Studium of the clinical impact of different forms of cardiac resynchronization therapy by patients with chronic heart failure MUDr. Lucie Burianová ABSTRACT: Introduction: Biventricular (BiV) pacing decreases mortality and improves quality of life of patients with severe heart failure. Haemodynamic and short time clinical studies suggest that isolated leftventricular pacing could have the same effect. Aims: Compare the effect of BiV and leftventricular pacing by subjects with dilated cardiomyopathy and severe heart failure with the attention to signs of dyssynchrony and remodelation of the left chamber. In methodical substudy compare the results of left chamber volumes and ejection fraction (EF LK) measured by CT angiography and 2-dimensional echocardiography with use of contrast agent (K-ECHO). Methods: Patients indicated for cardiac resynchronization therapy were randomized for either BiV or leftventricular pacing. After implantation of the device they were examinated clinically and by echocardiography every 3 months in the period of one year. Four years from the onset of the study the major adverse events in both groups were evaluated. The results of left chamber volumes and EF LK measured by K-ECHO and CT angiography were compared. Results: We enrolled 33 patients. We found clinical improvement in both...

Studium of the clinical impact of different forms of cardiac resynchronization therapy by patients with chronic heart failure MUDr. Lucie Burianová ABSTRACT: Introduction: Biventricular (BiV) pacing decreases mortality and improves quality of life of patients with severe heart failure. Haemodynamic and short time clinical studies suggest that isolated leftventricular pacing could have the same effect. Aims: Compare the effect of BiV and leftventricular pacing by subjects with dilated cardiomyopathy and severe heart failure with the attention to signs of dyssynchrony and remodelation of the left chamber. In methodical substudy compare the results of left chamber volumes and ejection fraction (EF LK) measured by CT angiography and 2-dimensional echocardiography with use of contrast agent (K-ECHO). Methods: Patients indicated for cardiac resynchronization therapy were randomized for either BiV or leftventricular pacing. After implantation of the device they were examinated clinically and by echocardiography every 3 months in the period of one year. Four years from the onset of the study the major adverse events in both groups were evaluated. The results of left chamber volumes and EF LK measured by K-ECHO and CT angiography were compared. Results: We enrolled 33 patients. We found clinical improvement in both...

Ce mémoire s’intéresse à la présence des œuvres d’art fictives dans le roman contemporain. Leur description précise remet en question les codes de la représentation et soumet le lecteur à une autre forme d’expérience face à l’œuvre d’art. C’est à travers les concepts d’immersion, d’intermédialité et d’interaction que la fiction de l’œuvre d’art dans le texte sera ici abordée à travers trois différents romans, soit The Body Artist de Don DeLillo, La Carte et le territoire de Michel Houellebecq et Œuvres d’Édouard Levé. La transformation de l’expérience de lecture suggère un renouvellement de l’esthétique littéraire, accentuant l’importance de la participation du lecteur dans la démarche créatrice, et ouvrant les possibilités de la transmission de l’art contemporain. Les dispositifs propres au récit sont mis de l’avant pour intégrer le médium visuel, et ainsi questionner le rapport à l’attribution du sens de l’œuvre d’art, à son interprétation et à sa perception. Le présent mémoire tentera de proposer des possibilités pour l’art contemporain de se manifester à l’extérieur des institutions muséales traditionnelles, permettant ainsi de considérer l’immersion littéraire comme étant non seulement une expérience de lecture, mais aussi une approche face à l’art visuel. / This thesis focuses on the presence of fictional works of art in the contemporary novel. Through their precise descriptions, the fictional works of art challenge the codes of representation and transform the reader’s experience in front of the artwork. It is through the concepts of immersion, intermediality and interaction that the fictional nature of the works of art in the text will be addressed here through three different novels which are The Body Artist by Don DeLillo, La carte et le territoire by Michel Houellebecq and Oeuvres by Édouard Levé. The transformation of the reading experience suggests a renewal of literary aesthetics, showing the importance of the reader’s participation in the artistic process and creating new opening possibilities for the transmission of contemporary art. Specific narrative devices are put forward to integrate the visual medium and to questions the meaning of the work of art, its interpretation and perception. This thesis attempts to provide opportunities for contemporary art to manifest itself outside the traditional museum institutions, thus considering the literary immersion not only as a reading experience, but also as an approach to experience visual art .

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Short summary: Background: High cardiovascular risk in patients with chronic kidney disease is partly due to mineral dysbalance, microinflammation and oxidative stress. CKD patients accumulate traditional and non-traditional CV risk factors. FGF23, MMPs and PlGF belong among these non-traditional biomarkers of CV risk. FGF23 is a phosphaturic hormone and inhibitor of calcitriol synthesis. It is associated with vascular calcifications. Matrix-metalloproteinases (e.g. MMP-2, MMP-9) are proteolytic, proinflammatory enzymes, contributing to myocardial remodelation. Placental growth factor (PlGF) is a proangiogenic cytokine that is associated with LV hypertrophy in animal model. Plasmatic FGF23, MMPs and PlGF are elevated in CKD. Aim: We aimed to describe dynamic changes between several novel biomarkers of CV risk (FGF23, MMP-2, MMP-9 and PlGF) in CKD stages 1-5, to describe their mutual correlations and possible association with traditional CV risk markers. We studied possible association of laboratory and echocardiographic parameters in patients with CKD stages 2-4. Methods: In a cross-sectional study we evaluated 80 patiens with CKD 1-5 and 44 healthy controls. In a prospective study we evaluated echocardiographic and laboratory parameters in 62 patients with CKD 2-4 for an average study period of 36±10...

Short summary: Background: High cardiovascular risk in patients with chronic kidney disease is partly due to mineral dysbalance, microinflammation and oxidative stress. CKD patients accumulate traditional and non-traditional CV risk factors. FGF23, MMPs and PlGF belong among these non-traditional biomarkers of CV risk. FGF23 is a phosphaturic hormone and inhibitor of calcitriol synthesis. It is associated with vascular calcifications. Matrix-metalloproteinases (e.g. MMP-2, MMP-9) are proteolytic, proinflammatory enzymes, contributing to myocardial remodelation. Placental growth factor (PlGF) is a proangiogenic cytokine that is associated with LV hypertrophy in animal model. Plasmatic FGF23, MMPs and PlGF are elevated in CKD. Aim: We aimed to describe dynamic changes between several novel biomarkers of CV risk (FGF23, MMP-2, MMP-9 and PlGF) in CKD stages 1-5, to describe their mutual correlations and possible association with traditional CV risk markers. We studied possible association of laboratory and echocardiographic parameters in patients with CKD stages 2-4. Methods: In a cross-sectional study we evaluated 80 patiens with CKD 1-5 and 44 healthy controls. In a prospective study we evaluated echocardiographic and laboratory parameters in 62 patients with CKD 2-4 for an average study period of 36±10...

 Title: Analysis of overhead throw in baseball  Objectives: to describe the work of muscles musculus trapezius dexter, sinister and musculus pectoralis major dexter, sinister during the classic side overhead throw, the throw without using left arm, the front throw, the pitch from the floor and the pitch from the pitching hill using the surface electromyography; to compare all types of the throws and to determine the differences between them  Methods: surface elektromyography, video content analysis  Results: based on the results of the analysis we can say, that the activity of the chosen muscles during the various types of throws differs in intensity and in the duration of action potencial as well  Keywords: baseball, surface elktromyography, overhead throw, throw without using left hand, front throw, pitch

Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....

Myocardial damage is one of the most serious consequences of arterial hypertension. Changes in the heart structure and function develop not only due to pressure overload itself, but many other hemodynamic and neurohumoral factors contribute to their formation. Our work has compared echocardiohraphic strucutural anf functional changes of the left ventricle, caused by essential hypertension and hypertension associated with primary aldosteronism (PA) as the most common reason for secondary hypertension. The first part of our work focused on the differences in left ventricle geometry in men with PA and essential hypertension after separating it's low-renin form (where, similarly to PA, the plasma volume expansion was considered to have the dominant effect on left ventricle remodelation). In men with low-renin forms of hypertension including PA, we observed greater both endsystolic and enddiastolic diameter of the left ventricle, lower relative wall thickness and more frequent eccentric type of hypertrophy when compared to essential hypertensives with normal renin levels. Whereas left ventricle cavity diameters were positively correlated to aldosterone levels, wall thicknesses were associated mainly with hypertension severity expressed as an average 24hour blood pressure and number of antihypertensives....

Klimatförändringar är en komplex risk som innebär nya utmaningar för dagens och framtidens riskhantering. Översvämningsrisken ökar i takt med att skyfall och kraftiga regn blir mer frekventa samtidigt som havsnivåerna stiger. Att samhällen klimatanpassas är av största vikt med tanke på att utsläppsnivåerna fortsätter att öka och en klimatförändring vid det här laget är oundviklig. I städer världen över syns en trend där tidigare industrihamnar omvandlas till områden med vattennära bebyggelse. För att hantera översvämningsrisken är det vanligt att olika typer av översvämningsskydd byggs, till exempel vallar och dammar. Forskning visar att sådana typer av skydd tenderar att leda till minskad riskuppfattning och en slags falsk trygghet som leder till ökad exploatering i översvämningshotade områden. Detta påverkar samhällens resiliens negativt och kan leda till förödande konsekvenser om skydden ger vika. Syftet med studien är att bidra till kunskap om hur klimatanpassningsåtgärder för översvämningar påverkar samhällens resiliens och att undersöka relationen mellan hantering av översvämningsrisk och utveckling av bebyggelse i urban miljö. Avsikten är att detta ska kunna stödja framtida utformande av klimatanpassningsåtgärder för att göra dem så ändamålsenliga som möjligt. Studien genomförs som en kvalitativ fallstudie av Arvika kommuns hantering av översvämningsrisk. Empirin består av utvalda dokument från kommunen samt intervjuer med representanter från räddningstjänst, länsstyrelse och myndigheten för samhällsskydd och beredskap. Materialet bearbetas med hjälp av innehållsanalys och kopplas till teorier kring resiliens och riskhomeostas. I resultatet framgår att kunskapen kring översvämningsrisk innan en stor översvämning i kommunen var bristfällig och att översvämningsrisk dittills prioriterats bort i kommunens riskinventering. Efter händelsen har kunskapen ökat, samverkan mellan aktörer har förbättrats och arbetssätten hos räddningstjänsten har förändrats. Intervjuerna visar att synen på översvämningsskyddets påverkan på resiliensen är övervägande positiv och att skyddet ses möjliggöra för exploatering i stadens hamnområde, men att detta är behäftat med en viss osäkerhet. / Climate change is a complex risk that entails new challenges for risk management. The risk of flooding increases as sea levels rise and rainfall and heavy rain become more frequent. The adaptation of communities to climate change is of the utmost importance, given that emission levels continue to increase and climate change at this stage is inevitable. In cities around the world, there is a trend where former industrial ports are being transformed into areas with waterfront buildings. To manage the risk of flooding different types of flood protection are built, for example levees, dikes and dams. Research shows that such types of protection tend to lead to reduced risk perception and a false sense of security which in turn results in increased exploitation of flood-threatened areas. This has a negative effect on the resilience of societies and can lead to devastating consequences should the protection break. The aim of the study is to contribute to knowledge about how climate adaptation measures for floods affect community resilience and to investigate the relationship between flood risk management and the development of buildings in urban environments. The intention is that the findings of this study can work as support in future design of climate adaptation measures to make them more efficient. The study is carried out as a qualitative case study of Arvika municipality's management of flood risk. Data are collected from key municipal documents and semi-structured interviews with representatives from the communal emergency service, the county administrative board and The Swedish Civil Contingencies Agency. The material is divided into categories with the help of qualitative content analysis and are later discussed using theories about resilience and risk homeostasis. The results show that the knowledge about flood risk before a major event in the municipality was deficient and that the risk of flooding up to that point had been neglected in the municipality's risk inventory. After the incident, the knowledge has increased, collaboration between actors has improved and the working methods of the emergency service have changed. The interviews show that the view of the flood protection's impact on resilience is predominantly positive and that the protection is seen as enabling exploitation in the city's port area, but that this is subject to a certain degree of uncertainty.