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Objective: Thrombocytopenia has recently become a significant problem in patients admitted to neonatal intensive care unit. In this population, the cases of acquired thrombocytopenia is more noteworthy. In this study, it was aimed to evaluate the causes of acquired thrombocytopenia in the neonatal intensive care unit. Methods: Total of 588 infants, who admitted to NICU between 2013-2014, enrolled in the study and they were divided into three groups according to their platelet levels; mild (100-150x109/mm³), moderate (50-99x109/mm³) and severe (<50x109/mm³) thrombocytopenia. İnfants Infants were classified into two groups according to the time at onset; early onset (within first 72 hours) and late-onset (after 72 hours) thrombocytopenia. Prenatal risk factors for thrombocytopenia; maternal hypertension and gestational diabetes, preeclampsia, delivery mode and active resuscitation at birth, perinatal asphyxia and neonatal risk factors; gestational age, gender, comorbid diagnoses were studied. Results: Thrombocytopenia was seen in 79 of 588 cases (13.4%). 28 (35.0%) of them had mild, 24 (30.0%) had moderate and 27 (34.0%) severe thrombocytopenia. Infants with early onset thrombocytopenia were 56.9% (n=45) of cases. 60.0% of neonates (n=48) were preterm, 40.0% of neonates was the term. 40.0% of cases were girls. According to the mode of delivery, 58 neonates were born by cesarean section. 43 babies were (54.0%) initially actively resuscitated in the delivery room. The most common neonatal factor was perinatal asphyxia. The most common diagnosis were related with respiratory problems (respiratory distress syndrome, congenital pneumonia, transient tachypnea of the newborn, meconium aspiration syndrome) (n=47) and the other diagnosis were hyperbilirubinemia (ABO incompatibility) (n=12), sepsis (n=9), congenital heart diseases (n=4), convulsion (n=2), hypoglycemia (n=2), Down syndrome (n=1), nutrition intolerance (n=1), Pierre Robin Syndrome (n=1). Conclusion: In the neonatal intensive care unit, thrombocytopenia incidence was determined as 13.4%. Maternal hypertension, pre-eclampsia, and prematurity were prominent risk factors for early onset thrombocytopenia, neonatal sepsis was the prominent factor of late-onset thrombocytopenia in newborn. [ABSTRACT FROM AUTHOR]

In the COVID-19 (SARS-CoV2) pandemic, which emerged in Wuhan, China, and influenced the whole world, the number of cases worldwide is approaching 7 million by June 2020 and number of deaths unfortunately reached around 400 thousand. The available data suggest that elderly people with chronic diseases such as chronic respiratory tract, diabetes, chronic kidney disease or cardiovascular disease are at higher risk for both in terms of disease and death. Hemodialysis patients are defined as a special subgroup for higher risk requiring different management approaches, partly because they are at more advanced age and they have to go to the hemodialysis unit and be in crowded environments. On the other hand, patients with COVID-19, especially who need intensive care, are at high risk of developing acute renal failure and their follow-up is also important. In this article, we wanted to share our experience as the nephrology clinic of Düzce University Medical Faculty, both in the management of our own nephrological patient population, especially in hemodialysis patients, and in the nephrological follow-up of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus is one of the major causes of respiratory tract infections during infancy with high rates of hospitalization and mortality during the first years of life. It is the most common cause of acute bronchiolitis and viral pneumonia in children below two years of age and second the most common cause of postneonatal infant mortality all around the world following malaria. In addition, the virus has been causally linked to recurrent wheezing and associated with pediatric asthma. The respiratory syncytial virus infections tend to be severe in high risk patients such as patients below six months of age, with prematurity, congenital heart diseases, neuromuscular diseases and immune deficiencies. No specific treatment is available for respiratory syncytial virus infections to date. Severe cases require supportive therapy, mainly oxygen supplementation and hydration, and less frequently, ventilatory support. Because there is no vaccine to prevent respiratory syncytial virus infections or clinically effective treatment to administer to children with respiratory syncytial virus infection, immunoprophylaxis with palivizumab is currently the only method for reducing morbidity associated with severe respiratory syncytial virus in high-risk infants. [ABSTRACT FROM AUTHOR]

Patient navigation program was first developed by Dr. Harold Freeman in New York in 1990 in order to decrease the mortality rates of the poor and black women with breast cancer at the 3rd and the 4th stages. Over time, the program has focused to remove the financial, logistics and sociocultural obstacles in the treatment. Patient navigation can be defined as a management program, which is specific to cultural values and which can be used as a map or a navigator by the patients, who are surrounded by the complex and dissociated health information system. The navigator program is used today due to the problems created by factors such as race, ethnic, gender or political discrimination, low socio-economic level, absence of social insurance, distance to the health services or illiteracy. The patient navigation program lays a bridge between the patients and the health system. Patient navigators, who receive intensive training, reach to the patients, support the patients, start and continue nursing and treatment and hold the medical records. The patient navigation program is the key for the under privileged patients with oncologic or chronic diseases to receive health services. [ABSTRACT FROM AUTHOR]