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Biochemical predictors of the treatment failure in pediatric IBD patients
Zárubová, Kristýna ; Bronský, Jiří (advisor) ; Hrdý, Jiří (referee) ; Petrášová, Miroslava (referee)
Up to 20 % of patients with IBD (inflammatory bowel disease) is diagnosed in childhood, the course of the disease tends to often be more severe and the treatment more difficult than in case of adults. Therefore, it is necessary to commence or eventually change the treatment in order to prevent development of complications. Early detection of relapse plays significant role for further course of the disease and general prognosis of the patient. Changes to laboratory parameters (e.g. to the level of fecal calprotectin) can significantly prevent the development of clinical symptoms and may indicate the necessity for control endoscopy, further escalation or change in therapy. The primary focus of this thesis are patients who underwent surgical bowel resection, who constitute one of the risk groups. Studies show that as many as 70 % of patients suffering from Crohn's disease reach the point of bowel surgery within the first 10 years of the diagnosis. According to the results, a promising predictor of relapse of the disease seems to be serum albumin, which may relate to the overall nutritional status of the organism. We have also examined the effectivity of using fecal calprotectin and CRP as relapse predictors. Testing directly in the resected bowel did not prove usability of calprotectin as a predictor,...
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Quality of life of selected groups of clients with Crohn's disease
Hejlová, Ivana ; Hlaváčová, Marie (advisor) ; Nikodemová, Hana (referee)
My dissertation work called "The quality of life within selected groups of clients with the Crohn's disease" is analysing the subjective evaluation of the clients' life situation, that describes their day-to-day struggle with this chronic disease. This work is divided into two parts, theoretical and empirical. The objective of the former is to present the current findings about the Crohn's disease, to describe the term "quality of life", defines its various meanings and history and specifies the assessment methods in the clinical practice. In the latter, there are set objectives and working hypotheses for own evaluation. The target of the empirical part is to obtain real life data through questioning methods, partly based on the standardised WHQL-BREF methodology. The obtained data will be subjected to primary analysis in order to create an evaluation result for a selected group of clients. In the last part, this dataset will be compared with the previously measured values on quality of life of clients with Crohn's disease.
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The influence of enteral nutrition on the course of Crohn's disease
Homzová, Nikola ; Lukáš, Milan (advisor) ; Bortlík, Martin (referee)
Introduction: Crohn's disease is an illness of the digestive tract with an uncertain etiology which threatens the nutritional state of patients and in addition to other problems results in a worsening of the disease in reaction to primary treatment. The possibilities of optimizing the nutritional state are several: changing diet, enteral or parenteral nutrition or combination of both. It is necessary to arrange an entirely individual approach for ensuring the highest measure of attention and nutritional effectiveness. Methods: The influence of enteral nutrition was monitored during a course of Crohn's disease. 84 patients with malnutrition and with an active form of Crohn's disease were included in this study. They were divided into 2 groups according to the type and dosage of enteral nutrition. The first group included patients who used partial enteral nutrition in the form of sipping with an energy value of 1200 kcal daily. Patients covered the remaining energy needs with a low-residue diet enriched by soluble fiber. The second group included patients who were given exclusive oligomeric enteral nutrition with a nasojejunal tube for a period of eight weeks. The amount of enteral nutrition in both groups was individually adjusted and calculated, according to the Harris-Benedict equation. The...
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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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Influence of education of nutrition specialist on vitamins level at patients with inflammatory bowel diseases.
Palugová, Natália ; Meisnerová, Eva (advisor) ; Šatný, Marek (referee)
In diploma thesis we deal with inflammatory bowel diseases. The theoretical part describes etiology, pathogenesis, clinical symptoms, out-of-body manifestation and drug therapy. Current knowledge about the relationship between nutrition and disease is described. Since inflammatory bowel diseases are incurable, therapy pays attention to keep the patient in remission and preventing relapse. Nutrition therapy plays an important role in achieving these goals. In the practical part, we deal with the level of nutrition awareness of patients, in the form of a questionnaire and a non- standardized interview. We also study the influence of education on vitamin levels in patients. We determine whether they know the importance of eating and eating nutrients in their illnesses. From the background, it can be appreciated that information resources are insufficient for patients. Patients would also welcome more detailed education, and therefore part of the practical part of the educational material for patients with Crohn's disease. Key words: Crohn's disease, ulcerative colitis, nutrition, education, diet
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The impact of a chronic disease on the choice of study field and subsequent employment
Svobodová, Julie ; Hájková, Vanda (advisor) ; Mlčková, Marie (referee)
The thesis consists of a comprehensive introduction to the problems of individuals suffering from inflammatory bowel diseases. The main topics comprise of the impacts of the disease on the process of education, the field of study and the highest achieved level of education and furthermore, the issues of employment as well as social and psychological aspects of these diseases. The thesis has focused on the detailed understanding of everyday and long- term problems encountered by the disabled people. The aim of the thesis was to provide information crucial for the decision-making in regards to the selection of the future field of work for individuals with inflammatory bowel diseases. The recipients of the information would be the individuals themselves, their families, as well as the professions of engaged or special teaching. The qualitative methodology implemented by the technique of semi- structured interviews was applied with ten randomly selected respondents diagnosed with inflammatory bowel diseases. An open coding method was used after the examination of the research data. The analysis of the acquired data has shown that most respondents felt a negative influence of the disease on the course of their education, the selection of their field of study or their highest achieved level of education....
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The influence of enteral nutrition on the course of Crohn's disease
Homzová, Nikola ; Lukáš, Milan (advisor) ; Bortlík, Martin (referee)
Introduction: Crohn's disease is an illness of the digestive tract with an uncertain etiology which threatens the nutritional state of patients and in addition to other problems results in a worsening of the disease in reaction to primary treatment. The possibilities of optimizing the nutritional state are several: changing diet, enteral or parenteral nutrition or combination of both. It is necessary to arrange an entirely individual approach for ensuring the highest measure of attention and nutritional effectiveness. Methods: The influence of enteral nutrition was monitored during a course of Crohn's disease. 84 patients with malnutrition and with an active form of Crohn's disease were included in this study. They were divided into 2 groups according to the type and dosage of enteral nutrition. The first group included patients who used partial enteral nutrition in the form of sipping with an energy value of 1200 kcal daily. Patients covered the remaining energy needs with a low-residue diet enriched by soluble fiber. The second group included patients who were given exclusive oligomeric enteral nutrition with a nasojejunal tube for a period of eight weeks. The amount of enteral nutrition in both groups was individually adjusted and calculated, according to the Harris-Benedict equation. The...
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The options of nutritional support in inflamatory bowel disease
Polachová, Monika ; Meisnerová, Eva (advisor) ; Novotný, Aleš (referee)
In my bachelor's work I describe the idiopathic inflammatory bowel diseases. The theoretical part is devoted to the history, epidemiology, etiopathogenesis, basic characteristics of the disease and the current treatment options. One of the serious consequences of the inflammatory bowel diseases is malnutrition, which then affects the treatment, worsens the course of the disease and reduces the quality of life of patients. The cause of malnutrition in these patients is both inflammatory activity during a relapse, the side effects of drug therapy and reduced food intake due to the numerous diarrhea and abdominal pain. In the practical part I monitored the patients during my practice in gastroenterology clinic. The aim of my work was to determine what attention is paid to the state of nutrition of patients with severe course of Crohn's disease and ulcerative colitis, which were indicated by the biological treatment. Monitoring of nutritional status, nutritional support and correction of malnutrition is an integral part of the treatment, during which a nutritional therapist plays an important role. Powered by TCPDF (www.tcpdf.org)
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