accepted for publication and the status of article IV was: In press.

Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology and Toxicology Student: Eliška Holinská Supervisor: Prof. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Pharmacoteraphy of headache in adults Headache is one of the most common health problem that encounters almost everyone during the life. Depending on the cause, headaches can be divided on the primary headaches, which are the subject of the diploma thesis, and secondary headaches, which are caused by other diseases. The primary headaches are migraine, tension-type headache, cluster headache and primary chronic daily headache. Headache is not a life-threating condition but it can significantly reduce the quality of life, particularly the chronic forms of headache. The determination of the right diagnosis is essential for the choice of appropriate therapy. For primary headache are typical negative test results, there are no structural lesions or signs of organic brain damage. Diagnostics is comlicated and it is primarily based on a carefully processed medical history. In the therapy of primary headache are used both pharmacological and non-pharmacological methods, optimaly in combination. Pharmacological treatment consists of preventive and acute therapy. The preventive treatment is given to reduce the...

<p>U poslednje vreme upotreba računara se smatra značajnim okidačem za nastanak primarnih glavobolja. Svi rizikofaktori pri radu na računaru značajni za nastanak glavobolja su nedovoljno jasni i ispitani, te su i strategije prevencije nepoznate. Ciljevi ovog istraživanja su utvrđivanje razlika u prevalenciji primarnih glavobolja kod ispitanika koji koriste i koji ne koriste računar, kao i utvrđivanje uticaja vremena provedenog u radu na računaru i pona&scaron;anja pri radu na računaru na ispoljavanje određenog tipa primarne glavobolje. U studiji preseka finalni uzorak je činilo 1500 ispitanika. Uzorak je podeljen na dve grupe: 1. ispitanici koji koriste računar (95.7%), 2. ispitanici koji ne koriste računar (4.3%). Obe grupe su nadalje podeljene na: 1. one koji imaju glavobolju i 2. one koji nemaju glavobolju. Kod ispitanika koji koriste računar, glavobolju je imalo 69.6% ispitanika, a kod ispitanika koji ne koriste računar 27.4%. Nadalje, kod ispitanika koji koriste računar od glavobolje tenzionog tipa boluje 30.3%, od migrene 16.7%, od verovatno sekundarne glavobolje 14.0% ispitanika. Kod ispitanika koji ne koriste računar od glavobolje tenzionog tipa boluje 19.4%, od migrene 4.8% ispitanika, i od verovatno sekundarne glavobolje 3.2% ispitanika. Utvrđeno je da su korisnici računara imali značajno veću prevalenciju primarnih glavobolja u odnosu na one koji ne koriste računar. Korisnici računara sa glavoboljom u odnosu na one bez glavobolje duže rade na računaru, če&scaron;će ne prave pauzu, a kada je i naprave, one traju kratko, če&scaron;će zauzimaju nepravilan položaj tela. Korisnici računara sa migrenom u odnosu na one sa glavoboljom tenzionog tipa značajno duže vremena provode na računaru kod kuće, ređe prave pauze, a kada ih prave one su kratke, pravilnije sede za računarom, a u pauzi ređe sede i koriste mobilni telefon ili tablet. Prilikom klasifikacije glavobolja izdvojila se grupa od 8.6% ispitanika koji su imali glavobolju koja se nije ispunjavala kriterijume za migrenu, glavobolju tenzionog tipa, ni trigeminalnu autonomnu glavobolju, a nije postojala sumnja da je to sekundarna glavobolja. Obzirom da se ona javljala isključivo kod korisnika računara i da je većina njih izvestila da rad na računaru može biti okidač, ona je svrstana u ostale primarne glavobolje, za koju se pretpostavlja da za njen nastanak upotreba računara ima značajan uticaj. Korisnici računara oboleli od ostalih primarnih glavobolja u odnosu na obolele od migrene vi&scaron;e vremena provode u radu na računaru na poslu, ređe zauzimaju pravilan položaj, ali če&scaron;će prave pauzu, a u odnosu na one sa glavoboljom tenzionog tipa, če&scaron;će izve&scaron;tavaju da vi&scaron;e vremena provode na računaru i na poslu i kod kuće, da nakon dužeg vremena prave pauzu ili nikada, i da im pauze kraće traju, ali da pravilnije sede pri radu na računaru. Na osnovu rezultata može se zaključiti da primarne glavobolje predstavljaju značajan zdravstveni problem kod korisnika računara. U uzorku su detektovani ispitanici sa glavoboljom, koja je bila prisutna samo kod korisnika računara, koja nije ogovarala postojećim kriterijumima klasifikacije ni za jednu primarnu glavobolju i za koju se sumnja da za njen nastanak rad na računaru imao značajan uticaj. Korisnici računara sa glavoboljom se ne pridržavaju definisanih ergonomskih preporuka pri radu na računaru, te se javlja potreba za sprovođenjem sistematske edukacije korisnika računara o ergonomskim preporukama u cilju prevencije ataka glavobolja.</p> / <p>As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on As of recently, the use of computers is considered a significant trigger for the development of primary headaches. The risk factors when working on a computer which are important for the occurrence of headaches are insufficiently clear and unexamined, thus making prevention strategies unknown. The aims of this study are to determine differences in the prevalence of primary headaches in respondents who use and do not use a computer, as well as to determine the impact of time spent working on a computer and computer work related behavior on the manifestation of a particular type of primary headache. In the cross-sectional study, the final sample consisted of 1500 subjects. The sample was divided into two groups: 1. respondents who use a computer (95.7%), 2. respondents who do not use a computer (4.3%). Both groups were further divided into: 1. those who have a headache and 2. those who do not have a headache. Among respondents who use a computer, 69.6% of respondents had a headache, and among respondents who do not use a computer, 27.4%. Furthermore, in respondents who use a computer, 30.3% suffer from tension-type headaches, 16.7% from migraines, and 14.0% from probable secondary headaches. In subjects who do not use a computer, 19.4% suffer from tension-type headaches, 4.8% from migraines, and 3.2% from suspected secondary headaches. Computer users were found to have a significantly higher prevalence of primary headaches compared to those who did not use a computer. Computer users with headaches, compared to those without headaches, work on influenced by computer use. Computer users with headaches do not adhere to the defined ergonomic recommendations when working on the computer, hence there is a need for systematic education of computer users on ergonomic recommendations in order to prevent headache attacks.</p>