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Respect to human dignity of critically ill patients at ICU and ARD
Vlčková, Vladislava ; Hrdličková, Renáta (advisor) ; Novák, František (referee)
This bachelor's thesis is focused on the issue of respect for dignity of patients at Intensive Care Unit (ICU) and Anaesthesiology and Resuscitation Department (ARD). The main objective of this work was to determine how nurses perceive and respect the human dignity of patients in intensive care. Furthermore, to determine which procedures are the most harmful to dignity and whether nurses respect the rights of patients and the Code of Ethics. The theoretical part is divided into three chapters. The first chapter defines the basic terms: human dignity, intimacy, shame, personality, morality, ethics and patients' rights. The second chapter is focused on document Essence of Care 2010, part of which deals with the issue of respect for human dignity in health and social care. The third chapter describes the important virtues, qualities and communication skills of nurses. The practical part describes objectives, methodology and organization of research. The research group involved 86 nurses (10 men, 76 women). All respondents work at ICU and ARD at the General University Hospital in Prague. The author created her own questionnaire to obtain necessary data. For statistical analysis of the data was used basic descriptive statistics with Microsoft Excel software. Overview of the results is presented in...
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Nasojejunal tube placement techniques
Součková, Veronika ; Novák, František (advisor) ; Paul, Oldřich (referee)
Author's title and name: Bc. Veronika Součková Institute: Charles University, Prague 1. Faculty of medicine Kateřinská 32, 121 08, Prague 2 Study branch: follow-up Master's - intensive care Study programme: specialization in intensive care Title: Nasojejunal tube placement techniques Consultant: MUDr. František Novák, Ph.D. Number of pages: 81 Number of attachments: 3 Number of tables, grafs and pictures: 24 Year of presentation: 2013 Keywords: Nasojejunal tube, placement techniques, enteral nutrition, endoscopy, fluoroscopy, blind bedside technique This dissertation is dedicated to the issue and options in the field of nasojejunal tubes placement technique. Theoretical part aims at the description of methods and procedures of placing the nasojejunal tube and briefly mentions possible complications and principles of enteral nutrition, which is administrated by this method. Empirical part of the dissertation aims at the comparison of placement the nasojejunal tube using the blind bedside technique developed at intensive care unit in General University Hospital in Prague to, endoscopic and fluoroscopic methods. The research brings description and comparison of the most frequently used methods of placement the feeding tube into the small intestine.
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Knowledge of procedures and skills in cardiopulmonary resuscitation on nurses working in the field of anesthesia and intensive medicine
Kšírová, Magdalena ; Toniková, Silvie (advisor) ; Novák, František (referee)
This thesis deals with the knowledge of processes and practical skills of cardiopulmonary resuscitation among nurses working in the field of anesthesia and intensive medicine. The theoretical part of this paper defines the notion of cardiopulmonary resuscitation, deals with its history, changing definitions, and the latest recommendations. It also describes and specifies terms such as competence, knowledge of the processes and the role of the nurse in the system. The empirical part, using a questionnaire survey, assesses orientation of nurses and nurses specialists in the latest recommendations in cardiopulmonary resuscitation and the related knowledge and competences in the use of resuscitation itself. The questionnaire survey was answered by 152 respondents from 3 large hospitals in Prague. There were also the results of its investigation, compared with the results of research conducted by Václav Kukol in 2010 - 2011 as part of their thesis. In the final discussion paper evaluates the confirmation of the hypotheses. Then attach the recommendations for practice.
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Refeeding syndrome
Krsková, Kateřina ; Novák, František (advisor) ; Křížová, Jarmila (referee)
Refeeding syndrome (RFS) is a serious metabolic disorder caused by improper procedure of realimentation in patients, who are starved or severely malnourished. All clinical features of the syndrome are result of many metabolic changes, which are mainly caused by depletion of phosphate, potassium, magnesium and thiamine, as well as retention of sodium and disturbed glucose metabolism. The theoretical part of this thesis summarizes the current knowledge about the prevention of the RFS. The research part of the thesis explores the influence of intense realimentation in high-risk patients, particularly the values of various biochemical parameters before or during the early beginning of the realimentation. We measured values of indirect calorimetry, BMI, serum concentrations of phosphate, potassium, magnesium, prealbumin, albumin, zinc, iron and vitamin D. We also monitored concentrations of phosphorus, potassium, magnesium and cortisol in urine. We reported reduced values of potassium in urine for all patients (5/5) and reduced values of phosphate in urine for four patients (4/5). In four patients (4/5) we also monitored decreased levels of serum prealbumin, including two patients even below the value of 0.1 g/l, which is considered to be a significant risk factor for the development of the RFS. We...
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Enteral and parenteral nutrition in the prevention of the refeeding syndrome
Papoušek, Jan ; Novák, František (advisor) ; Macášek, Jaroslav (referee)
In severely malnourished individuals whose energy intake from food was low for an extended period, the sudden restoration of nutrition could cause a rapid decrease in serum electrolyte levels, which can be life-threatening. This phenomenon is called the refeeding syndrome (RFS) and it is particularly noticeable in the introduction of the refeeding process and the administration of artificial nutrition. In the prevention of RFS it is necessary to correctly set the initial nutrition, carefully monitor the patient's health status and the development of serum electrolyte levels, particularly phosphorus, potassium, and magnesium. It is advisable to supplement lacking micronutrients, in particular vitamin B1. In my thesis I focus on practical procedures at the beginning of refeeding and observe the development of the health status of patients in the first five days of nurturing. The aim was to develop a refeeding procedure for people at high risk of RFS and verify its use in clinical practice. The research was based on predetermined selection criteria. Three eligible patients in different clinical status who met the criteria were chosen. Attending physicians were familiar with the recommended procedure of refeeding which served as a guide for the application of the specific nutrition products. All three patients...
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Diabetes mellitus in the population of seniors in residential institutions
Stellarová, Apolena ; Novák, František (advisor) ; Vařeka, Tomáš (referee)
The issue of nutrition is not an easy issue, and is even more demanding with respect to persons for whom it is necessary to take into account the Sénia. Moreover, if this period of life accompanies diabetes mellitus, significantly increasing the importance of nutrition. Diabetes mellitus is a disease that is now a very hot topic, because the figures showing the incidence of diabetes continues to rise and diabetes is becoming a disease of civilization. Bachelor thesis is divided into two parts. The theoretical part, which includes knowledge about diabetes mellitus and its treatment, but also deals with aspects of aging and life in residential facilities. In the practical part of me is contained examined the results. The target detection method was used quantitative survey. The questionnaire is designed to affect the possible disparity in attitudes of both groups of respondents. The process has been used quite satisfactory 110 completed questionnaires. The questionnaire contained questions about diet, diabetes mellitus, awareness of seniors, but also the drinking regime and physical activity. It was also used for target detection protocol, which included questions about diet, staffing and implementation of education in each of the 11 residential facilities. The survey was directed so as to achieve...
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Influence of supplementation with n-3 polyunsaturated fatty acids on inflammatory markers in patients on long-term parenteral nutrition
Svěchová, Hana ; Novák, František (advisor) ; Meisnerová, Eva (referee)
SMOFLipid® is a commonly used fat emulsion for parenteral nutrition. We investigated how enrichment of SMOFLipid® with n-3 polyunsaturated fatty acids (PUFA) in a form of second fat emulsion, Omegaven® , changes fatty acid composition of total plasma phospholipids and erythrocyte phospholipids, cytokine concentrations in serum and in supernatant from in vitro whole blood culture stimulated with lipopolasaccharide (LPS) and we evaluated also changes in oxido- reductive balance. Eight patients on long-term home parenteral nutrition recieved both emulsions, SMOFLipid® (6 weeks) and SMOFLipid® +Omegaven® (4 weeks), one by one. We observed no significant differences in common laboratory and clinical parameters between these two types of diet. Enrichment of SMOFLipid® with Omegaven® led to an increase in eicosapentaenoic (EPA) and docosahexaenoic acid (DHA) in total plasma phospholipids and there was also an increse in proportion of EPA in erythrocyte phospholipids, while proportion of DHA remained unchanged. These changes were in both phospholipids of plasma and erythrocyte compensated for a decrease in proportion of linoleic and arachidonic acid (n-6 PUFA). There were elevated IL-6 and TNF-α serum concentrations in patients after both diets. There was a decrease in IL-6 production by 36% with SMOFLipid®...
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Functional role of purinergic P2X receptors in the supraoptic nuclei of the rat and structure-function relations of recombinant P2X receptors.
Vávra, Vojtěch ; Zemková, Hana (advisor) ; Novák, František (referee) ; Vyklický, Ladislav (referee)
Purinergic P2X receptors are non-selective cationic channels gated by extracellular ATP. Up to now, seven mammalian subunits, termed P2X1-X7, have been cloned and characterized. These receptors comprise a new membrane channel family with distinct structural and functional features. P2X receptors take part in a signalling network called "purinergic signalling" which is widely exploited in both somatic and neuronal tissues. In the central nervous system, they are highly expressed in the hypothalamus and hypophysis, where they participate in the regulation of homeostatic and reproductional functions. The main focus of my Thesis is on the expression and functional role of P2X receptors in supraoptic nuclei of the rat hypothalamus. These nuclei contain two populations of magnocellular neurons which produce either oxytocin or arginine-vasopressin. Delivery of the hormones into the systemic blood relies on the electrical activity of supraoptic neurons, which is in turn governed by the incomming synaptic inputs. It has been recently shown, that the process of hormone release from supraoptic neurons is regulated by extracellular ATP. However, purinergic signals that regulate hormone secretion are not well understood. The aim of my study was to identify subtypes of P2X receptors expressed in the supraoptic...
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Role of protein kinase C isoforms in cardioprotective mechanism of chronic hypoxia
Hlaváčková, Markéta ; Novák, František (advisor) ; Kopecký, Jan (referee) ; Novotný, Jiří (referee)
Cardiovascular diseases, particularly acute myocardial infarction, are one of the leading causes of death in developed countries. It is well known that adaptation to chronic intermittent hypobaric hypoxia (IHH) confers long-lasting cardiac protection against acute ischemia/reperfusion injury. Protein kinase C (PKC) appears to play a role in its cardioprotective mechanism since the administration of general PKC inhibitor completely abolished the improvement of ischemic tolerance in IHH hearts. However, the involvement of individual PKC isoforms remains unclear. Therefore, the primary aim of this study was to investigate the potential involvement of PKCδ and PKCε, the most prevalent PKC isoforms in rat heart, in the mechanism of IHH-induced cardioprotection. We showed that IHH up- regulated PKCδ protein in left ventricle, enhanced its phosphorylation on Ser643 and increased its co-localization with markers of mitochondrial and sarcolemmal membranes. PKCδ subcellular redistribution induced by IHH as well as the infarct size-limiting effect of IHH was reversed by acute treatment with PKCδ inhibitor rottlerin. These data support the view that PKCδ plays a significant role in IHH-induced cardioprotection. On the other hand, adaptation to IHH decreased the PKCε total protein level without affecting its...
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Enteral nutrition in terms of intensive care - Experiences of nurses
Nejdlová, Tereza ; Hocková, Jana (advisor) ; Novák, František (referee)
My thesis is about enteral nutrition in intensive care with a focus on nurses. Enteral nutrition is a very hot topic not only in the field of intensive care, therefore my goal was to map the knowledge and experience of nurses in this important area of nursing. The final work consists of two parts. In the first part deals with the latest available knowledge in the field of enteral nutrition in intensive care in the country. This chapter contains individual subchapters consisting of definitions, indications, contraindications, distribution, technology and complications of enteral nutrition. In the second part I use research methods and statistical processing of data related to the enteral nutrition, and knowledge of nurses in this area. Prior research, I identified five hypotheses, which I after statistical processing of the questionnaires filled by the above- mentioned nurse intensive care or resuscitation, confirmed. The practical part is a discussion of the work and overall appreciation in the form of conclusions. I included the some topical pictures and diagrams to the appendix. Key words Enteral nutrition, nutrition, sipping, tube, intensive care, nurse, patient
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