The thesis summarizes present knowledge about assessment of growth and development in childhood (antropometric assessment, assessment of biological age and assesment of nutritional status). Nutrition in childhood and adolescence is also described. The thesis deals with silure to drive- its causes, definitiv, consequences and treatment. Most of nutritional screening forms (foreing and also Czech screening form) are mentioned. Practical part is realized on childern wards, Motol University Hospital. The aim of the thesis is to evaluate two nutritional risk screening which have been gradually introduced in Motol Univrsity Hospital to determinate the nutritional risk of hospitalized pediatric patients.

Proper nutrition is essential for every human being, whether healthy or sick. Nutrition is, according to associate docent Kohout, one of the areas that is most neglected in health and social facilities in the Czech Republic. Standardized nutritional care should be established in all hospitals, representing a comprehensive nutritional and qualified solution for clients/patients. The standardized nutritional care involves systematic assessment of nutritional status of a client/patient and a search for clients/patients at nutritional risk. It further includes an appropriate diet according to the needs and capabilities of a client/patient and timely provision of adequate nutritional support to clients/patients who were identified as nutritionally at risk. Finally, standardized nutritional care also includes monitoring and documenting the effects of nutritional therapy, because the effect of individual measures cannot be monitored without proper documentation. The objective is to monitor the process of identification, evaluation and implementation of actions to ensure nutritional care in selected medical facilities from the perspective of the senior nursing management. Another objective is to map how significant quality indicator this is and what problems are seen in creating and maintaining a standard situation. Data collection was carried out by an interviewing technique using questionnaires. Respondents were from hospitals in the Czech Republic where we addressed the members of their senior nursing management. H1 ``The hospitals use established control mechanisms to find out about the nutritional status of compliance with established standards of nutritional care{\crqq} has been confirmed. H2 ``Nutritional screening is performed by nurses on all clients/patients at reception{\crqq} has been confirmed. H3 ``Nutritional screening during hospitalization is repeated only in clients/patients at risk{\crqq} has been confirmed. H4 ``Nurses develop nutritional screening within the cooperation of nurses with a nutritional therapist in the provision of standardized nutrition care{\crqq} has been confirmed, and H5 ``The results of nutritional screening are used by nurses as the basis for the saturation of clients{\crq}/patients{\crq} nutritional requirements{\crqq} has also been confirmed. The second objective was to map how significant quality indicator this is and what problems are seen in creating and maintaining a standard situation. The performance of nutritional screening has become the second most important quality indicator according to the research. As for the problems seen by respondents in relation to creating and maintaining a standard situation, it can be said, on the basis of the research results, that the biggest problems in creating and maintaining a standard situation is the lack of personnel, economic demands and approach of the personnel, their reluctance and disinterest. We attempted to explore the process of identification, evaluation and implementation of actions to ensure nutritional care in selected medical facilities from the perspective of the senior nursing management and then, based the results, to suggest ways of potential improvement of the current situation in the field of clients{\crq}/patients{\crq} nutrition.

Huntington's disease is a dominantly-inherited autosomal neurodegenerative disease manifested by disorders of motility, cognitive function, behaviour, and weight loss, which is conditioned multifactorially. The aim of the study was to determine whether there are eating disorders in Huntington's disease, as well as its etiology and severity. Neurological scaling, anthropometric examinations, evaluation of three-day diet records, measurements with a manual dynamometer, bioimpedance analyses, indirect colorimetry and predictions of energy expenditure were performed on 10 patients. Algorithms were applied for the diagnosis of sarcopenia and malnutrition. Unwanted weight loss was observed in all patients and 4 out of 10 showed malnutrition. No difference was found between the values of measured resting metabolism and calculated according to the predictive equation. However, it has been shown that strict nutritional recommendations based on this data can be misleading for some patients with HN, as real energy consumption can be significantly higher. All our patients had a positive energy balance. A new diagnostic algorithm for the early diagnosis of sarcopenia has proven its worth. Using bioimpedance analysis and examination of the force of the handshake, we identified possible sarcopenia and already-present...

This diploma thesis is focused on patients who are undergoing surgery - intestinal resection. In a surgical patient, malnutrition is a frequent and significant negative factor that affects postoperative morbidity and lethality. Proper nutritional care has an irreplaceable role in the prevention and treatment of malnutrition. Nutritional elements are part of the perioperative care of the modern ERAS concept, which leads to reduction in the frequency of postoperative complications and a shortening of the hospitalization duration. The concept emphasizes early physical rehabilitation and shortening of the fasting period around the time of the operation, which leads to a significant saving of body protein. The theoretical part describes particular diseases that lead to surgical treatment. Special attention is paid to idiopathic intestinal inflammations and colorectal cancer. It also includes current recommendations of professional companies. The primary objective of the practical part is to compare two groups of patients who underwent intestinal resection. To find out whether targeted nutritional intervention (before, during and after surgery) has an impact on postoperative convalescence, the frequency of complications and the overall length of hospitalization. The aim was also to improve the quality of...

Anorexia nervosa (MA) is serious psychiatric disease associated with significant mortality. One of the main causes of mortality in these patients is cardiac complications. In 2003 - 2010 we examined 30 patients with established diagnosis of MA. Routinely used nutritional parameters are normal even in severe malnutrition in MA patients and we can ́t use them to diagnose or monitor nutritional status. Therefore we evaluated plasma aminoacids levels to detect minor changes of protein metabolism. According to our results we found mild hyperaminoacidemia and significant elevation of Gly/Val and Phe/Tyr ratio. In the second part of our research we performed non invasive examination s in risky patients with AN to consider possible cardiac complications. Results of ECG and echocardiography confirm results of the previous published studies. Original finding is significant decrease in flow mediated dilatation of brachial artery and its normalization after realimentation. We found also in ambulatory blood pressure monitoring significant decrease in blood pressure during the active period which was the consequence of changes in the heart rate variability. Decrease of the blood pressure in patients with AN in standing position was associated with increase of HF power in supine position and particularly with the lack of...

Need of nutritional intervention in patients after stroke Summary Aims: To identify how many patients after acute stroke have accurate oral intake of energy and proteins and how is this condition changed after one month of hospitalization. To evaluate the association between dysphagia and food intake. Methods: The evaluation was conducted by observations of food intake, eaten food records, calculating of energy and nutrients intake and comparing to needed energy (by Harris-Benedicts equation) and proteins. GUSS screening tool was used to evaluation of swallowing, ADL test for self-sufficiency assessment. Data included antropometrical indicators (weight, height, arm circumference) and nutritional screenings in Thomayer hospital in Prague. Results: Of the 35 patients, 54 % had adequate oral intake of energy and 23 % adequate intake of proteins in the first week after stroke. Adequate oral intake of energy was indicated in 66 % of patients and adequate intake of proteins in 11 % after one month of hospitalization. There were no significant improvements of oral energy intake (p=0,2891, α=0,05) or protein intake (p=0,1336, α=0,05) after one month of hospitalization. 84,4 % of patients suffered from dysphagia in first week after stroke and 60,6 % after one month of hospitalization. Correlation between inadequate...

Chronic kidney disease (CKD) and acute kidney injury (AKI) are major public health problems. It is important to be able to identify those at high risk of adverse outcome, CKD progression and associated cardiovascular disease. The aim of the thesis was to study novel promising biomarkers, their relationship to kidney function, chronic inflammation and/or cardiovascular risk - placental growth factor (PlGF), pregnancy associated plasma protein A (PAPP-A), matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), soluble receptor for advanced glycation end products (sRAGE), calcium binding protein S100A12 or extracellular newly identified RAGE binding protein (EN-RAGE), and high mobility group box protein-1 (HMGB-1) in patients with renal diseases including CKD, haemodialysis (HD), AKI patients, and healthy controls for comparison. First study revealed that PlGF is elevated in patients with decreased renal function. Second study demonstrated the association of MMP-2 and PAPP-A with proteinuria in patients with CKD. Moreover, serum MMP-2, MMP-9 and PAPP-A levels significantly differed in patients with various nephropathies. EN-RAGE levels are not elevated in patients with CKD, but are related to inflammatory status. PAPP-A, EN-RAGE and HMGB-1 levels are significantly elevated, but sRAGE and PlGF...

Chronic kidney disease (CKD) and acute kidney injury (AKI) are major public health problems. It is important to be able to identify those at high risk of adverse outcome, CKD progression and associated cardiovascular disease. The aim of the thesis was to study novel promising biomarkers, their relationship to kidney function, chronic inflammation and/or cardiovascular risk - placental growth factor (PlGF), pregnancy associated plasma protein A (PAPP-A), matrix metalloproteinase 2 (MMP-2), matrix metalloproteinase 9 (MMP-9), soluble receptor for advanced glycation end products (sRAGE), calcium binding protein S100A12 or extracellular newly identified RAGE binding protein (EN-RAGE), and high mobility group box protein-1 (HMGB-1) in patients with renal diseases including CKD, haemodialysis (HD), AKI patients, and healthy controls for comparison. First study revealed that PlGF is elevated in patients with decreased renal function. Second study demonstrated the association of MMP-2 and PAPP-A with proteinuria in patients with CKD. Moreover, serum MMP-2, MMP-9 and PAPP-A levels significantly differed in patients with various nephropathies. EN-RAGE levels are not elevated in patients with CKD, but are related to inflammatory status. PAPP-A, EN-RAGE and HMGB-1 levels are significantly elevated, but sRAGE and PlGF...