Tag: nevin manimala

Ter Arkh. 2026 Aug 18;98(8):478-485. doi: 10.26442/00403660.2026.08.203763.

ABSTRACT

BACKGROUND: Identifying the character, frequency, and intensity of cough is crucial in clinical practice, aiding in differential diagnosis, influencing treatment choices. «CoughScan» is a software with an embedded neural network model designed to assess cough frequency in real-time for diagnostic and monitoring purposes.

AIM: To obtain additional data on the efficacy and safety of Rengalin® in the treatment of cough in adults with acute respiratory viral infections (ARVI) using both traditional and new intelligent technologies.

MATERIALS AND METHODS: An observational study was conducted involving 60 patients with ARVI, receiving Rengalin® for cough management. Outpatient patients were divided into 2 groups: the main group (n=40) received Rengalin® for 7 days, while the control group (n=20) received no cough medication. The severity of symptoms of ARVI and cough was assessed with Cough severity scale (CSS), «CoughScan», Bronchitis Severity Scale (BSS).

RESULTS: The cough severity score on CSS decreased by 2.9 points in the Rengalin® group and by 1.5 points in the control group (p=0.0004). The average BSS score reduced by 1.3 units with Rengalin® and by 0.2 units in controls (p=0.0001). The mean duration of cough during treatment was 5.7±0.2 days versus 7.2±0.4 days without treatment (p=0.0178). Monitoring of daily cough intensity with «CoughScan» also showed a statistically significant advantage in the Rengalin® group (p<0.0001). A non-inferiority test based on the area under the curve (AUC) over 7 days indicated comparable results between «CoughScan» and the CSS, with differences within 10%.

CONCLUSION: «CoughScan» is a convenient and reliable tool for assessing cough dynamics in outpatient settings. Its data are comparable to the Cough severity scale regarding treatment efficacy, with antitussive activity of Rengalin® evident from the early days of therapy.

PMID:42625540 | DOI:10.26442/00403660.2026.08.203763

Ter Arkh. 2026 Aug 18;98(8):466-471. doi: 10.26442/00403660.2026.08.203726.

ABSTRACT

AIM: To evaluate the structure of cardiovascular pharmacotherapy prescribed during the preoperative period including antihypertensive, antiarrhythmic, antianginal, lipid-lowering, and antiplatelet drugs and to analyze its compliance with clinical indications in patients scheduled for elective orthopedic interventions on the major joints of the lower extremities.

MATERIALS AND METHODS: This prospective, single-center cohort study included 1,733 patients. In all patients, a detailed medical history was obtained, an additional physical examination including blood pressure measurement was performed, and previously prescribed cardiovascular therapy was analyzed.

RESULTS: The study population included 617 (35.6%) males and 1116 (64.4%) females with mean age 64.7±10.4 years. The majority (90.5%) patients were overweight, and 77.6% of patients had hypertension and other cardiovascular diseases; in 142 (10.5%) patients, no antihypertensive therapy had been prescribed prior to hospitalization, while in 295 (21.9%) patients, target blood pressure levels were not achieved despite previously prescribed therapy. Furthermore, 262 (15.1%) individuals were regularly taking various anticoagulants, and 534 (30.9%) were taking antiplatelet agents; of the latter group, 342 (19.7%) patients had no indications for such treatment.

CONCLUSION: The patient population undergoing total hip arthroplasty and total knee arthroplasty is characterized by a high prevalence of cardiovascular diseases; however, in a subset of these patients, antihypertensive therapy is suboptimal, and many patients with hypercholesterolemia do not receive statins despite clear indications. On the other hand, many patients take antiplatelet agents without appropriate indications – a situation that underscores the need to raise awareness among both patients and healthcare professionals.

PMID:42625538 | DOI:10.26442/00403660.2026.08.203726

Ter Arkh. 2026 Aug 18;98(8):458-465. doi: 10.26442/00403660.2026.08.203725.

ABSTRACT

AIM: To evaluate the prevalence and identify risk factors for Helicobacter pylori infection in patients with acute myocardial infarction (AMI) and stable coronary artery disease (CAD).

MATERIALS AND METHODS: A total of 110 patients were enrolled in a single-center study. The patients were divided into two groups according to the form of CAD. The first group (n=54) consisted of patients with AMI after primary percutaneous coronary intervention, with a mean age of 62.00 years; 53 patients (94.64%) were on dual antiplatelet therapy. The second group (n=56) included patients with stable CAD who had undergone coronary artery stenting within the previous year, with a mean age of 67.5 years, of whom 42 patients (77.78%) were on dual antiplatelet therapy. The standard examination included analysis of complaints, laboratory tests (complete blood count, biochemical blood test, coagulogram), as well as testing for H. pylori. The ¹³C-urea breath test was used for patients with AMI, while for patients with stable CAD, testing was performed via biopsy during esophagogastroduodenoscopy.

RESULTS: The frequency of H. pylori infection differed between the patient groups. Among patients with stable CAD, a positive result was found in 17 (31.5%) individuals, while a negative result was found in 37 (68.5%). In the group of patients who had experienced AMI, the proportion of infected individuals was higher, at 26 (46.4%), whereas non-infected patients numbered 30 (53.6%). According to univariate analysis, H. pylori-positive status was statistically significantly associated with smoking and the presence of dyspeptic complaints. These results persisted after adjusting for sex and age. In patients with AMI, the infection was also associated with higher systolic blood pressure, a decrease in total protein level, and a prolonged prothrombin time. The comparison groups were comparable in terms of received drug therapy, except for the more frequent prescription of proton pump inhibitors to H. pylori-positive patients.

CONCLUSION: The findings demonstrate a widespread prevalence of active H. pylori infection among patients with acute AMI and stable CAD. The risk factors identified point to this infection as a potentially modifiable contributor to an elevated risk of gastroduodenal ulcers and hemorrhage in this patient population.

PMID:42625537 | DOI:10.26442/00403660.2026.08.203725

Health Expect. 2026 Aug;29(4):e70809. doi: 10.1111/hex.70809.

ABSTRACT

BACKGROUND: Patient and public involvement and engagement (PPIE) is increasingly prioritised in health professional education; however, how it is conceptualised, implemented, and evaluated within pre-registration occupational therapy programmes remains unclear. This protocol outlines a scoping review designed to map how PPIE in occupational therapy education is conceptualised, operationalised, and reported internationally, and to identify reported barriers, facilitators, and outcomes.

METHODS: This scoping review will adhere to the methodological framework of Arksey and O’Malley (2005), as refined by Levac et al. (2010). We will search seven databases (MEDLINE, CINAHL, PsycINFO, ERIC, ASSIA, Web of Science and OTseeker) and grey literature from 2000 onward. Using the Person-Concept-Context framework, eligible sources will include peer-reviewed empirical studies and recognised grey literature reporting PPIE in pre-registration occupational therapy education. Two reviewers will independently screen titles/abstracts and full texts, and extract data using a piloted charting tool, with third-reviewer resolution. Findings will be synthesised using descriptive statistics and directed content analysis through a rights-based lens. Reporting will follow PRISMA-ScR.

DISCUSSION: The review will generate the first occupational therapy specific, rights-based synthesis of how PPIE is conceptualised, enacted, and evaluated in pre-registration education internationally. Findings will inform evidence-based, feasible, and equitable approaches to involvement, offering co-created recommendations for educators, programme leaders, and regulatory bodies. This work will also identify gaps to guide future research and policy.

LIVED EXPERIENCE OR PUBLIC CONTRIBUTION: People with lived experience who contribute to occupational therapy education will be recruited as contributors to this review and involved at key stages, including search strategy development, screening, data interpretation, and synthesis. Contributors will be supported and remunerated in accordance with National Institute for Health and Care Research (2024) and Royal College of Occupational Therapists (2022) guidance, and their involvement will be documented using the GRIPP2 (Staniszewska et al., 2017) reporting framework.

PMID:42625530 | DOI:10.1111/hex.70809

J Clin Hypertens (Greenwich). 2026 Aug;28(8):e70350. doi: 10.1111/jch.70350.

ABSTRACT

Cardiovascular risk factors are often undertreated in patients with dementia. Renin-angiotensin system inhibitors (RASI) are first-line treatments for hypertension. We examined the association between RASI and all-cause mortality in hypertensive patients with and without dementia, comparing angiotensin-converting enzyme inhibitors (ACEI) to angiotensin receptor blockers (ARB); and selected individual agents. This nationwide register-based cohort study included data from Swedish national registries 2007-2018. The study included 158 176 hypertensive patients with exposure to RASI medications (21 152 RASI users and 137,024 non-users), after excluding prevalent users. Propensity score matching was used to balance measured confounders. Cox regressions compared mortality risk among RASI users versus non-users, ACEI users versus ARB users, and users of enalapril, ramipril, losartan, and candesartan versus other RASI users. RASI use was associated with lower all-cause mortality (hazard ratio[HR] 0.93, 95% confidence interval[CI] 0.91-0.95, p< 0.001) in the full cohort, and among patients with dementia (HR 0.88, 95% CI 0.85-0.92). Compared to ACEI, ARB were associated with lower mortality in the full cohort (HR 0.90, 95% CI 0.85-0.96), but results were not significant in patients with dementia. The comparison of the individual drugs were consistent with class-level findings. RASI use was associated with lower all-cause mortality among older hypertensive patients, including those with dementia. These observational findings support continued attention to evidence-based hypertension treatment in patients with dementia.

PMID:42625529 | DOI:10.1111/jch.70350

Nurs Open. 2026 Aug;13(8):e70761. doi: 10.1002/nop2.70761.

ABSTRACT

AIM: To examine the cross-sectional indirect association between self-transcendence and depressive symptoms through cognitive flexibility and to determine whether the Alternatives and Control dimensions show different indirect associations.

DESIGN: The study had a descriptive, correlational, cross-sectional design.

METHODS: The study population consisted of students studying in the nursing and midwifery department of a state university’s Faculty of Health Sciences, and the sample consisted of 451 students (245 nursing and 206 midwifery). The data were collected using a Students’ Personal Information Form (SPIF), the Self-Transcendence Scale (STS), the Cognitive Flexibility Inventory (CFI) and the Beck Depression Inventory (BDI). The self-report questionnaires were administered in classroom settings. Item scoring was audited against the published Cognitive Flexibility Inventory scoring key. A one-factor model and a correlated two-factor model were compared using diagonally weighted least squares. Regression-based indirect associations were estimated with HC3 heteroskedasticity-consistent standard errors and 5000 bias-corrected and accelerated bootstrap samples. The parallel dimension model and covariate-adjusted models were treated as exploratory sensitivity analyses.

RESULTS: The mean Cognitive Flexibility Inventory total score was 59.44 ± 7.70, and 164 students (36.4%) scored at or above the Beck Depression Inventory screening cutoff of 17, indicating elevated depressive symptoms rather than a clinical diagnosis. The correlated two-factor model fit substantially better than the one-factor model (CFI = 0.939, TLI = 0.931, RMSEA = 0.069, SRMR = 0.094). In the prespecified total-score model, the indirect association between self-transcendence and depressive symptoms through cognitive flexibility was statistically significant (B = -0.174, BootSE = 0.051, BCa 95% CI [-0.278, -0.077]). In the exploratory parallel model, the indirect association through the Control dimension was statistically significant (B = -0.123, BootSE = 0.040, BCa 95% CI [-0.212, -0.057]), whereas the indirect association through the Alternatives dimension was not (B = 0.042, BootSE = 0.060, BCa 95% CI [-0.073, 0.160]).

CONCLUSION: The findings support a cross-sectional indirect association between self-transcendence and depressive symptoms through cognitive flexibility. The dimension-specific findings suggest that the total cognitive flexibility score may conceal different patterns across the Alternatives and Control dimensions. Temporal or causal mediation cannot be inferred from this cross-sectional study. Longitudinal and experimental studies are needed to further clarify these relationships.

PATIENT OR PUBLIC CONTRIBUTION: Health department students contributed by providing anonymous self-reports.

IMPACT: The findings identify the Control dimension as a potentially important focus for future longitudinal and intervention research on student mental health.

PMID:42625518 | DOI:10.1002/nop2.70761

Alzheimers Dement. 2026 Aug;22(8):e71753. doi: 10.1002/alz.71753.

ABSTRACT

INTRODUCTION: Dementia is a major public health concern, and cognitive screening may improve dementia management. We examined the impact of the 2007 introduction of a national cognitive screening program in South Korea on subsequent dementia care and hospitalization.

METHODS: A nationwide cohort of 76,640 dementia-free, policy-eligible adults aged 66 who underwent screening between 2004 and 2009 was used. Dementia care was defined as ≥1 dementia-related outpatient visit or anti-dementia medication within 2 years of screening and dementia-related hospitalization as post-screening hospitalization for dementia. Adjusted multivariable logistic regression and Cox proportional hazards regression models were used.

RESULTS: Overall, 1.4% received dementia care within 2 years, and 3.0% were hospitalized for dementia within 10 years. Cognitive screening was associated with a 37% higher likelihood of subsequent dementia care and a 12% lower risk of dementia-related hospitalization than those without screening.

DISCUSSION: Cognitive screening may facilitate earlier dementia care and reduce the risk of dementia-related hospitalization.

PMID:42625505 | DOI:10.1002/alz.71753

Alzheimers Dement. 2026 Aug;22(8):e71769. doi: 10.1002/alz.71769.

ABSTRACT

The global burden of Alzheimer’s disease (AD) is accelerating, with U.S. prevalence projected to reach nearly 13 million by 2060. Although the “amyloid cascade hypothesis” has long-guided drug development, a 2026 Cochrane review challenged amyloid beta (Aβ) targets for therapy by citing insufficient clinical benefit and safety concerns. We highlight several methodological limitations in this study. The primary concern is a “dilution effect” caused by analyzing monomer-selective antibodies alongside newer treatments that directly target toxic Aβ plaques. This statistical noise, compounded by a decade of failed studies, obscures the significant cognitive preservation achieved by U.S. Food and Drug Administration (FDA)-approved therapies, like lecanemab and donanemab. We contend that these cognitive outcomes are clinically meaningful, as dismissing them ignores the vital impact on preserved independence and reduced caregiver burden. We emphasize current stratified safety frameworks for amyloid-related imaging abnormalities (ARIA) management. The path forward lies in an integrated framework combining Aβ clearance with novel, multi-pathway therapies.

PMID:42625495 | DOI:10.1002/alz.71769

Pulmonology. 2026 Dec;32(1):2717024. doi: 10.1080/25310429.2026.2717024. Epub 2026 Aug 21.

ABSTRACT

This study aimed to identify the key concepts involved in designing epidemiological surveys to estimate the prevalence of second-hand tobacco smoke (SHS) exposure in Portugal and Brazil. A two-round Delphi study was conducted. Firstly, a group of experts was asked for their opinions on the relevance of various concepts (exposure scenarios, recall, time, environmental context, exposure intensity, and relationship to smoking) and domains. Based on their responses, a new questionnaire was developed. The experts ranked the importance of different questions. A thematic analysis was carried out. The experts considered it important to evaluate SHS exposure in general, as well as in specific settings, such as the home, workplace, public and private transport (with or without children), and leisure settings. They reported that recalling the number of hours of exposure spent indoors and outdoors on working and non-working days, and in the last month, provided a more detailed assessment. They also stated that exposure intensity should be assessed either by the presence and number of smokers or by the perception of a smoke-heavy environment. Differences in responses according to the country in which experts reside were minimal. The researchers provided clear, precise, and consistent recommendations for collecting comparable data across studies to enact smoke-free policies. This reinforces the feasibility of using standardised questionnaires to evaluate SHS exposure across countries.

PMID:42625490 | DOI:10.1080/25310429.2026.2717024

J Intern Med. 2026 Aug 21. doi: 10.1111/joim.70127. Online ahead of print.

ABSTRACT

Sudden cardiac death (SCD) is a leading cause of mortality across the chronic kidney disease (CKD) continuum and becomes particularly prominent in dialysis-dependent kidney failure. In hemodialysis, SCD accounts for roughly one quarter to one third of all deaths and up to 60%-75% of cardiovascular mortality, with marked temporal clustering around the long interdialytic interval and the first post-interval session. Traditional views have emphasized descriptive epidemiology and presumed ventricular tachyarrhythmias. More recent device-based studies challenge this paradigm, revealing a heterogeneous arrhythmic spectrum in which bradyarrhythmias, pauses, and conduction system disease are often at least as frequent as sustained ventricular tachycardia or fibrillation. This narrative, non-systematic review synthesizes epidemiologic, mechanistic, and interventional data on SCD in CKD and dialysis, with particular emphasis on insights from implantable loop recorder and implantable cardioverter-defibrillator cohorts and on modifiable dialytic and pharmacologic factors. A framework for prevention is proposed around three interacting domains: the structural myocardial substrate, the electrophysiologic milieu, and dialysis-related triggers. Within this framework, contemporary heart failure and CKD therapies (including sodium-glucose cotransporter 2 inhibitors, angiotensin receptor-neprilysin inhibitors, mineralocorticoid receptor antagonists, and beta-blockers), individualized dialysis prescriptions (targeting potassium, calcium, bicarbonate, ultrafiltration, and scheduling), and selective use of device therapy are considered complementary components of mechanism-driven SCD prevention. Methodological challenges in defining and adjudicating SCD in CKD are discussed, and priorities are outlined for improved phenotyping, continuous rhythm monitoring, and CKD-specific risk stratification, with the overarching aim of moving from descriptive statistics to effective risk modification.

PMID:42625486 | DOI:10.1111/joim.70127