National Repository of Grey Literature 30 records found  1 - 10nextend  jump to record: Search took 0.00 seconds. 
Vaginal Birth after Caesarean Section
Paymová, Lenka ; Rušavý, Zdeněk (advisor) ; Ulčová-Gallová, Zdeňka (referee) ; Švabík, Kamil (referee)
Vaginal birth after a previous caesarean section is a very actual topic for its potential in reduction of caesarean section rates. It has been widely discussed and studied in the world literature. Numerous guidelines dealing with management of this birth and the identification of both positive and negative outcome predictors were produced by scientific communities and administrative boards. However, the risk of childbirth related injury in women giving birth vaginally after a previous caesarean section was not clearly studied. Studies evaluating perineal injuries have conflicting results, while injuries to the higher levels of the pelvic floor have not yet been studied. In the first part of the presented research work, we retrospectively evaluated perineum and anal sphincter injuries in women who delivered vaginally after a previous caesarean section. We compared the results with a group of primiparous women after vaginal delivery. We also monitored the presence of risk factors for pelvic floor injury, including the influence of the timing of the previous caesarean section. It has been proven that women, who delivered vaginally after a previous caesarean section have significantly shorter first stage of labor. There was no difference in the frequency of perineal including anal sphincter injuries in...
Impact of Immunonutrition on the Patients With Cystic Fibrosis
Hloch, Ondřej ; Charvát, Jiří (advisor) ; Kohout, Pavel (referee) ; Rušavý, Zdeněk (referee)
The impact of immunonutrition in patiens with cystic fibrosis Abstract The aim of the study was to evaluate the application of immunonutrition in adults with cystic fibrosis (CF) and malnutrition, who have been receiving enteral nutrition in the form of standard sipping for at least a year. In 30 adult patients, immunonutrice (Impact) was given for 8 weeks. After 8 weeks, patients returned to standard nutritional support. The application of immunonutrition led to a significant reduction in systolic blood pressure and heart rate, to an increase in glomerular filtration and significant changes in the plasma aminoacidogram. Serum amyloid-A (SAA) levels decreased significantly and increased again after the intervention. However, immunonutrition administration was associated with an increase in serum malonyldialdehyde, a decrease in serum glutathione peroxidase and selenium. Thus, administration of immunonutrition led to an increase in oxidative stress, but almost all values remained within physiological limits. At 6-year follow-up, the long- term prognosis in the multivariate analysis depended only on baseline FEV1 and the degree of pulmonary involvement, respectively. The frequency and duration of subsequent hospitalizations and long-term prognosis were significantly associated with plasma fibrinogen levels....
Significance of Assessment of Glycemic Index of Foods in the Treatment of Insulin Resistance Syndrome
Víšek, Jakub ; Rušavý, Zdeněk (advisor) ; Rosolová, Hana (referee) ; Blaha, Vladimír (referee) ; Prázný, Martin (referee)
OBJECTIVE - The aim of this study was to compare the impact effectiveness of a diet with a low glycemic index versus a common diabetic diet in selected metabolic and anthropometric parameters. RESEARCH DESIGN AND METHODS - 20 volunteers with the type 2 diabetes treated only with metformin were randomly split into two groups. Each group was advised to follow a common diabetic diet (DD) or a diet with a low glycemic index (GI) for a period of 3 months in a crossover design. The effectiveness of the two diets was evaluated according to the selected metabolic and anthropometric parameters using a hyperinsulinemic euglycemic clamp with endogenous glucose production measurement, indirect calorimetry and bioimpedance analysis. RESULTS - Body weight after 3 months following DD was 93kg (83-104) vs. GI 92kg (85- 104) p<0.05, BMI DD 31.3 kg/m2 (27.5-35.9) vs. GI 30.7 kg/m2 (27-35.3) p<0.05, body fat DD 28% (25.5-43) vs. GI 27% (23-43) p<0.05. The diets did not differ in effects on glycosylated hemoglobin, fasting glucose, lipid profile, insulin sensitivity or hepatic glucose production. CONCLUSIONS - In comparison with a common diabetic diet, the diet with low GI leads to a slight weight loss, as well as the BMI and body fat reduction. No significant differences regarding glycemic control, lipid profile, insulin...
Impact of the Gastrointestinal System on Metabolic Control in Children with Type 1 Diabetes Mellitus - Gut Peptide Hormones
Huml, Michal ; Sýkora, Josef (advisor) ; Dědek, Petr (referee) ; Rušavý, Zdeněk (referee)
Our objective was to evaluate plasma levels of gut hormones and hormones associated with glucose metabolism in children with type 1 diabetes mellitus (T1DM), and to correlate plasma concentrations of gut hormones with blood biochemistry, markers of metabolic control and anthropometric parameters. A multiplex assay kit (LINCOplex® ) was used for the determina- tion of postprandial plasma levels of specific gut peptide hormones. Amylin, glucose- dependent insulinotropic polypeptide (GIP), active glucagon-like peptide 1 (GLP-1), active ghrelin, insulin, leptin, pancreatic polypeptide (PP), and polypeptide YY (PYY) were assessed prospectively in 55 subjects including 19 T1DM children (mean age: 13.4 years) and 21 healthy reference controls (mean age: 13. 4 years) and 15 patients with functional abdominal pain (FAP) (mean age: 10.5 years). In total, 440 plasma hormones samples were assessed in 55 patients. Entered data were examined using a non-parametric Wilcoxon's test. Further- more, statistically significant correlations were assessed by stepwise regression analysis. Our study demonstrated that the determination of specific postprandial gut hormones with the multiplex assay kit (LINCOplex® ) was highly efficient. Not only was a small amount of plasma sample (25µl) required for analysis, but also a...
Examination methods of skin microcirculation in diabetes foot syndrome
Krčma, Michal ; Rušavý, Zdeněk (advisor) ; Filipovský, Jan (referee) ; Horký, Karel (referee) ; Prázný, Martin (referee)
Introduction: Since the mid 1980s, a lot of attention has been dedicated to the importance of microcirculation; a part of arterial bed including arterioles, precapillary sphincters, capillaries, venules and arteriovenous shunts. It is a structure of decisive importance for an organism; in its domain an exchange of blood gases and metabolic products takes place and it contributes to thermoregulation. Mediation of vasomotor reaction and vasoarterial reflex maintaining a stable hydrostatic pressure is also an important function. Microcirculation is for its dimensions (capillary diameter approx. 5 x 10-5 mm2, blood flow velocity around 0.4 mm.s-1) relatively difficult to access for more detailed examination, yet its impairments are very severe and dominate in many metabolic disorders. Microcirculation impairment is crucial in diabetes mellitus, where arteriovenous shunts open at the expense of nutritive bed due to a loss of sympathetic tone in peripheral circulation in diabetic neuropathy (Netten, Houben). Blood flow is therefore seemingly sufficient, but the affected tissue undergoes ischemia (warm ischemia). To what extent hyperinsulinemia contributes to this effect is not yet clearly known, one of the possible explanations may be a stimulation of sympathetic activity. Not a few studies are dealing with...
Optimalisation of insulin treatment - continuous subcutaneous insulin infusion
Jankovec, Zdeněk ; Rušavý, Zdeněk (advisor) ; Jirkovská, Alexandra (referee) ; Vondra, Karel (referee) ; Prázný, Martin (referee)
Introduction: To be able to prove the efficiency and benefit of the treatment including its safety on a wide range of patients (as opposed to more or less strictly selected groups form clinical studies), we started to gather data about patients in the Czech register of patients treated with continuous subcutaneous insulin infusion (CSII) - further referred to as Register. The obtained data not only represent an effective feedback on our clinical practice and treatment, but also they serve as an important argument for promotion of the CSII efficacy during the negotiations of reimbursement from the health insurance system (the CSII treatment is significantly more expensive compared to other MDI regimens). Aim of study: The aim of the first study were to present data on current situation and treatment results of CSII on wide unselected population of patients with diabetes mellitus in the Czech Republic. In the second study patients were evaluated to compare treatment indication, efficacy and safety with specific regard to the type of diabetes. Patient and methods: The national register of patients treated with CSII exists in the Czech Republic since 1998. We gather data from 52 departments of diabetology in the Czech Republic from patients with diabetes of all types treated with CSII. The data were...
The relationship between autoimmunity and cytokines in clinical aspects of diabetes mellitus type 1
Janíčková Žďárská, Denisa ; Kvapil, Milan (advisor) ; Svačina, Štěpán (referee) ; Nečas, Emanuel (referee) ; Rušavý, Zdeněk (referee)
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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...
Effect of insulin on blood glucose and oxidative stress
Žourek, Michal ; Rušavý, Zdeněk (advisor) ; Vondra, Karel (referee) ; Filipovský, Jan (referee) ; Kuneš, Jaroslav (referee)
The author deals with oxidative stress and its effects on the pathogenesis of various diseases including the development of insulin resistance. The work is divided in the usual way overview of current knowledge on the issues, methods, results, discussion and conclusions. Part of this work is to describe an animal experiment in the waking state, whose introduction to our department was one of the tasks of this graduate work.
Obstetric interventions and pelvic floor disorders
Rušavý, Zdeněk ; Kališ, Vladimír (advisor) ; Roztočil, Aleš (referee) ; Mašata, Jaromír (referee)
Obstetric interventions and pelvic floor disorders - Abstract One of the principal objectives of obstetric interventions in the second stage of labor is prevention of pelvic floor trauma and associated pelvic floor disorders. The most commonly used and also most frequently discussed interventions are manual perineal protection and episiotomy. The majority of pelvic floor disorders are of subjective nature. Therefore, tools for objectification and severity quantification of these disorders are the key to reliable comparison and identification of the most effective interventions. The aim of the dissertation was to find the most effective modification of manual perineal protection, to compare two frequently used types of episiotomy regarding all pelvic floor disorders and finally to find a consensus on the most suitable instrument for anal incontinence severity assessment. Our studies concerning manual perineal protection experimentally described the direction and extent of perineal deformation during vaginal delivery. The subsequent studies on biomechanical model demonstrated that the most effective method of manual perineal protection in peak perineal strain reduction is when the fingers are placed on the perineum 6 cm laterally and 2 cm ventrally from the posterior commissure at both sides and are...

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