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The use of magnetic resonance spectroscopy for studying glucose metabolism
Kratochvílová, Simona ; Pelikánová, Terezie (advisor) ; Štich, Vladimír (referee) ; Polák, Jan (referee)
Magnetic resonance spectroscopy (MRS) is a noninvasive technique that enables to follow metabolic processes in selected tissues in vivo. Recently the attention has been focused on metabolic mapping in target organs of insulin action to describe the pathophysiology of insulin resistance. The aim of our study was to present the practical application of ³¹P (phosphorus) MRS and ¹H (proton) MRS in metabolic studies of skeletal muscle in insulin resistant subjects and in subjects with impaired fasting glucose. The third study was aimed to evaluate the brain metabolism with ¹H MRS in healthy controls and subjects with type 1 diabetes during hyperinsulinemia. ¹H and ³¹P MRS were performed using a MR Scanner Siemens Vision operating at 1,5 Tesla. To assess the parameters of glucose metabolism and insulin action oral glucose tolerance test and hyperinsulinemic euglycemic clamp were performed. The study 1 was aimed to evaluate the skeletal muscle (m. soleus) energetic metabolism in the offspring of hypertensive parents (OH) with a higher level of insulin resistance. The concentrations of selected high energy phosphates (phosphocreatine, inorganic phosphate, adenosintriphosphate, phosphomonoesters, phosphodiesters) were evaluated with ³¹P MRS. Their amount in OH was comparable to healthy controls. However we...
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Application of telemedicine for long-term monitoring of patients with metabolic diseases.
Vlasáková, Martina ; Mužík, Jan (advisor) ; Černý, Martin (referee) ; Bém, Robert (referee)
Telemedicine systems have the potential to enhance efficiency in compensating for metabolic disorders, yet they are not widely and durably utilized in the healthcare system. One of the defined barriers to the implementation of telemedicine systems is personalization, where offered solutions provide a uniform concept for all patients, and system configuration occurs based on patient feedback after system use. For the long-term utilization of a telemedicine system, the coordination of several factors is crucial, especially the correct selection of the type of technologies used, the positive impact on the patient's health, and the inclusion of individual patient requirements in system configuration. The aim of the work was to propose and verify functions, evaluate the impact of the telemedicine system Diani on compensating diabetes mellitus, and, through the analysis of monitored parameters, compile a guide for optimal system configuration based on individual patient needs. Based on literature reviews and market research, types of connectable peripherals for the telemedicine system were identified. Specific devices were then selected through a multicriteria analysis. Clinical studies were conducted to examine the functions of the telemedicine system and its impact on basic diabetes parameters. The...
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Stress hyperglycemia during extreme cycling sports
Hájková, Michaela ; Heller, Jan (advisor) ; Šteffl, Michal (referee)
Introduction: This work focuses on the differences in metabolism in patients with type 1 diabetes associated with the stress response and interaction of insulin with epinephrine and cortisol. The main topic is increased hyperglycaemia during and immediately after a stress situation and the possibilities of regulation in this disease. The practical part consists of a case study of a subject with type 1 diabetes mellitus and his state of hyperglycemia during races of extreme cycling disciplines. Objectives: The main aim of this work is to introduce and descript this phenomen in Czech language, to clarify the issues of this phenomen and to conduct a case study to verify results of theoretical part. Methods: Methods that were used in this work includes literature rewiew summerising available materials on this topic and in the practical part a qualitative research method, a case study, examining one subject. Data from platform Diasend were observed and compared and the subject provided an interview. Results: The results of the case study support the findings of the literature review. The highest glucose levels during sport related stress reached up to 20.0 mmol/l despite increased basal and bolus doses. Keywords: glucose metabolism, diabetes mellitus, glycaemia, epinephrine, cortisol
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Expert system for diagnosis of diabetes
Braniš, Lukáš ; Jurajda, Michal (referee) ; Jirsík, Václav (advisor)
This thesis deals with the design and creation of a knowledge base for the NPS diagnostic expert system. The knowledge base is designed to diagnose diabetes and its specific type. Part of the thesis is a brief introduction to the issue of artificial intelligence, acquaintance of the reader with the theory of expert systems and knowledge engineering. Further, the thesis deals with the complex issue of the disease diabetes mellitus, its types, properties, symptoms and diagnosis.
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Využití negativní termoterapie ve fyzioterapii poruch posturální stability u pacientů s diabetickou neuropatií
SVOBODA, Tomáš
Diabetic neuropathy is a chronic complication of both types of diabetes mellitus affecting the autonomic and peripheral nervous systems. Based on damaged nerve fibers, it bothers patients not only with subjective symptoms, but also affects the psyche and quality of life of a person. The goals of the work included a summary of physiotherapy methods used in the treatment of neuropathy, an evaluation of the effect of kinesiotherapy and cold-water immersion on postural stability and the creation of educational material for self-therapy. The thesis is written in the form of case reports of three patients who underwent examination focused on parameters associated with neuropathy and postural stability and intervention with the procedures before mentioned for a period of thirty days. The results of individual patients did not change significantly after completing the procedures. The muscle test (patients 1 and 3), sense of position and locomotion (patients 1 and 2), vibration sensation (patients 2 and 3), EPE, MVL (patient 1), RT (patient 3), FOAM-EC (patient 2 and 3) and Modified CTSIB (patient 1) improved, deterioration occurred in the muscle test (patient 2), sense of position (patient 3), Limits of stability (patients 1 and 3), RT, DCL (patient 1), MVL (patient 3).Due to the heterogeneity of the patients and the mutual use of kinesiotherapy and cold water immersion, it is difficult to compare the results of the patients with each other and to evaluate which modality had a greater influence on the results. Kinesiotherapy (balance exercises) has a positive effect on postural stability with the support of studies. In the case of cold exposure, this effect is not clear, even studies do not agree. Based on the results and studies, cold exposure can be used to reduce subjectively perceived symptoms.
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Education of diabetic patient with diabetic food after amputation
MELICHAROVÁ, Zuzana
This bachelor thesis is focused on education of patients with diabetic foot syndrome with limb shortening amputation and prevention of higher amputation. The theoretical part deals with the disease diabetes mellitus, its complications, diabetic foot syndrome and education on prevention of amputation. This disease is currently prevalent and its incidence is increasing. The aim of the study was to find out who and by what method most often educates patients with diabetic foot syndrome about prevention of amputation, in what way patients perceive shortcomings on the part of education and to map their knowledge about prevention of diabetic foot. A quantitative method of investigation was used for this study and data was collected using a self-administered questionnaire which was filled by a total of 30 respondents. The research sample consisted of 30 respondents (100 %). The results show that 24 people (80 %) are educated about amputation prevention by both a nurse and a doctor and 6 people (20 %) by a doctor only. The form of education was oral and written for 21 respondents (70 %) and oral only, in the form of an interview for 9 people (30 %). The biggest barriers to education were lack of time for 13 respondents (43 %), inappropriate environment for 9 respondents (30 %), lack of self-will to listen to the educator for 7 people (23 %), and lack of empathy from the educator for 3 people (10 %). 10 respondents (33 %) described their knowledge of prevention as good, 19 respondents (63 %) described their knowledge as normal and 1 respondent (3 %) described their knowledge as poor. The contribution of this bachelor's thesis can be pointing out the shortcomings in education and trying to eliminate them. This thesis contains an overview of recommendations that should be followed by patients with diabetic foot syndrome, so it can also serve as an educational material for nurses and diabetic patients.
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Modes of regime measure and their adherence in pacients with diabetes mellitus
MAURICOVÁ, Barbora
Introduction: The bachelor's thesis focuses on the methods of regimen measures and their adherence in patients with diabetes mellitus. The theoretical part deals with the disease diabetes mellitus and its regimen measures. Diabetes mellitus is currently a widespread chronic disease and its incidence is increasing. Research is therefore important to conduct to improve education, awareness and support diabetics in adhering to the measures. Aim: The aim of the study was to find out how patients adhere to the regimen. Methodology: For this thesis, data collection was carried out using a quantitative survey method. The data was collected using a customized non-standardized questionnaire. Data collection took place were in the South Bohemian hospital in standard and intesive care wards. The questionnaire consisted of 23 questions containing identification data and focused on adherence to regimen measures in diabetic patients. The data obtained were subsequently processed into tables and graphs, on the basis of which the hypotheses were evaluated. Results: The research sample was made up by 82 respondents (100 %). The results show that 17,1 % people follow a diabetic diet, 79,3 % take isnulin regularly, 82,9 % see their doctor regularly and 45,1 % keep a diary of their glucose levels, while 50 % don´t. The results show that adherence to the regimen is influenced by educational level and also by gender. Conclusion: Adherence to regimen measures in diabetics is a very important factor for a proper quality of life and to influence the treatment of this disease. Nutrition and exercise are essential components of the regimen. The results of our research have shown that diabetics do not follow a diabetic diet very well. Adequate awareness, education and motivation are essential for better adherence. This bachelor thesis offers material summarizing the findings on the disease itself, diet, physical activity and more.
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Education of diabetic patient after total pancreatectomy
BAKOVÁ, Terezie
This bachelor thesis titled "Diabetic patient education after total pancreatectomy" addresses the impact on quality of life of patients with new-onset diabetes after total pancreatectomy. It also deals with the process of education for these patients by general nurses and licensed practical nurses.The aim of this thesis was to map the education of patients after total pancreatectomy. To achieve this aim, a qualitative investigation was used, conducted using semi-structured interviews. The interviews were conducted with five patients after total pancreatectomy and six nurses who educate these patients. Three research questions were established to answer the stated aim. The questions investigated how education by licensed practical nurses and general nurses takes place in patients after total pancreatectomy. They also investigated what limitations occur in patients after the procedure. The problems encountered by patients in adhering to the treatment regimen were also investigated.The results of the research investigation indicate that nurses most often carry out education in an individual way, and they agree on the topics they include in the education. Education is mainly carried out in the areas of insulin administration, self-monitoring and prevention of complications. Results of other data indicate that insulin administration, compliance of dietary measures, and glucose fluctuations are the most common problems in patients' adherence to their treatment regimen. Digestive disorders, fatigue, changes in eating habits, and limitations in social life are considered the greatest limitations. The research also found that there are no leaflets available signeted for patients after total pancreatectomy. The results of this bachelor thesis may serve to inform future patients before undergoing total pancreatectomy, to provide information about the consequences and impact of this procedure on quality of life. They could also inform licensed practical nurses and general nurses about the problems and shortcomings experienced by patients after total pancreatectomy, and they could positively influence education in these areas.
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Importance of physical activity in patients with diabetes
Kozáková, Eva ; Škrha, Jan (advisor) ; Pehr, Martin (referee)
Aim of the thesis: The research aimed to evaluate the importance of long-term regular physical activity in patients with diabetes. Methods: In total, 53 patients with diagnosed diabetes from the Third Department of Internal Medicine of the General University Hospital in Prague were selected for the research. In order to achieve the aim of the study, a combination of data collection in the form of an anonymous questionnaire survey of own design and laboratory results from the medical records in the hospital's information system Medea was used. During the completion of the questionnaire, the patients were consulted in detail and they had the opportunity to ask their own questions and receive a short education on the subject. All data were recorded in tables and subsequently processed into graphs in the computer program Microsoft Office Excel. Statistical evaluation was performed using Tibco Statistica 14.0 software. Results: Regular physical activity is associated with more favourable laboratory results. The most important parameter in assessing physical activity was a question about daily physical activity lasting at least 30 minutes. Patients who were physically active more than 30 minutes per day had significantly better HbA1c (50±9 vs. 60±15 mmol/mol, p<0.01), total cholesterol (3.7±0.8 vs....
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