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Physical exercise in diabetes mellitus 2 type patients
Pelíšková, Pavlína ; Kohlíková, Eva (advisor) ; Vokrouhlický, Lubor (referee) ; Vrablík, Michal (referee)
Problem: Aerobic endurance exercise is traditionally considered the best motoric activity in Type 2 diabetes mellitus patients. The most recommended form is continuous training at a defined level of intensity. Interval training is less used despite its proven effectiveness given by the possibility of applying a higher training load. Hypothesis: Long-term individually prescribed physical exercise therapy in Type 2 DM patients treated with diet and oral antidiabetics is demonstrably and objectively beneficial for these patients concerning their health condition, as shown by the metabolic compensation and anthropometric and fitness parameters. Physical exercise therapy described here helps to improve the patients' health condition in short the term and maintain it in the long term. Objective: Our aim is to prove the positive effect of a long-term individually adapted regular physical exercise therapy in type 2 DM patients. Method: The research sample consisted of Type 2 diabetes mellitus patients (male and female) after termination of insulin therapy and its replacement by oral anti-diabetic drugs. A group of 31 patients treated with oral antidiabetics, diet and existing physical regimen is being compared with a group of 31 patients treated with diet, antidiabetics and defined physical exercise...
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The study of new risk factors of the cardiovascular diseases
Eremiášová, Lenka ; Danzig, Vilém (advisor) ; Vrablík, Michal (referee) ; Rosolová, Hana (referee)
Bilirubin is a major product of the heme catabolism in the vascular bed with substantial antioxidant properties. These importantly contribute to pathogenesis of diseases associated with increased oxidative stress, including cardiovascular or cancer diseases. In the first part of this PhD project serum bilirubin concentrations were examined in the 1 % representative sample of the general Czech population, together with determination of the prevalence of Gilbert's syndrome. Bilirubin concentrations were determined also within individual polymorphisms of the UGT1A1 gene (OMIM*191740) responsible for bilirubin biotransformation in the liver, including their association with the basic risk factors for atherosclerosis. We also assessed the activity of the standard liver enzymes (representing another significant risk factor for the development of cardiovascular diseases) with surprisingly high proportion of subjects with elevated values. Simultaneously, we determined the concentrations of serum bilirubin in a group of patients with an acute coronary syndrome, who manifested with significantly lower concentrations as compared to general population. In the second part of this research project, the relationship between plasma concentrations of bilirubin and individual variants of UGT1A1 gene polymorphisms...
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Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosis
Thieme, Filip ; Froněk, Jiří (advisor) ; Vrablík, Michal (referee) ; Broďák, Miloš (referee)
Univerzita Karlova v Praze 1. lékařská fakulta Doktorský studijní program Studijní obor: Experimentální chirurgie MUDr. Filip Thieme Název závěrečné práce Chirurgické modely studia proinflamačního vlivu tukové tkáně v rozvoji aterosklerózy Title Surgical models of the study of the pro-inflammatory effect of adipose tissue in the development of atherosclerosis Typ závěrečné práce Disertační Školitel: doc. MUDr. Jiří Froněk, Ph.D., FRSC Konzultant doc. MUDr. Libor Janoušek, Ph.D. Klinika transplantační chirurgie, IKEM Praha, 2021 Abstract Background: Atherosclerosis is a serious inflammatory systemic disease. Surgery mainly addresses its vascular complications. Conversely, surgery may also lead to the development and acceleration of atherosclerosis, e.g., in a living kidney donor. This would especially be the case in a donor who meets internationally recognized donation criteria but suffers from metabolic syndrome. The effort to refine assessments of living kidney donors in terms of eliminating the risk of developing atherosclerosis is a long-term project. Our aim is to determine risk factors for living kidney donors and to prevent long-term complications after donation. Collecting tissue from a living donor involves not oly subcutaneous tissue (SCAT) but also visceral (VAT) and perivascular tissue (PVAT),...
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Emerging cardiovascular risk markers in diagnostics and therapy
Tůmová, Eva ; Vrablík, Michal (advisor) ; Freiberger, Tomáš (referee) ; Polák, Jan (referee)
Cardiovascular diseases (CVD) have been one of the leading causes of morbidity and mortality in developed countries with an enormous influence on individual health and significant socioeconomic impact as well. The aim of most physicians in recent decades is to seek the best possible predicative risk factor (RF) (or combination of several RF) which could help to determine the individual risk of developing CVD. This risk stratification can be used to identify the high risk patients and treatment intensification or establishment of early preventive measures. Currently, several RF of atherosclerosis and CVD are commonly used to individualize health care. However, individuals with low levels of these RF suffer of CVD, therefore the effort to find as much as possible specific RF still persists. In recent years, the inflammatory markers, crucial in the atherosclerosis development, raise great expectation In our studies, we focused on investigating the levels of inflammatory parameters in specific groups of patients (obese children and patients with metabolic syndrome) and observed the effect of weight loss following lifestyle changes. Our main concern was lipoprotein-associated phospholipase A2 (Lp-PLA2), oxidized LDL particles (ox-LDL) and myeloperoxidase (MPO). The results demonstrated significantly...
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Soluble endoglin role in the pathogenesis of endothelial dysfunction
Vitverová, Barbora ; Nachtigal, Petr (advisor) ; Vrablík, Michal (referee) ; Mladěnka, Přemysl (referee)
Charles University, Faculty of Pharmacy in Hradec Kralove Department of Biological and Medical Sciences Candidate: Msc. Barbora Vitverova Supervisor: prof. PharmDr. Petr Nachtigal, Ph.D. Title of Doctoral Thesis: Soluble endoglin role in the pathogenesis of endothelial dysfunction The endothelium is a major regulator of vascular homeostasis and exerts a number of vasoprotective effects, including production of vasodilating agents, suppression of smooth muscle cell growth, or inhibition of inflammatory responses. Most of these effects are mediated by nitric oxide (NO), the most effective endogenous vasodilator. Decreased NO production or its activity is a hallmark of endothelial dysfunction leading to an impaired endothelial-dependent vasodilation. Endothelial dysfunction is the first and key step in the development of atherosclerosis and can be detected before structural changes in the vessel wall. Atherosclerosis is a complex inflammatory disease underlying many cardiovascular disorders including ischemic heart disease and represents the major cause of morbidity and mortality in developed countries. Statins are drugs of choice in the treatment of atherosclerosis and ischemic heart disease, which have been shown to reduce LDL cholesterol levels and modulate endothelial function with their...
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Assessment of dietary and regimen knowledge in patients with acute coronary syndrome
Eliášová, Marie ; Vrablík, Michal (advisor) ; Šatný, Martin (referee)
Introduction: Acute coronary syndromes (ACS) belong to cardiovascular diseases and contribute significantly to mortality, morbidity and disability in developed countries. Therefore the aim of current therapy is to reduce the risk of subsequent complications, including early death, and to increase patients' quality of life. For successful therapy it is necessary to follow regimen and dietary principles which are along with pharmacotherapy an integral part of treatment. Therefore sufficient knowledge of these principles by patients is a basic precondition for their successful treatment. Objectives: The aim of the diploma thesis was to assess dietary and regime knowledge in patients diagnosed with ACS. The specific objectives were: to determine an effect of sex or previous education on the knowledge; to describe patients' dietary habits; to specify their knowledge of nutrition; and to identify which knowledge is the most deficient. Methods: The research was carried out as a questionnaire survey. The questionnaire was compiled directly for the purposes of this thesis and was approved by the VFN Ethics Committee for use in inpatient wards at II. and III. internal clinics and at the Coronary unit of II. internal clinics of VFN. A total of 80 patients diagnosed with ACS were included in the study....
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Soluble endoglin role in the pathogenesis of endothelial dysfunction
Vitverová, Barbora ; Nachtigal, Petr (advisor) ; Vrablík, Michal (referee) ; Mladěnka, Přemysl (referee)
Charles University, Faculty of Pharmacy in Hradec Kralove Department of Biological and Medical Sciences Candidate: Msc. Barbora Vitverova Supervisor: prof. PharmDr. Petr Nachtigal, Ph.D. Title of Doctoral Thesis: Soluble endoglin role in the pathogenesis of endothelial dysfunction The endothelium is a major regulator of vascular homeostasis and exerts a number of vasoprotective effects, including production of vasodilating agents, suppression of smooth muscle cell growth, or inhibition of inflammatory responses. Most of these effects are mediated by nitric oxide (NO), the most effective endogenous vasodilator. Decreased NO production or its activity is a hallmark of endothelial dysfunction leading to an impaired endothelial-dependent vasodilation. Endothelial dysfunction is the first and key step in the development of atherosclerosis and can be detected before structural changes in the vessel wall. Atherosclerosis is a complex inflammatory disease underlying many cardiovascular disorders including ischemic heart disease and represents the major cause of morbidity and mortality in developed countries. Statins are drugs of choice in the treatment of atherosclerosis and ischemic heart disease, which have been shown to reduce LDL cholesterol levels and modulate endothelial function with their...
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Emerging cardiovascular risk markers in diagnostics and therapy
Tůmová, Eva ; Vrablík, Michal (advisor) ; Freiberger, Tomáš (referee) ; Polák, Jan (referee)
Cardiovascular diseases (CVD) have been one of the leading causes of morbidity and mortality in developed countries with an enormous influence on individual health and significant socioeconomic impact as well. The aim of most physicians in recent decades is to seek the best possible predicative risk factor (RF) (or combination of several RF) which could help to determine the individual risk of developing CVD. This risk stratification can be used to identify the high risk patients and treatment intensification or establishment of early preventive measures. Currently, several RF of atherosclerosis and CVD are commonly used to individualize health care. However, individuals with low levels of these RF suffer of CVD, therefore the effort to find as much as possible specific RF still persists. In recent years, the inflammatory markers, crucial in the atherosclerosis development, raise great expectation In our studies, we focused on investigating the levels of inflammatory parameters in specific groups of patients (obese children and patients with metabolic syndrome) and observed the effect of weight loss following lifestyle changes. Our main concern was lipoprotein-associated phospholipase A2 (Lp-PLA2), oxidized LDL particles (ox-LDL) and myeloperoxidase (MPO). The results demonstrated significantly...
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Assessment of knowledge about appropriate setup of nutrition in patients with cardiovascular disease risk factors
Lupoměská, Petra ; Vrablík, Michal (advisor) ; Altschmiedová, Tereza (referee)
This diploma thesis consists of two parts - the theoretical and the practical one. The theoretical part is divided into several chapters; the first three are focused on the main information about atherosclerosis such as its definition, predilection areas, process of atherosclerotic changes, the most important risk factors and its clinical consequences. The following chapter introduces the essential measures used in cardiovascular disease prevention. The last chapter deals with education and also describes education for cardiovascular disease prevention. The practical part is dedicated to the assessment of knowledge about the appropriate composition of diet in patients with cardiovascular disease risk factors. The research part was carried out on grounds of the quantitative survey through a questionnaire, which was completed by patients of the Centre for the Prevention of Cardiovascular Disease of the General Teaching Hospital in Prague in the course of three months - from 1st November 2017 to 31st January 2018. There are one main and two partial aims to the study; the main aim was to determine knowledge about the appropriate composition of diet in patients. This aim was accomplished, patients were successful in some knowledge questions, but only a small number of them knew the right answer to...
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Importance of diet in influencing the risk factors of CVD in patients treated with statins
Bártová, Kateřina ; Vrablík, Michal (advisor) ; Vaclová, Martina (referee)
Diet and other regimens are part of the treatment of dyslipidemia, where the objective is trough modification lipid and lipoprotein metabolism, to influence the cardiovascular risk and to reduce the risk of atherothrombotic compliations. The aim of this work was to investigate the importance of different diets in influencing the risk factors of KVO in patients treated with statins, i.e. to assess the dietary habits of these patients by means of a questionnaire and to monitor the changes, from before to after, of the selected anthropometric and laboratoty parameters. The study included 41 patients of an average age of age of 50 years ± 11. The duration of statin therapy: 88 % of them over half year, 12 % of them less than six months. 73 % of them do not smoke, 27 % were smokers. The dietary habits questionnaire was completed by the patient prior to education and subsequently evaluated. The monitored parameters - weight, waist circumference, blood pressure, total cholesterol, HDL-c, non- HDL-c, LDL-c, triglycerides, glycemia, glycated hemoglobin in diabetics were evaluated before and after 2-3 months of education. Patients were predominantly familiar with the basic rules of a low fat diet but over 30% patients consume food inappropriately for the diet and over 30 % of patients did not consume foods...
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