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Article: Carboxyhemoglobin Levels in Preterm Neonatal Late-Onset Sepsis: to Predict or not to Predict.

Vardar, Gonca / Ozek, Eren

Mediterranean journal of hematology and infectious diseases

2023 Volume 15, Issue 1, Page(s) e2023017

Abstract: Background: In this study, we aimed to evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates.: Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to ... ...

Abstract	Background: In this study, we aimed to evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates. Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to July 2022 were reviewed. COHb levels, C-reactive protein, procalcitonin, and neutrophil to lymphocyte ratio of septic preterm infants were compared to controls. In addition, serial COHb levels measured within six hours before or 24h after blood culture sampling, three to seven days prior, and three to five days after starting antimicrobial therapy were retrieved from patient records. Results: The study included 77 blood-culture-positive preterm infants and 77 non-septic controls. During the LOS episode, the COHb values were found to be significantly increased (median: 1.8, IQR: 1.4-2.5) when compared to the control group (median: 1.2, IQR: 0.8-1.6) (p < 0.001). ROC analysis yielded an AUC of 0.714 for COHb (95% CI: 0.631-0.796, p<0.001). At an optimal cut-off of >1.5%, the test's sensitivity was 64.94%, the specificity was 72.73%, the positive predictive value was 70.42%, and the negative predictive value was 67.47%. LOS led to a dramatic rise followed by a decrease after the initiation of the antimicrobial therapy [1.8 (1.4-2.5)] vs. [1.45 (0.2-4)] p<0.001. Conclusion: COHb levels increased at the beginning of LOS, decreasing in response to antibiotics. When used in conjunction with other sepsis biomarkers, the variation of COHb can be important in evaluating late-onset sepsis episodes in preterm infants.
Language	English
Publishing date	2023-03-01
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2674750-9
ISSN	2035-3006
ISSN	2035-3006
DOI	10.4084/MJHID.2023.017
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Perinatal and Neonatal Outcomes of Refugee Infants in a Tertiary Hospital in Turkey.

Vardar, Gonca / Ozek, Eren

Cureus

2023 Volume 15, Issue 9, Page(s) e44917

Abstract: Background Worldwide, the immigration problem has been increasing due to conflicts. In recent years, Turkey accepted more than 3.8 million refugees from many countries, principally Syria. Aims In this study, we aimed to evaluate the prenatal features and ...

Abstract	Background Worldwide, the immigration problem has been increasing due to conflicts. In recent years, Turkey accepted more than 3.8 million refugees from many countries, principally Syria. Aims In this study, we aimed to evaluate the prenatal features and neonatal outcomes of refugees and Turkish controls hospitalized in a tertiary neonatal intensive care unit in Turkey. Materials and methods This retrospective case-control study included comparative data related to populations based on whether they were refugees or not. Their perinatal and neonatal "outcomes" were compared. Results Among the 254 analyzed neonates, 127 were born to refugee mothers, and 127 controls were born to non-refugee Turkish mothers. The refugee rate in our hospitalized neonates was nine, a young mother's age (p=0.010) with a higher rate of adolescent pregnancies at OR 2.78 (95% CI 0.96-8.05) (p=0.032), and consanguineous marriage at OR 0.57 (95% CI 0.32-1.02) (p=0.031) in comparison to non-refugees. The incidence of ABO incompatibility-related hemolytic jaundice (p=0.013) was higher in the refugees. The rate of formula feeding in the first month of life was significantly higher at OR 0.49 (95% CI 0.25-0.92) (p=0.027) in neonates born to refugee mothers. Despite lower perinatal care rates in refugees at OR 7.23 (95%CI 4.12-12.69) (<0.001), preterm morbidities did not differ between refugees and non-refugee preterm infants ≤32 gestational age (p>0.05). Conclusion The importance of breast milk must be strongly encouraged to initiate and promote exclusive breastfeeding for the infants of refugees. Race is still an important risk factor for ABO incompatibility-related hemolytic jaundice. Providing high-quality healthcare is sufficient to prevent worse outcomes in refugee neonates.
Language	English
Publishing date	2023-09-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.44917
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Article: Breast milk stem cells: Are they magic bullets in neonatology?

Kersin, Sinem Gülcan / Özek, Eren

Turkish archives of pediatrics

2021 Volume 56, Issue 3, Page(s) 187–191

Abstract: Each mammal produces milk specific to its newborn that meets all nutritional needs. Breast milk is not only a secretory product but is also a complex liquid containing several components that provide enteral nutrition. The stage of lactation, the ... ...

Abstract	Each mammal produces milk specific to its newborn that meets all nutritional needs. Breast milk is not only a secretory product but is also a complex liquid containing several components that provide enteral nutrition. The stage of lactation, the fullness of the breast, the feeding of the baby, and the health of the mother during the breastfeeding period cause differences in the composition of breast milk. Although the positive effects of breast milk on the physical and intellectual development of a child in the short and long term have been known for centuries, its mechanism has not been elucidated. Stem cells are defined as the cells that possess specific markers and have not undergone differentiation. Under suitable conditions and stimuli, they can differentiate into desired cells. The detection of stem cells, whose exact origin is not known, in breast milk and their demonstration in the baby's body have prompted the necessity of exploring the possible role of stem cells in the treatment of diseases. In this review, breast milk-derived stem cells and their possible role in neonatology are discussed.
Language	English
Publishing date	2021-05-01
Document type	Journal Article ; Review
ISSN	2757-6256
ISSN	2757-6256
DOI	10.5152/TurkArchPediatr.2021.21006
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Article ; Online: Regional pulmonary oxygen saturations in late preterm and term infants with respiratory distress at birth.

Yasa, Beril / Kersin, Sinem Gülcan / Cetinkaya, Merih / Ozek, Eren / Bilgen, Hulya

Pediatric pulmonology

2024 Volume 59, Issue 4, Page(s) 923–929

Abstract: Background: Measurement of regional pulmonary oxygen saturation by near-infrared spectroscopy is a novel monitorization method. This study aimed to determine the early regional pulmonary oxygen saturations in neonates with respiratory distress.: ... ...

Abstract	Background: Measurement of regional pulmonary oxygen saturation by near-infrared spectroscopy is a novel monitorization method. This study aimed to determine the early regional pulmonary oxygen saturations in neonates with respiratory distress. Methods: This observational study was conducted at the delivery room in infants above 35 weeks of gestation who developed respiratory distress immediately after birth. Preductal oxygen saturation (Covidien Nellcor®) and regional oxygen saturations of both apical (raSO Results: Of the 165 infants included to the study, 15 were late preterm and 55 developed respiratory distress. Infants with respiratory distress had significantly lower gestational age and birth weight. Regional pulmonary oxygenations at both apex and basal lung areas were positively correlated with SpO Conclusion: This study is one of the pioneer studies evaluating the early pulmonary oxygenation values of infants with respiratory distress. Oxygenation of apical lung regions are better than basal areas. Higher fractionized tissue oxygen extraction showed the impaired pulmonary perfusion in infants with respiratory distress.
MeSH term(s)	Infant, Newborn ; Humans ; Oxygen ; Oxygen Saturation ; Birth Weight ; Dyspnea ; Lung ; Respiratory Distress Syndrome
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2024-01-05
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	632784-9
ISSN	1099-0496 ; 8755-6863
ISSN (online)	1099-0496
ISSN	8755-6863
DOI	10.1002/ppul.26849
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Jg. 1995 - 2021: Lesesall (1.OG)
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Article: The Factors Affecting the Postnatal Bonding of Mothers Whose Babies were Admitted to the Neonatal Intensive Care Unit During the COVID-19 Pandemic.

Gülcan Kersin, Sinem / Topuzoğlu, Ahmet / Bilgen, Hülya Selva / Özek, Eren

Turkish archives of pediatrics

2023 Volume 58, Issue 3, Page(s) 256–261

Abstract: Objective: COVID-19 pandemic has created challenges for sick preterm babies and their parents. This study aimed to explore the factors affecting the postnatal bonding of mothers who were not permitted to visit and touch their babies who were in the ... ...

Abstract	Objective: COVID-19 pandemic has created challenges for sick preterm babies and their parents. This study aimed to explore the factors affecting the postnatal bonding of mothers who were not permitted to visit and touch their babies who were in the neonatal intensive care unit during the COVID-19 pandemic. Materials and methods: This is a cohort study conducted in a tertiary neonatal intensive care unit in Turkey. The participants consisted of mothers who were offered full rooming in with their baby (group 1, n = 32) and mothers whose newborns had been admitted to the neonatal intensive care unit immediately after delivery and were hospitalized for at least 7 days (group 2, n = 44). The Turkish versions of Beck Anxiety Inventory, Edinburgh Postpartum Depression Scale, Adjustment Disorder-New Module 8, and Postpartum Bonding Questionnaire were applied to mothers. Tests were performed once in group 1 at the end of the first postpartum week (test1) and twice in group 2 before the baby was discharged from the neonatal intensive care unit (test1) and 2 weeks after the discharge (test2). Results: None of the Beck Anxiety Inventory, Edinburgh Postpartum Depression Scale, Adjustment Disorder-New Module 8, and Postpartum Bonding Questionnaire scores was abnormal. Although the scales were within normal ranges, Postpartum Bonding Questionnaire 1 and Postpartum Bonding Questionnaire 2 had statistically significant correlation with gestational week (r = -0.230, P = .046; r = -0.298, P = .009), Edinburgh Postpartum Depression Scale score (r = 0.256, P = .025; r = 0.331, P = .004), hospitalization (r = 0.280, P = .014; r = 0.501, P < .001), and neonatal intensive care unit anxiety (r = 0.266, P = .02; r = 0.54, P < .001). Postpartum Bonding Questionnaire 2 had statistically significant correlation with birth weight (r = -0.261, P = .023). Conclusion: Low gestational week and birth weight, increased maternal age, maternal anxiety, high Edinburgh Postpartum Depression Scale scores and hospitalization negatively affected maternal bonding. Although all self-reporting scale scores were low, being in the neonatal intensive care unit and not being able to visit (touch) the baby is a major stressor.
Language	English
Publishing date	2023-01-28
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-6256
ISSN	2757-6256
DOI	10.5152/TurkArchPediatr.2023.22104
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Article ; Online: Can We Estimate Late-Onset Sepsis by Serial Methemoglobin Levels? An Observational Study in Preterm Neonates.

Vardar, Gonca / Rzayev, Turkay / Tezel, Kubra Gokce / Ozek, Eren

Fetal and pediatric pathology

2023 Volume 42, Issue 5, Page(s) 753–765

Abstract: Objective: ...

Abstract	Objective:
MeSH term(s)	Infant ; Infant, Newborn ; Humans ; Infant, Premature ; Methemoglobin ; Sepsis/diagnosis ; Biomarkers
Chemical Substances	Methemoglobin (9008-37-1) ; Biomarkers
Language	English
Publishing date	2023-06-15
Publishing country	England
Document type	Observational Study ; Journal Article
ZDB-ID	2165508-X
ISSN	1551-3823 ; 1551-3815 ; 1522-7952
ISSN (online)	1551-3823
ISSN	1551-3815 ; 1522-7952
DOI	10.1080/15513815.2023.2223308
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Zs.A 2043: Show issues

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Article: Turkish Neonatal Society Guideline on the Diagnosis and Management of Germinal Matrix Hemorrhage-Intraventricular Hemorrhage and Related Complications.

Çizmeci, Mehmet Nevzat / Akın, Mustafa Ali / Özek, Eren

Turkish archives of pediatrics

2022 Volume 56, Issue 5, Page(s) 499–512

Abstract: Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) remains an important cause of brain injury in preterm infants, and is associated with high rates of mortality and adverse neurodevelopmental outcomes, despite the recent advances in ... ...

Abstract	Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) remains an important cause of brain injury in preterm infants, and is associated with high rates of mortality and adverse neurodevelopmental outcomes, despite the recent advances in perinatal care. Close neuroimaging is recommended for both the detection of GMH-IVH and for the follow-up of serious complications, such as post-hemorrhagic ventricular dilatation (PHVD). Although the question when best to treat PHVD remains a matter of debate, recent literature on this topic shows that later timing of interventions predicted higher rates of neurodevelopmental impairment, emphasizing the importance of a well-structured neuroimaging protocol and timely interventions. In this guideline, pathophysiologic mechanisms, preventive measures, and clinical presentations of GMH-IVH and PHVD will be presented, and a neuroimaging protocol as well as an optimal treatment approach will be proposed in light of the recent literature.
Language	English
Publishing date	2022-02-02
Publishing country	Turkey
Document type	Journal Article
ISSN	2757-6256
ISSN	2757-6256
DOI	10.5152/TurkArchPediatr.2021.21142
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Article: Intraventricular hemorrhage in preterm babies.

Özek, Eren / Kersin, Sinem Gülcan

Turk pediatri arsivi

2020 Volume 55, Issue 3, Page(s) 215–221

Abstract: Germinal matrix-intraventricular hemorrhage (GM-IVH) is a major complication of prematurity and inversely associated with gestational age and birth weight. The hemorrhage originates from the germinal matrix with an immature capillary bed where ... ...

Abstract	Germinal matrix-intraventricular hemorrhage (GM-IVH) is a major complication of prematurity and inversely associated with gestational age and birth weight. The hemorrhage originates from the germinal matrix with an immature capillary bed where vascularization is intense and active cell proliferation is high. It occurs in around 20% of very low-birth-weight preterm neonates. Germinal matrix-intraventricular hemorrhage is less common in females, the black race, and with antenatal steroid use, but is more common in the presence of mechanical ventilation, respiratory distress, pulmonary bleeding, pneumothorax, chorioamnionitis, asphyxia, and sepsis. Ultrasonography is the diagnostic tool of choice for intraventricular hemorrhage and its complications. Approximately 25-50% of the germinal matrix-intraventricular hemorrhage cases are asymptomatic and diagnosed during routine screening. These cases are usually patients with low-grade hemorrhage. Neurologic findings are prominent in severe intraventricular hemorrhage cases. The major complications of the germinal matrix-intraventricular hemorrhage in preterm babies are periventricular hemorrhagic infarction, posthemorrhagic ventricular dilatation, periventricular leukomalacia, and cerebellar hemorrhage. It is an important cause of mortality and morbidity. The management of hemodynamics and ventilation of patients, appropriate follow-up, and early diagnosis and treatment can minimize morbidity. Prognosis in intraventricular hemorrhage is related to the severity of bleeding, parenchymal damage, and the presence of seizures and shunt surgery. The main determinant of prognosis is periventricular hemorrhagic infarction and its severity. Moderate-severe intraventricular hemorrhage can cause posthemorrhagic hydrocephalus, cerebral palsy, and mental retardation. Even mild germinal matrix-intraventricular hemorrhage can result in developmental disorders. Long-term problems such as neurodevelopmental disorders and cerebral palsy are as important as short-term problems. Improving the quality of life of these babies should be aimed through appropriate treatment and follow-up. In this review, intraventricular hemorrhage and complications are discussed.
Language	English
Publishing date	2020-09-23
Publishing country	Turkey
Document type	Journal Article ; Review
ISSN	1306-0015
ISSN	1306-0015
DOI	10.14744/TurkPediatriArs.2020.66742
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Article: Inflammatory and Hematologic Liver and Platelet (HALP) Scores in Hypothermia-Treated Hypoxic-Ischemic Encephalopathy (HIE).

Toptan, Handan Hakyemez / Tezel, Kübra Gökçe / Tezel, Oğuzhan / Ataç, Ömer / Vardar, Gonca / Gülcan Kersin, Sinem / Özek, Eren

Children (Basel, Switzerland)

2024 Volume 11, Issue 1

Abstract: Objective: This study examined systemic inflammatory indices and "Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores" in neonates with hypoxic-ischemic encephalopathy (HIE).: Methods: A total of 43 neonates with moderate-to-severe HIE at 36 ... ...

Abstract	Objective: This study examined systemic inflammatory indices and "Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores" in neonates with hypoxic-ischemic encephalopathy (HIE). Methods: A total of 43 neonates with moderate-to-severe HIE at 36 weeks' gestation were assessed. Systemic inflammatory markers were measured before HT commenced within 0-6 h after birth and between 60 and 72 h during and after therapy or before adjusting for hypothermia. Results: Platelet counts, hemoglobin levels, and platelet indices in the HIE group were significantly lower at both time points ( Conclusions: A significant difference in systemic inflammatory markers was found between the HIE and control groups after hypothermia treatment, with significant reductions in the MLR and NLR. These markers, particularly MLR, were significant predictors of adverse clinical outcomes including seizures, PVL, and kidney damage.
Language	English
Publishing date	2024-01-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children11010072
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Article ; Online: Should Fathers Also Do Kangaroo Care?

Yaman, Akan / Kandemir, İbrahim / Özek, Eren / Bilgen, Hülya Selva

American journal of perinatology

2022 Volume 41, Issue S 01, Page(s) e142–e147

Abstract: Objectives: 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 ... ...

Abstract	Objectives: 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 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 ( 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. Key points: · * The vital signs during and after kangaroo care, both in the mother and father groups, were similar.. · * The rSO2 values increased significantly in both parents during and after kangaroo care, favoring the mother.. · * This difference can be ignored as the cerebral near-infra-red spectroscopy values are within normal limits in both groups, and the participation of fathers in kangaroo care should be encouraged..
MeSH term(s)	Humans ; Kangaroo-Mother Care Method ; Infant, Newborn ; Female ; Fathers ; Male ; Infant, Premature ; Heart Rate ; Oxygen Saturation ; Adult ; Respiratory Rate ; Body Temperature ; Mothers ; Spectroscopy, Near-Infrared ; Brain/metabolism
Language	English
Publishing date	2022-05-12
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	605671-4
ISSN	1098-8785 ; 0735-1631
ISSN (online)	1098-8785
ISSN	0735-1631
DOI	10.1055/a-1850-3422
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