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Reduction Modes to 3rd Medical Department in the Treatment of Obesity and Metabolic Syndrome and their Effect on the Outcome of Bariatric Operations
Jungová, Ivana ; Matoulek, Martin (advisor) ; Haluzík, Martin (referee)
(teze): Úvod: Redukční režimy na 3. interní klinice VFN Praha v léčbě obezity a metabolického syndromu a jejich vliv na úbytek hmotnosti po bariatrické operaci při aplikaci těsně před zákrokem. Metody: Porovnávání shromážděných dat týkajících se redukce hmotnosti v době před a 1 rok po bariatrickém zákroku pro dvě skupiny pacientů. Jedna skupina absolvovala těsně před operativním výkonem redukční pobyt. Druhá skupina byla přijata k operačnímu řešení z ambulantního režimu. Výsledky: Obě skupiny pacientů ve sledované době (1 rok po operaci) svou hmotnost významně redukovaly, vyšší úbytek v kilogramech po roce od zákroku byl zaznamenán u skupiny s redukčním pobytem (23,02 kg), u skupiny bez redukčního pobytu byl průměrný úbytek hmotnosti 21,17 kg. Po porovnání úbytku hmotnosti z průměrné hodnoty životního maxima skupin má významně vyšší redukci skupina s redukčním pobytem (51,9 kg), skupina bez redukčního pobytu redukovala ze svého životního maxima průměrně o 32 kg. Hodnota EWL (Excess Weight Loss) jeden rok po operaci byla vyšší u skupiny bez redukčního pobytu (39,36 %), u skupiny s redukčním pobytem dosáhla hodnoty 33,509 %. Stejně tak hodnotu EBMIL (Excess BMI Loss) měla skupina bez redukčního pobytu vyšší než skupina s redukčním pobytem. Procentuální roční úbytek hmotnosti byl u obou skupin...
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Local metabolism of glucocorticoids in female Prague hereditary hypertriglyceridemic rats
Klusoňová, Petra ; Pácha, Jiří (advisor) ; Kopecký, Jan (referee) ; Haluzík, Martin (referee)
11-hydroxysteroid dehydrogenase (11HSD1) is an oxidoreductase which catalyzes conversion of inactive 11-oxo steroid derivatives into active 11-hydroxy forms. 11HSD1 elevates intracellular level of active glucocorticoid (GC) hormones: cortisol in human tissues and corticosterone in rodents, therefore local level of active GCs can be set independently from systemic secretion driven by hypothalamo-pituitary-adrenal axis (HPA axis). Chronic systemic excess of GCs results in development of Cushing's syndrome which is characterised by central obesity and other metabolic disturbances. Despite normal serum levels of GCs, the patients with idiopathic obesity also develop metabolic syndrome. It was suggested that GCs could be elevated locally in target tissues due to enhanced 11HSD1 activity. This hypothesis was confirmed in transgenic rodent models. Prague hereditary hypertriglyceridemic (HHTg) rats represent a non-obese model of metabolic syndrome without genetic manipulations or specific mutations. The strain was bred by cross-mating of Wistar rat individuals with elevated serum levels of triglycerides (TGs). The strain exhibit hypertriglyceridemia and hypertension. When kept on high carbohydrate diet HHTg rats exhibit alterations in glucose homeostasis. Since there are no data that would describe...
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Automatic Analysis of Heart Rate Variability Signals
Kubičková, Alena ; Halámek, Josef (referee) ; Lhotská, Lenka (referee) ; Kozumplík, Jiří (advisor)
This dissertation thesis is dedicated to the heart rate variability and methods of its evaluation. It mainly focuses on nonlinear methods and especially on the Poincaré plot. First it deals with the principle and nature of the heart rate variability, then the ways of its representation, linear and also nonlinear methods of its analysis and physiological and pathophysiological influence on heart rate variability changes. In particular, there is emphasis on the metabolic syndrome. In the next section of the thesis there are compared and evaluated different ways of representation of the heart rate variability and further are tested selected methods of heart rate variability analysis on unique data from patients with the metabolic syndrome and healthy subjects provided by the Institute of Scientific Instruments, Academy of Sciences of Czech Republic. In particular, they are used the Poincaré plot and its parameters SD1 and SD2, commonly used time domain and frequency domain parameters, parameters evaluating signal entropy and the Lyapunov exponent. SD1 and SD2 combining the advantages of time and frequency domain methods of heart rate variability analysis distinguish successfully between patients with the metabolic syndrome and healthy subjects.
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Design and verification of the intervention program for client with metabolic syndrome visiting Wellbeing Centre VŠTJ MEDICÍNA in České Budějovice
BENÝŠKOVÁ, Ivetta
Presented personal case study shows the effects of targeted intervention motion drawn up the plan and verifying its functionality for clients with severe metabolic syndrome. The client is a 39-year old obese (BMI of 32.3, height 164 cm, weight 87 kg) diabetic. Emphasis was placed on the program-controlled weight reduction exercise. The client for 13 weeks completed 53 hours of physical activity of aerobic and weight training character in 46 training units. The results confirm the success of case reports targeted exercise intervention in the therapy of obesity and metabolic syndrome. Significantly decreased the value of glycated hemoglobin, waist circumference shrank by 5 cm, total weight reduction amounted to 2 kg. Within three months, an improvement in client anthropometric, biochemical and cardiovascular indicators.
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Nonlinear methods of heart rate variability analysis in metabolic syndrome
Vaňková, Eliška ; Kozumplík, Jiří (referee) ; Kubičková, Alena (advisor)
This work deals with the problematic of heart rate variability of patients with metabolic syndrome. Includes the theory, which describes the heart rate variability and the methods for its analysing. Especially it specifies nonlinear methods, particularly Lyapunov exponent and its calculation in Matlab software. Algorithm of the calculation is applicated to already measured tachogram of the healthy people and patients with the metabolic syndrome. Further, this work deals with general valorization of the results using Lyapunov exponent and her eis also done the statistical evaluation.
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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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Eating habits of patients with metabolic syndrome
NOVÁČKOVÁ, Anna
Metabolic syndrome (syndrome X, Reaven's syndrome) is frequently occurring disease in Czech Republic. The diagnosis often detected only separated parts of metabolic syndrome which are usually not connected with complex of MS. Medical conditions co-occurred within this syndrome are following: elevated fasting plasma glucose (insulinoresistance), abdominal (central) obesity (women waistline > 88 cm, men waistline > 102 cm), elevated blood pressure, high serum triglycerides (> 1,7 mmol/l), and low high-density cholesterol (HDL) levels (women 1,25 mmol/l, men 1,0 mmol/l). The incidence of MS can be divided into the prevalence of MS itself (this correspond with 30%) and the prevalence of each individual part of MS which correspond with 80% population. The most frequently reasons of MS are so called environmental impacts as e.g. central obesity, insulinoresustance syndrome, fatty liver, systemic inflammation, intestinal alterations, hypertension, hypertriglyceridemia, foetal malnutrition, low basal energetic outcome, sleep apnoea syndrome, changes of gut flora, hyperglycaemia and cumulation of visceral fat. This bachelor´s work is concerned with eating habits, life style and other factors which could be reason of described metabolic syndrome. The aim of this study is evaluation of eating habits and life style of patients suffered from MS before syndrome outbreak, as well as participation of obesity in MS outbreak assessment. Two explorative questions were formulated on the basis of described goals: First research question: Did the MS patients follow principles of healthy eating before syndrome outbreak? Second research question: Does obesity have a significant effect on MS outbreak? Definition and characterization of MS in relation to diet is described in theoretical part of my work as well as explanation for reasons of MS outbreak, descriptions of each separated diseases of MS complex and their treatment. Metabolic syndrome in connection with obesity and its classification into each level is defined inthis part. Obesity treatment together with prevention and treatment of MS are suggested in terminal part of this section. In practical part of work, the results of own research are presented. This section is focused on: 5. evaluation of eating habits before MS outbreak; 6. obesity incidence in MS patients; 7. patient´s life style; 8. the presence of individual diseases participate in MS. Research part of my bachelor´s work is prepared with using of quantitative assessment, which was done by questionnaire investigation in southbohemian and westbohemian region. Research population consists of thirty gender-nonspecific and age various patients diagnosed as having MS. The research questions were focused on mapping of respondent´s eating habits, life style (smoking, movement activity, daily eating portions and breakfast regularity), previous and current illnesses as well as diseases of respondent´s relations. The aim of described investigation was evaluation of obesity, life style and diet participations in MS outbreak. The results did not prove observance of healthy eating principles in MS patients before and after syndrome outbreak, while most of respondents were overweight or obesity. It can be assumed that genetic predispositions play role in MS outbreak. Additionally, very interesting is detected occurrence of MS in many individuals younger then forty years old. The present work extended the knowledge about risk factors of MS outbreak together with eating habits, obesity and MS outbreak connections. When reasons of MS seem to be more clear, it is easier to establish new more effective prevention. On the basis of the results, it can be arranged diet suggestions useable as effective prevention of MS outbreak.
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Dietary habits and lifestyle in metabolic syndrome
TOMANOVÁ, Gabriela
ABSTRACT Title of the work: Eating habits and a lifestyle by metabolic syndrome This bachelor thesis deals with the eating habits and the lifestyle in patients with metabolic syndrome treated in diabetologic clinics. The work is divided into two main parts. The first (theoretical) part deals with the existing and newly discovered knowledge in the area of this issue, the eating habits and lifestyle. Primarily, I studied the issue and changes in MS. In the initial chapter I mention the main components and consequently I deal with most discussed changes in the recent years. The last specified part deals with the factors affecting the MS; here,I have been concerned with the most important categories, including eating habits, physical activity, smoking, genetics and stress. The second part (empirical) should clarify the problems in complying with good eating habits and lifestyle. It should prove the correctness and effectiveness of education in persons showing symptoms of MS. The work was designed as a quantitative research in which the target file was constituted by a selected sample of 120 respondents showing MS in diabetologic clinics. To obtain the necessary information, a questionnaire survey was used. The research confirmed a relatively good education and eating habits in patients with MS. During questioning it was found that 77% of respondents claim to have a sufficient amount of information and good eating habits. But a deeper examination of their dietary habits revealed that only 67% of them actually know how to eat properly. On the other hand, 23% of the observed patients lack of the information from a doctor, therefore they cannot have good eating habits. A positive result is that two thirds of patients educated in the diabetologic clinics are really able to eat properly and work with the information they receive. Unfortunately, the remaining 10% have enough information from their doctor, but they cannot work with the information so as to achieve the correction of dietary habits. A part of this bachelor thesis forms a health educational material that is destined for patients who do not have enough information or those who are familiar with the issue, but are interested to learn more.
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Effect of healthy life for people aged 60 ? 80 years diagnosed with Diabetes mellitus using yoga exercises
KRAJÍČKOVÁ, Simona
In my Bachelor thesis I investigate the influence of Yoga practice on patients suffering from, and being treated for, Diabetes Mellitus Type 2. The research deals with the impact of a 12 week Yoga intervention program. The theoretical study of the subject includes a wide range of comprehensive and relevant literature available. The research part also describes the methodology. Input and output measurements of anthropometric as well as metabolic parameters were gathered, analyzed, discussed and prepared for presentation in cooperation with specialists from the field of Diabetology. In addition the following methods and research tools were employed: ?Quality of Life? questionnaire (PETR, 2000) and the projective technique ?Method of unfinished sentences? (VALKOVA, 2000). Nine selected individuals from the local Diabetes Association participated voluntarily in the research. In the period from November 2011 to January 2012 this group experienced the 12 week Yoga intervention program. Following the programs completion results were processed according to previously presented methods. The observed data shows that the applied Yoga intervention program positively affected the value orientation of the participants as well as positively impacting metabolic parameters (Glycated hemoglobin). The general improvement in overall life quality is evident in the research. Based on these results it can recommend applied Yoga intervention programs for all people diagnosed with Type 2 Diabetes Mellitus.
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