Legal obligations of property manager

Import 02/11/2016Cílem této bakalářské práce bylo vytvořit přehled zákonných povinností správce majetku v rámci životního cyklu stavby. Teoretická část bakalářské práce se zabývá zpracováním teorie týkající se obecně správy majetku. Rozdělení činností spojených s výkonem správy mejetku ve vztahu k různým druhům staveb. V další části jsou zmíněny základní požadavky na stavby s příslušnou legislativou a jednotlivé zákonné povinnosti které z těchto požadavků taktéž vycházejí. Praktická část bakalářské práce je vytvoření přehledové tabulky o jednotlivých zákonných povinností, které musí být v rámci správy objektu plněny.The aim of this thesis was to create an overview of legal obligations of property manager within the life cycle of the building. The theoretical part deals with processing theory on general asset management. Distribution of activities associated with facility management in relation to different types of buildings. In the next part are mentioned basic requirements for construction with the relevant legislation and the different legal obligations that are based on these requirements. The practical part is the development of a scoreboard of various statutory obligations which must be met within the administration object of individual responsibility.222 - Katedra městského inženýrstvívelmi dobř

Statutory Duty to Administer Municipalities and Cities

Cílem této diplomové práce je vytvořit přehled zákonných povinností při správě obecního a městského majetku. Práce rozlišuje oblasti správy obecního majetku a vzhledem k němu pak určuje povinnosti, které musí být plněny. Určuje povinnosti, které obce musí plnit a v jakých intervalech. Praktická část pak zobrazuje možnost použití softwaru Pit Fm, který nově obsahuje modul podpory legislativy a je schopný svého uživatele upozornit na jednotlivé povinnosti ve vztahu k určitým legislativním předpisům.The purpose of this thesis is to provide an overview of legal obligations of cities imposed on state-owned property management. This thesis defines the areas of state-owned property management and determines the responsibilities applied to them. In other words, what responsibilities cities are obliged to follow in specific time frames. The practical part of the thesis reviews the use of PitFM software with a recently added feature that enables users to be notified with a reminder as to which specific responsibilities arising from certain legal obligations must be fulfilled.222 - Katedra městského inženýrstvídobř

Alteration in lipoprotein-associated phospholipase A2 levels during acute coronary syndrome and its relationship to standard biomarkers

Abstract Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) probably plays an important role in the development of acute coronary syndrome (ACS); elevated levels of Lp-PLA2 are associated with a poorer prognosis in patients with ischemic heart disease. Alterations of Lp-PLA2 levels during ACS and its relationship to standard biomarkers are, however, unclear. Findings Fifty-one consecutive ACS patients were enrolled in the study. All were managed with early invasive strategy and according to the current guidelines for pharmacotherapy; intensive statin therapy was started in all patients at admission. Serum levels of Lp-PLA2, LDL-cholesterol (LDL), troponin l (Tnl), and C-reactive protein (CRP) were assessed at admission (D0), on the first morning (D1), and on the second morning of hospitalization (D2). Mean serum levels of Lp-PLA2 (ng/mL) decreased from 264.6±19.1 at D0, to 193.2±14.4 at D1 (P P = 0.002 vs. D0; P = not significant vs. D1). Alterations in Lp-PLA2 levels significantly correlated with changes in LDL (r = 0.43; P = 0.008). On the other hand, no relationship between Lp-PLA2 and Tnl or CRP was found. Conclusions Initially, serum levels of Lp-PLA2 were significantly elevated in ACS patients, but decreased within the first 24 hours after admission and subsequently remained stable. Lp-PLA2 levels correlated with LDL levels but not with Tnl or CRP levels. Our results demonstrated dynamic alterations in Lp-PLA2 levels during the early stages of ACS and, therefore, indirectly support the hypothesis of an active role for Lp-PLA2 in the pathogenesis of ACS.</p

Association of neuron-specific enolase values with outcomes in cardiac arrest survivors is dependent on the time of sample collection

Abstract Background Despite marked advances in intensive cardiology care, current options for outcome prediction in cardiac arrest survivors remain significantly limited. The aim of our study was, therefore, to compare the day-specific association of neuron-specific enolase (NSE) with outcomes in out-of-hospital cardiac arrest (OHCA) survivors treated with hypothermia. Methods Eligible patients were OHCA survivors treated with targeted temperature management at 33 °C for 24 h using an endovascular device. Blood samples for NSE levels measurement were drawn on days 1, 2, 3, and 4 after hospital admission. Thirty-day neurological outcomes according to the Cerebral Performance Category (CPC) scale and 12-month mortality were evaluated as clinical end points. Results A total of 153 cardiac arrest survivors (mean age 64.2 years) were enrolled in the present study. Using ROC analysis, optimal cutoff values of NSE for prediction of CPC 3–5 score on specific days were determined as: day 1 > 20.4 mcg/L (sensitivity 63.3%; specificity 82.1%; P = 0.002); day 2 > 29.0 mcg/L (72.5%; 94.4%; P  20.7 mcg/L (94.4%; 86.7%; P  19.4 mcg/L (93.5%; 91.0%; P 50.2 mcg/L at day 4 was associated with poor outcome with 100% specificity and 42% sensitivity. Moreover, NSE levels measured on all individual days also predicted 12-month mortality (P  18.1 mcg/L (85.3%; 72.0%; P  20.0 mcg/L, together with a change > 0.0 mcg/L from day 3 to day 4, predicted poor outcome (CPC 3–5) with 100% specificity and 73% sensitivity. Conclusions Our results suggest that NSE levels are a useful tool for predicting 30-day neurological outcome and long-term mortality in OHCA survivors treated with targeted temperature management at 33 °C. The highest associations of NSE with outcomes were observed on day 4 and day 3 after cardiac arrest

A Total of 207 Days of Veno-Venous Extracorporeal Membrane Oxygenation Support for Severe COVID-19 Prior to Successful Lung Transplantation: A Case Report

Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a life-saving treatment for respiratory failure that may serve as a bridge to patient recovery or lung transplantation. In COVID-19, recovery is somewhat unpredictable and occasionally occurs after &gt;100 days on VV-ECMO support. Thus, determining therapy cessation may be difficult. We report the case of a 59-year-old male without specific risk factors admitted to a tertiary center for rapidly progressive respiratory failure due to severe COVID-19, despite aggressive mechanical ventilatory support. Immediate insertion of VV-ECMO was associated with prompt resolution of hypoxemia and hypercapnia; however, all therapeutic efforts to wean the patient from VV-ECMO failed. During the prolonged hospitalization on VV-ECMO, sepsis was the most life-threatening complication. The patient overcame roughly 40 superinfections, predominantly affecting the respiratory tract, and spent 183 days on antimicrobial treatment. Although the function of other organ systems was generally stable, gradually progressive right ventricular dysfunction due to precapillary pulmonary hypertension required increasing doses of inotropes. A successful lung transplantation was performed after 207 days of VV-ECMO support. The present case provides evidence for prolonged VV-ECMO therapy as a bridge to lung transplantation in severe COVID-19 despite numerous, predominantly infectious complications

Acute Severe Heart Failure Reduces Heart Rate Variability: An Experimental Study in a Porcine Model

There are substantial differences in autonomic nervous system activation among heart (cardiac) failure (CF) patients. The effect of acute CF on autonomic function has not been well explored. The aim of our study was to assess the effect of experimental acute CF on heart rate variability (HRV). Twenty-four female pigs with a mean body weight of 45 kg were used. Acute severe CF was induced by global myocardial hypoxia. In each subject, two 5-min electrocardiogram segments were analyzed and compared: before the induction of myocardial hypoxia and >60 min after the development of severe CF. HRV was assessed by time-domain, frequency-domain and nonlinear analytic methods. The induction of acute CF led to a significant decrease in cardiac output, left ventricular ejection fraction and an increase in heart rate. The development of acute CF was associated with a significant reduction in the standard deviation of intervals between normal beats (50.8 [20.5–88.1] ms versus 5.9 [2.4–11.7] ms, p < 0.001). Uniform HRV reduction was also observed in other time-domain and major nonlinear analytic methods. Similarly, frequency-domain HRV parameters were significantly changed. Acute severe CF induced by global myocardial hypoxia is associated with a significant reduction in HRV

Electrocardiogram-synchronized pulsatile extracorporeal life support preserves left ventricular function and coronary flow in a porcine model of cardiogenic shock

<div><p>Introduction</p><p>Veno-arterial extracorporeal life support (ECLS) is increasingly being used to treat rapidly progressing or severe cardiogenic shock. However, it has been repeatedly shown that increased afterload associated with ECLS significantly diminishes left ventricular (LV) performance. The objective of the present study was to compare LV function and coronary flow during standard continuous-flow ECLS support and electrocardiogram (ECG)-synchronized pulsatile ECLS flow in a porcine model of cardiogenic shock.</p><p>Methods</p><p>Sixteen female swine (mean body weight 45 kg) underwent ECLS implantation under general anesthesia and artificial ventilation. Subsequently, acute cardiogenic shock, with documented signs of tissue hypoperfusion, was induced by initiating global myocardial hypoxia. Hemodynamic cardiac performance variables and coronary flow were then measured at different rates of continuous or pulsatile ECLS flow (ranging from 1 L/min to 4 L/min) using arterial and venous catheters, a pulmonary artery catheter, an LV pressure-volume loop catheter, and a Doppler coronary guide-wire.</p><p>Results</p><p>Myocardial hypoxia resulted in declines in mean cardiac output to 1.7±0.7 L/min, systolic blood pressure to 64±22 mmHg, and LV ejection fraction (LVEF) to 22±7%. Synchronized pulsatile flow was associated with a significant reduction in LV end-systolic volume by 6.2 mL (6.7%), an increase in LV stroke volume by 5.0 mL (17.4%), higher LVEF by 4.5% (18.8% relative), cardiac output by 0.37 L/min (17.1%), and mean arterial pressure by 3.0 mmHg (5.5%) when compared with continuous ECLS flow at all ECLS flow rates (P<0.05). At selected ECLS flow rates, pulsatile flow also reduced LV end-diastolic pressure, end-diastolic volume, and systolic pressure. ECG-synchronized pulsatile flow was also associated with significantly increased (7% to 22%) coronary flow at all ECLS flow rates.</p><p>Conclusion</p><p>ECG-synchronized pulsatile ECLS flow preserved LV function and coronary flow compared with standard continuous-flow ECLS in a porcine model of cardiogenic shock.</p></div

Comparison of the effect of different levels of continuous (C) and synchronized pulsatile (P) extracorporeal blood flow (EBF) on left ventricular performance parameters in a porcine model of cardiogenic shock.

<p>(A) LVESV, left ventricle end-systolic volume; (B) LVSV, left ventricle stroke volume; (C) LVEF, left ventricle ejection fraction; (D) CO, cardiac output. *P<0.05.</p

Pressure-volume loop analysis.

<p>LV, left ventricle; SBP, systolic blood pressure; LVESV, left ventricular end-systolic volume; LVEDV, left ventricular end-diastolic volume; LVEDP, left ventricular end-diastolic pressure.</p

Comparison of the effect of different levels of continuous (C) and electrocardiogram-synchronized pulsatile (P) extracorporeal blood flow (EBF) on coronary blood flow measured using an intracoronary Doppler wire in a porcine model of cardiogenic shock.

<p>*P<0.05.</p