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The genetic background of obesity and its treatment with bariatric surgery
Lischková, Olga ; Bendlová, Běla (advisor) ; Šeda, Ondřej (referee) ; Mráz, Miloš (referee)
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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Impact of bariatric surgery on Diabetes mellitus
Skalická, Iva ; Matoulek, Martin (advisor) ; Hvižď, Robert (referee)
This bachelor project is focused on the issues of obesity, diabetes mellitus and its influence after the performed bariatric surgery, it is divided into two parts, theoretical and practical. Theoretical part deals with obesity and its treatment, consider the obesity complications, especially the accompanying metabolical complication so called diabetes mellitus of the second type. Moreover it introduces various types of bariatric surgery with positive influence on health status of second type diabetes patients. It also describes new trends in this field and takes into account activities before and after bariatric surgery such as preparation for the operation or post operational care. Practical part is dealing with the influence of bariatric surgery on body mass and metabolical parameters of the patients. For purpose of this study the research was conducted, representative sample of 162 patients was chosen, 68 people suffered from diabetes, the rest did not. Patients of both groups have reduced their weights significantly after the bariatric surgery of all kinds. The surgery with the biggest second type diabetes mellitus compensation is gastric bypass. The results confirmed the positive impact of bariatric surgery for the obesity treatment namely the weight reduction and metabolical parameters,...
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Choice of bariatric procedures and their effect on the weight change of obese people
Vorudová, Jana ; Matoulek, Martin (advisor) ; Hvižď, Robert (referee)
Introduction: Bariatric surgery is one of the methods of treatment of higher degrees of obesity. It helps patients to reduce the weight if conservative methods of treatment are not effective, or if it is still necessary to deepen its effect. Bariatric procedures are divided according to the the way how they are carried out - restriction, malabsorption and combined performance. Objective: The aim of this work was to determine who gave the incentive to the patients to undergo the bariatric treatment, where they received further information and how many times they managed in the time before the operation to lose weight. Further information was obtained on subjective patient satisfaction with the results of surgery and furter the weight loss data were assessed and compared the changes of BMI after bariatric surgery. Methods: An anonymous questionnaire was sent out to collect the necessary data from 39 patients after various bariatric surgery. These data were subsequently processed and analyzed. These data were subsequently evaluated and processed using graphs and tables for better clarity Results: It was found that the doctor was the one who gave the incentive to undergo bariatric performance in 79 % of patients. It was also confirmed that 80 % of patients reduced their weight of at least 5 kg before...
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Quality of life after bariatric surgery.
Jankovská, Dominika ; Hošťálková, Monika (advisor) ; Hakenová, Renata (referee)
Dominika Zákoutská Quality of life after bariatric surgery This bachelors thesis is focused on the treatment of morbid obesity by surgical procedures and determining the quality of life after undergoing bariatric surgery. Obesity brings with it a number of different diseases and health complications. All complications lead to a deterioration in the quality of life and it also increase the risk of premature death. If it is not possible to treat obesity by conservative routes (non-invasive methods) it is necessary to proceed to surgical treatment. The most commonly used surgical procedures as adjustable gastric banding, gastric plication, sleeve gastrectomy, gastric bypass and biliopancreatic diversion. This thesis deals with the first three mentioned types of operations which are adjustable gastric banding, gastric plication and sleeve gastrectomy. The main aim of this bachelors thesis is to determine the quality of life for different types of bariatric surgery at least one year and no longer than 10 after the bariatric surgery. The quantitative questionnaire investigation of 73 clients was carried out at clinical center ISCARE I.V.F. a. s., where in front of one to ten years underwent bariatric surgery. Results of the questionnaire showed significant improvement in quality of life after bariatric...
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Post bariatric surgery diet
HOSKOVCOVÁ, Klára
This bachelor thesis on the topic of Post bariatric surgery diet is focused on current recommendations for short-term diet after bariatric surgery and mainly for long-term post bariatric surgery diet. Aims of this thesis are as follows: to map common types of bariatric surgery, describe causes of nutritional complications resulting from bariatric surgery and observe the form and recommendations for a Post baraitric surgery diet. The theoretical part compiles information on obesity and bariatric surgery, as well as the diet before and after bariatric surgery. For the practical part I used the method of combined research. The survey was carried out with a weekly food record and a semi-structured interview, which focused on the influence of the operation on the dietary habits and lifestyle of the respondents. Food records were analysed individually using post bariatric surgery diet recommendations, interview responses were transcribed and evaluated collectively. The research results show that respondents are sufficiently informed about the regimen and diet recommendations before the procedure, but their compliance varies individually. The most frequent variations include inadequate energy and nutrient intake, consumption of inappropriate food, distribution of food during the day and lack of physical activity. Six of eight respondents adhere fully to the dietary regimen recommendations, two respondents follow with difficulties: one due to a mental illness and the second due to dropping out of the regimen after losing weight. All respondents showed overall satisfaction with undergoing bariatric surgery and would undergo it again. Two respondents reported improvement in type 2 diabetes.
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The effect of different bariatric operations on the weight loss in the treatment of obesity
Janoušková, Eva ; Matoulek, Martin (advisor) ; Svačina, Štěpán (referee)
Introduction: Bariatric procedures belong to modern methods of therapy of obesity, especially in patients with higher degree of obesity. Currently, different procedures are performed, among those gastric banding, sleeve gastrectomy and gastric bypass. Our research investigated the effect of various bariatric procedures on the weight loss and some other metabolic values in the treatment of obesity. Methods: The data collection for quantitative research was carried out at the 3rd medical department of 1st faculty of medicine of Charles University and General Faculty Hospital in Prague, partially retrospectively and mainly prospectively. We monitored the change of weight and compensation of type 2 diabetes mellitus in the first year after operation in group of 54 patients of which 32 patients had a two-year monitoring as well. For monitoring changes of weight throughout a particular period of time after operation, the conversion on % EWL a % EBMIL was used. The data was evaluated by basic statistical methods. Results 1: In our reference group (n=54) average value of EWL was found 37,58 % in the first year after the surgery. The value of EWL for sleeve gastrectomy was 47,52 %. The value of EWL for gastric bypass was 39,82 %. The value of EWL for gastric banding was 23,28 %. Results 2: In the subset of...
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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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Specifics of nursing care for bariatric patients
ŠOPÍKOVÁ, Petra
This work focuses on the specific nursing care of bariatric patients. Bariatric surgery is an important branch, which effectively solves the problems of long-term morbid obesity and its comorbidities, both physical and mental. The patient undergoes planned bariatric procedures, such as, for example, the application of gastric banding and gastric sleeve. For a successful course of treatment the patient should be thoroughly educated about adhering to the regime of follow up measures that are essential for success. The aim of this study was to determine the specifics of the long-term care of patients after bariatric procedures. To attain this goal three research questions were set up. The first focused on finding out the specifics of the long-term care of patients after bariatric procedures. The second research question focused on information about the permanent change in lifestyle of the patient after bariatric procedures. In the third research question the long-term regime of follow up measures after bariatric procedures was addressed. Qualitative research conducted in the county of South Moravia was used in the research part. A semi-structured interview was chosen as a data collection technique. The research group consisted of seven women and one man. Interviews were processed through case studies and the most interesting results are given in categorization tables. The research results showed that patients have information on lifestyle change and understand it. Unfortunately, out of the 8 respondents, 6 respondents have problems adhering to the regime of follow up measures. The longer the respondents are post-surgery, the harder it is for them. The most frequent problem was the use of vitamin supplements, followed by keeping up physical activity and the removal of favorite foods. The long term follow up among respondents is without problems, except for one respondent who is seven years post- surgery. Other respondents stated that they regularly attend obesity and bariatric clinics. Educational material for patients who have had bariatric surgery was created based on this information. It focuses on long-term nursing care for bariatric surgery in the field of dietary measures, follow-up, physical activity and psychological care.
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Health educational background in the nutritional therapy of women after Gastric Plication in the age of 25 - 40 years
JIRKALOVÁ, Veronika
This Dissertation aims to document the influence of a nutrition therapist on the diet of female subjects in their reproductive age after gastric plication. The theoretical part clarifies the term "morbid obesity", it provides explanations for the main diagnostic criteria for this type of obesity, its risks, and last but not least it provides also a list of basic types of medical examinations of obese subjects. Another section of the theoretical part deals with weight-loss (bariatric) surgery where this term is described not only at a general level, but also specifically with the principle of gastric plication, indications as well as contraindications to this intervention. At the same time the Dissertation presents a Prague-based bariatric centre - OB klinika a.s., which is the only entity in the Czech Republic that deals with these activities. The last section in the theoretical part is focused on nutrition therapy and explains energy demands of human organism, describes healthy nutrition and clarifies essential features of obesity treatment, and it deals with the most important aspects as well - eating regime in the case of subjects after gastric plication. The practical part deals with 10 female subjects selected on a random basis, in the age category of 25 - 40 years of age, who underwent the gastric plication. Five of these subjects have been selected for the project entitled "New Chance" and they are monitored at a detailed level and follow the prescribed regime after gastric plication. The remaining five subjects undergo a standard post-operative regime. The five selected subject use menus prepared by a nutrition therapist and they are invited, in regular intervals, to visits with consultations regarding eating habits, drinking regime as well as any possible issues which may occur in the course of their treatment. With the help of tables and charts this part documents developments of weight reduction and at the same time it provides comparisons of changes before and after operation, especially in the areas important for a nutrition therapist.
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