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Lipid emulsions in lonf-term parenteral nutition
Ševela, Stanislav ; Novák, František (advisor) ; Cahová, Monika (referee) ; Lahoda Brodská, Helena (referee)
The combination of intestinal failure and parenteral nutrition is a condition associated with mild chronic inflammation and organ injury, the most significant of which is hepatic injury. This crossover-controlled trial investigated the effects of different intravenous lipid emulsions (IVLE) enriched with increased doses of omega-3 polyunsaturated fatty acids (n-3 PUFA) from fish oil (FO) in patients on home parenteral nutrition (HPNP) for chronic intestinal failure. Twelve patients were consecutively given three different IVLEs, with an FO emulsion added after each IVLE. The study also included twelve paired healthy controls for comparison. The aim of this study was to investigate how long-term administration of these IVLEs affected primarily the erythrocyte and plasma fatty acid (FA) spectrum, as well as the inflammatory response, antioxidant status, markers of liver function and bile acid spectrum in HPNP, and how these changes differed from healthy subjects. We demonstrated successful incorporation of n-3 PUFA into erythrocyte phospholipids and corresponding changes in the plasma FA spectrum, characterized in particular by significant increases in n-3 versus n-6 PUFA, with a decrease in the n-6/n-3 PUFA ratio. We also found a more prolonged effect on these changes with high dose FO...
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Alcoholic malnutrition and work with that issue in individual institutions in Czech republic
Šimonková, Eva ; Ryšánková, Marie (advisor) ; Ševela, Stanislav (referee)
Czech people are the leaders in alcohol consumption in Europe and in the whole world. Chronic consumption of excessive amounts of alcohol has a negative impact on the entire organism. Ethanol increases mucosal permeability, changes intestinal motility and disrupts water and electrolyte absorption. Its consumption affects the absorption of essential and non-essential amino acids. Last but not least, alcohol consumption causes a liver damage. Due to a nutrient absorption disorder combined with a lack of quality food, which alcoholics often replace with alcohol, chronic alcoholics are prone to protein-energy malnutrition, lack of vitamins, minerals and selected trace elements. Inadequate nutrition is a predictor to higher morbidity and mortality in chronic alcohol users, especially if they suffer from liver disease as a result of alcohol abuse. The aim of the work was to find out how experts in the Czech Republic take care of the nutritional status of their patients. If and how is malnutrition diagnosed and treated, and whether experts see the point of nutritional care for the alcoholics, especially in terms like a preventing the onset and progression of liver disease, and what is the potential difference between psychiatric facilities and gastroenterology departments. The research showed that the...
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Nutritional status assessment in patients with hepatopathy
Pirklová, Kristýna ; Novák, František (advisor) ; Ševela, Stanislav (referee)
In patients with liver cirrhosis, a high prevalence of malnutrition should be expected. Although the early diagnosis of malnutrition and well-chosen nutritional support have a positive effect on the patient's prognosis, early diagnosis of malnutrition might be difficult. There is currently no standardized diagnostic protocol for the nutritional status assessment of patients with liver cirrhosis. In patients with liver cirrhosis fluid retention occurs, which distorts the otherwise commonly used diagnostic criteria. The aim of the study: We wanted to evaluate the nutritional status of patients with liver cirrhosis in comparison with a acontrol group without severe comorbidity using anthropometric measurements, electrical bioimpedance, functional tests and laboratory parameters using diagnostic criteria GLIM (Global Leadership Initiative On Malnutrition) and various malnutrition screening tools. The work also focused on evaluating the quality of life of patients with chronic liver disease. Methods: The observational study included 11 patients with Child-Pugh stage cirrhosis A (n = 10) and B (n = 1), who were compared with a control group of 11 study participants without severe comorbidities. An examination panel consisting of anthropometric measurements, indirect calorimetry, electrical bioimpedance,...
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Indirect calorimetry in patients with home parenteral nutrition
Neradová, Andrea ; Meisnerová, Eva (advisor) ; Ševela, Stanislav (referee)
Introduction: Establishing the energy expenditure of patients with home parenteral nutrition (HPN) is a key component of nutritional care, just as important as being aware of how HPN affects energy expenditure. This helps prevent complications associated with excessive or insufficient nutrition. Certain studies have aimed at these issues have been carried out around the world, but little attention has been devoted to this subject in the Czech Republic as of yet. Several methods of ascertaining energy expenditure exist, with indirect calorimetry being considered the gold standard, however, in practice, various predictive equations are predominantly used instead. Aims: To compare the difference between the base metabolic rate (BMR) and the resting energy expenditure (REE) in patients with home parenteral nutrition. When measuring REE, to also establish the extent of the thermic effect of parenteral nutrition. Furthermore, to compare the results for energy expenditure (BMR, REE) obtained via indirect calorimetry with the results obtained via the frequently used predictive equations for calculating BMR and REE, and to ascertain which predictive equation most closely matched the measurements obtained via indirect calorimetry. Methodology: Outpatients with HPN seen at the 4th internal clinic of the...
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The influence on the quality of life by home enteral nutrition
Horáčková, Michaela ; Meisnerová, Eva (advisor) ; Ševela, Stanislav (referee)
This bachelor thesis deals with the influence of home enteral tube feeding on the quality of patient's life. The work is divided into the theoretical, and the practical part. The theoretical part deals with the clinical nutrition topic, it describes the basic components of nutrition and their distribution, energy metabolism, problems of malnutrition, its causes, types, effects, screening and diagnostics. It also describes a system of nutritional care and nutritional team. Further defined the term enteral nutrition and its allocation, indications, contraindications, monitoring of enteral nutrition, description of the types of tube feeding and appropriate appliances. Next part gives attention to problematics and specifications of domestic tube feeding. The last chapter deals with the concept of quality of life, both general definition of the term, and quality of life relative to health and how it could be evaluated. The practical part deals with research of the quality of life of patients with tube feeding. For evaluating the quality of life I used The Short Form (36) Health Survey. Patients of IV Internal Clinic of General University Hospital in Prague responded to the survey. Results are listed to graphs. The aim of this thesis, after researching patient's quality of life, was to confirm the...
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Quality of life at home enteral nutriton
Petříčková, Dagmar ; Meisnerová, Eva (advisor) ; Ševela, Stanislav (referee)
Author: Petříčková Dagmar Institution: Univerzita Karlova v Praze, 1. lékařská fakulta Title: Quality of life on home nasoenteral nutrition Tutor: as. MUDr. Eva Meisnerová Number of pages: 58 Number of supplements: 2 Year: 2016 Key words: malnutrition, enteral nutrition, quality of life, SF-36 questionnaire The theme of the thesis is the quality of life for patients at home nasoenteral nutrition. The theoretical part describes the problems of malnutrition as a frequent and serious complication of the disease. It emphasized the importance of prevention or early detection of emerging malnutrition. Various options and types of nutritional support are listed in the middle part. More detailed is characteristics and ways of enteral nutrition, its indications and contraindications . There is further elaborated the concept of quality of life, which may be significantly affected by disease or its treatment. This part includes a description of methods of examining the quality of life . The research part investigates the quality of life of patients at home nasoenteral nutrition. The results were obtained by using a standardized questionnaire SF- 36, which is a widely used tool to determine the quality of life in relation to health .
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