Understanding the new BRD4-related syndrome: Clinical and genomic delineation with an international cohort study

BRD4 is part of a multiprotein complex involved in loading the cohesin complex onto DNA, a fundamental process required for cohesin-mediated loop extrusion and formation of Topologically Associating Domains. Pathogenic variations in this complex have been associated with a growing number of syndromes, collectively known as cohesinopathies, the most classic being Cornelia de Lange syndrome. However, no cohort study has been conducted to delineate the clinical and molecular spectrum of BRD4-related disorder. We formed an international collaborative study, and collected 14 new patients, including two fetuses. We performed phenotype and genotype analysis, integrated prenatal findings from fetopathological examinations, phenotypes of pediatric patients and adults. We report the first cohort of patients with BRD4-related disorder and delineate the dysmorphic features at different ages. This work extends the phenotypic spectrum of cohesinopathies and characterize a new clinically relevant and recognizable pattern, distinguishable from the other cohesinopathies.

Determination of the inhibitory concentration 50% (IC50) of four selected drugs (chlortetracycline, doxycycline, enrofloxacin and difloxacin) that reduce in vitro the multiplication of Chlamydophila psittaci

A total of 18 chlamydial isolates from various psittacine birds, one isolate from a domestic pigeon and one isolate from a Pekin duck were isolated in continuous Buffalo Green Monkey (BGM) kidney cell cultures. All 20 isolates were identified by nested multiplex polymerase chain reaction as Chlamydophila psittaci. These isolates were multiplied to high titres and subsequently tested for in vitro sensitivity against two tetracyclines (chlortetracycline and doxycycline) and two quinolones (enrofloxacin and difloxacin) at concentrations of 0.0, 0.25, 0.50, 1.00, and 10.00 microg/ml. Replication of chlamydia in BGM cell cultures is assayed on the basis of formation of intracytoplasmic inclusions that are visualized by Giménez staining. All isolates, although to variable degrees, are sensitive to all four drugs. The number of chlamydial inclusions decreases gradually over a broad range of increasing concentrations of the drugs. The variation in the number of inclusions between isolates is remarkably high for chlortetracycline less for doxycycline and minimal for both fluoroquinolones, the enrofloxacin and difloxacin. The decline in numbers of inclusions is highly dose-dependend and the observed reduction stretches over a wide range of drug dilutions. Therefore, it is proposed to calculate drug sensitivity values in terms of inhibitory concentration 50%, (IC5). Its calculation includes all tested drug dilutions instead of the hitherto more common minimal inhibitory concentration, MIC, which is based on results of serial dilution tests for cell-free growing bacteria. Using a logistic regression model for the calculation of the inhibitory concentration 50% of all 20 chlamydial isolates, the IC50 is 0.807 microg/ml for tetracycline, 0.497 microg/ml for doxycycline, 0.180 microg/ml for enrofloxacin and 0.168 microg/ml for difloxacin. Complete prevention of inclusion formation was already seen for enrofloxacin at a concentration of 1.0 microg/ml in 12 out of 20 and for difloxacin in 5 out of 20 isolates whereas more than 10 microg/mI chlortetracycline is needed in 15 out of 20 isolates and for doxycycline 9 out of 20 isolates yielded inclusions at 10 microg/ml.

Treatment of coronary artery disease in hemodialysis patients: PTCA vs. stent

This retrospective study examined the utilization of coronary stent placement versus PTCA in hemodialysis patients with obstructive coronary disease. Prior studies have demonstrated suboptimal results with PTCA owing primarily to high rates of restenosis. We identified 19 hemodialysis patients who received a percutaneous coronary intervention who were matched with individuals without renal failure undergoing same vessel revascularization. Our study found that 71% of hemodialysis patients receiving PTCA had a recurrent cardiac event defined by subsequent angina, myocardial infarction, or cardiac death. At follow-up, 30% of patients who received stent placement had recurrent cardiac events. Intracoronary stent placement is both safe and feasible and produces more favorable clinical outcomes in the management of coronary disease in hemodialysis patients.

Aversiveness of denatonium saccharide and quinine in grasshopper mice Onychomys leukogaster

The responses toward denatonium saccharide and quinine by three rodent species differ from those exhibited by humans. This study measured the relative aversiveness of these two compounds in grasshopper mice (Onychomys leucogaster) to determine if this species responded similarly to or differently from these other rodents. In a choice test, the mice clearly preferred quinine over denatonium saccharide at concentrations of 1/10,000 and 1/50,000, but only marginally preferred quinine at a concentration of 1/1000. When denatonium or quinine was paired with toxicosis, both suppressed drinking at concentrations from 1/10,000 to 1/50,000, but only denatonium suppressed drinking at 1/100,000. Neither compound suppressed drinking at 1 part in million. Grasshopper mice perceived denatonium saccharide as more aversive than quinine in both experiments. Such a response resembled the behavior of humans more than that of the other three rodents previously tested.