New nuclear functions for calmodulin.

The data reported here summarize a series of results which reveal new functions for nuclear calmodulin (CaM). The addition of CaM inhibitors to cultures of proliferating NRK cells blocked the activity of the cyclin-dependent protein kinases 4 (cdk4) and 2 (cdk2), which are enzymes implicated in the progression of G1 and in the onset of DNA replication, respectively. CaM modulates the activity of cdk4 by regulating the nuclear location of both cdk4 and cyclin D, its associated regulatory subunit. By using CaM-affinity chromatography, we have recently identified two new nuclear CaM-binding proteins: (i) the protein La/SSB, which is an autoantigen implicated in several autoimmune diseases such as lupus erythematosus and Sjögren's syndrome (since La/SSB participates in the process of transcription mediated by RNA polymerase III, CaM could be involved in the regulation of this process); and (ii) the protein SAP145, a member of the spliceosome-associated proteins (SAPs) which is a subunit of the splicing factor SF3(b). This finding suggests the involvement of CaM in pre-mRNA splicing. Finally, a screening for new CaM-binding proteins in the fission yeast performed by using the phage display analysis, revealed that several nucleolar-ribosomal proteins associate to CaM, suggesting that CaM modulates ribosomal assembly and/or function.

[Efficacy of auditing in improving a Control Program of Pregnancy]. / Eficacia de la auditoría en la mejora de un Programa del Control de Embarazo.

OBJECTIVE: To compare the results obtained in two successive audits to observe the effectiveness of this control method. DESIGN: The care process followed by pregnant women attended in 1986-87 is compared with that in 1988. LOCATION: Cartuja Health Centre (Granada). PARTICIPANTS: Data referring to 20 markers with defined quality criteria are obtained by auditing clinical protocols. METHODS AND MAIN RESULTS: The qualitative markers were compared to the comparison test of two proportions for separate samples and the quantitative markers with the of student for separate samples and equal variants. The quality index improved in 9 markers and worsened in 1; the remainder did not change. The results prove the effectiveness of quality control to improve care given in a Health Centre.

[How we use opioid drugs on patients with neoplasms]. / Cómo utilizamos los fármacos opioides en los pacientes neoplásicos.

OBJECTIVE: To find the pattern of use of opiate drugs for treating pain in terminal cancer patients. DESIGN: Retrospective descriptive study. SETTING: Gavà 2 Health Centre, located in Barcelona's industrial belt. MATERIAL AND METHOD: Systematic review of the clinical records for the deaths recorded between May 1993 and March 1998. The following variables were recorded: age, sex, cause and place of death, professional attending patient during terminal phase, use of opiates (type, how they were taken, dosage and length of treatment) and prescribing doctor. RESULTS: Of the 429 deaths reviewed, 100 (23%) were caused by neoplasm (68% males), with an average age of 69 +/- 3 years. More than half the patients (55%) died at home. In the terminal phase they were mainly attended (69%) by their Primary Care team. 52% of the patients were given opiates, with morphine being the most common (71.1%), followed by codeine (40.3%) and tramadol (17.3%). The general practitioner was the prescribing agent in 69.2% of the cases. 76% of the patients who took codeine did so at infra-therapeutic doses (< 120 mg per day). Similarly, insufficient doses of morphine (< 60 mg per day) were given to half the patients who received it. 21.62% only took it during a period of 5 days or less before death. CONCLUSIONS: Primary care teams are taking on steadily greater protagonism in caring for terminal cancer patients. Although a large number of these patients are treated with opiates, these are given at often insufficient doses and for too short time periods.