Impact of access to treatment on patient-reported outcomes among rheumatoid arthritis patients with tDMARDs and bDMARDS in two Latin-American countries: A prospective observational study.

Background and Aims: A noninterventional prospective study was performed in Colombia and Peru. The aim was to describe the impact of access to treatment on Patient-reported outcomes (PRO) in patients with Rheumatoid arthritis (RA) after failure to conventional disease-modifying antirheumatic drugs (DMARDs) in real-life conditions. Methods: The impact of access to treatment was measured by access barriers, time to supply (TtS) and interruption evaluating their effect in changes of PROs between baseline and 6-month follow-up between February 2017 and November 2019. The association of access to care with disease activity, functional status, health-related quality of life was assessed using bivariate and multivariable analysis. Results are expressed in least mean difference; TtS in mean number of days for delivery of treatment at baseline. Variability measures were standard deviation and standard error. Results: One hundred seventy patients were recruited, 70 treated with tofacitinib and 100 with biological DMARDs. Thirty-nine patients reported access barriers. The mean of TtS was 23 ± 38.83 days. The difference from baseline to 6-month visit in PROs were affected by access barriers and interruptions. There was not statistically significant difference in the of PRO's score among visits in patients that reported delay of supply of more than 23 days compared to patients with less days of delay. Conclusion: This study suggested the access to treatment can affect the response to the treatment at 6 months of follow-up. There seems to be no effect in the PROs for delay of TtS during the studied period.

Usefulness of serum amylase and lipase as predictors of the severity of post-endoscopic retrograde cholangiopancreatography pancreatitis.

BACKGROUND: Post-ERCP pancreatitis (PEP) is the most common complication of Post-endoscopic retrograde cholangiopancreatography. OBJECTIVE: to demonstrate whether serum amylase and lipase values correlate with the presence and severity of PEP. METHOD: We conducted a retrospective, observational and analytical study of patients who underwent ERCP, those who developed pancreatitis were classified by severity according to the 2012 revised Atlanta criteria and their serum enzyme levels were analyzed. We used ROC (Receiver Operating Characteristics) curves to know the best enzyme cutoff points and analyzed their diagnostic yields. Chi-square, t-distribution and Mann-Whitney U test were used in the variable analysis and it was considered statistically significant when p < 0.05. RESULTS: A total 621 patients, 54 presented pancreatitis. For moderately severe and severe forms: lipase level of 1500 U/L had an area under the curve (AUC) = 0.827, 95% CI (0.67-0.98), sensitivity = 72.7%, specificity = 86%, negative predictive value = 92.5%, p < 0.05. Amylase level of 920 U/L presented AUC = 0.65, 95% CI (0.43-0.86), sensitivity = 63%, specificity = 67%, p > 0.05. CONCLUSIONS: Serum lipase shows correlation with the presence and severity of PEP. Amylase shows no significant correlation with PEP.

ANTECEDENTES: La pancreatitis poscolangiopancreatografía retrógrada endoscópica (PPCPRE) es la complicación más frecuente de este procedimiento. OBJETIVO: Demostrar si la amilasa y la lipasa séricas se correlacionan con la presencia y la gravedad de la PPCPRE. MÉTODO: Realizamos un estudio retrospectivo, observacional y analítico de pacientes a quienes se realizó CPRE. Los que desarrollaron pancreatitis se clasificaron por gravedad de acuerdo con la revisión de Atlanta de 2012 y se analizaron sus concentraciones séricas de enzimas. Empleamos curvas ROC (Receiver Operating Characteristics) para conocer los mejores puntos de corte enzimáticos y analizamos sus rendimientos diagnósticos. Usamos las pruebas de ji al cuadrado, t de Student y U de Mann Whitney para el análisis de las variables, y se consideró estadísticamente significativo un valor de p < 0.05. RESULTADOS: De un total de 621 pacientes, 54 presentaron pancreatitis. Para pancreatitis moderadamente grave y grave, unas cifras de lipasa de 1500 U/l presentaron un área bajo la curva (AUC) = 0.827 (intervalo de confianza del 95% [IC 95%]: 0.67-0.98), con una sensibilidad del 72.7%, una especificidad del 86% y un valor predictivo negativo del 92.5% (p < 0.05); y unas cifras de amilasa de 920 U/l presentaron un AUC = 0.65 (IC 95%: 0.43-0.86), con una sensibilidad del 63% y una especificidad del 67% (p > 0.05). CONCLUSIONES: La lipasa muestra correlación con la presencia y la gravedad de la PPCPRE. La amilasa muestra correlación no significativa con la PPCPRE.

Cytoplasmic polyadenylation in mammalian oocyte maturation.

Oocyte developmental competence is the ability of the mature oocyte to be fertilized and subsequently drive early embryo development. Developmental competence is acquired by completion of oocyte maturation, a process that includes nuclear (meiotic) and cytoplasmic (molecular) changes. Given that maturing oocytes are transcriptionally quiescent (as are early embryos), they depend on post-transcriptional regulation of stored transcripts for protein synthesis, which is largely mediated by translational repression and deadenylation of transcripts within the cytoplasm, followed by recruitment of specific transcripts in a spatiotemporal manner for translation during oocyte maturation and early development. Motifs within the 3' untranslated region (UTR) of messenger RNA (mRNA) are thought to mediate repression and downstream activation by their association with binding partners that form dynamic protein complexes that elicit differing effects on translation depending on cell stage and interacting proteins. The cytoplasmic polyadenylation (CP) element, Pumilio binding element, and hexanucleotide polyadenylation signal are among the best understood motifs involved in CP, and translational regulation of stored transcripts as their binding partners have been relatively well-characterized. Knowledge of CP in mammalian oocytes is discussed as well as novel approaches that can be used to enhance our understanding of the functional and contributing features to transcript CP and translational regulation during mammalian oocyte maturation. WIREs RNA 2016, 7:71-89. doi: 10.1002/wrna.1316 For further resources related to this article, please visit the WIREs website.

RNA-Seq profiling of single bovine oocyte transcript abundance and its modulation by cytoplasmic polyadenylation.

Molecular changes occurring during mammalian oocyte maturation are partly regulated by cytoplasmic polyadenylation (CP) and affect oocyte quality, yet the extent of CP activity during oocyte maturation remains unknown. Single bovine oocyte RNA sequencing (RNA-Seq) was performed to examine changes in transcript abundance during in vitro oocyte maturation in cattle. Polyadenylated RNA from individual germinal-vesicle and metaphase-II oocytes was amplified and processed for Illumina sequencing, producing approximately 30 million reads per replicate for each sample type. A total of 10,494 genes were found to be expressed, of which 2,455 were differentially expressed (adjusted P < 0.05 and fold change >2) between stages, with 503 and 1,952 genes respectively increasing and decreasing in abundance. Differentially expressed genes with complete 3'-untranslated-region sequence (279 increasing and 918 decreasing in polyadenylated transcript abundance) were examined for the presence, position, and distribution of motifs mediating CP, revealing enrichment (85%) and lack thereof (18%) in up- and down-regulated genes, respectively. Examination of total and polyadenylated RNA abundance by quantitative PCR validated these RNA-Seq findings. The observed increases in polyadenylated transcript abundance within the RNA-Seq data are likely due to CP, providing novel insight into targeted transcripts and resultant differential gene expression profiles that contribute to oocyte maturation.

Desarrollo de la habilidad de escritura como proceso / Development of the writing skill as a process

La enseñanza de una lengua extranjera es una tarea un poco difícil y para hacerla efectiva hay que lograr que todos los elementos que integran el proceso se lleven a cabo satisfactoriamente, no obstante, esto no siempre se presenta así. Tal es el caso de la habilidad de escritura en los estudiantes de 5to año de Medicina donde se evidencia que el no empleo de actividades que incluían dicha habilidad como proceso, afectaba su buen desarrollo, por lo que el objetivo de este trabajo es mejorar el desarrollo de tal habilidad a través de ejercicios que envuelven la escritura como proceso. Se procedió entonces a la aplicación de un número de ejercicios en un grupo de 5to año de medicina (grupo experimental 3 A ) los que se fueron evaluando durante su aplicación. Se llega a la conclusión que la utilización de estas actividades en las clases de inglés llevó a un buen desarrollo de la habilidad de escritura como proceso y de la lengua inglesa en general permitiendo un incremento en el nivel teórico y práctico del tema en cuestión. La aplicación práctica de dicho trabajo no solo se limita al grupo experimental sino que puede ser extendida al área clínica de las tres carreras de ciencias médicas y así ayudar a una mejor formación integral de los futuros profesionales de la salud.