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 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 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 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 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.Publication Metadata only Percentiles of oxygen saturations in healthy term newborns in the first minutes of life(SPRINGER, 2008) TOPUZOĞLU, AHMET; Altuncu, Emel; Ozek, Eren; Bilgen, Huelya; Topuzoglu, Ahmet; Kavuncuoglu, SultanThe aim of this study was to establish the reference values of preductal oxygen saturation (SpO(2)) in healthy infants immediately after birth. SpO(2) recordings of 200 term neonates (vaginal group;n=150 and cesarean group;n=50) with regular respiratory pattern were evaluated. The median SpO(2) values in the first, fifth and tenth minutes were 71, 92, and 98% in vaginal deliveries and 70, 79, and 96% in cesarean deliveries, respectively. SpO(2) was significantly lower in the cesarean group at any time after the first minute of life (p < 0.0001). The time needed to reach a SpO(2)> 90% was three times longer in cesarean deliveries. Healthy neonates are poorly saturated immediately after birth. The duration to reach a SpO(2)> 90% was longer in infants born by cesarean deliveries.Publication Metadata only Yenidoğan yoğun bakımdaki bebeklerin karbapenem dirençli gram(-) bakterilerle kolonizasyonundaki risklerin incelenmesi(2021-10-06) MEMİŞOĞLU, ASLI; ALTINKANAT GELMEZ, GÜLŞEN; KEPENEKLİ KADAYİFCİ, EDA; AY, NADİYE PINAR; BİLGEN, HÜLYA SELVA; HASDEMİR GÖKBOĞA, MÜNEVVER UFUK; ÖZEK, EREN; YALÇINOĞLU İ., MEMİŞOĞLU A., ALTINKANAT GELMEZ G., TAVİLOĞLU Z. Ş. , ÖZDEMİR H., KEPENEKLİ KADAYİFCİ E., AY N. P. , BİLGEN H. S. , HASDEMİR M. U. , ÖZEK E.Publication Metadata only Transcutaneous measurement of hyperbilirubinaemia: comparison of the Minolta jaundice meter and the Ingram icterometer(CARFAX PUBL CO, 1998) BEKİROĞLU, GÜLNAZ NURAL; Bilgen, H; Ince, Z; Ozek, E; Bekiroglu, N; Ors, RThe effectiveness of two different non-invasive transcutaneous bilirubin measurement devices was compared with serum bilirubin levels in 96 healthy newborns. Transcutaneous measurements were obtained with the Minolta Air Shields jaundice meter and the Ingram icterometer and serum bilirubin levels were determined by a direct spectrophotometric method (Bilitron 444). A linear correlation existed between serum bilirubin values and the readings on both the Minolta jaundice meter (r= 0.83) and the Ingram icterometer (r = 0.78). The Kappa coefficient was 0.66. The sensitivity, specificity and positive and negative predictive values were 100%, 56%, 33% and 100% for the Minolta jaundice meter and 100%, 48%, 29% and 100% for the Ingram icterometer, respectively. The high sensitivity and negative predictive value of both devices render them suitable for screening neonatal hyperbilirubinaemia. However, because of its low cost, the Ingram icterometer is preferable to the more complex and expensive Minolta jaundice meter, especially in countries with a high birth rate, such as Turkey.Publication Metadata only Cinacalcet as a First-Line Treatment in Neonatal Severe Hyperparathyroidism Secondary to Calcium Sensing Receptor (CaSR) Mutation(KARGER, 2020) BEREKET, ABDULLAH; Gulcan-Kersin, Sinem; Kirkgoz, Tarik; Eltan, Mehmet; Rzayev, Turkay; Ata, Pinar; Bilgen, Hulya; Ozek, Eren; Bereket, Abdullah; Turan, SerapIntroduction: Neonatal severe hyperparathyroidism (NSHPT) is a rare cause of neonatal hypercalcemia caused by a loss of function mutation in the calcium-sensing receptor (CaSR). Hypercalcemia in NSHPT can be life-threatening. Maintenance of serum calcium within a safe range is the primary goal of treatment through hydration, forced diuresis, and bisphosphonate treatment, nevertheless most cases require parathyroidectomy. We report a case with NSHPT diagnosed on the first day of life (DoL) and successfully treated with cinacalcet as the first-line treatment from the 2nd DoL up to the age of 18 months. Case Report: A full-term baby evaluated for weight loss at postnatal 14th hour and found to have hypercalcemia (14.4 mg/dL, reference range [RR]: 8.0-11.3). Despite hydration and diuresis, hypercalcemia persisted. Further evaluation revealed a parathyroid hormone (PTH) level of 1,493 pg/mL (RR: 15-65) and urine Ca/Cr of 0.09 mg/mg (RR: 0.03-0.81). Cinacalcet treatment was initiated on the 2nd DoL with the diagnosis of NSHPT due to hypocalciuric hypercalcemia and elevated PTH level. Ca levels decreased to normal levels on the 7th DoL. She was discharged from hospital at postnatal day 15 on cinacalcet treatment and still continued at 18 months of age. Sequencing of CaSR revealed a novel homozygous c.1836G>A (p.G613E) mutation in the patient, for which the parents and sister were heterozygous. Conclusion: This case represents the youngest age at cinacalcet initiation and the longest duration without parathyroidectomy in a homozygous NSHPT and demonstrates that cinacalcet is an effective first-line treatment in patients who are responsive to this treatment modality and allows avoiding/delay in surgical intervention in NSHPT.
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