Menedžment znanja v ospredje postavlja človeške vire in načrtno zvišuje njihovo vrednost. V očeh sodobnih menedžer- jev znanje pomeni najvišjo vrednoto. Učinkovito vodenje in upravljanje procesov ...znanja je njihova osrednja dejavnost; hkrati je tudi najvidnejša značilnost znanjskih organizacij. Znanje, podobno kot inovativnost in ustvarjalnost, je treba spodbujati in z njim ravnati na primerne načine. Zavezanost k pridobivanju novega znanja je odvisna od upravljanja medsebojnih odnosov, zato so skrbniki znanjskih procesov, t. i. sodobni menedžerji znanja, usmerjeni k vzpostavljanju partnerskih odnosov z vsemi člani organizacije. V središču partnerskega odnosa so posameznikove kompetence in ustvarjalna izraba znanja. Vodenje v znanjskih organizacijah s spodbujanjem k učenju, razpravi in medsebojni izme- njavi mnenj, ne nazadnje pa k osebnostnemu in profesionalnemu razvoju zaposlenih, izboljšuje kakovost dela. Slednje rezultira v razvijanju novih znanj in dvigu konkurenčnosti.
Summary
Objective
A high prevalence of insulin resistance (IR) has proven to manifest in patients with adrenal incidentalomas (AI). It has been demonstrated that an increase in IR is related to the ...size of tumourous masses; additionally, luteinizing hormone (LH)‐dependent adrenal pathologies are well documented in patients with LH‐responsive adrenal tumours occurring under conditions of physiologically elevated LH. We hypothesized that an association between LH and insulin might play a role in adrenal tumourigenesis and steroidogenesis.
Design
The aim of our study was to investigate the association between LH and IR; adrenal tumour size (ATS) and IR; LH and cortisol after the 1 mg overnight dexamethasone test (1 mg DST); and ATS and 1 mg DST cortisol in AI patients. This was a case‐control study conducted in the Clinic for Endocrinology, Diabetes and Metabolic Diseases in Belgrade, Serbia. The total study group consisted of 105 menopausal women: 75 AI patients 27 with nonfunctional AI (NAI) and 48 with (possible) autonomous cortisol secretion ((P)ACS) and 30 age‐, BMI‐, LH‐ and menopause duration‐matched healthy control (HC) women. To estimate IR, we used homeostasis model assessment (HOMA‐IR).
Results
Luteinizing hormone and ATS are in a significant positive correlation with HOMA‐IR and 1 mg DST cortisol in menopausal patients with AI and (P)ACS.
Conclusions
Our data point to a possible cause‐effect relationship between LH and insulin in patients with AI and (P)ACS adding to the body of evidence of their involvement in adrenal tumourigenesis and steroidogenesis.
The paper discusses the structural behaviour of concrete-filled steel tube columns (CFT) when applied to the top-down construction method as temporary internal supports for ceilings. Their ultimate ...capacity to take into account the actual boundary conditions of the column is essential for successful application in construction. The paper presents the full-scale in situ testing of four slender specimens with variable D/t ratios under concentric axial loading. The CFT columns were supported on the previously jacked concrete piles. In addition, detailed finite element numerical models in ABAQUS and PLAXIS computer programs were developed. The models include the nonlinear behaviour of materials and the nonlinear behaviour of soil. The soil–pile–column interaction and impact of the CFT column–pile connection stiffness on global column stability were considered. The numerical model was validated by comparison with the experimental results. In conclusion, the coefficient for the effective buckling length of the studied columns is proposed. Finally, the experimental results of the critical buckling forces were compared with widely used international design codes Eurocode 4-EC4, American standard-ACI and the Australian standard-AS.
Here we report how interference and scattering-enhanced absorption act together to produce the golden wing patches of the burnished brass moth. The key mechanism is scattering on rough internal ...surfaces of the wing scales, accompanied by a large increase of absorption in the UV-blue spectral range. Unscattered light interferes and efficiently reflects from the multilayer composed of the scales and the wing membranes. The resulting spectrum is remarkably similar to the spectrum of metallic gold. Subwavelength morphology and spectral and absorptive properties of the wings are described. Theories of subwavelength surface scattering and local intensity enhancement are used to quantitatively explain the observed reflectance spectrum.
Two gonadotrophins, two cell theory refers to necessity of both gonadotrophin activities for theca and granulose cells steroidogenesis of dominant follicle. The aim of this study was to determine the ...influence of recombinant LH in women qualified as poor responders in the first assisted reproduction procedure (IVF), on fertility results, expressed as percentage of clinical pregnancies.
The study included 12 women, 35 years and older who were their own controls. The next trial of IVF was with the same dose of recombinant FSH and GnRH agonist, and with the same, long protocol. Recombinant LH was added in the dose of 75 IU from the 2nd to 7th day of the cycle, and 150 IU from the 8th day of the cycle to the aspiration of oocytes.
Within the two different protocols: there was no significant difference between LH concentration in 8th and 12th day of cycle; there was no significant difference between E2 concentration on day 2nd and day 8th; there was a significant difference between E2 concentrations on day 12th; endometrial thickness was not significantly different on the day of aspiration, neither was the number of follicles and embryos. In the two patients, clinical pregnancy was detected (pregnancy rate 17%), and they delivered in term. So, a statistically significant difference between the two protocols was in the rate of clinical pregnancies.
The patients with low response to a long protocol in IVF procedures had significantly better results according to the clinical pregnancy rate when the recombinant LH was added to recombinant FSH in the stimulation protocol.
The role of pharmacies in the social and health systems has gone through significant changes in the last decades of the twentieth century. From the place for the production of medicines, through ...procurement and distribution, pharmacy eventually became the modern health care facilities that participates in the health system and the retail pharmaceutical market. The dualistic role of pharmacy requires adjustment to the demands of contemporary health policy and market principles. Implementation of modern tools of business, such as marketing, was not present to a greater extent until recently in pharmacies, so this study is focused on the example of Pharmacy Subotica, which emphasizes the practical importance and specifics of marketing in pharmaceutical practice. Activities in the implementation of the marketing mix in the period 2009-2012 will be shown in this paper, as well as indicators of business success of Pharmacies Subotica in the same period. Following a four-year period in which strategy related to elements of the marketing mix strategy (4P), was implemented the growth of financial performance indicators (number of issued fiscal receipt and financially volume of business). At the same time, due to the more rigid regulations, the number of prescriptions in 2012 declined in amount. Pharmacy Subotica is one of the first pharmacies in Serbia, which has structured and implemented marketing planning tools for the purpose of positioning in the retail pharmaceutical market. By modeling business policy in line with modern market principles, developments of information technology and the ethics of health care workers, this institution has made pioneering steps in pharmaceutical marketing in the Serbian pharmacy.
Thyroid disorders exert a great impact on pregnancy course and outcome. The aim of the study was to investigate impact of autoimmune thyroid disorders on pregnancy course and outcome, frequency of ...pregnancy complications and pregnancy loss.
We followed 63 pregnancies prospectively during the period 1985-2007, 28 with hyperthyroid and 15 with hypothyroid autoimmune disorders, and 20 healthy pregnancies. Follow up included clinical, sonographic and laboratory investigations, including OGTT and postprandial glicemia.
There was no difference between previous preterm and term labor in the observed groups (chi2 = 2.309; p > 0.05). Analysis of previous early pregnancy loss showed no significance (chi2 = 4.918; p > 0.05), including varieties of spontaneous and missed abortion (Fisher, p < 0.05). The hypothyroid patients developed gestational diabetes more frequently than the controls (chi2 = 7.638; p = 0.022), which is not the case with hyperthyroid patients (chi2 = 1.078; p > 0.05), or between the groups with thyroid disorders (chi2 = 3.619; p > 0.05). There was no difference among the groups in developing pregnancy-induced hypertension (chi2 = 1.953; p > 0.05).
Controlling thyroid diseases reduces pregnancy complications. Development of gestational diabetes in hypothyroid patients requires controlling glycoregulation in all pregnant women with hypothyroidism.
Objective: Trazodone is an effective antidepressant. The present study was designed as a non-interventional open-label, multi-centre, post-marketing study. The aim of the study was to evaluate the ...therapeutic effectiveness and tolerability of trazodone retard formulation (Trittico
®
retard) in everyday clinical practice.
Methods: Two hundred and forty-two patients with depressive disorder from 19 different centres were included in the study. The antidepressant and anxyolitic effects were assessed using Hamilton anxiety rating scale 14 items version, Hamilton depression rating scale 14 items version and Clinical Global Impression Severity scale.
Results: After only two weeks of therapy, a statistically significant improvement in the HAM-D score, was observed. This observation was maintained over the whole study period, up to the day 56.
Conclusions: Our study points toward clinical effectiveness of the prolonged-release formulation of trazodone in the treatment of unselected depressed patients in real-world practice.
Context:
Fetuses from mothers with autoimmune thyroid disease (AITD) may be affected by antithyroid antibodies, antithyroid drugs, and iodine.
Objective:
The study correlated fetal free T4 (fT4) with ...fetal ultrasound parameters and maternal thyroid function, thyroid antibodies, and medication dose from mothers with AITD.
Design and Setting:
The study was designed as a prospective cohort study and conducted in an academic referral center.
Patients:
Eighty-three of 85 women with AITD completed the study; 38 were treated for hyperthyroidism and 25 for hypothyroidism, and 20 were euthyroid.
Main Outcome Measures:
Outcomes were as follows: 1) fetal—fT4, TSH, ultrasound parameters (morphology, biometrics, heart rate); and 2) maternal—fT4, TSH, antithyroid drug dose, and antithyroid antibodies, thyroid peroxidase and TSH receptor (TRAK). Parameters were determined at the same time, between the 22nd and 33rd wk gestation.
Results:
A total of 48.3% of fetuses from hyperthyroid mothers, 60% of fetuses from hypothyroid mothers, and 10% of fetuses from euthyroid mothers had elevated fT4 levels (P = 0.006). In hypothyroid mothers, the presence of both thyroid antibodies was related to fetal hyperthyroidism, whereas absence was related to fetal euthyroidism (P = 0.019). Hyperthyroid mothers (TRAK-positive, thyroid peroxidase-negative) with hyperthyroid fetuses had significantly higher mean TRAK than hyperthyroid mothers with euthyroid fetuses (13.7 vs. 3.7 IU/liter; P = 0.02). Fetal fT4 correlated weakly negatively with maternal TSH within the normal range, but not with ultrasound parameters or with antithyroid drug dose.
Conclusion:
High fetal fT4 levels were unexpectedly frequent in women with AITD, including maternal autoimmune hypo- and hyperthyroidism. Further studies are needed, as well as noninvasive methods to assess fetal thyroid function.
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