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Some aspects of the pathophysiology of macrovascular complications of type 2 diabetic patients and of their assertion in practice
Adamíková, Alena ; Svačina, Štěpán (advisor) ; Anděl, Michal (referee) ; Vízek, Martin (referee)
Pacienti s diabetem 2. typu a dalšími rizikovými faktory (dyslipidémie, mikroalbuminurie) mají vysoké riziko asymptomatického kardiovaskulárního onemocnění. Pozitivní mikroalbuminurie ve skupině asymptomatických diabetiků 2. typu byla prokázána u 11,6% pacientů a u všech se vyskytla různě závažná forma kardiovaskulárních onemocnění. Dysfunkce endotelu, aktivní zánětlivý proces v cévní stěně, poruchy lipidového spektra, porucha reverzního transportu cholesterolu se podílejí na akceleraci aterosklerotického procesu u diabetiků 2. typu. Vysoká hladina zánětlivého markeru hs-CRP 3,053±2,668 mg/l přetrvávající ve studovaném souboru i přes zavedenou terapii poukazuje na nutnost systematického a trvalého aktivního terapeutického přístupu k diabetikům 2. typu s rizikovými faktory. Statisticky významný vztah dlouhodobé kompenzace diabetu dle HbA1c a parametrů transientní ischemické dilatace levé komory (TID) u těchto pacientů dokumentuje riziko hyperglykémie pro pseudodilataci levé komory srdeční způsobenou difuzní subendokardiální ischemií (p=0,035). Aktivní přístup k těmto rizikovým pacientům jak po stránce diagnostiky (zátěžové EKG, zátěžový SPECT myokardu), tak po stránce terapie, může podstatně ovlivnit jejich další kvalitu života a životní prognózu.
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Factors influencing the metabolism of homocysteine in selected diseases with complex etiopathogenesis
Veselá, Kamila ; Anděl, Michal (advisor) ; Nečas, Emanuel (referee) ; Rušavý, Zdeněk (referee) ; Poledne, Rudolf (referee)
At present, the great medicine to develop molecular genetic techniques, which significantly help to explain the causes of illnesses. In some diseases the genetic basis is well known. These are primarily contingent on monogenic diseases. Unfortunately, many diseases remain the genetic cause is still unknown. The largest group is the so-called complex diseases, where the origin and development of disease involving both genetic and nongenetic factors. These diseases include atherosclerosis, diabetes mellitus, orofacial clefts, preeclampsia, neural tube defects, and many others. Complex diseases are serious health and social problem in developed countries. Clasification of risk factors is the subject of much attention, because knowledge of these factors offer opportunities for effective prevention and treatment. The aim of my work was to obtain new knowledge of factors affecting homocysteine metabolism with regard to the formation of some complex diseases in the Czech population.
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Tea, historical context and health aspects
Pitáková, Barbora ; Anděl, Michal (advisor)
Tea-right after water-is the most widely used beverage worldwide. Tea has its history, culture and probably also a unique healing power. Tea has been drunk all over the world. The goal of my work was to submit a preview of current knowledge about influence of tea on human body. Though consumed in a large extent around the world, we do not dispose of comprehensive knowledge of its effects on our health. By now, there have not been any complex studies which would lead to some conclusions generally applicable in medical practice. Recently a vast research of the effects of tea has been carried out and it might be possible that the tea could class also with modern therapy of some diseases. The resent results of studies which deal with the effects of tea on human body hold out hopes for potential use of tea and its components in prevention and therapy of human diseases because the tea embodies antioxidant, antiinflammatory and anticarcinogenic effects and furthermore some features influencing obesity and diabetes complications. These features and effects-in case of application and usage in clinical practice of prevention and therapy of relevant civilization diseasescould be of outstanding benefit for patients. It is, however, necessary to carry out clinical and epidemiological studies which would confirm these hopes.
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Available alternative nutrition for infants
Farková, Blanka ; Anděl, Michal (advisor)
This essay discusses a detailed outline and a comparison of available alternative nutrition for infants on the market, including special ones which are used to solve pathological states. Essay discusses about the advantages of breastfeeding, the causes for feeding children with alternative nutrition and talks about the support of breastfeeding by the government and non-government organizations. At the same time outline deals fyziology of lactation, historical notes about breastfeeding and alternative nutrition for infants.
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Soft drinks and their effects on health
Ramstad, Gunnar Alexander Wilson ; Anděl, Michal (advisor)
The consumption of soft drinks has increased manifold over the last decades. In parallel to this increase it has been noticed an increase in health problems, especially obesity. Dentists continue to urge their patients not to drink soft drinks, and there has also been suggested a link between soft drink consumption and osteoporosis, hypokalemia and diabetes mellitus 2. Other additives, like caffeine, have been associated with headaches, restlessness and trouble with sleeping. Although more research is needed to confirm these relationships, many scientists suggest that we should start taking action to prevent children from developing the habits of large soft drink consumption we witness today. This could be accomplished by cooperation between parents, health practitioners, school system and government.
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Nutritional Status of Prague Homeless Population
Hrnčířová, Dana ; Anděl, Michal (advisor) ; Derflerová Brázdová, Zuzana (referee) ; Provazníková, Hana (referee) ; Tláskal, Petr (referee)
Socio-economic, health and hygienic characteristics place the homeless people at risk groups. The higher incidence of health problems may have a multi-faceted etiology, including: smoking, alcohol, drugs, poor hygiene, insufficient food intake, poor quality diets etc. The prevalence of chronic diseases and cardiovascular risk factors is generally significantly higher in the homeless population than in the general population. Nutritional status of the homeless is also often compromised; many studies have reported malnutrition and insufficient intake of micronutrients whose daily turnover is enhanced by heavy smoking and alcohol consumption. The objective of our studies was to (a) define in the Prague homeless population the prevalence of protein-energetic malnutrition and (b) describe some of the major cardiovascular risk factors and to make comparisons between this group and the general Czech population, (c) to assess levels of selected vitamins (A, E, C, B1, B2, B6) and trace elements (Zn, Se, Cu) in blood and (d) exposition to Pb and Cd and to compare the results with individuals representing the general Czech population, (e) to assess the nutrient intake of main nutrients and compare it with the daily recommendations.
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Occurence of malnutrition and carence states by elderly pacients admitted to hospital. Effect of hospitalization and possibilities of nutritional support.
Hrnčiariková, Dana ; Zadák, Zdeněk (advisor) ; Kalvach, Zdeněk (referee) ; Anděl, Michal (referee)
In hospitalized geriatric patients, malnutrition and deficiency states present a serious problem, which, in spite of its seriousness is at the margin of interest. It is necessary to ensure that hospitalization will not deteriorate nutritional deficit, and thus it will not increase the risk of complications of treatment and will not endanger the patient's life. Adequate dietary measures or nutrition support can prevent these problems. The present study aimed to evaluate the nutritional state of the elderly patients admitted to hospital and the effects of hospitalization and possible nutritional support on the changes in nutritional parameters and vitamin deficiency. A unique group of patients aged 80 years and older hospitalized at the standard ward of the Department of Gerontology and Metabolic Care, Faculty Hospital in Hradec Kralove, was studied. In the course of the study, approximately 70 anamnestic, anthropometric and laboratory parameters were examined, which were determined on the day of patients' admittance and then always in week's intervals. The obtained values were subjected to statistical analysis. The initial values of the parameters under study were evaluated, which show the condition of the admitted geriatric patient. The study focused on the relationship between positive and negative...
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Effects of acute starvation and of type 2 diabetes mellitus upon insulin resistance and substrate utilization in obese subjects
Duška, František ; Anděl, Michal (advisor) ; Haluzík, Martin (referee) ; Mourek, Jindřich (referee) ; Stárka, Luboslav (referee)
Very-low calorie diet or even total short-term fasting is widely used in clinical practice in order to improve metabolic compensation of patients with type 2 diabetes mellitus. Although benefits of weight reduction are well proven in T2DM, much less is known about effects of acute starvation, during which the interruption of the afflux of energy substrates is not followed by a major change of body composition. We hypothesize the improvement of insulin effects on glucose metabolism in T2DM as these patients may lack the key metabolic responses which impair insulin sensitivity in lean, non-diabetic subjects. Moreover, we assume according to "thrifty genotype hypothesis" that protein wasting during starvation will be positively related to insulin effects on glucose disposal and negatively related to insulin antilipolytic and antiketogenic effects. In the light of this we designed an observational, prospective, in-hospital study, comparing the effects of 60 hours fast on various aspects of insulin resistance, endocrine regulation and metabolism in 10 patients with T2DM and 10 obese controls without diabetes (OB).
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