L'angiographie coronarienne RX (ou coronarographie) reste la modalité de référence permettant de déterminer avec précision le degré et le nombre de sténoses coronariennes ainsi que le nombre de vaisseaux atteints. L'objectif de ce travail de thèse de doctorat concerne l'amélioration de la reconstruction 3D des coronaires afin d'améliorer le diagnostic, ainsi que la sécurité et la précision des interventions minimalement invasives. Dans un premier temps, une contribution majeure vise à améliorer l'étape de calibration du système d'imagerie rotationnelle R-X. Premièrement, nous avons donc proposé un nouvel algorithme de calibrage basé objet inspiré de la méthode de Xu et al, dédié au système robotisé Artis Zeego. Deuxièmement, nous transposons les géométries de projection dans le système de coordonnées du C-arm. Nous avons proposé des modèles de mouvement des géométries de projection en considérant objectivement et systématiquement tous les facteurs possibles. Ces modèles de mouvement permettent de simplifier la procédure de calibration en routine clinique. The résultats expérimentaux indiquent que les modèles de mouvement proposés ont une précision acceptable afin estimer les paramètres d'acquisition. Dans un second temps, une contribution majeure vise à proposer une nouvelle méthode de reconstruction des coronaires par compensation de mouvement. Les étapes de reconstruction sont: l'opérateur de projection, la segmentation des projections acquises, le recalage iconique, la reconstruction initiale et la reconstruction avec compensation de mouvement. Nous avons opté pour l'opérateur de projection Distance Driven simplifié proposé par Oukili. Nous avons adopté comme mesure de similarité l'information Mutuelle (MI) avec un terme de rigidité. Pour optimiser cette fonction de coût, nous avons utilisé la méthode Advanced Adaptive Stochastic Gradient Descent (ASGD). Nous avons adopté une reconstruction statistique itérative basée on MAP et l'a priori L0. Les résultats expérimentaux indiquent que la méthode proposée améliore visuellement la qualité de la reconstruction. Le contraste et les détails des reconstructions sont améliorés par compensation de mouvement. / The rotational angiography RX of the coronaries is a standard modality to determine the degree and the number of the coronaries stenosis. The objective of this dissertation aims at improving the 3D reconstruction of the coronary arteries, which can improve the diagnosis, the security and the precision of the minimal invasive interventions.For the first part, the major contribution is improving the calibration procedure of the rotational R-X imaging system. First, we propose a new calibration algorithm based on the classical helical phantom on the Artis-Zeego system. Second, we transfer the geometries to the C-arm coordinate system. Last, we propose the movement models of the projection geometries objectively and systematically at 3 representative work positions. The movement models simplify the clinical procedures. The experiment results indicate that the proposed movement models have an acceptable precision to estimate the acquisition parameters.For the second part work, the major contribution is proposing a new reconstruction method by motion compensation. The steps of the reconstruction method include: the forward projection, the segmentation of the acquired projection, registration, the initial and motion compensated reconstruction. We adopt the advanced Simplified Distance Driven projector to generate the forward projection. We use the mutual information (MI) and rigidity penalty (RP) to be the similarity measure. We adopt the advanced Adaptive Stochastic Gradient Descent (ASGD) to realize the optimization. The initial and the compensated reconstruction are based on the MAP iterative reconstruction. The experiment results indicate that the proposed method improves the quality of the 3D reconstruction. The contrast and the details of the coronary arteries are improved by the proposed motion compensation reconstruction method.

De preceptis is considered a major source of information on the origins of fauxbourdon, despite its being regarded as a disorganized compilation of multiple authorship, uncertain date, and unknown provenance. Internal cross-reference and writing mannerisms, however, show it to be a compilation of a single author's writings. Comparison of its pedagogical content to that of other theory treatises suggests that it was written c. 1500, not the accepted c. 1480. Evidence also indicates that Guillaume Garnier, a Flemish associate of Tinctoris and Gaffurius working in Italy, was its author. De preceptis ought to be considered a source, not for the origins of fauxbourdon, but for its reception-history, evidenced by the centrality of the parallel-consonance duet in Guilielmus's composition formulas, many of which resemble the frottola.

1 Criminal liability in healthcare with focus on an analysis of Czech and Slovak court rulings Abstract This master's thesis deals with the issue of criminal liability of healthcare workers. The aim of this thesis is to create a comprehensive overview of the Czech legislation of the relevant part of criminal law and individual institutes of medical law and to present related case law. Slovak legislation is used for comparison. The thesis consists of six parts, the first chapter is focused on the legal regulation of medical law and its international and national sources. It also deals with types of legal liability of healthcare professionals such as civil, labour, administrative and disciplinary liability. The second and one of the most extensive chapters approaches criminal liability and its necessary conditions. It describes the current concept of crime in more detail as well as the analysis of the necessity of the principle of subsidiarity of criminal repression. It also includes legal regulation of criminal liability of legal entities. The third chapter is dedicated to a cardinal concept - lex artis as an appropriate level of expertise, which contains a number of obligations that every healthcare worker must comply with. The process of proving criminal liability of medical workers in criminal proceedings...

Criminal liability of physician for a non lege artis medical procedure Abstract This diploma thesis is focused on the issue of the criminal liability of physician for a non lege artis medical procedure. The main objective of submitted thesis is to define all the requirements and elements of criminal liability of the physician, therefore, to find an answer to under what conditions and in what situations the physician will be criminally responsible, and in what situation he will not be criminally responsible. Another objective of the thesis is to provide a definition of what can be considered as a lege artis procedure, what will be considered as a non lege artis procedure, who will assess such a procedure and what will be the consequences for the assessment of the criminal liability of a physician. In this thesis it was used mostly the method of description, analysis, deduction and a partial comparison. Thesis is divided into four main chapters, which are further divided into relevant subchapters. The first chapter is focused on the definition of all prerequisites for the criminal liability of a physician and also deals with the question of possible criminal liability of a legal person who is authorized to provide health services. The second chapter defines individual circumstances excluding illegality. The...

This diploma thesis goes into a problem of the legal interpretation of the term lex artis, which some authors describe as well-known term of unknown content. Generally, this term relates to the activities of doctors and other health care professionals within taking care of patients, and usually we can meet with the ablative lege artis, which is used to denote a professionally correct action. This term is in common usage also in the reference books and case law where the breach of the duty to act lege artis is considered to be a precondition for liability of physician or health care provider for injury to the patient. Certain difficulty of using the term lex artis lies in the fact that the legislation in force does not mention not even define this term and its meaning must therefore be inferred from legislation by interpretation. For the legal definition of lex artis is from 1st April 2012 considered the provision of s. 4 (5) of Act No. 372/2011 Sb., about Health Services and Terms (the Health Services Act), as amended, which defines appropriate professional standard of providing health services and which is from the early beginning criticized by the part of professionals for its alleged conflict with patients' rights guaranteed by the Convention on Human Rights and Biomedicine. The aim of this...

1 Abstract The thesis is focused primarily on medical litigations in which either patient or (usually) his family apply for a remedy due to a medical malpractice (deviation from medical proffesional duty of care (lex artis) resulting in injury or death of the pacient. Author concentrate on this problematics from the perspective of defendant. At first, he think about setting targets of the hospital (defendant) in the dispute, then he consider ways to achieve these goals (which instruments can be used) . The thesis also consists of analyses of 20 medical litigations. Before the main part author introduces general theoretical questions and refer to the literature on which he based his thesis, as he decided to not deal with general issues. In this context he mentions areas to which, according to him, the doctrine does not yet provide answers. The author's research follows these questions and in following text he concentrates on them and tries to find the answers to controversial questions. These includes, for example, whether in practice the concept of "další nemajetkové újmy" is fulfilled the intention of the lawgiver, wheter the regulation of liberation of liability is applicable in medical litigations and what is its relationship with the "lex artis corrections". After this, the author specifies the methods...

La evolución de la profesión sanitaria y de la sociedad han dado lugar al abandono del paternalismo clásico y al nacimiento de la etapa de toma de decisiones compartida. La manifestación más directa de este cambio de paradigma ha sido el reconocimiento del derecho al consentimiento informado. En nuestro país, la plasmación del mismo se produjo con la aprobación de la Ley 41/2002, de 14 de noviembre, básica reguladora de la autonomía del paciente y de derechos y obligaciones en materia de información y documentación clínica. En suma, se concreta en un derecho de configuración legal que supone el reconocimiento, a todos los pacientes, de dos facultades íntimamente conectadas: de un lado, poder conocer el estado de su salud y las implicaciones de la intervención que, en su caso, deba llevarse a cabo; de otro, tras recibir esta información, decidir lo que estime más adecuado en este ámbito. Además, como tuvo ocasión de destacar nuestro Tribunal Constitucional, el consentimiento informado tiene implicaciones constitucionales en tanto en cuanto opera como una garantía del derecho a la integridad física y moral (art. 15 CE). Asimismo, lo cierto es que también pueden verse comprometidos otros derechos constitucionales como la libertad o la dignidad. De esta suerte, la tutela del consentimiento informado aparece como imprescindible, ya que, de otro modo, los usuarios de los centros de salud no podrán desarrollar su facultad de autodeterminación y su autonomía de la voluntad. En este sentido, entendemos que la responsabilidad civil merece ser repensada a la luz de los mandatos de nuestra Carta Magna, ofreciendo un sistema de reparación que sea respetuoso con los mismos.

Summary: The subject of this paper is providing of lege artis health care in the system of public health insurance. The aim of the thesis is to analyse the basic terminology, current legislation and its application in practice. Lex artis is in law an uncertain term, difficult to define, therefore its frequent usage should be restricted in the future. Due to the personal experience of the author there are many practical examples from the Czech health care system used in the paper. Related case law is taken into account continuously with the exception of the separately stated recent court judgment of the Constitutional Court of the Czech Republic. The study is divided into four main chapters, introduction and conclusion. The first chapter is dedicated to the concept of lege artis in detail, its terminology and relation to the current legislation. Further subchapters deal with available health care standards and their obligation. The final parts analyze the lege artis restrictions and way of its assessment. The second chapter is dedicated to the concept of public health insurance. First, the term is defined and the current law is considered. The following parts examine the issue of health insurance companies and the network of health care facilities. Chapter three presents the labor law aspects of lege artis...

The making of an end of life decision represents worldwide one of the most difficult issues that physicians can be confronted with - not only should it be regarded as consisting of medical and legal aspects, but ethics and moral values are present as well. Furthermore, it shall not be supposed that the economic parameter is negligible, unfortunately even to the contrary. The fact that the decision is often made by physicians under pressure caused by a system of limited resources (and therefore it can not avoid being distorted ) must be kept in mind. At any rate , according to Czech law under which neither assisted suicide nor life termination on the request is allowed, the legality and legitimacy of withdrawal and withholding of medical treatment is based on the argument of informed consent of the patient, advanced directives and the standard of lege artis treatment. These also shall be pleaded as defences in eventual criminal proceedings.

Medical interventions such as interventions in the physical integrity of the patient are some of the most important interventions in the personal rights of individuals guaranteed by constitutional laws and international conventions. The basis for criminal law investigation of physician's procedure is an issue of professionally correct procedure (procedure called lege artis). The healthcare provision - including the interventions in the physical integrity of the patient - is perceived in Czech law as a law qualified activity undertaken for the purpose approved by the legal order. As a result of the constitution of informed consent of the patient with a medical procedure this fact must be taken into account when defining a new criminal characteristics of medical intervention. The dissertation aims to provide a comprehensive legal analysis of the criminal aspects related to decisions made by physicians and to the medically indicated care provision in the context of legislative changes in healthcare, recodification of criminal law as well as civil law. Issues related to active intentional termination of life on request of the patient (euthanasia) were not subject to the processing of this matter. The dissertation analyzes in detail the individual institutes of healthcare legislation, medico-legal...