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Health and social risks in children predisposed to metabolic syndrome
SLADKÁ, Alena
Metabolic syndrome was defined for the first time in 1988 by Reaven, who defined it as a hormonal-metabolic syndrome - with symptoms of resistance to insulin , hyperinzulinismus, hypertension and with laboratory-proven higher level of lipoproteid VLDL and lower level of HDL and LDL cholesterol. Obese children have big troubles concerning social relationships. Overweight children are often an object of ridicule, teasing, verbal bullying, physical bullying, cyberbullying and sexual abuse. First goal of this thesis is to find out, whether obesity (mainly of android type) in children and adolescents (aged 10-18) having BMI higher than 28 and waist size for boys over 103 and for girls over 93, overall cholesterol level over 6,5, blood pressure higher than 130/70 are predispositions of manifestation of MS in adulthood and to find out what are the social and health impacts of the obesity in the childhood. Second goal of this thesis is to find out, whether patients with metabolic syndrome (MS) had predispositions for obesity or were obese in the childhood and what are the health and social impacts of MS in their life. The first research group consisted of ten children aged 10-18 with predispositions to manifestation of MS. Methods of accomplishing goals of this thesis: Survey of health and family anamnesis. All ten children aged 10-18 were repeatedly checked during six mounths for their body weight, waist size, blood pressure and cholesterol. Surveyed values are shown in the table. I Used a structured interview to survey relationships of obese ones with same-age children, whether they are an object of ridicule and bullying and what are other troubles caused by the disease. At the same time I gave questionnaires to parents to ascertain the eating habits and life style of the family. Health and social impacts for life of people with diagnosed MS, when they were diagnosed MS and their childhood condition were examined using structured interviews in the metabolic advice centre. The research group consisted of ten patiensts of metabolic advice centre. After analysis of data and health anamnesis it was proven that 60% of researched children suffer from higher morbidity (breathing issues, upper respiratory tract infection, and easier fatigue during physical exertion). 60% of children have serious issues to establish relationships and suffer from verbal and physical bullying. 40% of adult patients of metabolic advice centre had troubles with obesity already in their childhood. All of them suffer from type 1 diabetes. Two of them recieve disability pension due to MS. 90% of them told, that they regulary go see a doctor und regulary take cures. These facts cause worse financial situation (lower income, expenses for cures and travel to a doctor). Two respondents mentioned discriminating behaviour of medical staff, however they didn't mention the type of discrimination. According to the questionaries only one person considers the MS is caused by his lifestyle. Research group consisted all the time of ten children and ten adults with MS, because 'Snowball sampling' research methods didn't survey any new facts, which would be needed to verify.
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The issue of taking capillary blood for glycemia
KOPAČKOVÁ, Lucie
The proper technique of capillary blood sampling to determine the level of glycemia plays an important role in diagnostics and therapy of diabetes mellitus. There has been a large shift in this disease in recent years, especially in diagnostics and treatment. It is a disease characterized by high blood sugar levels. In practice, it often happens that although it is a procedure nurses carry out almost daily, during capillary blood sampling to determine the level of glycemia, a number of errors occurs. This fact inspired me to write a bachelor thesis on the topic "The issue of capillary blood sampling to determine the level of glycemia?. The empirical part of the thesis deals with both the disease Diabetes Mellitus itself and the capillary blood sampling. In the introductory part history and definition of diabetes are given, the causes of the disease, complications, diagnostics and treatment of Diabetes Mellitus are described. The issue of capillary blood sampling to determine the levels of glycemia is discussed in detail, as well as the recommended procedure of capillary blood sampling and devices designed for the sampling . The practical part of the thesis is focused on selected objectives, research questions and hypotheses. The objective of the research was to identify the factors that may affect the results of the examination, to find out whether nurses follow the recommended procedure for capillary blood sampling and to identify the most common errors nurses make during the sampling. To achieve the objectives both quantitative and qualitative research surveys were carried out. The qualitative research was conducted by observations of six nurses working in inpatient wards in České Budějovice Hospital, plc, supplemented by interviews with the nurses. The three research questions can be answered as follows. The most common factors that may affect the test results is poor sample handling, sample exposure to unsuitable temperature conditions, and forced squeeze of blood from a finger. While collecting capillary blood nurses often make mistakes in communicating with the patient, when they do not give information about the performed punction and do not properly explain the whole procedure to the patient. They wash their hands before blood sampling without using a disinfectant. The interviews gave the answer to the last research question that the most common problem the nurses are aware of during capillary blood sampling is forced squeeze of blood from a finger, poor disinfection of the punction site and a delayed transport to the laboratory. Qualitative research survey was supplemented by quantitative research, which consisted of 66 observations of capillary blood sampling, which were carried out by nurses in České Budějovice Hospital, plc. This research survey was conducted to verify the results obtained from the qualitative research. This hypothesis was formulated: H1: During capillary blood sampling to determine the level of glycemia nurses most often make mistakes in communication with the patient. Based on the quantitative research, it has been found out that the most common mistake made by nurses is a failure to use a disinfectant for hand hygiene before sampling blood (16%). The mistake in communication took the third place (14%). Based on the above results the conclusion can be made that H1: During capillary blood sampling to determine the level of glycemia nurses most often make mistakes in communication with the patient, has not been confirmed. Using the knowledge earned from literature and the conducted research I have proposed a standard of nursing care for nurses called "Capillary blood sampling to determine the level of glycemia." Nurses will have an opportunity to have a manual at hand that will serve them as a quide to correctly perform capillary blood sampling to determine the level of glycemia and they will not be consider the blood sampling to be a routine procedure.
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Impact of diet and adequate physical activity on the course of type 2 diabetes mellitus.
MATĚJKOVÁ, Miroslava
The aim of this work was to document the impact of proper nutrition on the course of type II diabetes mellitus. In the theoretical part of the thesis the individual types of diabetes and their treatment are described. Then the definition of healthy nutrition (dieting) and its effects on diseased patient follows. The subsequent theoretical part concerns about how healthy physical activity can aid diabetics. In addition the psychological aspects of the disease are mentioned. Research part of thesis is based on the description of the case report of a patient with type II diabetes. The author projected a dietary bill of fare and also a plan for physical activity. This work contains a complete characteristic of the patient including family, personal and nutritious history, medicaments and report of the cooperation with this patient. At the end of the work a detailed dietary and exercise plan, which was used by the author for this patients is enclosed.
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Kinesiotherapy of diabetes mellitus
CHALUPSKÁ, Tereza
My bachelor thesis is focused on kinesiotherapy in diabetes mellitus with focus on type 2 of the disease. Diabetes mellitus is a chronic whole-life disease leading to high morbidity, disability and mortality. A patient with high glycaemia level fluctuation and variable inadequate body mass (and further decompensation indicators) overburdens his/her organism and does not contribute to postponement of occurrence of cardiovascular, neuropathic, nephropathic, retinopathic and other problems. Adequately selected kinesiotherapy help people with diabetes mellitus compensate this disease. The theoretical part deals with diabetes mellitus in general and discusses physical activities focused on diabetes mellitus. The practical parts processes four case reports (women with diabetes mellitus type 2 diagnose) in the form of qualitative research. The first three respondents take regular exercises in groups divided according to physical and mental ability. The fourth respondent does not participate in any physical activity in the groups. Anamneses were found out through semi controlled interviews. Check-up results (dynamic examination of spine, anthropometrical examination, goniometrical examination, examination of shortened muscle groups, examination of weakened muscle groups, hypermobility examination, neurological examination, measurement of heart rate and blood pressure, determination of glucose concentration and HbA1c) were collected by direct observation. The aim of the work was to provide a theoretical outline of kinesiotherapy possibilities in diabetics, to map the forms of physical activities among diabetics and to evaluate efficiency of the individual physical activities of diabetics. Personal interest and active approach to physical activity regime are the main preconditions to successful kinesiotherapy in individuals suffering from diabetes mellitus. In the instance of individual and purely personal goal a suitable form of physical activities can be found for diabetics and thus contribute to compensation of the disease.
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Diagnostics of diabetes mellitus in adults including pregnant
ŠTĚRBOVÁ, Eva
Diabetes mellitus is worldwide spread chronical disease which affects both sexes and all age groups. If the disease is not treated it can cause hard damage to various systems or even kill. The thesis is divided into two parts. The objective of the first, theoretical part, was to bring closer the problems of diabetes mellitus, its classification and complications. Simultaneously, the possibilities of laboratory diagnostics of the disease were described. The objective of the second, empirical part was to assess if glycohemoglobin was a suitable compensation of oral glucose tolerance test as a marker of impaired glucose tolerance. For the thesis the data of 94 patients investigated at the Laboratory of Clinical Chemistry in Nemocnice České Budějovice, a. s. (Hospital České Budějovice Inc.) were used. The patients were divided into two groups: the group called ``Pregnant{\crqq} (51 pregnant women) and the group called ``Others`` (43 people). In both groups oral glucose tolerance test was carried out and glycohemoglobin was determined. The level of glucose in blood was determined by a fotometric enzymatic method at the analyzer ADVIA 1650 Chemistry system, glycohemoglobin was determined by effective liquid chromatography at the analyzer TOSOH A1c 2.2 (HLC 723 Ghb V, G5). The group of pregnant cannot be reliably evaluated because only one woman was diagnosed gestational diabetes mellitus according to oral glucose tolerance test. In the group of Others impaired glucose tolerance according to oral glucose tolerance test was proved in 14 individuals, 5 of them had increased glycohemoglobin and 9 individuals had glycohemoglobin in referential range. Diagnostic sensitivity, specificity a effectiveness at cut off 4,0 % was counted for glycohemoglobin. Sensitivity was 36 %, specificity 96 % and effectiveness 73 %. The results show that the use of oral glucose tolerance test as a marker of impaired glucose tolerance is still more suitable than the use of glycohemoglobin which does not have sufficient sensitivity for the diagnosis of the disease.
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Feasibility of performing laboratory tests in the paediatrician´s office
HOLOUBKOVÁ, Hana
The thesis deals with feasibility of performing laboratory tests in the paediatrician´s office. The objective of my thesis was to learn about the current state of feasibility of performing laboratory tests right in the paediatrician´s office. To meet this objective I distributed questionnaires and visited twenty randomly selected pediatricians. Thereby I got familiar with the structure of tests used in paediatric practice. I have learnt to perform and interpret relevant laboratory methods. The theoretical part of the thesis gives an account of examinations carried out in paediatricians´ offices. It deals in detail with laboratory analyses performed on urine, blood, stool and swab samples. The practical part gives a description of techniques of particular methods and their current use in paediatricians´ offices. These methods are chemical examination of urine by using urinalysis reagent strips, examination of the urine sediment, Uricult examination, C-reactive protein determination, determination of sedimentation rate, determination of glycemia using glucometer, test for occult bleeding, rotavirus and adenovirus assay, Dentocult examination and detection of Streptococcus pyogenes. The results shown in graphs illustrate how frequently the methods are performed.
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Importance of self-monitoring of children with diabetes
PAPOUŠKOVÁ, Helena
In the research we focused on children treated in an endocrinological out-patient clinic. We addressed six respondents to participate in the qualitative research. Three objectives were set: C1: to ascertain how important for the patients the regular monitoring of glycaemia is; C2: to ascertain whether child patients are able to observe the therapeutic regime; C3: to ascertain whether providing parents, teachers, kitchen staff and instructors of spare-time activities with information has an effect on the care of children with diabetes.
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Selfmonitoring of Type 1 Diabetes mellitus in adolescents
KORELOVÁ, Andrea
Type 1 diabetes mellitus is a chronic, lifelong disease. The younger the patient, the more seriously the disease affects his (her) childhood. The disease brings about a lot of changes, it involves the loss of freedom and independence. Diabetes makes the normal troubles of adolescence even more difficult. Adolescence is a hard stage of life for patients with the type 1 diabetes mellitus because it is a period when the compensation of diabetes is more difficult than in the previous and following stages of life. Regular self-monitoring is one of the crucial tasks. The selfmonitoring is important for the overall compensation of diabetes and also for the clinical results of treatment. Self-monitoring is the process of monitoring and measurement of one´s own glycemia and ketones in blood and sugar and ketones in urine. It enables the diabetic patient a better orientation in the disease and a certain level of independence. Self-monitoring helps parents gain confidence in cure of their children suffering from diabetes. The theoretical part of my thesis deals with the questions of the type 1 diabetes mellitus and the method of self-monitoring. The objective of the practical part was to survey the subjective view of adolescents with the type 1 diabetes mellitus on self-monitoring and the level of their self-reliance. I set hypotheses suggesting that adolescents perceive self-monitoring to be uncomfortable and cannot cope with the procedures independently. These hypotheses were not confirmed in my research. To get relevant data, I used the questionnaire method. I handed out questionnaires to young patients with diabetes aged 13{--}18 years. A letter for patients´ parents asking for their written consent with the research was attached to the questionnaire.
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Prevention of diabetes I. type and health promotion, education of diabetics and patients after pancreas transplantation
MRÁZ, Marek
The bachelor theses attend to people with diabetes mellitus Type 1 and patients after pancreas transplantation. The first chapters of theoretical part deal with pancreas anatomy, matter of disorder, its medication, belated complications, movement and nutrition connected with diabetes. The last chapter of this part is about pancreas transplantation. The practical part shows importance of education and knowledge of diabetics. It deals with life quality of diabetics who undergo pancreas transplantation. It compares their health and mental condition during diabetes, before and after pancreas transplantation.
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Changes of blood sugar during different types of intensive strength training\\
HALABURDA, Josef
The aim of this work should be watching and registration of training intensity (kind of oxercise, intent of exercise and registration of responses). With a view to response of change of plasma glukose. The result of this work should be summary of exercises together with response of changes of plasma glukose. The value of this response we have measured, together with a kind of exercise can help trainers and teachers to judge intensity of training. There were four testing subjects in the group we have measured. \\
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