Ribonucleotide synthesis by NME6 fuels mitochondrial gene expression

Replication of the mitochondrial genome and expression of the genes it encodes both depend on a sufficient supply of nucleotides to mitochondria. Accordingly, dysregulated nucleotide metabolism not only destabilises the mitochondrial genome, but also affects its transcription. Here, we report that a mitochondrial nucleoside diphosphate kinase, NME6, supplies mitochondria with pyrimidine ribonucleotides that are necessary for the transcription of mitochondrial genes. Loss of NME6 function leads to the depletion of mitochondrial transcripts, as well as destabilisation of the electron transport chain and impaired oxidative phosphorylation. These deficiencies are rescued by an exogenous supply of pyrimidine ribonucleosides. Moreover, NME6 is required for the maintenance of mitochondrial DNA when the access to cytosolic pyrimidine deoxyribonucleotides is limited. Our results therefore reveal an important role for ribonucleotide salvage in mitochondrial gene expression.

Avaliação da Qualidade dos Registos de Medicação Prolongada: Estudo QMP

<p><strong>Introduction:</strong> The growing concern surrounding health safety issues makes it essential that everyone, in particular the elderly due to their commonly prescribed multiple drugs, has a complete and up to date list of prescriptions. We planned to assess the quality of the electronic records of prolonged medication.<br /><strong>Material and Methods:</strong> This is an observational, transversal and descriptive study, with an analytical component, in which we assessed the technical quality of prolonged medication records of elderly patients of four primary health care, before and after a guided intervention. The doctors received training in good practice recording methods and both professionals and patients were stimulated to use the prolonged medication guide.<br /><strong>Results:</strong> We evaluated 388 medical records of 33 physicians. The ideal category ‘Appropriated medication with posology’ improved from 23.5% to 48% (p &lt; 0,001). The remaining categories ‘Inappropriated Medication’ and ‘Appropriated medication but absent posology’ decreased from 16.7% to 7% (p = 0,006) and from 59.8% to 46.0% (p = 0,02), respectively. The variables mentor’s training skills, workplace, length of family practice and the percentage of elderly in the physician’s list showed statistical significance differences at the beginning of the study which disappeared after the intervention, except for the latter.<br /><strong>Discussion:</strong> In this study, physicians accepted the proposed changes, regardless of age, gender, mentor’s training skills, workplace or length of family practice. Longer duration appointments in the eldery group may be an obstacle in achieving the best results.<br /><strong>Conclusion:</strong> This original study reveals the necessity to implement periodic postgraduate training to encourage physicians to keep medical records up to date.</p><p><br /><strong>Keywords:</strong> Long-term Care; Electronic Prescribing; Drug Prescriptions; Family Practice; Aged.</p>

[Quality assessment of long-term prescription records: QMP study]

INTRODUCTION

The growing concern surrounding health safety issues makes it essential that everyone, in particular the elderly due to their commonly prescribed multiple drugs, has a complete and up to date list of prescriptions. We planned to assess the quality of the electronic records of prolonged medication.

MATERIAL AND METHODS

This is an observational, transversal and descriptive study, with an analytical component, in which we assessed the technical quality of prolonged medication records of elderly patients of four primary health care, before and after a guided intervention. The doctors received training in good practice recording methods and both professionals and patients were stimulated to use the prolonged medication guide.

RESULTS

We evaluated 388 medical records of 33 physicians. The ideal category 'Appropriated medication with posology' improved from 23.5% to 48% (p < 0,001). The remaining categories 'Inappropriated Medication' and 'Appropriated medication but absent posology' decreased from 16.7% to 7% (p = 0,006) and from 59.8% to 46.0% (p = 0,02), respectively. The variables mentor's training skills, workplace, length of family practice and the percentage of elderly in the physician's list showed statistical significance differences at the beginning of the study which disappeared after the intervention, except for the latter.

DISCUSSION

In this study, physicians accepted the proposed changes, regardless of age, gender, mentor's training skills, workplace or length of family practice. Longer duration appointments in the eldery group may be an obstacle in achieving the best results.

CONCLUSION

This original study reveals the necessity to implement periodic postgraduate training to encourage physicians to keep medical records up to date.