Acta Medica Ruha

Cardiopulmonary Bypass Circuit Coatings: Recent Advances and Future Perspectives

2025-12-12T00:56:15+03:00

Introduction: Cardiopulmonary bypass (CPB) circuits expose blood to non-physiological surfaces, leading to platelet activation, coagulation disturbances, complement activation, hemolysis, and systemic inflammation. Early-generation heparin-coated circuits reduced thrombin formation, decreased heparin requirements, and mitigated inflammatory responses, laying the foundation for modern hemocompatible devices.

Objective: This review aims to summarize recent advances in CPB circuit coatings, critically evaluate their hemocompatibility, and highlight emerging strategies that enhance blood compatibility and reduce complications during extracorporeal circulation.

Method: Literature from the past decade was analyzed, focusing on polymer-based, zwitterionic, endothelial-mimetic, and nitric oxide–releasing coatings. Studies evaluating in vitro, preclinical, and clinical outcomes were considered, with emphasis on platelet activation, coagulation, complement activation, hemolysis, and inflammatory markers.

Results: Hydrophilic polymers such as PEG- and PMEA-based coatings reduced protein adsorption and platelet adhesion. Zwitterionic polymers demonstrated non-fouling properties under prolonged blood contact. Endothelial-mimetic coatings replicated vascular surface functions, enhancing hemocompatibility in preclinical models. Nitric oxide–releasing surfaces inhibited platelet activation and fibrin deposition. Improved hemocompatibility assessment using biomarkers including PF4, β-thromboglobulin, P-selectin, complement factors, and hemolysis indices enabled comparative evaluation of coating performance. Miniaturized extracorporeal circuits further decreased systemic inflammation and improved clinical outcomes.

Conclusion: Contemporary CPB circuit coatings substantially improve blood compatibility compared with uncoated circuits. While heparin-coated systems remain widely used, emerging polymeric, zwitterionic, endothelial-mimetic, and nitric oxide–releasing surfaces offer additional benefits. Ongoing research into hybrid multifunctional coatings, long-term durability, and clinical translation is essential to optimize CPB safety and physiological performance.

Rapid Treatment Recommendations for Unilateral Pulmonary Edema in the Emergency Department

2025-12-04T20:43:18+03:00

This letter reviews a reported case of unilateral pulmonary edema, emphasizing its cardiac origins, the diagnostic challenges involved, and the importance of rapid intervention in the emergency department. This case study focuses on an elderly patient who showed significant improvement following pleural puncture and medical treatment, emphasizing the importance of combining interventional and supportive treatments for prompt respiratory stabilization.

Health Workers' Knowledge and Attitudes Regarding Lactational Amenorrhea at Family Health Centers

2025-11-18T14:47:28+03:00

Introduction: The Lactational Amenorrhea Method (LAM) is an effective, low-cost postpartum family planning strategy when applied under three essential criteria: amenorrhea, exclusive and frequent breastfeeding, and an infant younger than six months. Healthcare professionals play a key role in providing accurate counseling on LAM; however, knowledge gaps may limit the method’s effective use.

Objective: This study aimed to evaluate the knowledge and attitudes of healthcare workers employed at Family Health Centers in Şanlıurfa regarding LAM.

Method: This descriptive study was conducted between September and October 2024 among 166 healthcare workers from 28 Family Health Centers. Data were collected using an online questionnaire assessing sociodemographic characteristics, awareness of LAM, and knowledge of LAM criteria.

Results: Although 87.3% had heard of LAM and 85.5% reported being familiar with the method, correct knowledge of key criteria was limited. While 65.1% correctly identified the effective postpartum period for LAM, only 4.8% demonstrated full knowledge of breastfeeding requirements, and merely 1.2% correctly identified all menstrual bleeding characteristics indicating method failure.

Conclusion: Despite high awareness of LAM, substantial gaps exist in healthcare workers’ detailed knowledge of the essential criteria for its effectiveness—particularly regarding menstrual bleeding characteristics. Regular training programs and updated counseling protocols are recommended to strengthen healthcare workers’ knowledge and enhance the quality of postpartum family planning services in regions with high numbers of breastfeeding women.

Surgical Management and Pathological Outcomes of Pet-Avid Solitary Pulmonary Nodules: A Single-Center Retrospective Cohort

2026-02-09T14:00:19+03:00

Introduction: Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is frequently used to estimate malignancy risk in solitary pulmonary nodules (SPNs), yet false-positive uptake is common in inflammatory and granulomatous disease.

Objective: To describe our surgical management of PET-avid SPNs and to evaluate the association between maximum standardized uptake value (SUVmax) and malignancy.

Method: We retrospectively reviewed 69 consecutive patients with SPNs (≤3 cm) showing increased FDG uptake (SUVmax ≥2.5) who underwent surgery between December 2008 and September 2011 at Akdeniz University. All patients lacked a definitive diagnosis after noninvasive or minimally invasive attempts. The initial procedure was diagnostic wedge resection with intraoperative frozen section; surgery was terminated for benign lesions, whereas primary lung cancer prompted anatomic resection with systematic mediastinal lymph node sampling. Categorical variables were compared with chi-square and continuous variables with Student’s t-test or Mann–Whitney U test as appropriate (p<0.05).

Results: The cohort included 46 men (66.7%) and 23 women (33.3%), with a mean age of 58.16±12.11 years. Final pathology showed benign disease in 46.4%, primary lung cancer in 42.0%, and metastasis in 11.6%. Wedge resection was performed in 55.1% and anatomic resection in 44.9%. Mean SUVmax was significantly higher in malignant than benign nodules (10.54±7.30 vs 4.61±2.27; p<0.001).

Conclusion: Nearly half of PET-avid SPNs were benign, underscoring the limited specificity of FDG-PET/CT in endemic inflammatory settings. Higher SUVmax was associated with malignancy, but surgical resection remains a valuable diagnostic and potentially curative strategy when tissue diagnosis cannot be obtained otherwise.

Is There a Relationship Between Helicobacter Pylori and Infantile Colic? Evaluation With Sociodemographic Variables

2025-12-28T19:49:43+03:00

Introduction: Infantile colic is a common condition in early infancy, characterised by episodes of inconsolable, high-pitched crying in otherwise healthy infants during the first three months of life. Despite its high prevalence and frequent healthcare utilisation, the etiology of infantile colic remains unclear, and no definitive risk factors have been established.

Objective: To investigate the association between Helicobacter pylori infection and infantile colic in infants aged 6 weeks to 3 months and to evaluate other potential risk factors.

Methods: This case–control study included 70 infants presenting to an outpatient clinic. Thirty-five infants diagnosed with infantile colic were compared with 35 age-matched healthy infants without colic. Helicobacter pylori positivity and additional potential risk factors were assessed and analysed between groups.

Results: Helicobacter pylori positivity was detected in 20% of infants with infantile colic and in 6.1% of infants in the control group. Although H. pylori infection was more frequently observed in the colic group, the difference did not reach statistical significance. No other evaluated risk factor showed a significant association with infantile colic.

Conclusion: While Helicobacter pylori infection was detected more frequently among infants with infantile colic, the findings do not support a significant etiological relationship. Larger, well-designed studies are needed to clarify the potential role of H. pylori in the pathogenesis of infantile colic.