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Issues of care for a morbidly obese patient in standard beds and intensive care units.
KRÁL, Dominik
This bachelor thesis deals with the issue of care for a morbidly obese patient in standard units and intensive care units. The work is focused on how nurses in standard units and intensive care units care for a morbidly obese patient. The theoretical part consists of the characteristics of obesity, examination methods, treatment, the possibilities of prevention of obesity and selected aspects in the care for a morbidly obese patient in standard units and in the intensive care unit. The research part focuses on the obstacles which nurses perceive in providing care for a morbidly obese patient and on how nurses care for the hygiene, skin, nutrition, excretion and mental needs of a morbidly obese patient. The aim of the thesis is to map the issue of nursing care for a morbidly obese patient. This part was processed in the form of qualitative research survey using semi-structured interviews. Five nurses from the standard ward and four nurses from the intensive care units took part in the interviews. After obtaining the necessary information, it was processed in the form of open coding and the creation of six categories. The results show that the complexity of care is determined by patient's mobility, state of health and his cooperation. Other obstacles are his proportions, lack of staff and the need for more time for overall care. For healthcare professionals, care is more physically demanding when handling the patient during hygiene, after excretion and during positioning. The nurses regularly monitor the skin. They consult patient's nutrition with a dietitian. They use interview with the patient to identify his mental needs. Based on the findings, a brochure for nurses was created, which focuses on the most common problems in the care for obese patients, which nurses may encounter in their practice.
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The effect of urate transporter polymorphisms on uric acid excretion
Mančíková, Andrea ; Krylov, Vladimír (advisor) ; Novotný, Jiří (referee) ; Ježek, Petr (referee)
Uric acid excretion disorders are the most common cause of primary dysuricemia. The kidneys eliminate two-thirds of uric acid production and the other third is eliminated in the gastrointestinal tract. Renal reabsorption and secretion occur through the polarised epithelial cells in the proximal tubules. Uric acid transporters are expressed on these cell membranes. Reabsorption deficiency leads to hypouricemia and elevated fraction excretion associated with urolithiasis, nephrolithiasis or acute renal injury. Decreased uric acid secretion in the kidneys and small intestine leads to hyperuricemia, which develops into gout in 10% of individuals. Genome wide association studies detected a strong effect of SLC22A12 (URAT1), SLC2A9 (GLUT9) reabsorbing transporters and ABCG2 (ABCG2) secreting transporter on uric acid serum concentration variability. This thesis aimed to map out urate transporter allelic variants in a cohort of primary dysuricemia patients and identification of the variants causing defective uric acid excretion. Six non-synonymous variants were described in SLC22A12 (URAT1) and SLC2A9 (GLUT9) genes in hypouricemic individuals, which had not been identified previously in any population studies. Significant decreases in uric acid transport have been demonstrated experimentally in vitro,...
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The effect of urate transporter polymorphisms on uric acid excretion
Mančíková, Andrea
Uric acid excretion disorders are the most common cause of primary dysuricemia. The kidneys eliminate two-thirds of uric acid production and the other third is eliminated in the gastrointestinal tract. Renal reabsorption and secretion occur through the polarised epithelial cells in the proximal tubules. Uric acid transporters are expressed on these cell membranes. Reabsorption deficiency leads to hypouricemia and elevated fraction excretion associated with urolithiasis, nephrolithiasis or acute renal injury. Decreased uric acid secretion in the kidneys and small intestine leads to hyperuricemia, which develops into gout in 10% of individuals. Genome wide association studies detected a strong effect of SLC22A12 (URAT1), SLC2A9 (GLUT9) reabsorbing transporters and ABCG2 (ABCG2) secreting transporter on uric acid serum concentration variability. This thesis aimed to map out urate transporter allelic variants in a cohort of primary dysuricemia patients and identification of the variants causing defective uric acid excretion. Six non-synonymous variants were described in SLC22A12 (URAT1) and SLC2A9 (GLUT9) genes in hypouricemic individuals, which had not been identified previously in any population studies. Significant decreases in uric acid transport have been demonstrated experimentally in vitro,...
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In vitro study of drug-drug interactions of HIV protease inhibitor darunavir on efflux ABC transporters
Bezděková, Dominika ; Červený, Lukáš (advisor) ; Vokřál, Ivan (referee)
Charles University Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Dominika Bezděková Supervisor: doc. PharmDr. Lukáš Červený, Ph.D. Title of diploma thesis: IN VITRO STUDY OF DRUG-DRUG INTERACTIONS OF HIV PROTEASE INHIBITOR DARUNAVIR ON EFFLUX ABC TRANSPORTERS Abstract: Darunavir is a drug used in the therapy of HIV belonging to the group of protease inhibitors. These protease inhibitors are used as a part of the combination antiretroviral therapy. For the increase of bioavailability, darunavir is always used in combination with ritonavir or cobicistat. As the CYP3A4 and ABCB1 (P-glycoprotein) transporter substrate, darunavir is a drug with a high potential to drug interactions. Considering the amount of adverse effects that can be caused by darunavir, it is necessary to know these drug interactions for the safety of therapy. Inhibition of the intestinal ABCB1 by the co-administrated drugs could also lead to the increased bioavailability of darunavir and to reduction of frequency of administration leading to a cheaper therapy. This thesis studies the drug-drug interactions of darunavir with in vitro methods using two cell lines - MDCKII and Caco-2 cells. The results from the transport of darunavir across the MDCKII cell monolayer indicates that darunavir is a ABCB1...
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The effect of urate transporter polymorphisms on uric acid excretion
Mančíková, Andrea ; Krylov, Vladimír (advisor) ; Novotný, Jiří (referee) ; Ježek, Petr (referee)
Uric acid excretion disorders are the most common cause of primary dysuricemia. The kidneys eliminate two-thirds of uric acid production and the other third is eliminated in the gastrointestinal tract. Renal reabsorption and secretion occur through the polarised epithelial cells in the proximal tubules. Uric acid transporters are expressed on these cell membranes. Reabsorption deficiency leads to hypouricemia and elevated fraction excretion associated with urolithiasis, nephrolithiasis or acute renal injury. Decreased uric acid secretion in the kidneys and small intestine leads to hyperuricemia, which develops into gout in 10% of individuals. Genome wide association studies detected a strong effect of SLC22A12 (URAT1), SLC2A9 (GLUT9) reabsorbing transporters and ABCG2 (ABCG2) secreting transporter on uric acid serum concentration variability. This thesis aimed to map out urate transporter allelic variants in a cohort of primary dysuricemia patients and identification of the variants causing defective uric acid excretion. Six non-synonymous variants were described in SLC22A12 (URAT1) and SLC2A9 (GLUT9) genes in hypouricemic individuals, which had not been identified previously in any population studies. Significant decreases in uric acid transport have been demonstrated experimentally in vitro,...
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Chronic constipation as a bio-psycho-social problem of comprehensive rehabilitation of the elderly
ROŽĎALOVSKÁ, Petra
Biological changes related to seniority are in general manifested with slowdown of physiological functions, notable the slowdown of intestinal peristalsis. Problems with excretion often occur and they may end up as a constipation, which can become repeated, long-term and becomes chronic. Excretion belongs to basic human needs and it creates a feeling of satisfation. If it is disrupted, it affects the senior also psychosocially.In the theoretical part of my bachelor thesis I focus on the target group the elderly and related fields, gerontology and geriatrics, periods of human life aging and seniority and last but not least also the term of comprehensive rehabilitation and its seriousness. I state definitions of constipation, its partition, diagnosis, prevention and treatment. As a result of life and health changes also changes the quality of life of seniors. The practical part of my thesis was focused on two goals. Goal 1 charted respondents incidence of chronic constipation, goal 2 assessed the respondents extent to which chronic constipation affects the quality of life of seniors. Research indicates that practical knowledge is associated with the theory. By appropriate prevention, we should strive to reduce frequency of congestion in the elderly and thereby eliminate the deterioration of their quality of life.
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