Thrombocytopenia in Neonates

Thrombocytopenia defined as platelet count below 150,000/μL is not an uncommon event at the neonatal intensive care unit (NICU). In our region we calculated a prevalence of nearly 2 of 1000 live births. Early-onset neonatal thrombocytopenia (NT) occurring within the first 72 hours of life is more common than late-onset NT. Preterm infants are affected more often than term infants and bacterial infection is the most common diagnosis associated with NT. There are a lot of maternal, perinatal, and neonatal causes associated with NT and complications include bleedings with potentially life-threatening intracranial hemorrhage. Alloimmune thrombocytopenia (NAIT) often presents with severe thrombocytopenia (<30,000/μL) in otherwise healthy newborns and needs careful evaluation regarding HPA-1a antigen status and HLA typing. Platelet transfusions are needed in severe NT and threshold platelet counts might be at ≤25,000/μL irrespective of bleeding or not. Immune mediated NT recovers within 2 weeks with a good prognosis when there happened no intracranial hemorrhage. This short review gives an overview on etiology and causes of NT and recommendations regarding platelet transfusions

Die Außenhandelspolitik Österreichs im Rahmen der Europäischen Union

Während der beiden letzten Jahrzehnte wurde der Kompetenzbereich internationaler Handelspolitik weit über ihre traditionellen Aufgabengebiete Zölle und Quotenregelungen erweitert und umfasst heute Felder wie Dienstleistungen und Investitionen, Nahrungsmittelsicherheit, oder Umweltschutz. Die von den USA und der EU dominierten technokratischen Entscheidungsfindungsprozesse gerieten durch den Aufschwung der Schwellenländer und das Engagement neuer Akteure unter dem Label der Globalisierungsbewegung zunehmend unter Druck. Die österreichische Außenhandelspolitik ist in die Gemeinsame Handelspolitik der EU (GHP) eingebettet und somit wurde der Großteil des Policy Prozesses auf eine supranationale Ebene verlagert. In der politikwissenschaftlichen Literatur wurden die handelspolitischen Präferenzen der EU-Mitgliedsstaaten bisher vernachlässigt. Daher untersuche ich die österreichische Außenhandelspolitik als Teil eines Mehrebenensystems anhand der aktuellen Verhandlungsrunde in der Welthandelsorganisation. In theoretischer Hinsicht stütze ich mich dabei auf zwei Ansätze Argumentativer Politikfeldanalyse, genauer Deliberative Policy Analyse wie sie von Maarten A. Hajer mitbegründet wurde und Frame Analyse. Dieser interpretative Zugang stellt methodische Werkzeuge zur Verfügung, die es ermöglichen Bedeutungszuschreibungen, Deutungsrahmen und Geschichten in das Zentrum des Forschungsinteresses zu rücken. Um das Umfeld des handelspolitischen Policy Making in Österreich besser zu verstehen, behandeln einzelne Kapitel die historische Entwicklung und die Struktur der GHP sowie die ökonomische Bedeutung des Außenhandels für Österreich. Im letzten Abschnitt beleuchte ich den diskursiven Wettkampf, aus dem die Präferenzen der österreichischen Handelspolitik hervorgehen.During the last two decades the scope of international trade policy was extended beyond its basic areas tariffs and quota regulations, to fields such as services and investments, food safety, or environmental protection. The traditional technocratic policy-making style dominated by the United States and the EU was challenged by the rise of the emerging market economies and new actors under the label of the globalisation movement. Austrian trade policy is embedded into the Common Commercial Policy of the EU (CCP), which means that large parts of the policy process are transferred to a supranational level. Political Science literature offers virtually no accounts on the national preferences of the EU member states in trade policy. Therefore I analyse Austrian trade policy in an explorative way, as part of a multilevel decision-making system, through the example of the current round of negotiations in the World Trade Organisation. The theoretical background of my thesis is based on a mixture of two different approaches in Argumentative Policy Analysis, namely Deliberative Policy Analysis as developed by Maarten A. Hajer and Frame Analysis. Theses interpretive approaches offer useful tools, which put meanings, frames, and stories into the centre of the research project. To grasp the environment of Austrian trade policy-making, one chapter is concerned with the historical developments and the structure of the CCP, while another chapter presents the state and significance of foreign trade in Austria. In the final chapter I uncover the discursive struggle which forms the key preferences of Austrian trade policy

Early-onset neonatal sepsis: Still room for improvement in procalcitonin diagnostic accuracy studies

To perform a systematic review assessing accuracy and completeness of diagnostic studies of procalcitonin (PCT) for early-onset neonatal sepsis (EONS) using the Standards for Reporting of Diagnostic Accuracy (STARD) initiative.EONS, diagnosed during the first 3 days of life, remains a common and serious problem. Increased PCT is a potentially useful diagnostic marker of EONS, but reports in the literature are contradictory. There are several possible explanations for the divergent results including the quality of studies reporting the clinical usefulness of PCT in ruling in or ruling out EONS.We systematically reviewed PubMed, Scopus, and the Cochrane Library databases up to October 1, 2014. Studies were eligible for inclusion in our review if they provided measures of PCT accuracy for diagnosing EONS. A data extraction form based on the STARD checklist and adapted for neonates with EONS was used to appraise the quality of the reporting of included studies.We found 18 articles (1998-2014) fulfilling our eligibility criteria which were included in the final analysis. Overall, the results of our analysis showed that the quality of studies reporting diagnostic accuracy of PCT for EONS was suboptimal leaving ample room for improvement. Information on key elements of design, analysis, and interpretation of test accuracy were frequently missing.Authors should be aware of the STARD criteria before starting a study in this field. We welcome stricter adherence to this guideline. Well-reported studies with appropriate designs will provide more reliable information to guide decisions on the use and interpretations of PCT test results in the management of neonates with EONS

Maintaining an affective commons through events: a practice-based study of three collaborative communities

Depto. de Ingeniería de Software e Inteligencia Artificial (ISIA)Fac. de InformáticaFALSEunpu