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Conservative Treatment of Acute Pancreatitis and Use of Enteral Nutrition
Česák, Vojtěch ; Rušavý, Zdeněk (advisor) ; Kvapil, Milan (referee) ; Sobotka, Luboš (referee)
Acute pancreatitis is a disease which can present in a mild or severe form. In the last few years, the incidence of acute pancreatitis has been steadily rising. The treatment of severe cases is complex and nutrition is one of the key treatment factors. Enteral and parenteral nutrition are documented parts of acute phase treatment included in many guidelines. However, there is a controversy about the timing of initiation of peroral nutrition after the acute phase of severe pancreatitis has resolved. This dissertation shows the results of monocentric prospective randomized trial which compares the safety and effectivity of peroral nutrition compared to enteral nutrition in patients with severe acute pancreatitis during hospitalization as well as in long term after hospital discharge. Patients with severe acute pancreatitis were randomized into two groups - enteral nutrition versus peroral nutrition. The randomized nutrition strategy was initiated within the first 14 days of hospitalization. We monitored the length of hospital stay, tolerance of nutrition, complications, body weight and nutrition parameters. The two groups did not differ significantly in the length of hospital stay. The number of complications was similar between the groups, there was no significant difference in the rate of acute...
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The influence of enteral nutrition on the course of Crohn's disease
Homzová, Nikola ; Lukáš, Milan (advisor) ; Bortlík, Martin (referee)
Introduction: Crohn's disease is an illness of the digestive tract with an uncertain etiology which threatens the nutritional state of patients and in addition to other problems results in a worsening of the disease in reaction to primary treatment. The possibilities of optimizing the nutritional state are several: changing diet, enteral or parenteral nutrition or combination of both. It is necessary to arrange an entirely individual approach for ensuring the highest measure of attention and nutritional effectiveness. Methods: The influence of enteral nutrition was monitored during a course of Crohn's disease. 84 patients with malnutrition and with an active form of Crohn's disease were included in this study. They were divided into 2 groups according to the type and dosage of enteral nutrition. The first group included patients who used partial enteral nutrition in the form of sipping with an energy value of 1200 kcal daily. Patients covered the remaining energy needs with a low-residue diet enriched by soluble fiber. The second group included patients who were given exclusive oligomeric enteral nutrition with a nasojejunal tube for a period of eight weeks. The amount of enteral nutrition in both groups was individually adjusted and calculated, according to the Harris-Benedict equation. The...
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The nutrition of patients with percutaneous endoscopic gastrostomy in practice
JIROVSKÁ, Nikola
The bachelor thesis is focused on patients with percutaneous endoscopic gastrostomy in practice. The thesis is divided into theoretical and practice part of the issue. The theoretical part deals with stoma history, nutritional status diagnostics and general information on stoma. The core of the theoretical part contains the most important part of the thesis: introduction to PEG. The next chapter is dedicated to energy values determination and enteral nutrition, followed by the section dedicated to aid tools for enteral nutrition application. The last chapter in the theoretical part describes nutrition complications in percutaneous endoscopic gastrostomy. The aim of my work was to evaluate nutraceuticals intake administered to PEG, and to explore patients' or care staff 's awareness of PEG care in general. To achieve my goals, I have used qualitative research. Using a semi-structured interview with a nurse, and with patient and nursing staff in two other cases, I have gradually discussed PEG issues. I have worked with six patients, each of them I have interviewed twice. In the next section, I have determined requirements for nutrients, energy, selected vitamins and trace elements, which I then compared with a real enteral nutrition intake. I have used Nutriservis application to evaluate and determine the diet. Nursing staff often does not have enough information about the care that patients with PEG require, and availability of respective literature in the Czech language is very limited. Nursing education in the past did not include PEG care. The method was introduced in the Czech Republic only in the 1990s. Nearly all patients in my research were underweight. Moreover, despite their weight was changing, the type of nutrition and its quantity remained the same. The most common patients' complication was diarrhea. Although literature reports that the PEG tube should last for several years, it lasts for a year or two, according to the nursing staff. The information contained in my work can help not only patients with PEG and their families, but also health care professionals who look after PEG patients
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The influence on the quality of life by home enteral nutrition
Horáčková, Michaela ; Meisnerová, Eva (advisor) ; Ševela, Stanislav (referee)
This bachelor thesis deals with the influence of home enteral tube feeding on the quality of patient's life. The work is divided into the theoretical, and the practical part. The theoretical part deals with the clinical nutrition topic, it describes the basic components of nutrition and their distribution, energy metabolism, problems of malnutrition, its causes, types, effects, screening and diagnostics. It also describes a system of nutritional care and nutritional team. Further defined the term enteral nutrition and its allocation, indications, contraindications, monitoring of enteral nutrition, description of the types of tube feeding and appropriate appliances. Next part gives attention to problematics and specifications of domestic tube feeding. The last chapter deals with the concept of quality of life, both general definition of the term, and quality of life relative to health and how it could be evaluated. The practical part deals with research of the quality of life of patients with tube feeding. For evaluating the quality of life I used The Short Form (36) Health Survey. Patients of IV Internal Clinic of General University Hospital in Prague responded to the survey. Results are listed to graphs. The aim of this thesis, after researching patient's quality of life, was to confirm the...
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Quality of life at home enteral nutriton
Petříčková, Dagmar ; Meisnerová, Eva (advisor) ; Ševela, Stanislav (referee)
Author: Petříčková Dagmar Institution: Univerzita Karlova v Praze, 1. lékařská fakulta Title: Quality of life on home nasoenteral nutrition Tutor: as. MUDr. Eva Meisnerová Number of pages: 58 Number of supplements: 2 Year: 2016 Key words: malnutrition, enteral nutrition, quality of life, SF-36 questionnaire The theme of the thesis is the quality of life for patients at home nasoenteral nutrition. The theoretical part describes the problems of malnutrition as a frequent and serious complication of the disease. It emphasized the importance of prevention or early detection of emerging malnutrition. Various options and types of nutritional support are listed in the middle part. More detailed is characteristics and ways of enteral nutrition, its indications and contraindications . There is further elaborated the concept of quality of life, which may be significantly affected by disease or its treatment. This part includes a description of methods of examining the quality of life . The research part investigates the quality of life of patients at home nasoenteral nutrition. The results were obtained by using a standardized questionnaire SF- 36, which is a widely used tool to determine the quality of life in relation to health .
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The options of nutritional support in inflamatory bowel disease
Polachová, Monika ; Meisnerová, Eva (advisor) ; Novotný, Aleš (referee)
In my bachelor's work I describe the idiopathic inflammatory bowel diseases. The theoretical part is devoted to the history, epidemiology, etiopathogenesis, basic characteristics of the disease and the current treatment options. One of the serious consequences of the inflammatory bowel diseases is malnutrition, which then affects the treatment, worsens the course of the disease and reduces the quality of life of patients. The cause of malnutrition in these patients is both inflammatory activity during a relapse, the side effects of drug therapy and reduced food intake due to the numerous diarrhea and abdominal pain. In the practical part I monitored the patients during my practice in gastroenterology clinic. The aim of my work was to determine what attention is paid to the state of nutrition of patients with severe course of Crohn's disease and ulcerative colitis, which were indicated by the biological treatment. Monitoring of nutritional status, nutritional support and correction of malnutrition is an integral part of the treatment, during which a nutritional therapist plays an important role. Powered by TCPDF (www.tcpdf.org)
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The Nutrition Day at the standard and intensive care beds in the teaching hospital
Lupoměská, Petra ; Meisnerová, Eva (advisor) ; Novák, František (referee)
The Bachelor thesis consists of two parts - the theoretical and the practical one. The theoretical part is divided into several chapters; the first one is focused on the main information about malnutrition such as its definition, prevalence, classification, causes, impact and the methods of diagnosing. The following chapter describes the algorithm for nutritional care; the rest of the chapters deal with the artificial nutrition, where the indications, contraindications, complications and other essential information related to enteral and parenteral nutrition are described. The practical part is dedicated to the worldwide programme "Nutrition day" and also to the evaluation of the data given by patients of the 4th internal clinic VFN in Prague during the programme. The research part was carried out on grounds of quantitative survey through a standardized questionnaire. There are two aims to the study; the first one was to find out the food intake of all patients of the 4th internal clinic. This goal was not accomplished, because not every patient placed in the standard ward was willing to complete the questionnaire. However, the study showed that only 29 % out of 62 patients who completed the questionnaire ate the whole portion of meal. The second aim was to find out if the daily calorie intake...
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Nasojejunal tube placement techniques
Součková, Veronika ; Novák, František (advisor) ; Paul, Oldřich (referee)
Author's title and name: Bc. Veronika Součková Institute: Charles University, Prague 1. Faculty of medicine Kateřinská 32, 121 08, Prague 2 Study branch: follow-up Master's - intensive care Study programme: specialization in intensive care Title: Nasojejunal tube placement techniques Consultant: MUDr. František Novák, Ph.D. Number of pages: 81 Number of attachments: 3 Number of tables, grafs and pictures: 24 Year of presentation: 2013 Keywords: Nasojejunal tube, placement techniques, enteral nutrition, endoscopy, fluoroscopy, blind bedside technique This dissertation is dedicated to the issue and options in the field of nasojejunal tubes placement technique. Theoretical part aims at the description of methods and procedures of placing the nasojejunal tube and briefly mentions possible complications and principles of enteral nutrition, which is administrated by this method. Empirical part of the dissertation aims at the comparison of placement the nasojejunal tube using the blind bedside technique developed at intensive care unit in General University Hospital in Prague to, endoscopic and fluoroscopic methods. The research brings description and comparison of the most frequently used methods of placement the feeding tube into the small intestine.
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Current possibilities and resources of enteral nutrition
Hrnčířová, Naďa ; Heczková, Jana (advisor) ; Meisnerová, Eva (referee)
0BABSTRACT This thesis is focused on enteral nutrition. This issue is an integral part of intensive and resuscitation care, but it is also a part of standard and follow-up care. There are more and more new resources and the products for enteral nutrition are improving. The theoretical part deals with malnutrition, discusses the different components of nutrition. Much of the thesis forms ways of application of nutrition. The issue is a nasogastric tube, a nasojejunal tube, percutaneous endoscopic gastrostomy, percutaneous endoscopic jejunostomy, feeding button or sipping. There are further expanded the introductions, nursing care, indications and contraindications of these options. The following chapters analyse the modes of enteral feeding, advantages and disadvantages of enteral nutrition compared to parenteral. The practical part is focused on research using anonymous questionnaires in the area of enteral nutrition. The survey was conducted in four departments of three teaching hospitals in Prague. It was focused on nurses and paramedics in medical intensive metabolic care units. The survey had 73 respondents. The aim was to identify the mode of feeding that nurses prefer and how they apply it, analyze the extent to which the nurses actively involve themselves in this, how they are oriented in...
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Evaluation of nitrogen balance with respect to the administered parenteral and enteral nutrition and the composition of the body in critically ill patients
Vaňková, Martina ; Hronek, Miloslav (advisor) ; Havel, Eduard (referee)
The aim of this thesis was to identify and assess the nitrogen balance due to the field of nutritional support, body composition, energy expenditure, utilization of nutritional substrates and their changes during the hospitalization. Nitrogen balance was determined in 12 men and one woman (age 44 ± 16,4 years) with multiple injuries (ISS 40 ± 11) in the ICU based on 2 measurements in the time interval of 1-7 days, as the difference between the received and the ecrected nitrogen. The energy expenditure and nutritional substrate utilization nutritional indirect calorimetry, body composition analysis and blood chemistry laboratory were examined at patients. Correlation analysis revealed dependence between nitrogen balance and other monitored parameters and also dependence on the length of their trauma. Total protein intake averaged 1,40 ± 0,69 g.kg-1 .d-1 . At this dose were recorded negative values of nitrogen balance in the first measurement of the 9-patients and in the second measurement of the whole group. In this work also the results of uptake of parenteral and enteral route were compared. In practice, significant correlations were found between total uptake and energy expenditure (p = 6,31.10-3 ; r = 0,6) in the first measurement, and on the other hand negative correlation during the second...
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