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Education of diabetic patient after total pancreatectomy
BAKOVÁ, Terezie
This bachelor thesis titled "Diabetic patient education after total pancreatectomy" addresses the impact on quality of life of patients with new-onset diabetes after total pancreatectomy. It also deals with the process of education for these patients by general nurses and licensed practical nurses.The aim of this thesis was to map the education of patients after total pancreatectomy. To achieve this aim, a qualitative investigation was used, conducted using semi-structured interviews. The interviews were conducted with five patients after total pancreatectomy and six nurses who educate these patients. Three research questions were established to answer the stated aim. The questions investigated how education by licensed practical nurses and general nurses takes place in patients after total pancreatectomy. They also investigated what limitations occur in patients after the procedure. The problems encountered by patients in adhering to the treatment regimen were also investigated.The results of the research investigation indicate that nurses most often carry out education in an individual way, and they agree on the topics they include in the education. Education is mainly carried out in the areas of insulin administration, self-monitoring and prevention of complications. Results of other data indicate that insulin administration, compliance of dietary measures, and glucose fluctuations are the most common problems in patients' adherence to their treatment regimen. Digestive disorders, fatigue, changes in eating habits, and limitations in social life are considered the greatest limitations. The research also found that there are no leaflets available signeted for patients after total pancreatectomy. The results of this bachelor thesis may serve to inform future patients before undergoing total pancreatectomy, to provide information about the consequences and impact of this procedure on quality of life. They could also inform licensed practical nurses and general nurses about the problems and shortcomings experienced by patients after total pancreatectomy, and they could positively influence education in these areas.
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Diet at patients after total pancreatectomy
ŠEDIVÁ, Denisa
In the bachelor degree project Diet for the patients after total pancreatectomy I deal with a diet of the patients who underwent surgery called total pancreatectomy. The introduction of the theoretical part is focused on the anatomy of the pancreas and its function. The following part of the project is directly focused on carcinoma, its epidemiology, incidence, cause of the disease and also development. I also deal with clinical symptoms, treatment and pancreatectomy itself. The last part of the project is oriented towards nutrition for the patients after surgery. Further in this section, I deal with pancreatic and diabetic diet and diet during chemotherapy, which many of the respondents have undergone. As the goal of the project, I chose to look into the alimentation of the patients with this disease and to find out how difficult it is to combine three types of diet together. I focused on the observation of the intake of basic nutrients such as carbohydrates, fats, and proteins. The practical part I compose as a qualitative research. There were 6 respondents who took part in the research. Unfortunately, only two of them provided me with their blood glucose values to evaluate their alimentation according to the diabetic diet. The result was very surprising. In relation to the seriousness of the illness, most of them ate basically without restriction. They were eating everything they wanted except sweet dishes, for example cakes and fried dishes. They just watched their blood glucose values. Despite all the experienced weight loss, their current alimentation meets recommendation and no one of them suffers from lack of any of the macronutrients according to the results.
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Palliative nursing care for a patient with pancreatic cancer
ŠAŠKOVÁ, Karolína
The bachelor's thesis, which is called Palliative nursing care for a patient with pancreatic cancer, is divided into two parts - for the theoretical and practical part. In the theoretical part, I deal with the definition of "palliative nursing care", its history, the difference between general and specialized palliative nursing care, the goals of palliative care are described, the role of the nurse is described, and the specifics of palliative nursing care are discussed. The second part of the theoretical part focuses on the definition of pancreatic cancer, etiology, risk factors, clinical picture, diagnosis and TNM classification. In the practical part of the bachelor's thesis, the results of qualitative research are presented, where I find answers to research questions that are important for the research goals. The aim of this work is to find out what are the specifics of nursing in the terminal stage, whether nurses make differences in nursing in certain stages of the disease, how they maintain mental health and whether they have the opportunity to fulfill the patient's spiritual wishes. The research is carried out through a semi-structured interview, which is conducted with the nurses of the internal medicine and oncology departments. The research shows that the specifics of palliative nursing care depend on the nurses' emotions, nursing care in certain stages of the disease is conditioned by the cooperation of the patient, and that mental hygiene is very important for nurses and its fulfillment is achieved through physical activities. Finally, it is found that the fulfillment of the patient's spiritual needs depends on the availability of the given need. This work provides readers with information regarding palliative nursing care for patients with pancreatic cancer in practice. It helps to understand the burden that nurses experience both psychologically and physically when caring for palliative patients. In addition, this information can offer nurses ideas and advice on maintaining mental health and possible changes in the approach to palliative care.
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Peritoneal lavage cytology and biochemistry in cases of upper GI tumours
Hoskovec, David ; Antoš, František (advisor) ; Lischke, Robert (referee) ; Aujeský, René (referee)
Introduction: Intraperitoneal tumor seeding is a common form of recurrence after surgery for GI tumours. Early diagnosis and treatment may influence the course of disease. Hypothesis and objectives of the work The finding of free tumor cells and / or elevation of tumor markers in peritoneal fluid predicts intraperitoneal tumor recurrence. The results of these tests can be used to indicate HIPEC. Aim of this work is to determine the sensitivity and specificity of cytology and tumor markers levels and importance of these tests for early diagnosis and prognosis of recurrence. Another objective was to confirm the applicability of RT PCR for identification of free tumor cells. Patients and methods . Materials are sourced both during initial surgery (220 patients) and by the dispensary controls (25 patients). The peritoneal fluid was examined cytologically and biochemically too. 50 samples was exemined by RT PCR. Results Elevation of tumor markers or finding of free intraperitoneal tumor cells predicts recurrence. The prognosis of these patients corresponds to stage IV TNM classification, regardless of other parameters TNM. Low sensitivity of these tests (34% for cytology, 53% for tumor markers) does not allow its use as an indicator of HIPEC. Due to degradation of RNA we did not confirm the value of RT...
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Pancreatic Cancer Diagnosis
Bunganič, Bohuš ; Zavoral, Miroslav (advisor) ; Rejchrt, Stanislav (referee) ; Urban, Ondřej (referee)
Pancreatic cancer is a malignant disease with an unfavorable prognosis. Currently, the diagnosis of pancreatic cancer is based mainly on CT, MR and EUS imaging methods, because a reliable biomarker of pancreatic cancer is not available. It is considered a success in the current clinical practice if patients suitable for surgical resection can be selected, because in this group the overall survival is slightly better than in the group where surgery is not technically possible. In the first part, the presented dissertation focuses on testing of already established imaging diagnostic methods used in common practice, i.e. EUS and EUS FNA, as well as modern examination possibilities, such as contrast endosonography, and the comparison of the accuracy of the methods used. The dominant role of the EUS FNA was confirmed. In the next phase of the work, the methodological procedure of EUS FNA collection and the preprocessing of pancreatic tissue samples was tested with regard to the quantity and quality for epigenetic examination and further testing using the prognostic role of KRAS and miR-21. It has been suggested that cytological smears are the most suitable source of biological material for DNA and miRNA analysis, where non-tumor tissue contamination is low. Although the prognostic role of KRAS is...
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Case study of physiotherapy treatment of a patient after hemicolectomy and middle pancreatectomy
Linhartová, Kamila ; Hassmannová, Kristina (advisor) ; Charvát, Robert (referee)
Author: Kamila Linhartová Title: Case study of physiotherapy treatment of a patient after hemicolectomy and middle pancreatectomy Aims: Aim of this bachelor thesis is to summarize theoretical information about hemicoletcomy and middle pancreatectomy and to demonstrate possible physiotherapy treatment on a case study of a patient after the surgical approaches mentioned above. Methods: Detailed research of theoretical background of oncological diseases of large intestine and pancreas, hemicolectomy, middle pancreatectomy and physiotherapy treatment after abdominal surgery was performed to process the general part of this bachelor thesis. The special part of this thesis consist of a case study of a patient after hemicolectomy and middle pancreatectomy, which originated from bachelor clinical practice at Institute of Clinical and Experimental Medicine in Prague, in the time period between 18. 1. 2021 and 12. 2. 2021. The case study includes anamnesis, entry kinesiological analysis, suggestion and goals of physiotherapy treatment, individual therapy sessions, output kinesiological analysis and an evaluation of effects of performed treatment. Results: During therapy interventions general condition and muscle strength in a patient increased, breathing stereotype adjusted, soft tissues in the abdominal...
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Possibilties of Portal Vein Reconstruction During Surgical Treatment of Pancreatic Cancer - Experiment on a Large Animal
Pálek, Richard ; Liška, Václav (advisor) ; Ryska, Miroslav (referee) ; Loveček, Martin (referee)
Possibilities of Portal Vein Reconstruction during Surgical Treatment of Pancreatic Cancer - Experiment on a Large Animal Introduction: Pancreatic cancer is a fatal malignancy that is known as one of the leading causes of cancer mortality worldwide. The only potentially curative treatment is radical surgical resection. Because of the lack of early symptoms, the diagnosis is usually made in advanced stages of the disease. In the majority of patients, the tumor is already locally advanced or it has distant metastases at the time of diagnosis. Pancreatic cancer tends to infiltrate the portal vein (PV) or the superior mesenteric vein (SMV). Nowadays, resection of infiltrated parts of PV/SMV is recommended in specialized centers. There are several established techniques of PV/SMV reconstruction. The use of allogeneic venous grafts seems to be a method with minimal risk of adverse effects but there is only limited experience with these grafts. The optimal anatomical origin of allogeneic venous grafts for PV/SMV reconstruction remains unknown. Aims: The aim of this experiment was to compare two types of allogeneic venous grafts used for PV reconstruction in a large animal model of pancreatico- duodenectomy. These grafts were harvested from the systemic venous system (inferior caval vein grafts - IVC grafts) and...
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The importance of biosynthetic and catabolic pathway of cholesterol in inflammatory and tumor diseases
Leníček, Martin ; Vítek, Libor (advisor) ; Haluzík, Martin (referee) ; Mareček, Zdeněk (referee)
This thesis focuses on the importance of intermediate products of biosynthetic and catabolic pathway of cholesterol. The aim of the first part of the thesis is mainly to investigate, whether statins (HMG- CoA reductase inhibitors) possess antitumor properties and to compare the differences in antitumor potential of individual statins. The other part of the thesis aims at the utilization of 7α-hydroxycholest-4-en-3-one (C4), a promising marker of cholesterol 7α-monooxygenase (CYP7A1) activity and bile acid malabsorption. We demonstrated antitumor effect of statins on an experimental model of pancreatic cancer. Individual statins, however, differed significantly in their efficacy, depending on their physico-chemical properties. Our data suggests, that the most likely (but not the only) mechanism of antitumor effect of statins is decreased prenylation of signaling proteins, especially Ras protooncogene. We set up a reliable method for measurement of C4, which facilitated our research in CYP7A1 regulation. We demonstrated, that promoter polymorphism -203A>C might affect CYP7A1 activity, that diurnal variability of CYP7A1 activity might be triggered by insulin, and that insulin resistance in patients with non-alcoholic fatty liver disease impedes the feedback regulation of CYP7A1, which may lead to disease...
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Glutathione and glutathione-dependent enzymes in various pathophysiological states.
Kodydková, Jana
Backround: Oxidative stress (OS) has been implicated in pathogenesis of human disorders such as depressive disorder, sepsis, cardiovascular disease, acute and chronic pancreatitis, and cancer. Increased OS is result of imbalance between increased reactive oxygen and nitrogen species (RONS) production and / or insufficient activity of antioxidant defence system. Antioxidant system, which is composed of antioxidant enzymes such as superoxide dismutase, catalase, glutathione peroxidases (GPX), glutathione reductase (GR) and non- enzymatic antioxidant reduced glutathione (GSH) plays an important role in the protection of cells against enhanced OS. The aim of this study was to assess the OS markers and antioxidant enzymes in different pathophysiological states. Materials and methods: Activities of erythrocyte glutathione peroxidase (GPX1), GR and concentration of GSH as well as levels of OS markers were analysed in six different pathophysiologic states. These parameters were measured in 35 women with depressive disorder (DD), 40 patients with metabolic syndrome (MetS), 30 septic patients (S) followed up in the course of sepsis; 15 non-septic critically ill patients (NC), 13 patients with acute pancreatitis (AP), 50 with chronic pancreatitis (CP) and 50 patients with pancreatic cancer (PC), compared to...
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Resting energy expenditure and nutritional intake in patients with pancreatic cancer before elective pancreatectomy
Heniková, Marina ; Gojda, Jan (advisor) ; Urbánek, Miroslav (referee)
Aims: The aim of this work was to determine whether a increased resting energy expenditure contributes to the nutritional risk for patients with pancreatic cancer. What the variability of resting energy expenditure is and whether it predicts weight loss. Another aim was to verify that lower protein-energy intake also has an impact on weight loss. Methods: Data for the diploma thesis were obtained from the project "Pancreatic Cancer: Metabolic Derangements Associated With Insulin Resistance", which takes place at the Department of Clinical Physiology of Metabolism at 2nd Department of internal medicine in the University Hospital Královské Vinohrady. The project includes 40 - 50 patients with pancreatic tumor resection per year. Data were collected from the beginning of December 2019 until the end of April 2020. The project is funded by the grant AZV NV19-01-00101. 10 consecutive patients (4 women and 6 men) with pancreatic cancer who had a complete dataset for analysis were selected for the research set for the diploma thesis. The patients underwent anthropometric examination, blood tests were taken, and indirect calorimetry was performed. Results: The first part of the research was focused on anthropometric parameters, parameters of nutritional status and the presence of cancer cachexia. The second...
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