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Pitfalls of the surgical treatment of obesity from the patient's point of view
Hakenová, Renata ; Heczková, Jana (advisor) ; Stoklasová, Radka (referee)
This thesis examines the surgical treatment of obesity from the perspective of the patient. The theoretical portion deals with etiopathogenesis, diagnosis, complications, related illnesses, conservative and surgical treatments (definitions, overview and types, principles of basic bariatric approaches, as well as effects and indications, side effects, and results of treatment. It also includes the specifics of the pre-operative preparation, immediate and long- term post-operative care, psychological preparation and post-bariatric-surgery nutrition. The empirical portion consists of quantitative research in the form of a survey instrument with closed-end questions with the possibility of individual responses. The respondents were patients who had been diagnosed as morbidly obese or third-degree obesity and who had also been through surgery within the past three years. One hundred and fifty surveys were distributed, 125 were returned, and 10 of those were not used for incompleteness, and another 6 were not used because the respondents did not meet the criteria. One of the primary goals of the research was to ascertain the information that patients were missing before bariatric surgery and whether this information had a significant effect on the result of the bariatric approach. Another primary goal of...
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History of the pain treatment
Erbenová, Helena ; Mellanová, Alena (advisor) ; Vaňková, Milena (referee)
The thesis focuses on the history of pain treatment from the beginning of humanity to present days. It aims to provide a comprehensive overview of the research development, creation of theories and struggling of a man with the pain, an unpleasant sensory perception, without which the mankind would most probably not survive. From the skeletal remains we learn about pain-killing practices among primitive people who were, besides various potions, charms, spells and rituals, able to use even the trepanation techniques. We find that people in ancient times apparently understood the pain caused by traumatic mechanisms but they could not handle the pain caused by some internal disorder. Early findings about the treatment of pain were thus linked to the nature. People used plants with narcotic and analgetic effects e. g. opium, cannabis, mandrake and physical quantities such as pressure, heat, cold or even shocks generated by electric fish. Over the time they improved this knowledge and reached for new findings. This thesis presents also ideas and creation of theories of pain provided by thinkers and scholars across centuries. Works from antiquity had apparently the biggest and the longest lasting influence on pain and medical problematics. From historical sources we read that new discoveries in medicine...
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Patient education nurse anesthetist
Kloubcová, Lenka ; Hošťálková, Monika (advisor) ; Heczková, Jana (referee)
Bachelor thesis is focused on assessing the quality of patient education nurse anesthetist. Patient education is considered from the perspective of nurse anesthesia. The theoretical part of this work is devoted to general anesthesia characteristics, definitions and history of anesthesia. The following section deals with different types of anesthesia, complications of anesthesia and drugs used in anesthesia. Furthermore, the work focuses on the characteristics of the patient before, during and after anesthesia, and the specifics of the individual parts of anesthesia from the viewpoint of anesthesia nurses. The last chapter includes the very concept of education and the importance of good communication with the patient throughout the preparation of the patient for anesthesia. The basis of this work is a quantitative research ideas anesthesia nurses by anonymous questionnaires. Here the sisters reflect the stated objectives of work. The stated goal of the work is to identify the knowledge of anesthesia nursing Educational process, whether anesthesiology nurses involved in patient education before elective surgery and anesthesia nurses whether they have created suitable conditions for patient education. These objectives were met. As a possible solution for improving the efficiency of education could...
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Hemodynamic optimalization in hepatic recection
Zatloukal, Jan ; Pradl, Richard (advisor) ; Cvachovec, Karel (referee) ; Málek, Jiří (referee)
Lowering of central venous pressure in hepatic surgery is nowadays widely recommended and used procedure. Low central venous pressure anesthesia is associated with decreased blood loss and improved clinical outcome. There are several approaches how to reach low central venous pressure. Till now none of them is recommended as superior in terms of patient safety and clinical outcome. Concurrently there is still debate if to use the low central venous pressure anesthesia principle or if it could be replaced with a principle of anesthesia with high stroke volume variation (or another dynamic preload parameter) with the use of a more sophisticated hemodynamic monitoring method. Results of our study didn't show any significant difference between two approaches used for reduction of central venous pressure, but suggest that the principle of low central venous pressure anesthesia could be possibly replaced by the principle of high stroke volume variation anesthesia which presumes the use of advanced hemodynamic monitoring. KEYWORDS Hepatic resection, central venous pressure, Pringle maneuver, hemodynamics, hemodynamic monitoring, fluid therapy, anesthesia
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Endothelial Glycocalyx - Diagnostic Approach and Intervention Assesment
Pouska, Jiří ; Beneš, Jan (advisor) ; Málek, Jiří (referee) ; Štourač, Petr (referee)
UNIVERZITA KARLOVA Lékařská fakulta v Plzni Dizertační práce Endothelial glycocalyx - diagnostic approach and intervention assessment MUDr.Jiří Pouska ABSTRACT Endothelial glycocalyx (EG) is fine structure on the surface of endothelium. After extensive research in past years, revisited Starling principle was finally formulated. It describes fluid physiology in capillaries precisely. EG has pivotal role in keeping endothelium semipermeable and thus avoiding extensive filtration of fluids to interstitium. Assessment of EG is clinically difficult. Many pathological conditions lead to damage of EG (sepsis etc.). Intravenous fluid therapy is mainstay of treatment of such conditions. Our aim was to determine the changes of EG integrity depending on the choice of intravenous fluid and its infusion time in physiological and pathological conditions. Key words: Endothelial glycocalyx, infusion therapy, anaesthesia, sepsis, microcirculation.
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Nursing care in anestesiology for a patient undergoing endarterectomy
Mocková, Karolína ; Di Cara, Veronika (advisor) ; Pucholtová, Romana (referee)
The subject of my bachelor thesis is a description of nursing process for the patients in anesthesia during the endarterectomy. By myself, I find this topic very interesting, because the disease of the cerebrovascular system is currently the most frequent disease. Stenosis of carotids is responsible for the one-third cases of stroke. In most cases is asymptomatic. Stenosis of carotids is more frequent in the age of 60 and higher. The goal of my bachelor thesis is to describe the nursing process on the operating theatre during the endarterectomy and the differences in the nursing process for the patients in a general anesthesia and locoregional anesthesia. Point out the importance of the cooperation between anesthesiology team and surgical team. In my bachelor thesis, I used the method of the case study of the patient on the operating theatre in the county hospital. For my thesis I have used following sources: Czech or foreign professional literature, Czech or foreign scientific articles, my own observations and providing professional nursing care, interview with the patient, information from health care personnel and patient's medical documentation. Analyzing of the nursing care I found that the healthcare professionals follow the nursing standards and recommended procedures. I found also the...
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Nursing process for client Stenosis of the internal carotid artery
Duštírová, Monika ; Kordulová, Pavla (advisor) ; Trávníčková, Ivana (referee)
Tématem bakalářské práce "Ošetřovatelský proces u klienta se stenózou arteria carotis interna" přibližuji problematiku a specifika pooperační péče u pacientů s touto diagnózou. Zúžení krční tepny na podkladě vytvoření aterosklerotického plátu je nejčastější příčinou cévní mozkové příhody. Nedostatečné prokrvení některých částí mozku může způsobit jeho poškození a vést k nezvratným změnám. Odstranění zúžení krční tepny patří k nejčastěji prováděným cévním operacím, v ČR je ročně odoperováno přibližně 1500 pacientů. V teoretické části mé závěrečné práce se zaměřuji na anatomii a fyziologii cévního řečiště mozku a tepenného systému. Zabývám se zde zúžením krční tepny, včasnou diagnostikou a bezpečnou léčbou, především chirurgickou. Podklady pro vypracování práce jsem získala vyhledáváním v databázích NLK, PubMed, Embase, Medvik a CINAHL apod. Dále jsem čerpala z internetových zdrojů profesních organizací a společností zabývající se touto problematikou. Zahrnuta byla i doporučení profesních organizací jako je ESVS - European Society for Vascular Surgery, SVN - Society of Vascular Nursing. METODIKA: Pro vypracování bakalářské práce jsem zvolila případovou studii pacienta se stenózou arteria carotis interna po chirurgickém operačním výkonu endarterektomii. Informace k vypracování bakalářské práce byly...
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Monitoring quality indikators of anesthesilogy care
Šimonová, Petra ; Jeřábková, Lenka (advisor) ; Dynáková, Šárka (referee)
Safety and quality of care are considered to be one of the main priorities in anaesthesia and their management and monitoring should be continuous and systematic. Quality indicators in anaesthesia must be frequently evaluated. Their evidence and evaluation create not only safe environment for patients but also continuously improve quality of anaesthesiologic care. The main objective of this diploma thesis was to evaluate patient's satisfaction with provided anaesthesiologic care, one of the main quality indicators in anaesthesia. Other objectives were research of quality indicators recommended in the Czech Republic and quality indicators recommended by foreign medical societies. The last partial objective was to create quality indicators checklist tailored for specific department of anaesthesiology based on collected data. Quantitative method research was conducted, using unstandardised questionnaire for patients, hospitalized and anaesthetised. 140 questionnaires were distributed of which 117 questionnaires returned. Based on objective the author of diploma thesis found out that Czech society of anaesthesia, resuscitation and intensive care determines quality indicators monitored in the Czech Republic. Quality indicators in foreign countries are in form of criteria that are necessary to adhere to....
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Test of exposiv partitions in anestetic praxis.
Klimešová, Marie ; Dvořák, Miroslav (referee) ; Jehlička, Karel (advisor)
On anesteziologic workplace are workers meet with various substances and materials every day. Are they put at risk of outbreak of fire or explosion? I´m going to put mind to this issue in my work, which is aimed at monitoring concentrations of explosive substances used in anesthesia. A related study of gases and vapors of volatile liquids concentration, explosiveness, flammability and other properties. I'm interesting in security and the timely identification of gases and vapors of volatile substances of the leak of anesthetic workplace, then studying the detection system and the detectors themselves. I meet with gas analyzers of company Brűel & Kjaer.
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Skull Trepanation in Prehistory of the Europe: The Oldest Surgical Procedures
Moravec, Tomáš ; Komárek, Stanislav (advisor) ; Pankowská, Anna (referee)
The main aim of the thesis is to provide a comprehensive overview of trepanations in the prehistory of Europe and to compile a brief overview of the oldest findings in Europe and closer in the Czech Republic. At first, the thesis deals with the types of trepanations according to their execution and the problems with trepanation diagnosis, where the work focuses on various groups of defects created by different mechanisms, which can be incorrectly diagnosed as trepanations. Further, the thesis deals with the reasons for trepanation and the description of the trepanations tools and techniques used in the prehistory. It also briefly mentions the first references to surgical interventions and the origin of anesthesia. Additionally, the thesis deals with the overview of the oldest findings in Europe and the Czech Republic and their brief description. And finally, there is a mention of trepanations at the present time.
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