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Lifestyle of patients with peripheral arterial disease before and after surgery
REZKOVÁ, Helena
Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.
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The need for security and safety in connection with a planned surgery with the patient's perspective and nurses
BOHDALOVÁ, Jaroslava
A planned operation performance always affects patient´s needs for assurance and safety. It is important to provide necessary information connected with the planned operation performance itself so that the patient can feel assure and safe. The key role for the patient and her/his needs for assurance and safety is in general nurse´s hands because she is the closest person to the patient and can help to inspire her/his needs for assurance and safety with konfidence best through the aid of her knowledge and skills that she should have as well as through the aid of her attitudes. The target of the thesis was to find out how a planned operation performance affects patient´s needs for assurance and safety and how a general nurse inspires patient´s needs for assurance and safety connected with a planned operation performance with confidence. The following research questions were stated: How does a planned operation performance affect patient´s needs for assurance and safety? How does a general nurse affect patient´s needs for assurance and safety connected with a planned operation performance to inspire her/him with confidence? What is insufficient in filling patient´s needs for assurance and safety before a planned operation performance? How can a general nurse help a patient control her/his fear and state of anxiety related to a planned operation performance? The method qualitative research with the use of depth interview was used to figure out the investigation. The respondents were willing to record the interview which were verbally rewritten and then subjected to the contents analysis by the method paper and pencil. From the research it is clear that a planned operation performance affects patient´s needs for assurance and safety in a negative way disregarding to her/his previous experience. Patient´s worries and negative feelings can be eliminated by a general nurse who treats her/him as equal, taking up an individual approach, informing her/him about all performances and proceedings, having a calming and welcoming way of communication, using empathy and listening as well as trying to meet patient´s wishes according to her possibilities. The research reveals the advantage of patients´ readiness for planned operation performances. Patients can learn it in the framework of educational proceeding in the out-patients´ department at the same time when they learn that they are going to be operated. The research also shows that general nurses do not have enough knowledge in the sphere of therapeutical communication. The results indicate that it would be suitable to start educating patients as soon as it is known how their disease will be solved and treated in order to reduce the negative impact of surgical treatment to patients´ needs for assurance and safety. General nurses should complete their knowledge and skills to be able to help patients to cope with their difficult life-situation. On the basis of the research investigation and after the consultation with the senior nursing officer, the training course will be organized. The topic of the training course will concentrate on communication with patients before planned operation performances with a view to therapeutical communications and therapeutical interviews. Other discovered facts, for example, the lack of information provided to patients and possibilities regarding better patients´ readiness for planned operation performances will surely be solved by the hospital management.
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Consumption of fiber in old age
ŠÁLEK, Jan
The theme of this bachelor thesis is the Consumption of fiber in the old age (seniors). Formerly, the dietary fiber was considered unnecessarily burdensome for human organism. Later, it was found that it has a relatively large impact on human health, especially by serving as a prebiotic for symbiotic bacteria inhabiting the gastrointestinal tract. There is still prevailing opinion that roughage divides into a soluble and insoluble, despite that some types of fiber cannot be definitely classified and placed into any of these groups because they have characteristics of both of them. The daily recommended dose is 30 g. The qualitative research was used for elaboration of the practical part. The first goal was to find out how much fiber seniors consume. The second aim was to compare the consumption of fiber among elderly people living alone and the elderly living in retirement homes built for them. The research group, at the first research question, consists of 20 seniors from the Southern Region aged over 65 years. The research group, at the second research question, consists of five retirement homes from the whole Czech Republic. All respondents were given a record sheet for one week, and instructions on how to fill it. Acquired menus were subsequently re-calculated through the program "Nutriservis Professional". The results show higher consumption of fiber than the average in the Czech Republic, but there is still almost a half missing to get the recommended daily dose. There was observed BMI and its impact on the consumption of fiber. No significant effect was found, because overweight had all interviewees except one respondent. The financial limit is visible for evaluated diet of homes for the elderly, therefore, there are no whole grain products, vegetables and almost no fruit. Despite these limitations, the average consumption of fiber is almost equal to elderly people living alone. In conclusion, there is a proposition how to, despite the low funds, increase the intake of roughage, and avoid or, at least, reduce the problems associated with its low consumption. Recommendations for respondents are individual and given under each evaluation.
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Cystic fibrosis and Nutrition
PECHOVÁ, Jana
The name of bachelor's thesis is "Cystic fibrosis and nutrition". Cystic fibrosis is hereditary chronic disease. It is dysfunction ducts of chloride in a human organism. The manifestation of cystic fibrosis is large quantities of a mucus in the respiratory and digestive system of patient with this diagnostic. This disease we put in the group of very rare illnesses. The smaller percentage citizens in the Czech Republic have this disease. For the people with cystic fibrosis is priority follow recommended eating habits. Prognosis of this disease is getting better and patients can live full-value life. This thesis dealing with how observe the recommended eating habits and eating regimens. The thesis contains some objectives. First, there is finding out whether children who suffer from cystic fibrosis can all sorts of foodstuffs whether they have special requests for quality and preparation of foodstuffs. The second most important objective is appraisal of diets some sample of people with cystic fibrosis. For objectivity this thesis was chose four respondents in age bracket from three to eighteen years. On the basis of evaluation their week-long diet, questionnaires with their parents and with them and manoeuver a conversation will be to find out whether children observe all principle of recommended eating regimens. In the theoretic part of the thesis are use opinions of experts who are occupying with cystic fibrosis exhaustively. Their experience show how is important to choose right diet and observe correct eating principles and eating regimens. These opinions are use in the practical part. Conclusions from discussion can be used for practical work nutritive therapists who can meet with children with cystic fibrosis.
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Nutritional care of children at pediatric clinics and hospitals
METELCOVÁ, Jana
The main goal of this work called Nutritional Care in Children's Hospital and Hospital facilities is to verify whether the nutritional standards created for older child patients meet the needs and are checked and if their physiological needs are fulfilled in chosen hospitals. The next objective is to evaluate the satisfaction of the hospitalised patients with the meals given to them by hospitals. The theoretical part of this work deals with nutritional care, therapeutic care and nutritional needs of adolescents. It further deals with nutritional risks and marginally mentions technological processes regarding meal preparation. The method of qualitative research was used by using questionnaires filled in by chosen children patients who were then interviewed. Children aged 10 to 14 were supposed to be on diet number 13, half of them were boys and the other half were girls. The research was conducted in the children's ward in the hospital in Jindřichův Hradec in December 2015 and in the same type of ward in the hospital in České Budějovice in February 2016. The initial number of respondents was five patients in each ward, then using snow ball sampling method their number increased into ten in each ward. The weekly menu according to which the meals were distributed was obtained from the catering facilities of the hospitals. By using the program "Nutriservis Profi" the contents of nutrients in the meals were obtained. The results gathered from the program "Nutriservis Profi" were compared with recommended values for particular age group defined by The Czech Society for Nutrition, so meeting the physiological needs of the patients could be evaluated. From the results it was found that both hospitals have problems with supplying enough fibre content, phosphorus and calcium in meals for children's patients. There is also sodium, potassium, cholesterol and vitamin C surplus in the menus. Thanks to the internship in both hospitals in Jindřichův Hradec and České Budějovice meeting the physiological needs of the children could be evaluated. Considering the fact that the previous evaluation revealed some imperfections, therapists from both hospitals should concentrate more on checking nutritional values in meals, consequently it was recommended to focus more on the variety of the menus and their improvement. There were also inadequacies in attendance at the children's ward. There was a comparison of the results from both hospitals, based on questionnaires and interviews from the children's point of view. Based on the data, children hospitalized in Jindřichův Hradec were more satisfied with the meals. In the conclusion there is a summary of the research and suggested suitable improvements for hospitals. There is a model menu for diet number 13 in the attachment which could be used by hospitals.
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Diets for food allergies
DOBRUSKÁ, Klára
I have chosen topic Diet with Food Allergy as a topic of my bachelor thesis. This illness is quite common these days. It affect infants mostly but allergy of cow´s milk protein of children under three years disappears itself mostly. There is increasing amount of causes when patient suffers more allergies. Number of people who have the most serious reaction the anaphylactic shock, icreeases. It can end with death. Doctors recommend to patients to strictly follow the elimination diet which is basic treatment of this illness. The most accurate diagnosis of illness (immunological or not) is another important factor for effective treatment. I have chosen three aims for this bachelor thesis. First to find out if patients are informed about their illness. Second to map eating habbits of people with food allergy. Third the evaluation of correctness of daily menus. I used approach of guality research. Research group consisted of six respondents with different food allergy. Those respondents wrote down their weeks menus. Menus were evaluated with program Nutriservis and it was assessed if it follows recommended dietary value. Suitable intake of energy and essential nutrients was calculated for every respondent. It was evaluated if respondents follows priciples of rational diet and if their diet contains sufficient amount of minerals and vitamins. Questionnaires were another key point of this research. Questionnaires were about illness know-how of patients and who has instructed them about it. It was found out the patients hasn´t got enough information about their illness and half of them has no idea which essential nutrients, minerals and vitamins could lack in their diet. It resulted from menus simultaneously that five of six respondents do not follow principles of rational diet and eat very monotonously. Only one respondent follows strictly elimination diet others violate diet exceptionally. Respondets would appreciate other research would focus on creation of special centres and training of doctors and nutritional therapist who would be focused on food allergies. Spreading the information about illness not only to patients but to public also is really important. Another important point is to increase amount of books about food allergies at the market.
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Is it possible in clinical practice to perform selection of unrelated donors based on KIR genotypes for AML patients?
FRYČOVÁ, Michaela
Acute myeloid leukemia (AML) is an aggressive malignant disease, during which is for most of the patients only possible treatment the curative allogeneic stem cell transplantation. Besides reaction of the graft against the host is a fundamental limiting factor of the successful transplantation the relapse of the disease. According to several recent published studies, the results of transplantation in patients with AML may be influenced except the HLA genes by others so-called non - HLA genes. Especially there is mounting evidence influence of the donors KIR genes (Killer -cell Immunoglobulin - like receptors) in protection against the relapse after transplantation. HLA and KIR genes are coded on different chromosomes (HLA- sixth chromosome and KIR chromosome 19), therefore are segregated independently and HLA identical donors with recipients usually have different compositions of the KIR genes. Cooley et al. (2010) demonstrated that the specific motifs composition of centromeric and telomeric B haplotypes of KIR genes helps to protect against relapse and increases the chances of complete cure AML. In cases where there are multiple HLA identical unrelated donors (UD) then logically the composition KIR genes by the individual donor could be a criterion in selecting the most appropriate donor, therefore, the one with the greatest potential to protect over the relapse . Based on this study and other data the genetic screening of KIR was started with potential donors, if it was possible to choose from several 10/10 or 10/09 HLA identical UD for the patient. Genotyping was performed by PCR-SSP methodology using commercially available kits. It was performed gene classification 160 preferably identical HLA donors for 55 selected patients with AML. The presence of KIR haplotypes A and B as well as their combinations was determined from the type and number of the KIR genes. All genotypes were entered into the calculator, which allows you to enter up to five potential donors and obtain their assigned into one of three categories according to content KIR B. Groups , "neutral" , "better" , "best" , refer to the appropriate protection against relapse. KIR gene classification in the search for donors revealed 43 donors with AA haplotypes, 90 donors with AB haplotypes and 27 donors with BB haplotypes . After assigning state of the presence KIR B was discovered 107 " neutral " donors , 35 "better " donors and the 18 "best " donors . At 40 (~ 73 %) patients were available donors with the different states of the presence of KIR B. These patients represent a group of patients where the selection criterion of the presence B KIR gene at the donor could be used. We confirmed that the additional selection of HLA-matched unrelated donor on the basis of the content B of KIR genes is feasible. Selection such donor for transplantation may improve the outcome of patients with AML.
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Card of Cryptosporidium infections by humans and animals
BLÁHOVEC, Ondřej
The representatives of the Cryptosporidium genus are one of the causes of gastrointestinal tract diseases in humans and animals. In animals the host may even be a respiratory apparatus. The disease is called cryptosproridiosis. In majority of cases this infection can bypass without any major problems, but in immunosuppressed individuals it can cause serious health problems. Cryptosporidium has a monoxenous development cycle, which basically means that the entire development takes place in a single host. Exogenous stage is represented by oocysts, which are in case of a gastrointestinal disease excreted in faeces. In case of a respiratory disease the oocysts make they way out via respiratory and nasal secretions. This leads to contamination of the environment or water. In general, it is expected that Cryptosporidium isolates, which are present in one class of vertebrates, are not infectious to a non-specific host from other classes. It is also expected that cryptosporidia have low host specificity. But this does not exclude that some kinds have gradually extended its specificity to more species. It is also apparent that cryptosporidium infections are common in animals that inhabit the external environment, so even a human can be endangered by this zoonosis, although the incidence in the Czech Republic is low. The reason for the low numbers may as well be that parasitological examination is not performed very often, so the estimated prevalence in the population is probably much higher. Therefore to reveal the originator of this disease it would be appropriate to perform a parasitological examination in persons who are in contact with animals, this way the cryptosporidium infection would be excluded or proven.
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Nové postupy biomonitoringu cizorodých látek ve vodním prostředí
ČERVENÝ, Daniel
Within the presented work, several approaches of biomonitoring were studied. A well-established method for human health risk assessment was applied to evaluate the quality of fish from open waters in the Czech Republic. As this work is targeted on sport fishermen, who frequently consume their own catches, besides the publication in scientific journal, a brochure with results of this study was distributed via the Czech Fishing Union. Health risks for consumers related to the consumption of wild fish were found strongly species and locality dependent. As there is no risks related with the consumption of carp (Cyprinus carpio) at all investigated sites, frequent consumption of predatory fish should be avoided at some fishing grounds. The use of passive samplers has become more and more attractive in the last two decades. As these devices are able to mimic the biological uptake of chemicals, their potential for replacing fish as bioindicators in routine biomonitoring programmes is evident. In our study, the comparison between analysis of fish tissues and POCIS extracts from selected sampling sites confirms this idea about interchangeability of these indicators in the case of PFASs as target pollutants. Moreover, no metabolic transformation of contaminants present in water take place in passive samplers contrary to living organisms, thus these reflect the actual contamination at the locality more precisely. The use of passive samplers completely fulfils the internationally accepted principles of Replacement, Reduction, Refinement (the three R´s). Another promising approach using YOY fish as bioindicators was evaluated within the present study. Multispecies samples of YOY fish homogenate was found as a better indicator for wide range of pollutants than muscle tissue of adult fish within one species from the same locality. As all inner organs and tissues are presented in analysed samples, more target pollutants in higher concentrations are detected compared to the muscle of adults. Besides the higher sensitivity in pollutants detection and quantification, practical and economic benefits are of concern in the case of the YOY fish approach. The YOY fish approach also particularly fulfil the three R´s strategy, as sampling of this age group of fish has a smaller impact on the environment than the sampling of adults. In case of mercury, that was found as a limiting contaminant for the consumption of fish from open waters in the Czech Republic, a nonlethal method of finclips sampling can be used for the monitoring of this compound in aquatic environments. Besides the monitoring, our optimised method for the estimation of muscle tissue concentrations could be used for human health risk assessment as well. The difference between real muscle concentrations and concentrations estimated using our method differs less than 10% in most of the investigated localities. Benthic organisms are an important part of the food web in aquatic environments, but insufficient information about its contamination is available. In another study included in this thesis, first evidence about bioaccumulation of certain pharmaceuticals in benthic organisms was described. Although, pharmaceuticals are generally considered to be not accumulative in organisms, our study proved that certain pharmaceuticals have bioaccumulation potential. From this finding, it is evident that not only the concentrations of pharmaceutical dissolved in water but also the diet represents an important exposure pathway of contamination by these compounds for organisms (fish) inhabiting aquatic environments.
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Relationship between the coat colour and melanoma occurrence in horses
Hovorková, Kristýna ; Hofmanová, Barbora (advisor) ; Majzlík, Ivan (referee)
The literary review is divided into two main parts, the first part is dealing with the coloring of horses and their genetic base and the second part is dealing with melanoma formations of horses and their division. In the chapter about several color types of horses there is a description of forming basic color types which is done by three locuses: COLOR, EXTENSION and AGOUTI. Locus COLOR (CREAM) controls whether or not to create pigment. EXTENSION locus controls about the type of pigment and AGOUTI locus controls the distribution of pigment.
The next subsection gives a breakdown of the white color in horses. Greying proces is related with locus GREY where there is a loss of pigment and the coat itself. This process and mutation is commonly connected with dermal melanoma. Non-pigmented spots called vtiligos are connected with the greying process, which is more intense with increasing age. Vtiligios are commonly found in grey horses, at the same locations as dermal melanoma. The places are perianal area under the tail, around the vulva, lips, eyes and around the penis.
Melanoma formations are divided according to whether they occur in Grey horses or other colored horses and whether they have a benign or malignant potential. A further breakdown of melanomas at grey horses is whether it is a separate, smaller segments or large, associated lesions, when this condition is called dermal melanomatosis.
At the end of the thesis there is a description of the treatment options for melanoma. The most effective appears to be a surgical removal of smaller formations. There were studies which have examined the anticancer action of the drug cimetidine but the results are not yet sufficiently conclusive. As preventing the occurrence of melanoma in grey horses it is appropriate to implement the necessary measures and individuals who are concerned should not be included in the next breeding.
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