Glycaemic control in critically ill patients has been a topic of considerable attention for the past 20 years. In literature and at scientific meetings, there have been ongoing debates regarding the efficacy of glycaemic control in these patients with frequently entirely opposite opinions. These range from a strict invasive approach with target glycaemia 4-6 mmol/l to a liberal approach tolerating even values higher than 12 mmol/l. In the preview of this PhD thesis we have analysed so far published literature and describe the reasons for this inconsistency. According to the results of recent studies, the most significant efficacy of tight glycaemic control has been observed in cardiac surgical patients. If we consider the concept of tight glycaemic control as efficient strategy, there are three important questions remaining unanswered as follow. Does the specific algorithm-protocol play a key part in the concept of tight glycaemic control alongside the knowledge and skills of nursing staff in safe and efficient blood glucose control? What is the ideal timing of starting the strategy of tight glycaemic control (TGC) in cardiac surgical patient? And is there any benefit in outcome respect to mortality or morbidity? Do we have any more safe and efficient option or add-on to standard perioperative...

The basic examination of the cerebrospinal fluid provides a quick orientation in the diagnostic algorithm of CNS diseases about the nature of the pathological process. The current evaluation of cytology and biochemical parameters of glucose metabolism reports about the cells present and at the same time about the level of their activation. The aim of the work was to investigate the relationship between biochemical and cytological findings in cerebrospinal fluid in a large data set (n = 8 178), or confirm the hypothesis of a significant alteration in the Coefficient of Energy Balance (CEB) in cytological classes typically accompanying oxidative burst of phagocytes. CEB was subjected to analysis and comparison with other energy parameters (lacto-glucose ratio, gluco-lactate ratio, concentration of lactate and glucose in cerebrospinal fluid). The relationships between blood and cerebrospinal fluid glucose and lactate concentrations were investigated. CEB values were statistically significantly different in cytological groups, which reflected purulent inflammation, tumor involvement or infection by potential intracellular pathogens, the hypothesis was confirmed. Other energy parameters excluding glycorrhachia distinguish these cytological groups as well as CEB. There are inaccuracies in the derivation...

The topic of the diploma thesis is the influence of a low-carbohydrate diet on the treatment of type 1 diabetes mellitus. It is an autoimmune disease for which it is necessary for patients to administer insulin. The selection of suitable sports activities, good health and mental condition and, above all, the adjustment of eating habits also contribute to the successful compensation of diabetes. This work demonstrates a low-carbohydrate diet as one of the possibilities diabetics can eat. The work is divided into two parts, theoretical and practical. The theoretical part briefly describes the disease and presents the recommended and a low- carbohydrate diet. The following section also addresses physical activity. It describes the issues of sports for people with diabetes who are on a regular diet, as well as on low-carbohydrate diet. The practical part shows the results of glucose sensors (Free Style Libre, Dexcom G6 and Medtronic), which continuously measure blood sugar levels. In the practical part, eight respondents with type 1 diabetes, who switched the recommended diet for a low-carbohydrate diet, were surveyed in the form of a questionnaire. The purpose of the questionnaire was to assess the effects of switching to a low- carbohydrate diet on: the compensation of diabetes; the frequency of...

Author's name: Bc. Irena Malá School: Charles university, Prague 1st Faculty of Medicine Institut of Theory and Practice of Nursing Vídeňská 800, 140 59 Prague 4 - Krč Program: Health Care Administration Title: Early postoperative care of the patient with the left ventricular assist device HeartMate II Diploma thesis supervisor: PhDr. Hocková Jana, PhD. Number of pages: 170 Number of attachments: 41 Year: 2013 Key words: early postoperative care, hypotermia, blood transfusion, fluid resuscitation, perioperative cardiovascular dysfunction, pharmacologic support, ventricular assist device HeartMateII, monitoration, device, cardiac arrhythmias, ventilation management, postoperative anticoagulation, glycemic kontrol, renal insufficiency, nutrition, nursing, complications, physiotherapy, psychological aspects The occurrence of the heart failure is similar to an epidemic with high mortality. This fact, together with stagnate or even decreasing number of suitable donors, led to a need of replacing the heart pump activity with an artificial one. Mechanical cardiac support systems are sophisticated devices that are able to support a certain period of time or completely replace the function of the heart as a pump. The indications implantation of mechanical cardiac support is significant symptomatic heart...