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Intensive care of patient with metformin intoxication
Zajícová, Alena ; Povolná, Pavla (advisor) ; Hocková, Jana (referee)
Metformin is the first-line oral antidiabetic drug for patients with type 2 diabetes mellitus. As the rate of new diagnosed cases of diabetes increases year-on-year, the number of patients who are prescribed metformin rises as well. In the Czech Republic only, 858,010 patients were treated for diabetes in 2015. 786,586 of them were treated for the type 2 diabetes mellitus. Metformin intoxication, called also MALA (metformin- associated lactic acidosis) after its main symptom, is a rare complication (≤ 10 cases per 100,000 patients per year) in the metformin treatment, but the mortality is high (up to 50%). Metformin-induced lactic acidosis develops when the contraindications of metformin therapy are not respected or in the event of an acute disease linked with dehydration and hypoxia. Patients with MALA are hospitalized at the int ernal medicine intensive care unit or the department of anesthesiology and critical care with multiple organ failure. This thesis aims at determining whether procedural nursing care standards, implemented in the form of a nursing process, are actively used in practice on intensive care beds. Methodology: The empirical part is compiled in the form of a qualitative research, as a case study of a female patient suffering from metformin intoxication, caused by a suicide...
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Role of therapeutic approach in the treatment outcome, hospital costs, one-year post-hospital medical costs and quality of life in the patients who survived acute methanol poisoning.
Rulíšek, Jan ; Zacharov, Sergej (advisor) ; Máca, Jan (referee) ; Kieslichová, Eva (referee)
(English) Background: Methanol poisoning is severe medical condition with a need of urgent intensive treatment. Mass poisoning outbreak took place in the Czech Republic in 2012-2013. Costs of hospital treatment of methanol poisoning present significant financial burden to healthcare systems. The effect of treatment modality choice on clinical outcome and healthcare costs is not known, as well as its impact on the quality of life of methanol poisoning survivors after hospital discharge. Aim: To compare different therapeutic methods, choice of antidote (fomepizole versus ethanol) and extracorporeal elimination method (intermittent vs. continuous dialysis) for optimizing clinical outcome, cost-effectiveness, hospital costs, post-discharge costs, and the quality of life in survivors. Methods: For prospective cohort study, all patients hospitalized with acute methanol poisoning were included (n=106); for hospital and one-year healthcare costs study, all survivors of acute methanol poisoning (n=83) were included. For longitudinal quality of life study all survivors with informed consent (n=54) and control group of chronic alcohol abusers, age- and gender-balanced, without history of methanol poisoning (n=23), were included. Results: Comparative data of clinical effectiveness of elimination techniques...
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Mikrobiální kontaminace při výrobě a prodeji lahůdkářských výrobků
Stojanová, Kateřina
This diploma thesis deals with microbiology of delicatessen. It focuses on the microbiology of individual components of delicatessen, particularly bacteria which can cause alimentary infections and alimentary intoxication. The thesis also discusses the possible occurrence of molds or yeasts and describes ways how it can be prevented. It also refers to some of the basic measures stated in the legislation. At the end of the thesis, the numbers of selected groups of microorganisms in paneled sandwiches and production areas are determined: total count of microorganisms, coliform bacteria, molds and yeasts, spore aerobic microorganisms, Clostridium perfringens, Salmonella spp.
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Mikroorganismy jako původci alimentárních onemocnění
Hloch, Marek
This bachelor thesis deals with the issue of microorganisms causing foodborne diseases. The work is divided into several parts. The first part classifies foodborne diseases and describes the main ways of food contamination and the factors that have affect on the development of these diseases, including the basic classification of bacterial toxins. The main part deals with the characteristics of individual species of microorganisms, a description of the diseases they cause and prevention, leading to a reduction in the occurance of these microorganisms in food. The last part captures the current state of foodborne diseases in the Czech Republic and European Union.
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An algorithm of the pre-hospital and the acute hospital care during an ethylene glycol intoxication.
MILOTA, Jiří
Ethylene glycol intoxication is a serious life threatening condition, that may appear to be a serious risk in connection with the easy availability of preparations containing this substance. The work titled An algorithm of the pre-hospital and the acute hospital care during an ethylene glycol intoxication provides information on this issue and summarizes appropriate treatment in pre hospital and acute hospital care, which should lead to increased treatment efficiency and reduced health consequences. The most common source of ethylene glycol in the household is anti freeze mixtures for vehicles, the most often accidental ingested liquid. The toxic nature of ethylene glycol is a decomposition into acidic metabolites and formation of calcium crystals causing necrosis and organ failure. A typical immage of ethylenglycol intoxication is a consciousness depresion, total acidosis, acute renal failure, and an increased anion gap. Appropriate therapy should be initiate by first aid, followed by professional pre hospital and hospital care. There should be made a gastric decontamination in first houre of ingestion. Vital functions must be provided, but the key method is using of antidotes (alcohol dehydrogenase inhibitors ethanol or fomepizol). In case of indikation causal treatment also includes elimination methods, most often intermittent hemodialysis and cofactor application. Symptomatic treatment is based on acid base homeostasis and specific biochemical levels balance. The thesis was made by form of review and synthesis using large number of science sourc es dealing with the current issue of EG intoxication. The main purpose of work is comparing of Czech and global authors to illustrate different possibilities of treatmet and create educational material for students of health care disciplines or medical professionals looking for quick and simply way to solve acute emergency or crate an idea of adequate care.
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Acute intoxication in prehospital emergency care
KUTLÁK, Ondřej
This bachelor thesis on Acute Intoxication in Pre-hospital Emergency Care is divided into twoparts: theoretical and research. The theoretical part is initially focused on the causes of acute intoxications and effects on the human organism. Most of the space is devoted to selected types of intoxication and their therapy. For the research part, Objective 1 has been set: To map the level of the theoretical knowledge of medical rescuers in connection with the providing of pre-hospital emergency care in the case of intoxicated persons. Two research questions were identified on the basis of this objective. The research question 1 is: How do the health rescuers in the care of the intoxicated patient progress from the point of view of differential diagnosis? Research Question 2: How do medical rescuers approach the treatment of the intoxicated patient from the point of view of therapy? The qualitative research method was used in the form of semi-structured interviews with 8 medical rescuers performing their profession at the Medical Rescue Service in Písek and Český Krumlov. The data obtained was divided into 12 categories. The summary of the research showed a sufficient knowledge of the clinical manifestations of selected acute intoxications presented in the practical part of this work. The other group studied was the therapy of selected acute intoxications presented in the practical part of this work. The research has shown that the knowledge of acute intoxication therapy is average. Since the appropriate knowledge of medical rescuers is necessary to manage this profession, I consider it important to examine them periodically.
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The issue of biological exposure tests in clinical and toxicological laboratory.
WOLFOVÁ, Šárka
The aim of this work is to draw up a well-arranged paper on the use of biological exposure tests (BET) during the monitoring of intoxication by various toxic substances. In the theoretical part the advantages of BET are explained, the issue of selection of biological material, the correct time of sampling according to the duration of the exposure and the biological half-life of the toxic substances are explained. The term "maximum allowable limit" (NPL) is explained to compare BET results. The toxicity of heavy metals, organic solvents and pesticides is described. The practical part describes the BET monitoring by determining direct and indirect indicators of lead exposure using the method of atomic absorption spectrophotometry with electrothermal atomization, photometry in visible and UV area, pressure microwave mineralization and chromatographic techniques. Several cases of actual intoxication are described, as well as attempts to distort the results with the aim of achieving occupational disease due to exposure to lead. By monitoring the entire BET spectrum, this intention is revealed and objectively assessed. The relevance and timeliness of BET is highlighted, not only in the field of professional as well as non-professional exposures, and the developmental trend of gradual reduction of NPLs related to the widening of knowledge about the toxicity of monitored toxic substances.
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Intensive care of patient with metformin intoxication
Zajícová, Alena ; Povolná, Pavla (advisor) ; Hocková, Jana (referee)
Metformin is the first-line oral antidiabetic drug for patients with type 2 diabetes mellitus. As the rate of new diagnosed cases of diabetes increases year-on-year, the number of patients who are prescribed metformin rises as well. In the Czech Republic only, 858,010 patients were treated for diabetes in 2015. 786,586 of them were treated for the type 2 diabetes mellitus. Metformin intoxication, called also MALA (metformin- associated lactic acidosis) after its main symptom, is a rare complication (≤ 10 cases per 100,000 patients per year) in the metformin treatment, but the mortality is high (up to 50%). Metformin-induced lactic acidosis develops when the contraindications of metformin therapy are not respected or in the event of an acute disease linked with dehydration and hypoxia. Patients with MALA are hospitalized at the int ernal medicine intensive care unit or the department of anesthesiology and critical care with multiple organ failure. This thesis aims at determining whether procedural nursing care standards, implemented in the form of a nursing process, are actively used in practice on intensive care beds. Methodology: The empirical part is compiled in the form of a qualitative research, as a case study of a female patient suffering from metformin intoxication, caused by a suicide...
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Specifics of nursing care for adolescent with intoxication
MAREŠOVÁ, Daniela
As the number of young people experiencing and experimenting with addictive substances gradually increases, so does the number of hospitilised drugged juveniles. There is also an increase in suicidal attempts undertaken by children using medicaments. Consequently, nurses encounter adolescents whose organisms are intoxicated by alcohol, drugs or medicaments at an increased rate. The purpose of this thesis is to determine nursing specifications which nurses implement when attending to young patients. It focuses on the differences of particular intoxications, the procedures followed, challenges and conventions. Additionally, a comprehensive view of this care is presented of which the recipients are, above all, underaged. This assignment has been compiled using qualitative investigations in the form of semistructured interviews. Conversations with ten nurses from child health departments, children's intensive care and resuscitation units, in addition to detoxication centres for children and youths have been acquired. The research conducted has found that the care for these patients is both physically and mentally demanding for the nurses. No divergence of treatment for underaged patients of any intoxication type has emerged and the most significant feature is coping with frequent aggression expressed on the part of the patients. Conclusions indicate the fact that a patient's age, manifestation, consciousness, vomiting and aggressiveness play a major role as opposed to the initial source of intoxication. This assignment intends to raise nurses' awareness and conversance with nursing care which is provided to intoxicated juveniles. Thereby, this paper contributes to the improvement of the care provided for these young patients.
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Social work with adolescents addicted to psychoactive substances
Malíková, Kristýna ; Krahulcová, Beáta (advisor) ; Nová, Monika (referee)
The aim of this thesis is to draw attention to the serious problem of drug addiction among adolescents who are abusing addictive substances or marijuana. This increasingly important issue is discussed a lot, but very often neglected by the society. This thesis provides definitions and characteristics of individual drugs and their effects on adolescents. The need for prevention and treatment of adolescent clients is emphasized, alongside with the family support, which is often crucial. In the practical part, the author of the thesis focuses on organizations that are critically important in this field. These organizations focus on prevention, counseling services, social inclusion and treatment facilities (inpatient and outpatient services), etc. Their characteristics and methods of client treatment are described. Furthermore, in this work the author presents a survey that confirms the findings of some detailed quantitative research papers. The main findings are that drug abuse is a major problem of this century and also a burden on society, especially on the adolescents themselves. The solution is very complicated and time consuming, but everyone can contribute by not being indifferent to this problem.
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