Nevin Manimala

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):406-411. doi: 10.32687/0869-866X-2026-34-s1-406-411.

ABSTRACT

This article examines the relationship between coverage by dispensarization (preventive health screening) and qualitative characteristics of employment in the regions of the Central Federal District of Russia. An analysis of statistical data for 2017-2023 is presented, describing the level of participation of the working population in preventive medical examinations and key parameters of employment quality, including working conditions, forms of labour relations, and social protection of workers. It is noted that there is substantial differentiation among the Central Federal District regions both in dispensarization coverage and in employment quality indicators. The study finds that regions with higher employment quality also demonstrate higher participation rates of the working population in dispensarization, supporting the hypothesis that characteristics of labour relations affect accessibility to preventive medical care. Key factors linking employment quality and dispensarization coverage are identified as the formal nature of labour relations, which enables workers to exercise their legally guaranteed right to time off for medical examinations, and employer engagement in creating conditions for staff participation in preventive activities. The article concludes that improving employment quality through strengthening social and labour guarantees and enhancing working conditions can be regarded as an important resource for increasing dispensarization coverage among the working population and, consequently, for improving public health.

PMID:42402115 | DOI:10.32687/0869-866X-2026-34-s1-406-411

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):460-465. doi: 10.32687/0869-866X-2026-34-s1-460-465.

ABSTRACT

The article presents an analysis of the dynamics in the number of healthcare organizations of various forms of ownership in the Russian Federation for the period from 2009 to 2024. The study was conducted using statistical and analytical methods of time series data processing. Opposite trends in the development of the public and private healthcare sectors have been identified. In the public sector, a reduction in the number of hospital organizations by 27.66% was recorded, alongside a simultaneous increase in the number of outpatient clinics by 23.63%, reflecting the optimization processes in the inpatient sector and the strengthening of primary health care. The private sector demonstrated exponential growth: the number of hospital organizations increased almost fourfold, and outpatient clinics more than doubled. The capacity of private outpatient clinics increased more than fourfold. All identified trends are confirmed by statistical significance. The results obtained indicate the transformation of private medicine into a significant element of the national health protection system, capable of filling the deficit niches of the public sector.

PMID:42402114 | DOI:10.32687/0869-866X-2026-34-s1-460-465

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):513-519. doi: 10.32687/0869-866X-2026-34-s1-513-519.

ABSTRACT

In the context of contemporary globalization, rural residents frequently encounter multiple barriers when attempting to access timely and high-quality healthcare. This article analyzes factors influencing the accessibility and quality of medical services for rural populations, including geographical isolation, limitations in material, human, and technological resources, and specific features of the socio-economic environment. Special attention is given to vulnerable groups within the rural population-such as women, children and adolescents, persons with disabilities, older adults, and inhabitants of areas prone to natural disasters – for whom restricted access to healthcare has cumulative and long-term effects, adversely impacting both physical and mental health indicators. Based on a systematic review of domestic and international publications from recent years, the study identifies key barriers and enabling factors that can improve access to healthcare in rural settings, including the development of primary healthcare services.

PMID:42402107 | DOI:10.32687/0869-866X-2026-34-s1-513-519

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):431-435. doi: 10.32687/0869-866X-2026-34-s1-431-435.

ABSTRACT

The quality of healthcare is a complex, interdisciplinary category. Current approaches to assessing quality of life are typically based on statistical data, medical statistics, and subjective assessments obtained through mass population surveys. Using expert surveys as a method not only for assessment but also for a deeper professional understanding of processes occurring in the healthcare system, predicting their consequences, and identifying the causes of changes in public opinion appears most appropriate, particularly for regional healthcare systems. Experts from regional communities are most immersed in issues related to their local context. The research methodology was based on the «structure, process, result» (Donabedian) approach and included a survey of experts from regional professional communities in the regional capital of the Kursk border region (n = 40). The experts included representatives from healthcare management, business, science and education, medical professionals, opinion leaders, and political scientists. The results of the expert survey revealed contradictions in regional healthcare management, which are exacerbated by a significant outflow of professional personnel.

PMID:42402106 | DOI:10.32687/0869-866X-2026-34-s1-431-435

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):426-430. doi: 10.32687/0869-866X-2026-34-s1-426-430.

ABSTRACT

This article is based on the results of a study analyzing the opinions and perceptions of medical students regarding their future professional activities. The objective of the study was to examine and analyze the attitudes and plans of medical students regarding their chosen profession. The object of the study was the professional attitudes of students in the Faculty of General Medicine. The theoretical methodology of the article is based on a sociological approach to professionalization, taking into account the activity-based and certification approaches. The empirical basis of the study was the results of a sociological survey conducted among 220 medical students in January 2026 (KSMU, Kursk, n = 100; RNRMU, Moscow, n = 75; PSPbSMU, St. Petersburg, n = 45). The study found that young people, typically those who have completed pre-professional school training, consciously choose medical universities. Half of the study participants expressed a willingness to remain in the state healthcare system, with minor regional differences. To create an effective healthcare system capable of adequately responding to the needs of young professionals, it is necessary to develop conditions for retaining young professionals in state healthcare, taking into account the expectations of todays students (unique experience, stability, career advancement, etc.).

PMID:42402105 | DOI:10.32687/0869-866X-2026-34-s1-426-430

Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med. 2026 Jun 27;34(0):358-362. doi: 10.32687/0869-866X-2026-34-s1-358-362.

ABSTRACT

Road accidents are a significant public health issue and a common cause of death. This article analyzes the main risk factors for road accidents and their impact on road mortality and injury. The most significant of these are speeding, alcohol consumption, and motorcycle use. Age, gender, and mobile phone use while driving are also significant factors. Seasonality, time of day, and road surface quality have a lesser impact on the risk of road accidents. Knowledge of road accident risk factors will enable the implementation of more effective measures to prevent road incidents. This, in turn, will reduce road user fatalities and injuries and reduce the material costs associated with the consequences of road accidents.

PMID:42402099 | DOI:10.32687/0869-866X-2026-34-s1-358-362

Ann Pharmacother. 2026 Jul 5:10600280261452547. doi: 10.1177/10600280261452547. Online ahead of print.

ABSTRACT

BACKGROUND: Acute kidney injury (AKI) is common in critically ill patients, but the optimal dosing of beta-lactam antibiotics in this setting remains controversial. It is not known whether the benefit of initiating beta-lactams at normal doses outweighs the risk of accumulation and toxicity.

OBJECTIVE: We aimed to evaluate the association between early dose adjustment of piperacillin/tazobactam (PT) and 28-day intensive care unit (ICU) mortality in critically ill patients with AKI.

METHODS: We conducted a retrospective multicenter cohort study using the eICU Collaborative Research Database v2.0 and included adult ICU patients with AKI who received PT and had a pretreatment serum creatinine level corresponding to an estimated glomerular filtration rate (eGFR) <40 mL/min/1.73 m². The exposure was PT dose in the first 24 hours, which was categorized as normal (≥13.5 g/24 h) or adjusted (<13.5 g/24 h). The primary outcome was 28-day ICU mortality.

RESULTS: Among 1639 eligible patients, 224 (13.7%) received normal-dose PT and 1415 (86.3%) received adjusted doses. The overall 28-day ICU mortality was 11%, with significantly lower mortality in the normal-dose group (6.7%) compared with the adjusted-dose group (11.7%) (unadjusted odds ratio [OR] 1.85, 95% confidence interval [CI] 1.07-3.20; P = .028). After multivariable adjustment, early dose adjustment was independently associated with higher 28-day ICU mortality (adjusted OR 2.11, 95% CI 1.13-3.96; P = .020). Results were consistent across multiple subgroup and sensitivity analyses, but statistical significance was attenuated when the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation was used for eGFR estimation.

CONCLUSION AND RELEVANCE: Early dose adjustment of PT in critically ill patients with AKI is associated with increased 28-day ICU mortality. This finding suggests that renal dose adjustment of PT should be deferred beyond the first 24 hours of therapy in this population. Prospective studies are needed to confirm this finding, define the optimal timing of subsequent dose adjustments, and assess safety outcomes.

PMID:42402098 | DOI:10.1177/10600280261452547

Discov Nano. 2026 Jul 5;21(1):323. doi: 10.1186/s11671-026-04748-7.

ABSTRACT

The flow of blood through stenotic arteries is considered one of the most significant areas of investigation in the world of mathematical fluid mechanics. This significance arises from the topic’s application to the field of biomedicine. Within an arterial system of blood that has been stenosed, the goal of this research initiative is to investigate the effect that nanoparticles have on the characteristics that define the human circulatory system. The current investigation analyzes blood flow behavior in a controlled, permeable artery employing the Casson hybrid nanofluid model and, additionally, gold, Cu, and silver nanoparticles. The current study examines the investigation of magnetohydrodynamics (MHD) Casson hybrid nanofluid Darcy-Forchheimer flow (DFF) over a stenotic artery with a heat source/sink. By transforming the partial differential equations (PDEs) into ordinary differential equations (ODEs) by utilizing suitable similarity variables. After that, the mathematical solution of these equations used the BVP4c method in the MATLAB solver and analysis for skin and Nusselt number table values for hybrid nanofluid cases. The statistical analysis is used to solve for different physical factors. During a study in which values of both variables are subject to essentially unknown oversights, the task is utilizing statistical techniques to discover the best possible linear equations. In this concept, two different hybrid nanomaterials are used for analyzing heat transfer characteristics. According to these graphical results, the present model concludes that case-2 has better performance than case-1. Rising values of the magnetic parameter improve heat transfer owing to Joule heating impacts and control flow via the Lorentz force, which in turn affects the distribution of shear stresses close to the artery wall. The current work highlights the role of nanoparticles and magnetic fields in enhancing flexibility near arteries’ surfaces. This work has substantial repercussions for the treatment of cancer and the treatments that are used to avoid cardiovascular disease, as it suggests that improved heat transfer and shear stress distribution can enhance the effectiveness of therapies targeting tumor cells and improve blood flow in cardiovascular interventions.

PMID:42402075 | DOI:10.1186/s11671-026-04748-7

ARP Rheumatol. 2026 Apr-Jun;5(2):117-122.

ABSTRACT

BACKGROUND: The prevalence of Direct Coombs test (DCT) positivity in systemic lupus erythematosus (SLE) ranges from 12.8% to 65.2%. Approximately 5-11% of people with SLE have autoimmune haemolytic anaemia (AIHA), characterised by autoantibodies against erythrocytes that cause haemolysis. In about half of the SLE patients, DCT positivity occurs even in the absence of AIHA, likely due to immune complexes binding to red blood cells via complement receptor 1 (CR1), suggesting a higher immune complex load.

OBJECTIVES: To determine the DCT positive rate in SLE patients without AIHA and its association with disease activity, as measured by the SLE Disease Activity Index 2000 (SLEDAI-2K) score.

METHODS: This descriptive cross-sectional study was conducted at a tertiary care centre in South India from March 2023 to March 2025. SLE patients who met the 2019 ACR/EULAR classification criteria without AIHA were included. Disease activity was measured using the SLEDAI-2K. The DCT was performed using the standard antihuman globulin, and a reaction grade of 1+ or higher was considered positive. The study compared DCT-positive and DCT-negative groups using statistical analysis.

RESULTS: The study included 92 SLE patients, most of whom were female (97.8%), with a mean age of 35.1 ± 9.49 years, and a mean disease duration of 4.56 ± 4.36 years. DCT positivity without AIHA was found in 33.6% of the patients. DCT-positive patients had a higher median SLEDAI-2K score than DCT-negative patients (8 [IQR 3.5-10.5] vs 0 [IQR 0-5]; p < 0.001). DCT positivity was also strongly associated with arthritis (p < 0.001) and with higher anti-double-stranded DNA antibody levels (p = 0.008).

CONCLUSION: In individuals with SLE, DCT positivity without AIHA was common and was associated with higher contemporaneous disease activity, arthritis, and elevated anti-double-stranded DNA antibody levels. These findings suggest that DCT positivity may reflect increased immune activity at a single point in time. However, its utility in predicting future flares or monitoring longitudinal disease activity remains uncertain and requires prospective validation.

PMID:42402059

Ann Med. 2026 Dec;58(1):2696600. doi: 10.1080/07853890.2026.2696600. Epub 2026 Jul 5.

ABSTRACT

BACKGROUND: To determine the circumstances of acute poisoning cases at the Poison Control Center (2021-2024) and analyze their risk factors.

METHODS: We retrospectively analyzed the demographic characteristics, clinical features, and prognosis of patients with acute poisoning at the Poison Control Center.

RESULTS: This study included 10,402 cases comprising drug poisoning (5,074), alcohol poisoning (2,316), carbon monoxide poisoning (1,803), pesticide poisoning (882), and chemical poisoning (327). The age group with the highest incidence of poisoning was 21-40 years old (37.94%, p < 0.01). Women have a higher proportion of drug poisoning (72.59%, p < 0.01), while men have a higher proportion of alcohol poisoning (74.31%, p < 01). Patients with pesticide poisoning were predominantly educated to the middle school level or below (73.02%, p < 0.01), whereas those with alcohol poisoning were mainly educated to the high school level or above (73.88%, p < 0.01). Carbon monoxide and pesticide poisoning occur primarily in rural areas. Poisoning incidents at home accounted for 74.32%, alcohol poisoning frequently occurred in entertainment venues (60.58%, p < 0.01). Carbon monoxide poisoning is more common in January and December, whereas drug poisoning has a higher incidence throughout the year. Carbon monoxide, chemical and alcohol poisoning were predominantly accidental, whereas drug and pesticide poisoning were mainly intentional. Gastric lavage dominated pestic ide poisoning; Antidotes prevailed in alcohol poisoning.The overall mortality rate was 1.56 %, highest for pesticide poisoning (8.28%, p < 0.01).

CONCLUSION: Different types of poisoning have distinct sociodemographic characteristics, that should be considered when developing prevention and treatment policies. Personalized treatment plans should be tailored to different poisonings.

PMID:42402047 | DOI:10.1080/07853890.2026.2696600