Factors determining the readiness of a patient with coronary artery disease to use telemedicine technologies for rehabilitation: prospective cohort study

BACKGROUND: Despite its relevance and established efficiency, the third stage of cardiac rehabilitation (CR) lacks a universal solution. The longest rehabilitation period requires many resources and effort on the part of the healthcare system. Digital technologies rapidly developing and being introduced into medicine can significantly assist in organizing the CR process. The healthcare system is already mastered and actively adopting telemedicine technologies into daily practice. OBJECTIVE: We aimed to determine the patients’ preparedness for the upcoming surgical treatment of the chronic types of coronary artery disease to engage in remote cardiac rehabilitation programs using telemedicine technologies. MATERIALS AND METHODS: A study of 213 patients treated for artery disease and preparing for planned coronary bypass surgery was conducted. Gender, age, socioeconomic factors, and digital literacy were analyzed. The patients were offered one of two options for completing the third stage of CR: a standard option in which CR is performed under the supervision of a medical worker in a medical organization at the place of residence according to the recommendations received upon hospital discharge or an alternative in which CR is performed at home using remote monitoring under the supervision of specialists from the CR laboratory of the Research Institute for Complex Issues of Cardiovascular Diseases. Patients were divided into two groups based on their choice: those who agreed to participate in the outpatient stage of CR using telemedicine technologies (loyal patients) and those who refused to use telemedicine technologies (nonloyal patients). The factors indicating more loyalty were identified using survey data and correlation analysis, and a portrait of a patient eager to use remote rehabilitation programs was formed. RESULTS: Social factors, such as living in big cities (p 0.001) and having a spouse (p=0,030), were associated with increased loyalty to participating in CR via telemedicine technologies. Male gender (p 0.001), obesity (p 0.001), and smoking (p 0.001) were associated with the reluctance to participate in the alternative CR program. The education level (p=0.060) did not show a significant impact on the loyalty to use telemedicine technologies. CONCLUSION: 46% of patients were interested in using remotely controlled CR programs. The social factors determine the loyalty to telemedicine technologies in patients

G-Quadruplex Formed by the Promoter Region of the hTERT Gene: Structure-Driven Effects on DNA Mismatch Repair Functions

G-quadruplexes (G4s) are a unique class of noncanonical DNAs that play a key role in cellular processes and neoplastic transformation. Herein, we focused on the promoter region of human TERT oncogene, whose product is responsible for the immortality of cancer cells. It has been shown by chemical probing and spectroscopic methods that synthetic 96-nt DNAs modeling the wild-type G-rich strand of the hTERT promoter and its variants with G>A point substitutions corresponding to somatic driver mutations fold into three stacked parallel G4s with sites of local G4 destabilization caused by G>A substitutions in the G4 motif. These models were used to elucidate how the hTERT multiG4 affects the binding affinity and functional responses of two key proteins, MutS and MutL, involved in the initial stage of DNA mismatch repair (MMR) in Escherichiacoli and Neisseriagonorrhoeae with different MMR mechanisms. We have shown for the first time that (i) point substitutions do not affect the effective binding of these proteins to the hTERT G4 structure, and (ii) the endonuclease activity of MutL from N. gonorrhoeae is significantly suppressed by the stable G4 scaffold. It is likely that some of the genomic instability associated with G4 may be related to the blockage of human intrinsic methyl-independent MMR attempting to operate near G4 structures

Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children. Version 2

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus

Особенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (COVID-19), у детей. Версия 2

The Ministry of Health of the Russian Federation jointly with professional association and experts in the field of pediatrics, infectious diseases and resuscitation has revised guidelines “Clinical Features and Management of the Disease Caused by New Coronaviral Infection (COVID-19) in Children” in order to provide the child population with effective medical care during the pandemic of the new coronaviral infection. The practical experience of specialists from various countries was considered during the development of this document. Special attention should be given to the evidence base of the presented data, as well as to the efficiency and safety issues of medications used in treatment of coronaviral infection and its complications. The authors highlight the problems of prevention, diagnostics and management of pathological conditions caused by COVID-19 in the article according to the presented guidelines. Patient’s management is presented depending on the age and severity of the disease itself. The therapy is considered with regard to etiological, pathogenetic and symptom focus.С целью обеспечения детского населения эффективной медицинской помощью в условиях пандемии новой коронавирусной инфекции Минздравом России совместно с профессиональными ассоциациями и экспертами в области педиатрии, инфекционных болезней и реанимации были переработаны методические рекомендации «Особенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (COVID-19), у детей». При разработке документа был учтен практический опыт не только специалистов нашей страны, но и зарубежных коллег. Особое внимание уделено доказательной базе представленных данных, а также вопросам эффективности и безопасности лекарственных препаратов, применяемых при лечении данной инфекции и ее осложнений. В статье на основании указанных методических рекомендаций авторы освещают вопросы профилактики, диагностики, лечения патологических состояний, обусловленных COVID-19. Тактика ведения пациента представлена в зависимости от возраста и степени тяжести течения болезни, терапия рассмотрена с позиций этиологической, патогенетической и симптоматической направленности