Management and strategic efficiency of construction companies

Management and strategic efficiency of construction companies Over the past two decades, Croatian construction companies have been undergoing intensive dynamic changes caused by political and economic influences on the construction market: privatisation of state-owned companies, opening of Croatian market, vigorous post-war reconstruction activities, intensive construction of motorways, etc. Such turbulent changes have influenced construction companies in a variety of ways. A number of Croatian companies that used to be dominant have disappeared from the market. Some companies have transformed their management and construction processes. The Balanced Scorecard model for shaping and implementing business strategies of construction companies is presented in the paper. Menadžment i učinkovitost strategije graditeljske tvrtke Hrvatske graditeljske tvrtke zadnjih 20-ak godina prolaze kroz intenzivne dinamične promjene uvjetovane političkim i ekonomskim utjecajima na graditeljskome tržištu kao što su proces privatizacije državnih tvrtki, otvaranje hrvatskog tržišta, intenzivna obnova u ratu porušenih objekata ili intenzivna izgradnja autocesta. Takve turbulentne promjene utjecale su na graditeljske tvrtke na različite načine. Neke, prije Domovinskog velike hrvatske tvrtke nestale su s tržišta, a neke su transformirale menadžment i provedbu procesa građenja. U radu je prikazan Balanced Scorecard, model pristupa oblikovanju i provedbi poslovne strategije graditeljske tvrtke

Application and development of information technology in the civil engineering sector in Croatia

Prikazuju se rezultati rada na dva znanstvena projekta o primjeni i razvoju informatičke tehnologije u hrvatskom graditeljstvu. Opisuju se istraživanja koja se nastavljaju na ona opisana u prethodno objavljenim radovima. Ovdje su prikazani rezultati ankete provedene u 2002., na koju se od 105 pozvanih tvrtki odazvalo 58. Istaknuto je da se u odnosu na prethodno razdoblje primjećuje napredak, ali da još nije stanje zadovoljavajuće te se daju prijedlozi za poboljšanje stanja.Results obtained on two research projects focusing on the use and development of information technology in construction industry in Croatia are presented. The research following that presented in previous papers is described. Results obtained during survey conducted in 2002, when 58 out of 105 companies responded to the survey, are presented. It is emphasized that, compared to the previous period, the situation has improved although it can still not be considered satisfactory. Proposals are given for making improvements in this field

Information technology in Croatia\u27s construction industry

Prikazani su zbirni rezultati istraživanja za znanstveni projekt “Razvoj primjene informatičke tehnologije u hrvatskom graditeljstvu”. Rezultati se temelje na obrađenim podacima iz dobivenih odgovora na pitanja postavljena u anketnom ispitivanju glavnih menadžera iz 49 graditeljskih tvrtki. Autori ističu bitne razloge zaostajanja hrvatskog graditeljstva u primjeni suvremene informatičke tehnologije u odnosu na razvijeni svijet i predlažu smjernice za njezin učinkovitiji razvoj.Summarized results as obtained in the scope of the research project called "Developments in the use of information technology in Croatia\u27s construction industry", are presented. The results are based on the analysis of answers obtained during survey involving general managers from 49 construction companies. Authors present main reasons why Croatia\u27s construction industry is lagging behind developed countries in the use of modern information technology, and provide guidelines aimed at fostering more efficient advances in this field

Correlation between intra-abdominal hypertension and arterial lactate concentration in severe sepsis patients

Intra-abdominal hypertension (IAH) in severe sepsis patients with consequent multiple organ failure is associated with increased arterial lactate levels. In this nonrandomized, prospective control trial, the correlation between intra-abdominal hypertension and arterial lactate concentration in severe sepsis patients was analysed. Thirty-eight patients undergoing major abdominal surgery with confirmed severe sepsis constituted the severe sepsis patients group. Control group included thirty-eight patients undergoing elective abdominal surgery with at least two risk factors for IAH. Intra-abdominal pressure (IAP) was assessed in both groups every six hours during the first 72 hours, through a Foley catheter placed in the urinary bladder. IAH was diagnosed with two consecutive measurements of IAP >12mmHg. At the same time lactate levels in arterial blood, SvO2 and CVP were assessed. Data were compared using Student’s t test. P <0.05 was considered statistically significant. In the sepsis group, 25 patients (65.8%) had IAP >12mmHg, 10 patients (26.3%) had IAP >16mmHg and three patients (7.9%) had IAP >20mmHg. In the control group, all patients had IAP up to 7mmHg. Arterial blood lactate levels were significantly increased in severe sepsis patients with IAP >16mmHg (4,2mmol/L versus 1,2mmol/L, P<0.05) compared to the control group. Mortality in severe sepsis patients with IAH was 24.5% (10 patients). Arterial blood lactate levels were significantly higher in severe sepsis patients IAH >16mmHg compared to control group. Continuous IAP monitoring in severe sepsis patients is important for early detection of splanchnic hypoperfusion with consequent multi-organ failure, and for timely application of efficacious therapeutic procedures

RENAL REPLACEMENT THERAPY IN A POLYTRAUMATIZED PATIENT WITH HEMOPHILIA

Zatajenje bubrežne funkcije je rijetka pojava u bolesnika s nasljednim koagulacijskim poremećajima. Međutim, kada nastupi veoma brzo napreduje do završnog stadija bubrežne bolesti i potrebe za nadomještanjem bubrežne funkcije. Javljaju se problemi vezani uz odabir metode dijalize, periproceduralne nadoknade nedostatnog faktora koagulacije te heparinizacije dijaliznog sustava. Kod hemoiličara uvijek treba biti oprezan tijekom samog postupka dijalize zbog mogućeg razvoja komplikacija koje ih mogu vitalno ugroziti. Ovo je prikaz slučaja teško politraumatiziranog bolesnika koji boluje od hemofilije A. Tijekom intenzivnog liječenja razvio je akutno bubrežno zatajenje te tešku sepsu. S obzirom na okolnosti najbolja metoda izbora za njega je bila kontinuirana veno-venska hemodijaliza. Unato uspješno provedenoj dijalizi bez komplikacija bolesnik umire od protrahirane sepseRenal failure is a rare complication of hereditary coagulopathies. However, when it occurs, it rapidly progresses to a stage that requires replacement of renal function. Major problems include the choice of dialysis method, prevention of complications and supplementation of deicient factor. In hemodialysis, it is challenging to prevent system clotting and avoid bleeding. We present a case of polytraumatized male patient with hemophilia A, who developed compartment syndrome with acute renal failure. Continuous venovenous hemodialysis (CVVHD) improved his condition and he recovered his kidney function. However, over the next few days he developed severe sepsis with deterioration of renal function. CVVHDF (hemodiailtration) was restarted. Several large hematomas were found in the abdominal cavity and in the inguinal region, one of them inducing compartment syndrome with leg necrosis. The patient died from cardiorespiratory arrest

Transfusion in polytraumatised patients

Background and Aim. Recent evidence indicates that surgical bleeding due to injured vessels and traumatic coagulopathy are the main reasons of uncontrolled haemorrhage in polytraumatized patients in the first 24 hours. The cornerstone of the treatment is adequate empiric early transfusion. The aim of our study was to survey the early transfusion in patients with major trauma and define the ratio of applied transfusion component in our hospital. Patients and Methods: Patients with major trauma for a one year period, admitted to the Emergency Department of the Clinical Hospital Centre, Zagreb, were enrolled in our retrospective study. The following data were collected: age, sex, mechanism of injury, initial shock index (SI), initial Glasgow Coma Score (GCS), Injury severity score (ISS), and initial hemoglobin (Hb) and prothrombin time (PT). Intra-operative transfusion and transfusion within the first 24 hours of injury, Intensive care unit (ICU) stay and clinical outcome were assessed. Results. 16 patients with major trauma were admitted. Eight patients received transfusions. Two patients received a massive transfusion. The transfusion ratio of Fresh frozen plasma (FFP) : Packed red blood cells (PRBC) : Platelets (PLT) during major trauma resuscitation was 1:1,5:1 in our study. One of the 16 patients died. Conclusion. Early and aggressive resuscitation with transfusion blood products in major trauma patients within the first 24 hours with the FFP:PRBC:PLT ratio 1:1:1 is the key for prevention of trauma induced coagulopathy and its lethal consequences. Massive transfusion protocol for major trauma patients should be implemented in everyday practice

Uloga čimbenika rasta fibroblasta 23 u akutnoj ozljedi bubrega

Acute kidney injury is a clinical syndrome associated with increased patient morbidity and mortality, as well as serious short-term and long-term consequences, especially in the perioperative period. Yet, patients having suffering from temporary acute kidney injury and achieving full recovery of kidney function usually complain of poor quality of life associated with loss of energy and limited physical activity. Therefore, there is a necessity for a novel biomarker of acute kidney injury with better features than currently used serum creatinine and urine output. So far, several investigations have demonstrated that the fibroblast growth factor 23 could be that desperately searched novel biomarker of acute kidney injury. It cannot only detect kidney dysfunction at the time but also before the injury process begins. Moreover, serum levels of the fibroblast growth factor 23 can predict adverse progression of the kidney injury. However, the role of the fibroblast growth factor 23 in the acute but also in chronic kidney dysfunction is still a riddle that requires additional research to clarify it.Akutna ozljeda bubrega je klinički sindrom povezan s povišenim rizikom pobola i smrtnosti te kratkotrajnim i dugotrajnim posljedicama, osobito kod bolesnika u perioperacijskom razdoblju. Zbog toga potreban je novi biomarker akutne bubrežne ozljede, bolje specifičnosti i osjetljivosti od serumske vrijednosti kreatinina i diureze. Nekoliko dosadašnjih radova je pokazalo da čimbenik rasta fibroblasta 23 može pravodobno prepozanti poremećaj bubrežne funkcije tijekom samog procesa oštećenja. Također, povišene serumske vrijednosti čimbenika rasta fibroblasta 23 mogu upozoriti na nepovoljan ishod bubrežne ozljede. Međutim, uloga čimbenika rasta fibroblasta 23 u akutnoj bubrežnoj ozljedi je velika nepoznanica te su potrebna daljnja istraživanja