Person: BİLGEN, HÜLYA SELVA
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BİLGEN
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HÜLYA SELVA
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Publication Metadata only Comparison of three neonatal pain scales during minor painful procedures(TAYLOR & FRANCIS LTD, 2008) TOPUZOĞLU, AHMET; Uyan, Zeynep Seda; Bilgen, Huelya; Topuzoglu, Ahmet; Akman, Ipek; Ozek, ErenObjective. There is no single or widely accepted method to define pain in neonates. The aim of this study was to compare three different neonatal pain scales in the estimation of the pain response to minor painful stimuli in healthy term neonates. Method. Thirty healthy neonates were included in the study. Video recordings of infants during heel prick blood sampling were evaluated by two observers according to the Neonatal Infant Pain Scale (NIPS), the Neonatal Facial Coding System (NFCS), and the Douleur Aigu du Nouveau-n (DAN). Crying times of infants were recorded, and the correlation between the three pain scales and crying time was calculated. The pain scores and inter-observer variability were analyzed. Results. The highest correlation between the crying time and each of the three different neonatal pain scales was found for NIPS (r=0.74, p < 0.001), while similar results were found for the DAN scale (r=0.67, p < 0.001) and the NFCS (r=0.67, p < 0.001). Inter-observer variability was similar for the three scales (NFCS r=0.95; DAN r=0.97; NIPS r=0.96). NFCS had a coefficient of variation (CV) of 59.8 +/- 32.2%. The DAN scale and NIPS had similar CV values (41.5 +/- 26.1% and 43.2 +/- 31.6%, respectively), but these values were significantly lower than that of NFCS. Conclusion. All three scales provided comparable results, with a slight difference favoring NIPS. Therefore, NIPS can be used to evaluate pain during minor painful procedures in neonates.Publication Open Access Successful Treatment of Candida parapsilosis Fungemia in Two Preterms with Voriconazole(HINDAWI LTD, 2015) ÖZEK, EREN; Altuncu, Emel; Bilgen, Hulya; Soysal, Ahmet; Ozek, ErenHerein, we report two preterms with invasive candidiasis refractory to liposomal amphotericin B (AMB) treatment in spite of low MIC levels (MIC: 0.5 mcg/mL). Both of the patients' blood cultures were persistently positive for C. parapsilosis despite high therapeutic doses (AMB: 7mg/kg per day). After starting voriconazole blood cultures became negative and both of the patients were treated successfully without any side effects. In conclusion, although it is not a standard treatment in neonatal patients, our limited experience with these patients suggests that voriconazole appears to be a safe antifungal agent to be used in critically ill preterm infants with persistent fungemia despite AMB treatment.Publication Metadata only Comparative heel stick study showed that newborn infants who had undergone repeated painful procedures showed increased short-term pain responses(Blackwell Publishing Ltd, 2016) MEMİŞOĞLU, ASLI; Gokulu G., Bilgen H., Ozdemir H., Sarioz A., Memisoglu A., Gucuyener K., Ozek E.Aim: We evaluated the short-term effect of repeated pain exposure on the pain responses of newborn infants using different pain assessment methods, as this area had been under-researched. Methods: We compared 20 term, large for gestational age infants and 40 term, appropriate for gestational age controls. All had undergone a heel stick for a newborn screening test just before discharge, but the larger babies had also undergone at least other five painful stimuli prior to that. A pulse oximeter and a skin conductance algesimeter (SCA) were connected to the babies during the heel prick, and video recordings were made. Crying time, the Neonatal Infant Pain Scale (NIPS), heart rate, peripheral oxygen saturation (SpO2) and SCA measurements were compared within and between the groups. Results: After the heel prick, the crying time (p = 0.021) and NIPS (p = 0.013) scores were significantly higher in the study group and the SpO2 levels were significantly lower (p = 0.009), but the heart rate (p = 0.981) was not significantly different between the groups. SCA measurements did not differ significantly between the groups. Conclusion: Babies who received more painful stimuli during the first few days of life showed greater pain responses during a subsequent heel prick. ©2016 Foundation Acta Pædiatrica. Published by John Wiley & Sons LtdPublication Open Access COMPARISON OF SUCROSE AND HUMAN MILK ON NEWBORNS' PAIN RESPONSE(1998-09) SAVE, DİLŞAD; Örs, Rahmi; Özek, Eren; Baysoy, Gökhan; Cebeci, Dilşat; Bilgen, Hülya; Türküner, Merih; Başaran, MüjdatPublication Metadata only Delayed cord clamping in term large-for-gestational age infants: A prospective randomised study(WILEY, 2019) YOLDEMİR, AHMET TEVFİK; Vural, Irmak; Ozdemir, Hulya; Teker, Gulsen; Yoldemir, Tevfik; Bilgen, Hulya; Ozek, ErenAim To compare the post-natal effects of delayed cord clamping (DCC) and early cord clamping (ECC) in term large-for-gestational age (LGA) infants. Methods This prospective randomised study included 51 term LGA infants. The umbilical cords of these infants were clamped at 15 s in group 1 (ECC group (n = 26)) and at 60 s in group 2 (DCC group (n = 25)). Data for Apgar scores, cord blood, pH and lactate values, second haematocrit, 24th bilirubin levels, duration of hospital stay and admission to the neonatal intensive care unit (NICU) were recorded. Results The demographic characteristics of the infants in the study group were not significantly different. No statistically significant difference was observed in the post-natal haematocrit and bilirubin levels between the groups. Six infants (group 1, n = 3; group 2, n = 3) were diagnosed with polycythaemia (P = 0.79); however, these infants remained asymptomatic, and no treatment was required. One infant in each group developed hyperbilirubinemia, which required phototherapy (P = 1.00). The infant with hyperbilirubinemia in the DCC group presented with asymptomatic polycythaemia. Three neonates in the DCC group required admission to the NICU for transient tachypnoea. Conclusions No significant increase in the rate of post-natal complications of DCC in term LGA infants was observed in the study. However, before recommending DCC on a routine basis, studies with a larger sample size and long-term follow-up are required to elucidate the risks and benefits of DCC in this group of infants.Publication Metadata only Use of recombinant factor VIIa in a preterm infant with coagulopathy and subdural hematoma(TAYLOR & FRANCIS LTD, 2007) BİLGEN, HÜLYA SELVA; Altuncu, Emel; Berrak, Su; Bilgen, Huelyya; Yurdakul, Ziya; Canpolat, Cengiz; Oezek, ErenActivated recombinant factor VIIa was administered to a preterm infant with bleeding diasthesis and a huge subdural hematoma that could not be controlled by the blood products. The coagulation tests were normalized the following day. Recombinant factor VIIa can be a choice in selected cases with intractable bleedings unesponsive to conventional replacement therapy.Publication Open Access Maternal Thyroid Dysfunction and Neonatal Thyroid Problems(HINDAWI LTD, 2013) BEREKET, ABDULLAH; Ozdemir, Hulya; Akman, Ipek; Coskun, Senay; Demirel, Utku; Turan, Serap; Bereket, Abdullah; Bilgen, Hulya; Ozek, ErenAim. To investigate obstetric features of pregnant women with thyroid disorders and thyroid function tests of their newborn infants. Methods. Women with hypothyroidism and having anti-thyroglobulin (ATG) and anti-thyroid peroxidase (anti-TPO) antibodies were assigned as group I, women with hypothyroidism who did not have autoantibodies were assigned as group II, and women without thyroid problems were assigned as group III. Results. Pregnant women with autoimmune hypothyroidism (group I) had more preterm delivery and their babies needed more frequent neonatal intensive care unit (NICU) admission. In group I, one infant was diagnosed with compensated hypothyroidism and one infant had transient hyperthyrotropinemia. Five infants (23.8%) in group II had thyroid-stimulating hormone (TSH) levels >20 mIU/mL. Only two of them had TSH level >7 mIU/L at the 3rd postnatal week, and all had normal free T4 (FT4). Median maternal TSH level of these five infants with TSH >20 mIU/mL was 6.6 mIU/mL. In group III, six infants (6.5%) had TSH levels above >20 mIU/mL at the 1st postnatal week. Conclusion. Infants of mothers with thyroid problems are more likely to have elevated TSH and higher recall rate on neonatal thyroid screening. Women with thyroid disorders and their newborn infants should be followed closely for both obstetrical problems and for thyroid dysfunction.Publication Metadata only Should fathers also do kangaroo care(2022-07-01) ÖZEK, EREN; BİLGEN, HÜLYA SELVA; Yaman A., Kandemir I., Ozek E., Bilgen H. S.Objective The aim of the study is to compare the effect of maternal and paternal Kangaroo care (KC) on vital signs and cerebral oxygen saturation (rSO2) parameters. Methods This randomized study included 35 preterm infants born at 32 weeks gestation or earlier. The body temperature, respiratory rate, heart rate, oxygen saturation (sPO2), and cerebral oxygen saturation (rSO2) were measured at the postnatal 35th week of gestation during three periods: in the incubator before KC, during KC with the mother or father , and in the incubator after KC. The measured parameters of the three periods were compared within each group (mother or father) and between the groups (mother and father). Results There was no statistically significant difference between the vital signs during the three periods, both in the mother and father groups, and between the parents. The rSO2 values increased significantly in both parents ( p <0.001) during and after KC. When we compared parents, rSO2 values were significantly higher during ( p = 0.015) and after ( p = 0.046) mother KC. Conclusion The difference between M-KC and F-KC can be ignored as the cerebral near infra-red spectroscopy values are within normal limits. The active participation of fathers in KC should be encouraged by health professionals in all NICUs.Publication Open Access Regional pulmonary oxygen saturations immediately after birth(2022-03-01) GÜLCAN KERSİN, SİNEM; ILGIN, CAN; ÖZEK, EREN; BİLGEN, HÜLYA SELVA; GÜLCAN KERSİN S., Yasa B., Cetinkaya M., ILGIN C., ÖZEK E., BİLGEN H. S.Background: Partial oxygen saturation (SpO2) increases within minutes during transition from the intrauterine to extrauterine life. This study aims to determine the postnatal course of pulmonary regional oxygen saturation (rSO2) measured by Near-Infrared Spectroscopy (NIRS). Methods: We conducted an observational study at the delivery room in infants above 35 weeks of gestation who did not need resuscitation and did not develop respiratory distress. Preductal pulse oximetry (Covidien NellcorTM) and right pulmonary apex oxygen saturation (raSO2) and basal oxygen saturation (rbSO2) (Covidien INVOSTM) were measured, starting from the postnatal third minute of life, until the 15th minute. The correlations between SpO2 and pulmonary rSO2 were analyzed. Results: Of the 110 infants included in the study, 87 were term and 23 were late preterms. The gestational age and birth weight were 38.5 ± 1.36 weeks and 3285 ± 508 g, respectively. Median (5th–95th percentile) raSO2 and rbSO2 were 79% (58–95%) and 78% (46–95%) at the third minute, respectively. The rSO2 values measured from both sides increased and reached a steady-state around postnatal 9 min, similar to SpO2 values. The pulmonary NIRS values were significantly higher for babies born by C-Section compared to babies born by vaginal delivery (p < 0.05). Conclusion: We found that rSO2 measurements increased within minutes in the postnatal period in late preterm and term babies without respiratory distress and reached a plateau at the postnatal 9th minute. The normal values obtained from this preliminary study may be used to predict the prognosis of cases with respiratory distress.Publication Metadata only The effect of the mode of delivery on neonatal thyroid function(TAYLOR & FRANCIS LTD, 2007) BEREKET, ABDULLAH; Turan, Serap; Bereket, Abdullah; Angaji, Meryem; Koroglu, Ozge Altun; Bilgen, Hulya; Onver, Tamer; Akman, Ipek; Ozek, ErenBackground. We aimed to investigate the effect of the mode of delivery and the type of anesthesia on postnatal thyroxine (T4), free T4 (f-T4) and thyroid-stimulating hormone (TSH) in a large number of healthy full-term neonates. Methods. Serum samples for T4, TSH and f-T4 were drawn from neonates at the time of discharge (postnatal days 1-7) in a pilot thyroid-screening program. Six hundred and thirty-eight neonates were grouped as: vaginal delivery (VD; 332), elective cesarean section (elective C/S; 252) and emergency cesarean section (emergency C/S; 54). The elective C/S group was subdivided into local and general anesthesia groups to investigate the influence of the type of anesthesia used on thyroid function. Results. Mean +/- SD serum T4, TSH and f-T4 levels tended to be higher in the VD group compared to the elective C/S group at almost all time points. However the differences did not reach statistical significance, except for the T4 levels at postnatal day 3 in the VD group, which was higher (195.6 +/- 37.3 nmol/L) compared to the elective C/S group (160.9 +/- 34.8 nmol/L) (p < 0.001). The only difference in the anesthesia groups was the slightly higher f-T4 levels from postnatal day 4 in the local anesthesia group compared to the general anesthesia group. Conclusions. The mode of delivery or type of anesthesia does not have considerable influence on postnatal thyroid functions in the neonates, although minor differences exist. Therefore similar cut-off values can be used for thyroid screening of term newborns regardless of the mode of delivery or type of anesthesia used.