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The effect of metabolic surgery in obese patients to calcium-phosphate metabolism and serum concentrations of some micronutrients
Černá, Martina ; Raška, Ivan (advisor) ; Michalská, Dana (referee)
This thesis focuse on bariatric-metabolic surgery and its impact on serum concentrations of various metabolic parameters. The thesis is divided into two parts - theoretical and practical. Basic facts about bariatric-metabolic surgery such as its history, indications, contraindications, surgical methods and their results, nutrition after surgery and the frequency of micronutrient's deficits are described in the theoretical part. Furthermore, information about calcium-phosphate metabolism and metabolites such as calcium, phosphorus, magnesium, vitamin D, vitamin K, parathyroid hormone and osteomarkers is also included. The influence of nutrition and nutritional status on the quality of bone tissue is also mentioned. Last section of the theoretical part is focused on the important vitamins and minerals. The practical part discusses measurements of selected metabolites in serum before and half a year after the surgery. Results of questionnaires which were given to respondents are also included. Questionnaires were focused on lifestyle, nutrition, physical activities and whether the patients take some supplements of micronutrients and protein concentrates. The goal of this work is to evaluate the effect of the surgery on serum concentrations of metabolic parameters and their effect on the health and...
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The genetic background of obesity and its treatment with bariatric surgery
Lischková, Olga
Obesity is a frequent metabolic disease that causes many other health and socioeconomic complications. Obesity arises due to excessive energy intake and decrease in energy expenditure, which is a conseqence of contemporary lifestyle. Moreover, obesity has a strong genetic component. Common obesity is polygenic, multifactorial disease, in which individual genes interact with each other and with environmental factors. Genome-wide association studies, conducted between 2006-09, led to the discovery of dozens of gene loci that predispose individuals to obesity. The strongest signals were registered for polymorphisms in FTO (fat mass and obesity-associated) and near a gene MC4R (melanocortin 4 receptor). However, the contributions of these variations on the phenotype of obesity are very small, therefore, it is necessary to validate the results of such robust studies. It is very important to uncover the effects of genetic variants for understanding the molecular mechanisms of energy metabolism. The studies presented in this thesis refer about the impact of polymorphisms in selected genes on anthropometric and metabolic parameters of the patients of the Institute of Endocrinology and of healthy volunteers who underwent functional tests. Our cohort includes a representative sample of Czech children (COPAT...
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Psychosocial Effect Of Bariatric Surgery and the Patient's Satisfaction with the Surgery
Kravarová, Eva ; Papežová, Hana (advisor) ; Dragomirecká, Eva (referee) ; Stárková, Libuše (referee)
The doctoral dissertation is focused on the evaluation of the effect of bariatric surgery and on identifying the parameters that are related to the patients' satisfaction with the surgery. Telephone survey was used to collect data. 122 bariatric candidates were inquired, 86 of them were operated. The average time after the surgery was 20,2 months. The average weight loss was 26.6 kgs. There was a significant improvement in the monitored domains - physical appearance, general health, self-esteem, marital satisfaction, occupational functioning and social functioning. The negative effects of the surgery (post-surgery vomiting, difficulties in dietary adherence, other complications) were also experienced by significant number of patients. In total, 87% respondents were satisfied with the surgery and 13% were dissatisfied. The chi-square test was used to identify factors influencing subjective satisfaction with the surgery and the results were recorded at 95% and 99% significance levels. The satisfaction is associated with the improvement of general health and self-esteem (p<0.01), physical appearance, marital satisfaction, occupational functioning and social functioning (p<0.05). Less satisfied were patients who had troubles with postoperative dietary adherence and those with an insufficient weight...
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The Effect of Exercise Intervention on Physical Fitness and Quality of Life in Patients after Bariatric Surgery
Pacholíková, Pavlína ; Daďová, Klára (advisor) ; Vilikus, Zdeněk (referee)
Title: The Effect of Exercise Intervention on Physical Fitness and Quality of Life in Patients after Bariatric Surgery Objectives: The aim of this thesis is to evaluate the effect of a three-month physical intervention on the physical fitness and quality of life in patients after bariatric surgery. Compare the measured values from six-minute walk test (6MWT) and the questionnaire survey of quality of life between the group undergoing exercise program and the group of non-exercise patients. Methods: The diploma thesis was constructed as a quasi-experiment. A six-minute walk test, a visual analogue pain scale, a Borg scale and a standardized IWQOL-Lite questionnaire were used to asses physical fitness and quality of life. The study involved 28 patients (8 undergoing an exercise program, 20 non-excercisers). The groups were measured before the planned bariatric surgery and about 3-4 months after the surgery. For the analysis of final values, the Microsoft Excel and its add-in Realstatistics was used. Results: In patients undergoing the exercise program, the VAS on average decreased of 2,04 cm, 6MWT improved on average of 42,75 m, and quality of life of 34 points. In non-exercise patients there was an average decrease in VAS of 0,08 cm, an increase in 6MWT of 41,45 m and an increase in quality of life...
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Physiotherapy for bariatric surgery patients
Kolmašová, Petra ; Cibulková, Natálie (advisor) ; Nováková, Petra (referee)
Title of thesis: Physiotherapy for bariatric surgery patients Abstract: This bachelor thesis is focused on physiotherapy for patients after bariatric surgery. The main aim of the study is to create a handbook for bariatric patients, which they will be able to exercise at home. Partial aim is to find out how the quality of life and pain perception of bariatric patients changes due to group exercise, individual physiotherapy and bariatric surgery itself. The SF-MPQ, DIBDA, map pain and IWQOL-Lite questionnaire were used to determine the results. The theoretical part describes the diagnosis and examination of obesity, health complications asociated with obesity and its treatment, both conservative and surgical. It also summarizes the indications and contraindications of bariatric-metabolic surgery and types of procedures. Furthermore, it focuses on physical activity in bariatric patients and the role of physiotherapist in bariatrics. The practical part contains case reports of two patients, who underwent bariatric surgery and then attended group exercise and individual physiotherapy for four weeks. The initial examination, including questionnaires, was performed about a week before the surgery. The same type of questionnaires was used in the final examination after four-week therapy, which started 3-4 weeks...
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The influence of 3-month exercise program on postural stability in individuals after bariatric surgery
Mašková, Kateřina ; Daďová, Klára (advisor) ; Vilikus, Zdeněk (referee)
Title: The effect of movement program on static postural stability in individuals after bariatric surgery Aims: The aim of this diploma thesis was to find out whether a three-month regular exercise program including strenght and aerobic training has an impact on static postural stability in obese individuals who underwent bariatric surgery. Methodology: The special part was written on the basis of data obtained from posturographic measurement of obese patients who underwent bariatric surgery. The static postural stability was measured using pressure plate a MobileMat from Tekscan. Participants were measured before surgery and approximately 4 months after surgery. A total of 30 subjects aged 31-65 years with BMI values between 35-55 kg/m2 (obesity class II and III) who underwent initial and exit examination including stabilometry, were included in this diploma thesis. They were divided into 2 groups, first group participating in a three-month exercise program (n = 10; age 51 ± 7.3 years; BMI 41.7 ± 6.4 kg/m2 ) and a group undergoing bariatric surgery only (n = 20; age 48 ± 9, 4 years; BMI 43.6 ± 6.5 kg/m2 ). The exercise program included exercise three times a week: once a week one-hour strength training and one-hour aerobic group training, and at least once a week home intervention. Results: In...
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Nutritional profile in patients with bariatric metabolic surgery
Fišerová, Veronika ; Karbanová, Martina (advisor) ; Sadílková, Aneta (referee)
Introduction: Obesity is a major health problem that affects an individual's overall health. Bariatric metabolic surgery is most important and has permanent impact on weight loss in comparison with conservative therapy. The downside is that it often leads to a row nutritional deficiencies requiring long-term supplementation. Object: The aim of the thesis is to map the intake of nutrients in the diet of bariatric patients six months and one year after the procedure. The research is primarily focused on the intake of vitamin D and calcium in diet, vitamin D, parathyroid hormone and calcium levels are also evaluated. Marginally, laboratory values are assessed prior to surgery as deficiencies are known to occur before surgery. Methodology: The research sample consists of 30 respondents who are six months (M6) and one year (Y1) from the procedure. Micronutrients are evaluated from three-day dining records recorded by respondents for at least one week. The research laboratory data was used from the medical information system of the hospital information system. The evaluation parameters for vitamin D-25 (OH)D (limit level was established to > 30 ng/ml). To assess the parathyroid hormone concentration, a minimum limit is set to 1.58 pmol/l, calcium 2.00-2.75 (mmol/l). We were wondering if the profile of...
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Bariatric surgery and compensation of diabetes
Patková, Barbora ; Matoulek, Martin (advisor) ; Peška, Tomáš (referee)
Introduction: Obesity and type 2 diabetes mellitus (hereinafter referred to as DM2T) are called the greatest epidemic of the 21st century. Its occurrence is on the rise not only in the Czech Republic but all around the world. Overweight and obesity are the key factors in developing DM2T, they are affecting the occurrence of the disease in men in 64 % and 77 % in women. Based on the observations, nearly 60 % of the population in the Czech Republic are considered obese or overweight. Bariatric/Metabolic surgery is one of the most effective treatments of the DM2T. Objectives: The objective of this thesis is to describe and analyze the effect of each bariatric surgery on the patients of 3rd Internal Clinic of Endocrinology and Metabolism, General University Hospital and 1st Medical Faculty, Charles University in Prague within the first two years post-surgery. The same time period is observed to monitor the DM2T compensation depending on the type of bariatric surgery. Methodology: 128 patients were observed (including 52 patients diagnosed with DM2T), that underwent the bariatric surgery. The data were gathered from the medical records in the hospital's information system Medea. These data were further analyzed, processed and assessed in Microsoft Excel and also together with the agency STEM/MARK a.s....
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Nursing care of the patient after gastric bypass for morbid obesity
Miksová, Jana ; Kordulová, Pavla (advisor) ; Chvojková, Kateřina (referee)
In my bachelor thesis I was dealing with the problem of morbid obesity (BMI 40 and more) with combined surgery according to worldwide criteria IFSO - International Federation for the Surgery of Obesity and Metabolic Disorders. I consider this topic as a big issue nowadays which is confirmed also by statistics WHO - World Health Organisation. Aim of my bachelor thesis was to describe the hospitalisation of the patient with minigastric bypass for morbid obesity. Further I was trying to find out whether the clinical practise is or is not different compared to nursing care which is stated in literature, health magazines and professional websites. Information and documentation needed for the theoretical part of my thesis was found in search of National Health Library, database Medvik, PubMed and others. Also, I have used information from IFSO, EASO - European Association for the Study of Obesity, SAGES - Society of American Gastrointestinal and Endoscopic Surgeons and Czech Obesitological company. The form used in bachelor thesis is case study based on the search of the particular patient, model used is according Marjory Gordon and nursery process. Available source was also health documentation, interview with the patient and discussion with the nursery team. When the nursery care was provided by the...
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Nursing care of the patient after gastric bypass for morbid obesity
Miksová, Jana ; Hejtmánková, Lenka (advisor) ; Hladká, Petra (referee)
Bachelor thesis is focused on treatment options for morbid obesity, particularly surgical methods of treatment. The aim of bariatric surgery is to achieve substantial and complete cure of comorbidities when sick morbid obesity occured. The main objective is to demonstrate the patient with morbid obesity solved by Minigastric bypass and uncomplicated course of hospitalization. The first partial objective is to monitor the influence of the force motivation during recovery, followed by development. The second partial objective is to monitor the success of the surgery. These data are obtained through interview, observation and analysis of patient¨s medical records. For the solving case study the nursing model Marjory Gordon was used. The phases of the nursing process will be carried out from case history, followed by setting the goals, intervention, implementation and evaluation of the overall care plan. During my practice and after writing my bachelor thesis I came to the conclusion that the motivation, support of loved ones and positive attitude toward accepting herself with accepting the new lifestyle, is essential for successful undergoing this type of surgery and the further development. The prevention of the obesity with the projects focused on solving this obesity issue before it happens, which...
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