0BABSTRACT This thesis is focused on enteral nutrition. This issue is an integral part of intensive and resuscitation care, but it is also a part of standard and follow-up care. There are more and more new resources and the products for enteral nutrition are improving. The theoretical part deals with malnutrition, discusses the different components of nutrition. Much of the thesis forms ways of application of nutrition. The issue is a nasogastric tube, a nasojejunal tube, percutaneous endoscopic gastrostomy, percutaneous endoscopic jejunostomy, feeding button or sipping. There are further expanded the introductions, nursing care, indications and contraindications of these options. The following chapters analyse the modes of enteral feeding, advantages and disadvantages of enteral nutrition compared to parenteral. The practical part is focused on research using anonymous questionnaires in the area of enteral nutrition. The survey was conducted in four departments of three teaching hospitals in Prague. It was focused on nurses and paramedics in medical intensive metabolic care units. The survey had 73 respondents. The aim was to identify the mode of feeding that nurses prefer and how they apply it, analyze the extent to which the nurses actively involve themselves in this, how they are oriented in...

Background: Achalasia is a primary esophageal motility disorder that can be classified into three types (I-III) based on high-resolution manometry (HRM). Exact pathogenesis is unknown, but immune-mediated processes and genetic predisposition play a role, which is supported by finding of a genetic risk variant (rs28688207 insertion) in HLA-DQB1 gene that is strongly associated with achalasia. Per-oral endoscopic myotomy (POEM) has become a standard treatment for achalasia, but the long-term efficacy, safety and impact on esophageal physiology are not fully understood. The aims of our studies were to perform the first genotype-phenotype analysis investigating the frequency of rs28688207 accross three HRM types of achalasia, to evaluate the efficacy and safety of POEM and to assess the post-POEM esophageal motility patterns. Patients and methods: These were three retrospective studies of prospectively collected data. Genotyping of the rs2868827 insertion was performed using real-time PCR in 347 patients from Czech Republic (n = 163), Germany (n = 114), Greece (n = 70). The efficacy and safety of POEM were evaluated in 133 patients treated in our center. The post-POEM esophageal motility was assessed using the Chicago Classification in 237 patients in whom HRM was performed prior to and after POEM....

Although it is not a new method endoscopy has undergone incredible development in recent years. The examination is however very unpleasant for a patient, which is why health care staff should be well trained, particularly for child patients. The aim of the thesis was to map the specifics of nursing care for children undergoing endoscopic examination of the gastrointestinal tract. We approached the whole issue from the point of view of caring staff ? nurses. In the theoretical part we first described the gastrointestinal tract anatomy, endoscopy development and types of endoscopic examination. Then we dealt with the role of a nurse in the care for child patients undergoing these examinations. We formed three goals for the research. Goal 1: To find out how nurses prepare child patients for the individual endoscopic examinations. Goal 2: To verify whether nurses caring about a child patient undergoing gastrointestinal tract endoscopy are specifically trained. Goal 3 served as the output of the work: To elaborate recommendation for nurses preparing child patients for the individual endoscopic examinations. We chose quantitative research for collection of the necessary information. A questionnaire designed for nurses caring for child patients was the data collection technique. The questionnaire was anonymous, distributed at paediatric clinics of faculty hospitals of Moravian region. 104 questionnaires suitable for processing returned from 140 issued. The research has shown that nurses working at the clinics where the research was performed master the correct nursing care for child patients undergoing endoscopic examination of the gastrointestinal tract. Nevertheless the fact that most information is gained upon practical experience, with low emphasis on initial and repeated training of nurses also results from the research. A recommendation was elaborated upon the gathered information in the form of a standard nursing procedure proposal.