Person: ÖZEK, EREN
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ÖZEK
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EREN
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Publication Open Access Effect of video camera monitoring feedback on hand hygiene compliance in neonatal intensive care unit, an interventional study(2023-01-02) SİLİ, ULUHAN; MEMİŞOĞLU, ASLI; ÖZEK, EREN; KEPENEKLİ KADAYİFCİ, EDA; Bilgin H., SİLİ U., Pazar N., Kucuker I., Kepenekli E., Yanar M. A., MEMİŞOĞLU A., ÖZEK E., Adhikari N. K., Pinto R., et al.Background: The purpose of this study was to determine whether use of a video camera surveillance system for hand hygiene (HH) monitoring, video-based education, and feedback could improve the HH compliance in a neonatal intensive care unit (NICU). Methods and materials: This was an interventional before-after trial conducted in a level-III NICU between July 2019 and June 2020. HH compliance was measured using randomly selected video-camera footage in the baseline, intervention, and maintenance periods. After the baseline, an intervention consisting of feedback and education with video scenarios was implemented. The primary outcome was change in HH compliance. The compliance rates were analyzed as an interrupted time series (ITS) with a segmented regression model adjusted for autocorrelation for each study period. Results: We identified a total of 8335 HH indications. There were non significant increases in the total compliance rate (9.0%, 95% CI -2% to 20%) at the time of intervention and in the compliance rate after intervention (0.26%, 95% CI -0.31% to 0.84%) per day. The hand hygiene compliance before patient contact significantly increased (19.8%, 95% CI, 4.8%-34.8%). Incorrect glove use improved non-significantly with the intervention (-3.4%, 95% CI -13.4% to 6.7%). Conclusion: In this study of HH monitoring using video-camera footage combined with an intervention including feedback and education, there were inconsistent improvements in HH compliance. However, these improvements were not sustained in the long term. Frequent feedback and education may be required to sustain high compliance.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 Metadata only The neuroprotective and anti-apoptotic effects of melatonin on hemolytic hyperbilirubinemia-induced oxidative brain damage(WILEY, 2016) MEMİŞOĞLU, ASLI; Pazar, Asilay; Kolgazi, Meltem; Memisoglu, Asli; Bahadir, Elif; Sirvanci, Serap; Yaman, Akan; Yegen, Berrak C.; Ozek, ErenMelatonin exerts protection in several inflammatory and neurodegenerative disorders. To investigate the neuroprotective effects of melatonin in an experimental hemolysis-induced hyperbilirubinemia, newborn Sprague-Dawley rats (25-40 g, n = 72) were injected with phenylhydrazine hydrochloride (PHZ; 75 mg/kg) and the injections were repeated at the 24th hour. Rats were treated with saline or melatonin (10 mg/kg) 30 min before the first and second PHZ injections and 24 h after the 2nd PHZ injections. Control rats (n = 24) were injected with saline, but not PHZ. At sixth hours after the last injections of saline or melatonin, all rats were decapitated. Tumor necrosis factor (TNF)-alpha, IL-1 beta, IL-10 and brain-derived neurotrophic factor (BDNF) and S100B levels in the plasma were measured. Brain tissue malondialdehyde (MDA), glutathione (GSH) levels and myeloperoxidase (MPO) activities were measured, and brain tissues were evaluated for apoptosis by TUNEL method. In the saline-treated PHZ group, hemoglobin, hematocrit levels were reduced, and total/direct bilirubin levels were elevated when compared to control group. Increased plasma TNF-alpha, IL-1 beta levels, along with decreased BDNF, S100B and IL-10 values were observed in the saline-treated PHZ group, while these changes were all reversed in the melatonin-treated group. Increased MDA levels and MPO activities in the brain tissues of saline-treated hyperbilirubinemic rats, concomitant with depleted brain GSH stores, were also reversed in the melatonin-treated hyperbilirubinemic rats. Increased TUNEL(+) cells in the hippocampus of saline-treated PHZ group were reduced by melatonin treatment. Melatonin exerts neuroprotective and anti-apoptotic effects on the oxidative neuronal damage of the newborn rats with hemolysis and hyperbilirubinemia.Publication 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 Effects of caffeine therapy for apnea of prematurity on sleep and neurodevelopment of preterm infants at 6 months of corrected age(2023-12-01) BARIŞ, HATİCE EZGİ; ÖZDEMİR, HÜLYA; ERDEM ERALP, ELA; ÖZEK, EREN; BORAN, PERRAN; Yola Atalah Y. E., Barış H. E., Küçük Akdere S., Sabancı M., Özdemir H., Gücüyener K., Erdem Eralp E., Özek E., Boran P.Publication 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 Transient Tachypnea of the Newborn: The Treatment Strategies(BENTHAM SCIENCE PUBL LTD, 2012) ÖZEK, EREN; Yurdakok, Murat; Ozek, ErenTransient tachypnea of the newborn results from delayed clearance of lung fluid and is a common cause of admission of full term and late preterm infants to neonatal intensive care units. The condition is particularly common after elective cesarean section. Conventional treatment involves supplemental oxygen, withholding enteral feeds and administration of intravenous fluids and antibiotics. Rarely, infants require CPAP and mechanical ventilation. Occasionally some babies develop severe hypoxemia and may require high concentrations of oxygen. The most effective strategy for accelerating reabsorbtion of fetal lung fluid is exogenous glucocorticoids. Potential therapies for TTN must be based on an understanding of the physiology of normal fetal lung fluid clearence at bith. Furosemide, racemic epinephrine and inhaled - agonists have been studied for possible benefit in TTN. The routine administration of these drugs can not be recommended unless additional data become available.Publication Metadata only Yenidoğan nefrolojisi(Türkiye Klinikleri Yayınevi, 2022-10-01) ÖZEK, EREN; ALPAY, HARİKA; Özek E. (Editör), Alpay H. (Editör)