Uvod: Značajno mesto u morbiditetu nedonoščadi predstavljaju plućne bolesti. Ultrazvučnim (UZ) pregledom pluća može se smanjiti ukupna doza jonizujućeg zračenja kojoj su nedonoščad izložena u ...svakodnevnom kliničkom radu. Cilj: Ispitati povezanost između UZ nalaza na plućima i RTG nalaza i kliničkih parametara respiratornog statusa kod nedonoščadi. Utvrditi da li se UZ-om detektovane subpleuralne konsolidacije mogu morfološki diferencirati. Utvrditi da li UZ nalaz na plućima pomaže neonatologu u proceni efekta terapije tokom lečenja nedonoščadi. Materijal i metode: Prospektivnim tipom jednogodišnjeg istraživanja obuhvaćeno je 100 nedonoščadi kojoj je nakon prijema na Odeljenje intenzivne nege i terapije (OINT) bio indikovan RTG snimak pluća. Za izvođenje UZ pregleda pluća korišćeni su Siemens Sonoline Adara i Siemens Sonoline Sienna UZ aparati. Korišćena je siva skala i konveksna sonda (5 MHz) i linearna sonda (7,5 MHz). Za ispitivanje korelacije između UZ nalaza na plućima i kliničkih parametara respiratornog statusa (FiO2, PCO2, SaO2) korišćen je Pearson-ov koeficijent korelacije. Posebno je ispitivana korelacija kod nedonoščadi koja su bila na mehaničkoj ventilaciji (MV) i kod nedonoščadi koja su bila na oksigenoterapiji (OxTh). Utvrđivanje razlika između UZ-om uočenih konsolidacija i RTG-om uočenih konsolidacija, urađeno je prebrojavanjem ukupnog broja uočenih konsolidacija svakom od dve navedene radiološke metode i poređenjem prosečnog broja uočenih konsolidacija UZ-om, odnosno RTG-om. U svim statističkim testovima je korišćen je nivo značajnosti p<0,05 i interval poverenja (CI) 95%. Rezultati: Kod nedonoščadi koja su bila na MV, kao i kod nedonoščadi na OxTh, postoji statistički značajna korelacija između UZ nalaza na plućima i kliničkih parametara respitatornog statusa (p<0,001). Kod bolesnika na MV procenat podudaranja, odnosno nepodudaranja UZ nalaza i FiO2 iznosio je 81%, odnosno 19%. Procenat podudaranja, odnosno nepodudaranja UZ nalaza i PCO2 je bio 80%, odnosno 20%, dok je u slučaju SaO2 procenat podudaranja sa UZ nalazom bio 80%, a nepodudaranja 20%. Kod nedonoščadi na MV, procenat podudarnosti UZ nalaza na plućima i sva tri klinička parametra zabeležen je u 68%, sa dva klinička parametra u 21%, dok je u 11% zabeležena podudarnost samo sa jednim kliničkim parametrom. Kod nedonoščadi koja su bila na OxTh procenat podudaranja, odnosno nepodudaranja UZ nalaza i FiO2 iznosio je 94%, odnosno 6%. Procenat podudaranja, odnosno nepodudaranja UZ nalaza i PCO2 je bio 94%, odnosno 6%, dok je u slučaju SaO2 procenat podudaranja sa UZ nalazom bio 93%, a nepodudaranja 7%. Kod nedonoščadi na OxTh procenat podudarnosti UZ nalaza na plućima i sva tri klinička parametra zabeležen je u 85%, sa dva klinička parametra u 10%, dok je u 5% zabeležena podudarnost samo sa jednim kliničkim parametrom. Prosečan broj UZ-om uočenih konsolidacija po svakom pojedinačnom UZ pregledu pluća je bio 0,80, dok ih je na pojedinačnom RTG snimku uočeno 0,25. U 29% slučajeva konsolidacije su istovremeno uočene i UZ i RTG pregledom pluća, dok je u 71% slučajeva konsolidacije bilo moguće otkriti samo UZ pregledom pluća. Od ukupno 304 subpleuralnih konsolidacija koje su uočene UZ-om, u 172 slučaja (56,58%) je na osnovu prethodno klinički i/ili laboratorijski postavljene dijagnoze indirektno utvrđeno poreklo konsolidacije: u 125 slučajeva (72,67%) uzrok je bio atelektaza, u 39 slučajeva (22,67%) neonatalna pneumonija i u 8 slučajeva (4,66%) plućna hemoragija. Zaključci: Postoji statistički značajna korelacija između ultrazvučnog nalaza na plućima nedonoščadi i kliničkih parametara respiratornog statusa - FiO2, PaCO2 i SaO2, kako kod nedonoščadi na MV, tako i kod nedonoščadi na OxTh, zbog čega ultrazvučni nalaz na plućima može biti od pomoći neonatologu u praćenju efekta primenjene terapije. Na osnovu karakteristika ultrazvučno uočenih subpleuralnih konsolidacija nije moguće utvrditi njihovu etiologiju, već samo u korelaciji sa kliničkim i laboratorijskim nalazima. Ultrazvuk pluća je senzitivnija metoda za uočavanje subpleuralnih konsolidacija u odnosu na radiografiju pluća.
In today’s business environment which is constantly changing, organizations are faced with the imperative to build their competitive advantage through reshaping existing resources and capabilities ...and through creating new ones. Therefore, organizational design has been imposed as an important factor in the business success of the modern company. There are many examples that traditional organizational forms have experienced transformation: they have moved from organizational forms toward new organizational forms. It has also turned out that the basic support for this transition was the introduction of the information and communication technology (ICT) in companies’ operations. Consequently, ICT companies, as the most advanced companies, have become the leaders in introducing the new organizational forms in their functioning and facilitate introduction of new organizational forms in other organizations. In this sense, the aim of this paper is to present new organizational forms based on ICT and, on the example of the ICT industry in Serbia, to show how ICT supports their implementation. Special attention will be put on the advantages which new organization forms generate in terms of flexibility and integration of creative potentials, but some disadvantages will be analyzed as well.
The aim of this paper is to explore the impact of information technology (IT) on organization including all elements that are integral part of organizational design through Star Model (Kates and ...Galbraith, 2007), and to show that IT has become an important strategic resource that provides a concentration of all relevant information for quality decision-making and integration of complex organization with the concept of “Big Data” (Manyika et al, 2011). In order to achieve the aim, research was performed in organization in the health sector which affects the quality of life and standard of living. TheIT impact on organizational design and through him on organizational effectiveness in the health care is visible and provide insight into the implications of information technology and opportunities for reasoning about matters that are the subject of research: whether and how information technology causes changes in the design of the organization; whether it affects all elements of design equally; on which elements has the most intense impact and why; whether and why employees and users of health services exhibit resistance to information technology; under what conditions can be reduced or completely eliminated the resistance of employees and users of health services?
This paper aims to point to the widespread practice of neglecting behavioral aspects of different forms of fusions and integrations of enterprises that have emerged in the process of privatization ...through strategic partnerships with foreign companies among Serbian enterprises. The initial hypothesis in this paper is that the process of privatization, restructuring and transformation in Serbian enterprises cannot be completely successful and equally advantageous for all the subjects involved if there is no concern for human dimension of these processes. Without this concern there is a possibility for behavioral problems to arise, and the only way to resolve them is through post festum respecting and introducing elements that should never have been neglected in the first place. This paper refers to the phenomenon of collision of cultures and the ways of resolving it while forming strategic partnerships.
There is still no good solution for the treatment of all the forms of clubfoot.
The first written description of the treatment of this deformity was given by Hippocrates. In the Middle Ages, Galenus, ...Celsus and Averroe only reviewed the lessons of Hippocrates's principles. The first description of orthopedic prosthetic for the treatment of clubfoot was published in "Opera Chirurgica" by Amboise Peréa in 1575. In 1796, Bruckner wrote the first monography about clubfoot. The biggest contribution to the modern way of treating clubfoot was given by Abel Mix Phelebs, who described the medial "release" in 1890. Since 1980 an advantage has been given to early non-operative treatment. The progressive operative approach (use of "release procedures") was introduced.
The first procedures were performed by D. Jovcić and S. Stojanović in Belgrade in 1937. In the period from 1960 to 1970, more and more orthopedic and pediatric surgeons became interested in clubfoot treatment. In 1970 one of the main topics of the 5th Congress of Orthopedics and Traumatology in Belgrade was "Foot Surgery". Many specialists from Belgrade were engaged in clubfoot treatment: D. Rakić, S. Rajić, S. Popović, L. Stojanović among pediatricians, and B. Radulović, P. Klisić among orthopedic surgeons, as well as R. Brdar, Z. Vukasinović and G. Cobeljić with their assistants. In Novi Sad, in 1967, D. Pajić began diagnosis and treatment of clubfoot. Very soon D. Pajić became a symbol of clubfoot treatment followed by hardworking assistants L. Petković and V. Tomasević.
The treatment of clubfoot is still controversial and continues to be one of the most interesting fields in pediatric orthopedics.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
The aim of this paper is to investigate the role of managers with leadership
potentials in knowledge management within organization. This aim is further developed
through the research questions: (1) ...Does leadership have important role in knowledge
management? (2) Under which conditions leadership influences knowledge management and
what is the direction of this influence? (3) Which elements of the leadership, skills and
virtues of the leader, are important and what roles do they have in knowledge management?
The paper is based on the field investigation, employing interviews and survey as the
research techniques, on the random sample of Serbian companies.
The aim of this paper is to explore the impact of information technology (IT) on organization including all elements that are integral part of organizational design through Star Model (Kates and ...Galbraith, 2007), and to show that IT has become an important strategic resource that provides a concentration of all relevant information for quality decision-making and integration of complex organization with the concept of "Big Data" (Manyika et al, 2011). In order to achieve the aim, research was performed in organization in the health sector which affects the quality of life and standard of living. TheIT impact on organizational design and through him on organizational effectiveness in the health care is visible and provide insight into the implications of information technology and opportunities for reasoning about matters that are the subject of research: whether and how information technology causes changes in the design of the organization; whether it affects all elements of design equally; on which elements has the most intense impact and why; whether and why employees and users of health services exhibit resistance to information technology; under what conditions can be reduced or completely eliminated the resistance of employees and users of health services? PUBLICATION ABSTRACT
Uvod: Značajno mesto u morbiditetu nedonoščadi predstavljaju plućne bolesti. Ultrazvučnim (UZ) pregledom pluća može se smanjiti ukupna doza jonizujućeg zračenja kojoj su nedonoščad izložena u ...svakodnevnom kliničkom radu. Cilj: Ispitati povezanost između UZ nalaza na plućima i RTG nalaza i kliničkih parametara respiratornog statusa kod nedonoščadi. Utvrditi da li se UZ-om detektovane subpleuralne konsolidacije mogu morfološki diferencirati. Utvrditi da li UZ nalaz na plućima pomaže neonatologu u proceni efekta terapije tokom lečenja nedonoščadi. Materijal i metode: Prospektivnim tipom jednogodišnjeg istraživanja obuhvaćeno je 100 nedonoščadi kojoj je nakon prijema na Odeljenje intenzivne nege i terapije (OINT) bio indikovan RTG snimak pluća. Za izvođenje UZ pregleda pluća korišćeni su Siemens Sonoline Adara i Siemens Sonoline Sienna UZ aparati. Korišćena je siva skala i konveksna sonda (5 MHz) i linearna sonda (7,5 MHz). Za ispitivanje korelacije između UZ nalaza na plućima i kliničkih parametara respiratornog statusa (FiO2, PCO2, SaO2) korišćen je Pearson-ov koeficijent korelacije. Posebno je ispitivana korelacija kod nedonoščadi koja su bila na mehaničkoj ventilaciji (MV) i kod nedonoščadi koja su bila na oksigenoterapiji (OxTh). Utvrđivanje razlika između UZ-om uočenih konsolidacija i RTG-om uočenih konsolidacija, urađeno je prebrojavanjem ukupnog broja uočenih konsolidacija svakom od dve navedene radiološke metode i poređenjem prosečnog broja uočenih konsolidacija UZ-om, odnosno RTG-om. U svim statističkim testovima je korišćen je nivo značajnosti p<0,05 i interval poverenja (CI) 95%. Rezultati: Kod nedonoščadi koja su bila na MV, kao i kod nedonoščadi na OxTh, postoji statistički značajna korelacija između UZ nalaza na plućima i kliničkih parametara respitatornog statusa (p<0,001). Kod bolesnika na MV procenat podudaranja, odnosno nepodudaranja UZ nalaza i FiO2 iznosio je 81%, odnosno 19%. Procenat podudaranja, odnosno nepodudaranja UZ nalaza i PCO2 je bio 80%, odnosno 20%, dok je u slučaju SaO2 procenat podudaranja sa UZ nalazom bio 80%, a nepodudaranja 20%. Kod nedonoščadi na MV, procenat podudarnosti UZ nalaza na plućima i sva tri klinička parametra zabeležen je u 68%, sa dva klinička parametra u 21%, dok je u 11% zabeležena podudarnost samo sa jednim kliničkim parametrom. Kod nedonoščadi koja su bila na OxTh procenat podudaranja, odnosno nepodudaranja UZ nalaza i FiO2 iznosio je 94%, odnosno 6%. Procenat podudaranja, odnosno nepodudaranja UZ nalaza i PCO2 je bio 94%, odnosno 6%, dok je u slučaju SaO2 procenat podudaranja sa UZ nalazom bio 93%, a nepodudaranja 7%. Kod nedonoščadi na OxTh procenat podudarnosti UZ nalaza na plućima i sva tri klinička parametra zabeležen je u 85%, sa dva klinička parametra u 10%, dok je u 5% zabeležena podudarnost samo sa jednim kliničkim parametrom. Prosečan broj UZ-om uočenih konsolidacija po svakom pojedinačnom UZ pregledu pluća je bio 0,80, dok ih je na pojedinačnom RTG snimku uočeno 0,25. U 29% slučajeva konsolidacije su istovremeno uočene i UZ i RTG pregledom pluća, dok je u 71% slučajeva konsolidacije bilo moguće otkriti samo UZ pregledom pluća. Od ukupno 304 subpleuralnih konsolidacija koje su uočene UZ-om, u 172 slučaja (56,58%) je na osnovu prethodno klinički i/ili laboratorijski postavljene dijagnoze indirektno utvrđeno poreklo konsolidacije: u 125 slučajeva (72,67%) uzrok je bio atelektaza, u 39 slučajeva (22,67%) neonatalna pneumonija i u 8 slučajeva (4,66%) plućna hemoragija. Zaključci: Postoji statistički značajna korelacija između ultrazvučnog nalaza na plućima nedonoščadi i kliničkih parametara respiratornog statusa - FiO2, PaCO2 i SaO2, kako kod nedonoščadi na MV, tako i kod nedonoščadi na OxTh, zbog čega ultrazvučni nalaz na plućima može biti od pomoći neonatologu u praćenju efekta primenjene terapije. Na osnovu karakteristika ultrazvučno uočenih subpleuralnih konsolidacija nije moguće utvrditi njihovu etiologiju, već samo u korelaciji sa kliničkim i laboratorijskim nalazima. Ultrazvuk pluća je senzitivnija metoda za uočavanje subpleuralnih konsolidacija u odnosu na radiografiju pluća.
Introduction: Lung diseases play a major role in morbidity of premature neonates. Using lung ultrasound (LUS) as a diagnostic tool lowers the dose of ionizing radiation of prematures in every day clinical work. Objectives: To assay the interconnection between LUS and chest X ray (CXR) and clinical parameters of respiratory status (FiO2, PCO2 i SaO2) in prematures. To investigate the possibility of sonographic determination of etiology of subpleural consolidations based on their appearance. To determine whether LUS can be of clinical benefit to the neonatologist in assessing the effect of therapy used in treating prematures. Material and methods: Prospective one year study included 100 premature neonates who underwent a CXR exam after the admission in the Intensive care unit (ICU). Siemens Sonoline Adara i Siemens Sonoline Sienna US machines were used, as well as the gray scale, convex probe (5 MHz) and linear probe (7,5 MHz). Pearson correlation coefficient was used to test the interconnection between LUS and clinical parameters of respiratory status (FiO2, PCO2, SaO2). The test was performed separately for both prematures on mechanical ventilation (MV) and prematures on oxygen therapy (OxTh). Determination of differencies between consolidations seen on LUS and those seen on CXR was done by counting the number of consolidation detected with each method and by comparing the average number of consolidations detected with LUS and by CXR. The assessment of statistical significance was done using the p value, and the p value<0,05 and the confidence interval (CI) of 95% was considered as statistically significant. Results: Statistically significant correlation (p<0,001) was established between clinical parameters of respiratory status and LUS both in prematures on MV and on OxTh. The percentage of concurrence, or nonconcurrence of LUS and FiO2 was 81% and 19% (respectively). The percentage of concurrence, or nonconcurrence of LUS and PCO2 was 80% and 20% (respectively), while in case of SaO2 the percentage of concurrence with LUS was also 80% and the percentage of nonconcurrence was 20%. In the group of prematures on MV the percentage of concurrence of LUS with all three clinical parameters was in 68%, with two parameters the concurrence was evident in 21% and with a single clinical parameter in 11%. In prematures on OxTh, the percentage of concurrence, or nonconcurrence of LUS and FiO2 was 94% and 6% (respectively). The percentage of concurrence, or nonconcurrence of LUS and PCO2 was also 96% and 4% (respectively), while in case of SaO2 the percentage of concurrence with LUS was also 93% and the percentage of nonconcurrence was 7%. In the group of prematures on OxTh the percentage of concurrence of LUS with all three clinical parameters was in 85%, with two parameters the concurrence was evident in 10% and with a single clinical parameter in 5%. The mean number of subpleural consolidations detected by LUS per exam was 0.80. The mean number of consolidations detected on each CXR was 0.25. In 29% consolidations were detected both with LUS and CXR, but in 71% consolidations were only detected using LUS. 304 subpleural consolidations were seen on LUS, but only in 172 cases (56.58%) it was possible to determine the etiology of consolidations and this was done indirectly, in concordance with previously clinically and/or laboratory diagnosis: in 125 cases (72.67%) the origin was atelectasis, in 39 cases (22.67%) neonatal pneumonia and in 8% (4.66%) pulmonary haemorrhage. Conclusion: Statistically significant interconnection between LUS and clinical parameters of respiratory status - FiO2, PaCO2 i SaO2 exists both in MV prematures and prematures with oxygen supplementation. Previously mentioned suggests that LUS can be of use to neonatologist in following the effect of administred therapy in prematures. The origin of subpleural consolidations cannot be determined on the basis of their appereance or features seen on LUS. The etiology of sonographic subpleural consolidations can only be indirectly determined in correlation with clinical and laboratory findings. LUS is more sensitive than CXR in detecting subpleural consolidations.
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