Acta Medica Ruha
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Emerging Paradigms in Cardiovascular Medicine: The Role of Biomarkers, Artificial Intelligence, and Gut Microbiota in Personalized Therapy — The Evolving Landscape of Cardiovascular Care: Review Article
Get PDFIntroduction: Cardiovascular diseases (CVDs) remain one of the leading causes of morbidity and mortality worldwide. While conventional diagnostic and therapeutic methods have made significant contributions, they may fall short in detecting the disease at early stages and in developing personalized treament strategies.
Objective: This review discusses three innovative approaches—biomarker-based analyses, artificial intelligence (AI)-assisted decision systems, and gut microbiota-focused applications—that have rapidly advanced in recent years and are expanding in their potential clinical applications.
Methods: With the advent of next-generation biomarkers (e.g., soluble urokinase-type plasminogen activator receptor [suPAR], suppression of tumorigenicity 2 [ST2], galectin-3, and growth differentiation factor-15 [GDF-15]), processes such as heart failure, myocardial injury, and vascular inflammation can now be assessed more sensitively and at earlier stages.
Results: AI algorithms accelerate and enhance diagnostic accuracy by analyzing imaging data, electrocardiogram (ECG) signals, and multivariate clinical parameters. Meanwhile, the influence of gut microbiota on cardiovascular pathophysiology is increasingly understood, with microbial metabolites such as trimethylamine-N-oxide (TMAO) shown to play a significant role in atherosclerotic processes.
Conclusion: A comprehensive evaluation of these three approaches offers new perspectives for the development of personalized cardiology practices and lays the groundwork for more effective strategies in diagnosis, monitoring, and treatment
Experiences of Nurses Providing Care to Burned Children Regarding Atraumatic Care Practices: A Qualitative Study: Research Article
No full textIntroduction: In pediatric burn care, atraumatic approaches are crucial to reducing children’s stress, pain, and anxiety, yet nurses’ experiences in this area remain insufficiently explored.
Objective: The aim of this study was to explore the experiences of nurses providing care to burned children regarding atraumatic care practices.
Method: This phenomenological qualitative study was conducted between March-July 2025 in the pediatric surgery department of training and research hospital in western Turkey. Fifteen nurses who had at least one year of experience in pediatric burn care were selected through purposive sampling. Data were collected via in-depth individual interviews using a semi-structured interview form and analyzed using inductive content analysis with the support of MAXQDA software.
Results: Analysis revealed one main theme, “Atraumatic Care for Injured Children,” comprising three categories and thirteen codes. Nurses reported employing strategies such as distraction, breastfeeding for infants, collaboration with families, providing age-appropriate explanations, and understanding children’s emotions during painful procedures like burn dressing. These practices were perceived to reduce fear and stress, decrease pain perception, alleviate psychological trauma, enhance treatment compliance, foster a sense of security, and increase patient-family satisfaction. Additionally, nurses recommended increasing the availability of distraction tools (e.g., toys, bubble machines, audiovisual devices) and arranging child-friendly physical environments to strengthen atraumatic care practices.
Conclusion: Atraumatic care is a key nursing approach that supports both the physical and psychological well-being of burned children. To improve care quality, it is recommended to provide supportive resources, increase the number of distraction tools, and design child-friendly care environments
Obesity and Cardiometabolic Diseases: A Gut Microbiota Centered Perspective: Review Article
No full textThe escalating trajectory of obesity worldwide constitutes a severe public health crisis, intimately linked to elevated rates of death and chronic disease burden. Contemporary medical understanding has shifted from viewing obesity solely as a caloric equilibrium issue to recognizing it as a complex, multifactorial pathology driven by neurohormonal disruptions, metabolic dysregulation, and inflammatory cascades. Adipose tissue is no longer regarded merely as an energy depot; it is an active endocrine organ where cellular expansion and hypoxia precipitate chronic low-grade inflammation, a precursor to insulin insensitivity and metabolic breakdown. Recently, the intestinal ecosystem has been identified as a central architect in the development of metabolic syndrome and cardiovascular impairments. Individuals with obesity typically exhibit a distinct microbial signature characterized by diminished diversity and dysbiosis. Mechanistically, the gut flora dictates host metabolic health by modulating lipid profiles, energy harvesting, and immune responses via several pathways, including the fermentation of fibers into short-chain fatty acids, the regulation of bile acid signaling, the modulation of metabolic endotoxemia, and the inhibition of FIAF. Of particular concern is the synthesis of trimethylamine-N-oxide (TMAO) by gut bacteria, which directly exacerbates atherosclerotic plaque progression and heightens platelet reactivity. Furthermore, the bidirectional communication via the gut-brain axis plays a pivotal role in regulating satiety and dietary choices. In light of these associations, therapeutic strategies that reshape the microbial landscape—ranging from probiotic and prebiotic administration to fecal microbiota transplantation and novel pharmacological modulators—hold significant promise for mitigating the cardiometabolic risks associated with obesity
Examining the Relationship Between Occupational Fatigue and Health Perception Among Textile Factory Workers: Research Article
No full textObjective: The study examined the relationship between occupational fatigue and health perceptions among workers in a textile factory.
Method: This descriptive study was carried out in textile factories. These were located in the Nusaybin district of Mardin. The study took place between October 2023 and October 2024. A total of 760 textile workers were included in the study. However, of those who agreed to participate in the study, only 654 were included in the sample. Data were collected using three forms: the Information Form, the Occupational Fatigue, Exhaustion and Recovery Scale, and the Health Perception Scale. The analysis of the data involved descriptive statistics, a t-test for independent groups, an analysis of variance and a correlation analysis. All the necessary permits have been obtained for the work to be carried out.
Results: The study found very weak relationships between health perception and chronic fatigue (r = .161, p = .000) and between perceived health and acute fatigue (r = .115, p = .003) among the subscales of the Occupational Fatigue, Burnout and Recovery Scale. A weak but significant relationship was found between health perception and the recovery sub-dimension (r=.299, p=0.000).
Conclusion: Therefore, proactive measures should be taken to reduce occupational fatigue levels among textile factory workers and encourage positive health perceptions
Effects of Non-pharmacological and Complementary Interventions on Foot Function in Painful and Non-painful Diabetic Peripheral Neuropathy: Review Article
Get PDFDiabetic peripheral neuropathy (DPN) is a major determinant of diabetic foot disease and lower-limb amputation, affecting not only pain but also foot function, gait, balance, and ulcer risk. While non-pharmacological and complementary interventions are increasingly used as adjuncts to pharmacotherapy in both painful and non-painful DPN, the extent to which these approaches influence foot-related outcomes remains unclear. This review synthesises current evidence on the effects of non-pharmacological (e.g. foot–ankle exercise, physical therapy, insoles and orthoses, educational and web-based programmes) and complementary interventions (e.g. reflexology, acupuncture, Reiki, foot massage) on foot function in individuals with DPN. Across randomized and controlled trials, foot–ankle–focused exercise programmes consistently improved intrinsic foot muscle strength, plantar pressure distribution, ankle–foot kinematics, balance, and gait performance, and reduced mechanical risk factors associated with ulceration. Insoles and orthoses with various materials and designs were shown to lower peak plantar pressures and pressure–time integrals and redistribute load away from high-risk metatarsal head regions, supporting their role as effective off-loading strategies. Complementary therapies demonstrated beneficial effects on neuropathic pain and overall quality of life; however, foot function-specific outcomes (e.g. plantar pressure, deformity progression, ulcer incidence, foot-related quality of life) were rarely assessed and were typically reported only as secondary, limited endpoints. Overall, the evidence supports integrating structured exercise and podiatric off-loading strategies into DPN management, while highlighting the need for methodologically robust trials that systematically evaluate foot-centred outcomes to clarify the true podiatric impact of complementary interventions
The Effect of Breast Milk and Breastfeeding Education Given to Prenatal Mothers on Postnatal Breastfeeding Behaviors and Attitudes: Research Article
No full textIntroduction: Antenatal breastfeeding education plays a crucial role in positively shaping mothers' postnatal attitudes and practices, thereby promoting sustained breastfeeding and enhancing neonatal health outcomes.
Objective: This study aimed to evaluate the effects of breast milk and breastfeeding education provided to antenatal mothers on their postnatal breastfeeding behaviors and attitudes.
Methods: A descriptive and cross-sectional study was conducted at the Department of Obstetrics and Gynecology at Ankara University Cebeci Research and Practice Hospital between August 2021 and August 2023. In the study, data were collected from 199 mothers who gave birth at 36 weeks or more in the Obstetrics and Gynecology clinic, who were not separated from their babies for any reason after birth, who did not have any health problems that could prevent breastfeeding, and who agreed to participate in the study, using the Descriptive Characteristics Form, the Effects of Breast Milk and Breastfeeding Education on Postpartum Breastfeeding Behaviors Form, and the Breastfeeding Attitude Assessment Scale questionnaires 6 months after birth. Descriptive analysis, one-way ANOVA test, and independent groups t-test were used for statistical analysis.
Results: Among the 199 mothers, 100 received prenatal education on breastfeeding, while 99 did not. Notably, 97% of mothers who received training planned to breastfeed for over two years, compared to only 8.1% of those without training (p<0.01). Additionally, the average score on the breastfeeding attitude scale was significantly higher in the educated group (132.14±8.42) than in the uneducated group (68.28±10.85) (p<0.01).
Conclusion: It was found that mothers who received antenatal breast milk and breastfeeding education had better postnatal breastfeeding attitudes and breastfed longer than mothers who did not receive education. There was no difference in duration of first breastfeeding or duration of first skin-to-skin contact between mothers who received education and those who did not
Is Preoperative Upper Gastrointestinal Endoscopy Necessary Before Cholecystectomy? Research Article
No full textIntroduction: Cholecystectomy is one of the most frequently performed surgical procedures for the treatment of gallbladder diseases. However, the persistence of symptoms or the emergence of new gastrointestinal complaints in some patients post-cholecystectomy remains a notable concern. The literature indicates an increased incidence of alkaline reflux gastritis in the long term following cholecystectomy. Nevertheless, the preoperative status of the gastric mucosa and the presence of Helicobacter pylori (H. pylori) infection in these patients have not been sufficiently investigated. This study aims to evaluate preoperative upper gastrointestinal endoscopy (UGIE) findings in patients undergoing cholecystectomy to determine the prevalence of chronic gastritis and H. pylori infection. Additionally, we seek to analyze the association between preoperative findings and the persistence of postoperative symptoms, thereby contributing to clinical strategies for post-cholecystectomy patient management.
Methods: In this retrospective study, 465 patients who underwent cholecystectomy within the past year were reviewed. Among these, 50 patients (29 female, 21 male) who had undergone preoperative UGIE were included. Of the 465 patients reviewed, only those who had undergone preoperative UGIE and met the inclusion criteria (laparoscopic cholecystectomy, no gastrointestinal malignancy) were included, resulting in a final cohort of 50 patients. Demographic characteristics and endoscopic biopsy results were analyzed. Statistical evaluation was performed using SPSS software.
Results: The study cohort of 50 patients comprised 56% females and 44% males, with a mean age of 42.3 ± 12.1 years. Chronic gastritis was identified in 68% of patients, and H. pylori positivity was detected in 52%.
Conclusions: Preoperative evaluation of gastric mucosa and consideration of H. pylori eradication in patients undergoing cholecystectomy may hold clinical significance for managing postoperative symptoms. Routine preoperative endoscopy may be beneficial in identifying patients at risk for persistent postoperative symptoms
Nutrition and Longevity in Aging: Dietary Strategies for Healthy Lifespan Extension: Review Article
No full textAging involves progressive physiological decline, increasing susceptibility to chronic disease and functional loss. Nutrition is a key modifiable determinant of healthspan, influencing oxidative stress, mitochondrial function, proteostasis, and nutrient-sensing pathways such as Mechanistic Target of Rapamycin (mTOR), Adenosine Monophosphate-Activated Protein Kinase (AMPK), Insulin-Like Growth Factor-1 (IGF-1), and sirtuins. Adequate protein preserves muscle mass, while high-quality fats especially omega-3s support cardiovascular, metabolic, and cognitive health. Low-glycemic, fiber-rich carbohydrates enhance insulin sensitivity and promote a diverse gut microbiome that generates short-chain fatty acids with anti-inflammatory effects. Dietary patterns like the Mediterranean diet, Blue Zone diets, and the Longevity Diet are linked to lower cardiometabolic risk and slower biological aging. Caloric restriction, intermittent fasting, and fasting-mimicking diets activate autophagy and mitochondrial efficiency. Effective implementation requires considering multimorbidity, polypharmacy, psychosocial factors, and food access. Advances in nutrigenomics, microbiome science, and digital health enable personalized nutrition, while sustainable plant-forward diets support both healthspan and environmental goals. Integrating nutrition into clinical care and public health can extend healthy lifespan and improve quality of life in older adults
Religious Coping, Hopelessness and Quality of Life in Mothers of Children in Pediatric Cardiac Surgery Intensive Care Unit: Research Article
No full textIntroduction: Congenital heart diseases are among the leading causes of infant mortality.
Objective: This research investigated the religious coping, hopelessness and quality of life in mothers of children who underwent open heart surgery and were hospitalized in the Pediatric Cardiac Surgery Intensive Care Unit.
Methods: In the study, data were collected from 225 mothers whose children underwent open-heart surgery using a Demographic Form, Religious and Spiritual Coping Scale, Beck Hopelessness Scale, and Quality of Life Scale.
Results: It was found that while the hopelessness sub-dimension and total score and the negative religious coping scale sub-dimension mean scores were low, the positive religious coping scale sub-dimension mean scores were high and the quality of life scale mean scores were moderate. It was determined that there was a negative relationship between the negative religious coping sub-dimension and the quality of life scale's general health status, social relations, and environment sub-dimensions, and between the quality of life scale and the hopelessness scale.
Conclusion: It can be said that more studies are needed to understand the relationship between the religious coping styles of mothers with children with congenital heart disease and their levels of hope and quality of life, and to eliminate the contradictions in the literature
Effect of Spiritual Well-Being Level on Pain, Nausea and Vomiting in Patients Undergoing Cholecystectomy Surgery: Research Article
No full textIntroduction: Spiritual well-being is considered an important component of holistic health and may influence patients’ perceptions of pain and other postoperative symptoms. Although cholecystectomy is a common surgical procedure, limited evidence exists regarding the role of spiritual well-being in the early postoperative recovery process. Understanding this relationship may guide nurses and clinicians in providing more individualized and holistic postoperative care.
Objective: This study aimed to examine the influence of spiritual well-being levels on early postoperative pain, nausea, and vomiting among patients who underwent cholecystectomy.
Methods: This descriptive study included 170 patients who underwent cholecystectomy. Data were collected using the Descriptive Characteristics Form, the Spiritual Well-Being Scale, and the Visual Analog Scale for pain intensity. Postoperative nausea and vomiting were assessed based on patient self-report during the early postoperative period.
Results: The mean age of the participants was 46.89±9.89 years, and 71.8% were women. The mean score on the Spiritual Well-Being Scale was 112.44±16.21, while the mean postoperative pain intensity measured by the Visual Analog Scale was 4.84±2.26. Analysis demonstrated that spiritual well-being was not significantly associated with postoperative pain levels, nausea, or vomiting.
Conclusions: The findings indicated that spiritual well-being did not influence early postoperative pain, nausea, or vomiting among patients who underwent cholecystectomy. These results suggest that spiritual well-being alone may not play a determining role in acute postoperative symptom experience. Further research involving different populations and longitudinal designs is recommended to explore the broader effects of spiritual well-being on surgical recovery