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Nutrition care in the treatment of pediatric patients with Crohn's disease
ČADOVÁ, Andrea
This bachelor thesis deals with the nutrition care of pediatric patients with Crohn's disease. The main goal is to find out whether the patients' parents and the patients themselves are sufficiently informed about nutrition and if Crohn's disease had impact on the eating habits of the children. The theoretical part is focused on the current epidemiology, etiopathogenesis, clinical presentation, diagnostic procedure and treatment options. It is also focused mainly on clinical nutrition and dietary measures. For this research, I chose a qualitative approach, which was attended by ten children respondents and ten mothers. The practical part is divided into three subchapters. The first of them is devoted to case reports with basic information about patients obtained from personal and nutritional anamnesis. The second part evaluates the answers of the mothers of the respondents and the respondents themselves to the questions asked during the semi-structured interviews. The last part is devoted to the evaluation of eight week-long menus and two 24-hour calls. This research has shown that parents and pediatric patients are well informed about the diet of Crohn's disease but some of them think that not all the questions they had were answered. Then they can search answers for their unanswered questions on non-professional websites. For most respondents, Crohn's disease did not have a particularly significant impact on their eating habits. Reduction of the number of fried meals and fast food was the most common change in the patients' lives.
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Management of multidisciplinary care in patients with inflammatory bowel disease.
KALMÁROVÁ, Diana
The diploma thesis deals with the management of multidisciplinary care for patients with inflammatory bowel diseases and is divided into a theoretical and a practical part. The theoretical part focuses on inflammatory bowel diseases, their characteristics, etiology and pathogenesis, diagnosis, treatment and psychosocial side of the disease. Another part of the theoretical part is the characteristics of management in nursing, nursing managers, the nursing profession itself, the multidisciplinary team in health care, the issue of competencies and the need for a multidisciplinary approach in the case of inflammatory bowel disease. The first aim of the thesis was to map the role of individual medical and non-medical staff involved in the care of patients with inflammatory bowel diseases, the second goal to find out how cooperation among these workers work and the third objective to identify dispensaries in patients with IBD outside hospital care. For the empirical part of the diploma thesis, a qualitative research survey was chosen, and semi-structured interviews were used as the method of data collection. Five variants of interviews were created, for nurses, doctors, nutrition therapists, psychologists and patients diagnosed with inflammatory bowel diseases. The research was conducted at the Clinical and Research Centre ISCARE in Prague and at the General University Hospital in Prague with the prior consent of the management of these facilities, except for patients who were contacted through patient groups and a psychologist who worked in his private outpatient facility. Based on interviews with nurses, doctors and a nutritional therapist, we were able to find out that as far as IBD centres are concerned, care is really interconnected and individual experts work as a multidisciplinary team led by doctors of various specialties, nurses, ostomy nurse, nutritional therapist. and a social worker. An exception is the representation of a psychologist, who unfortunately is not part of the team and there may be a problem with his / her availability, which was pointed out by some of the interviewees in the interviews. From the results of the research survey, we also managed to find out that patients have various options for better management of the disease, which are most often recommended to them by their attending physicians, but also by nurses. Nurses working in IBD centres are well versed in this issue and know the supportive options for patients with IBD. However, a problem in cooperation was found and appeared on the part of nurses, who in some cases take a passive attitude to education from an ostomy nurse, who is also an important member of a multidisciplinary team. Furthermore, based on research, we found that patients with IBD are often anxious and may have trouble trusting the nursing staff, so the main task of the nurse caring for such patients is to be more aware of these diseases, to know the supportive options, and to be able to educate clients. Respecting and understanding cooperation with other professionals are is important.
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Nutritional Particularities of Ulcerative Colitis
VÁVROVÁ, Veronika
This bachelor thesis is focused on nutrition issues in people suffering from one of the idiopathic intestinal inflammations, namely ulcerative colitis. The theoretical part deals with the characteristics of the disease, its symptoms, complications and treatment. Furthermore, it focuses more on nutrition and dietary recommendations during periods of remission, relapse and short bowel syndrome. The practical part is divided into three parts in which the method of qualitative investigation is used. The first part of the research examines how the respondents suffering from ulcerative colitis were acquainted with the residue-free diet, using semi-structured interviews. The second part of the research maps how the nutrition differs in individual respondents by considering their case history and evaluating their three-week diet. And in the third part, with the help of their nutritional history, the foods most frequently causing problems for respondents are mapped. The results of the research show that most respondents were educated by a doctor, not a nutrition therapist. Even some respondents were not answered their diet questions, so they had to search for diet information on the Internet or visit a nutritional clinic because they were already at risk of malnutrition or malnutrition. Energy and nutrient intake is sufficient for most respondents. Respondents with insufficient energy and nutrient intake supplement their energy and nutrients with sipping. As emerged from the research, almost all respondents eat rationally, only omitting meals that cause them problems. The most common meals, which bring about indigestion, are spicy dishes, fruits and vegetables with peel, grilled meat, milk and cabbage.
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Bacterial components in experimental intestinal inflammation prevention and therapy
Kverka, Miloslav ; Tlaskalová - Hogenová, Helena (advisor) ; Šedivá, Anna (referee) ; Stříž, Ilja (referee)
Although strong protective immune response is essential for preventing invasion by pathogens, equivalent responses against antigens originating from commensal bacteria can lead to chronic inflammatory diseases, such as inflammatory bowel disease (IBD). Manipulating the mucosal immune responses with microbial antigens might be an excellent tool to IBD therapy or prevention. Our aim was to gain some insight into the regulation of the intestinal inflammation and to isolate bacterial immunomodulatory components that could be used in intestinal inflammation therapy and prevention. One particular mechanism of how healthy colon tissue regulates the inflammation during acute experimental colitis is through modulation of bioavailability of glucocorticoids (GCs) in gut mucosa. Here, we show that intestinal inflammation changes the local GC metabolism, which ultimately leads to decrease in inflammatory readiness of cells in the gut mucosa and in mesenteric lymph nodes. This pre-receptor regulation of GC function could represent an important homeostatic function of the gut mucosa. The actual triggers of intestinal inflammation in IBD seem to be either microbial dysbiosis or microbes with special "pathogenic" abilities, which both could be rectified by feeding with probiotics. Here, we report that oral feeding with live...
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Clinical and genetic predictors of drug dependency in inflammatory bowel disease
Ďuricová, Dana ; Lukáš, Milan (advisor) ; Keil, Radan (referee) ; Špičák, Julius (referee)
IN ENGLISH Drug dependency in inflammatory bowel disease (IBD), Crohn's disease (CD) and ulcerative colitis (UC), is a specific disease phenotype which determines disease prognosis and hence may be used as a prognostic marker for treatment management. Drug dependency in IBD has been well described in corticosteroid treatment and recently also in infliximab (IFX) therapy. The aims of this thesis were: 1) to assess the occurrence of IFX dependency in paediatric and adult patients with CD; further to search for clinical and genetic predictors of IFX outcome and to evaluate the impact of IFX dependency on surgical rate; 2) to assess in CD patients the outcome of the first course of 5-ASA monotherapy with emphasis on 5-ASA dependency and to define clinical predictors of 5-ASA treatment outcome. We found that 66% of children and 29% of adults with CD became IFX dependent. The high frequency in paediatrics is in agreement with previously published studies, while the finding in adult patients indicates a lower rate of IFX dependency in the only study to date. Perianal disease and no bowel surgery prior to IFX start were predicative of IFX dependency in paediatric patients. In adult cohort, 2 genetic variants LTA c.207 A>G and CASP9 c.93 C>T were associated with IFX outcome, whereas no relevant clinical...
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Dysregulation of E3 ubiquitin ligases in inflammatory bowel diseases
Armerová, Eliška ; Petrezsélyová, Silvia (advisor) ; Červená, Klára (referee)
E3 ubiquitin ligases are a large family of enzymes involved in many cellular processes such as DNA damage repair, transport of membrane proteins, chromatin modification, cell cycle and apoptosis. E3 ubiquitin ligases have been shown to play a significant role in the maintenance of intestinal homeostasis, and their abnormal function associated with their deregulation contributes to inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. In recent years, GWAS has identified approximately 200 risk loci that are susceptible to these diseases. Including those encoding E3 ubiquitin ligases.The aim of this work is to compare the already identified E3 ubiquitin ligases associated with these diseases and to give an overview of them with a focus on the regulation of intestinal homeostasis. Key words: E3, ubiquitination, inflammatory bowel diseases, intestinal homeostasis, CD, UC
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Dysregulation of E3 ubiquitin ligases in inflammatory bowel diseases
Armerová, Eliška ; Petrezsélyová, Silvia (advisor) ; Červená, Klára (referee)
E3 ubiquitin ligases are a large family of enzymes involved in many cellular processes such as repair of damaged DNA, transport of membrane proteins, chromatin modification, cell cycle and apoptosis. E3 ubiquitin ligase has been shown to play a significant role in the maintenance of intestinal homeostasis, and their abnormal function associated with their deregulation contributes to inflammatory bowel diseases such as ulcerative colitis and Crohn's disease. In recent years, approximately 200 risk loci have been identified that are susceptible to these diseases, including those encoding E3 ubiquitin ligase. 10 of them have been identified. The aim of this work is to compare the already identified E3 ubiquitin ligases associated with these diseases and to give an overview of them with a focus on the regulation of intestinal homeostasis. Key words: E3, ubiquitination, inflammatory bowel diseases, intestinal homeostasis, CD, UC
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Inflammatory Bowel Diseases in pregnancy
Kovářová, Tereza ; Krátká, Zuzana (advisor) ; Hadlová, Petra (referee)
(EN) Inflammatory bowel disease is a chronic autoimmune disease of the intestinal tract including Crohn's disease, ulcerative colitis, and other unspecified colitis. Depending on the type of disease, inflammation affects the small or large intestine or rectum. It is a multifactorial disease in which the intestinal microflora, the immune system status, and genetic predisposition are crucial. IBD is most often diagnosed in late adolescence or early adulthood. Due to the availability of quality treatment, the health status of IBD patients also improves, allowing them to consider starting a family after the disease has calmed down. Patients have fewer children than the general population, but there was no significantly higher risk of infertility. A prerequisite for successful pregnancy and childbirth is a stable condition of the disease and the use of treatment during pregnancy to prevent relapse. A specific problem of patients is voluntary childlessness because of worries about the worsening of IBD during or after pregnancy, about negative effects of treatment on a foetus, but also an occurrence of disease in offspring This work aims to summarize the issue of pregnancy in patients with IBD and to provide information on the current situation in patients with IBD in the Czech Republic. Keywords:...
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Pathophysiology of inflammatory bowel disease. Relation to primary scklerosing cholangitis, liver transplantation and carcinogenesis.
Bajer, Lukáš ; Drastich, Pavel (advisor) ; Živný, Jan (referee) ; Procházka, Vlastimil (referee)
Inflammatory bowel disease (IBD) represents a group of multifactorial illnesses with increasing incidence worldwide. Crohn's disease (CD) and ulcerative colitis (UC) are the two most thoroughly defined phenotypes of IBD. IBD associated with primary sclerosing cholangitis (PSC) - a progressive biliary disease leading to cirrhosis and liver failure - is considered as specific IBD phenotype (also referred to as 'PSC - IBD') due to its clinical and pathophysiological characteristics. The aim of the experimental part of this thesis was to define specific features of PSC - IBD in the key areas of IBD pathogenesis. These are: microbiota composition, gut - barrier failure, genetic predisposition and aberrant cellular and antibody immune response. Furthermore, the other goals were to describe relation of IBD status and activity to liver transplantation (LTx) and carcinogenesis based on thorough analysis of clinical data in patients under surveillance at the liver transplantation unit. Using the next-generation parallel sequencing technology, we discovered specific bacterial and mycobial features of gut microbiota composition in PSC - IBD which significantly differed from UC and healthy controls recruited from Czech general population. Moreover, we identified numerous seral biomarkers distinguishing CD, UC...
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