Aagesenbengtsen1224
Cortical dysplasia, complex, with other brain malformations 3 (CDCBM3) is a rare autosomal dominant syndrome caused by Kinesin family Member 2A (KIF2A) gene mutation. Patients with CDCBM3 exhibit posterior dominant agyria/pachygyria with severe motor dysfunction. Here, we report an 8-year-old boy with CDCBM3 showing a typical, but relatively mild, clinical presentation of CDCBM3 features. Whole-exome sequencing identified a heterozygous mutation of NM_001098511.2c.1298C>A [p.(Ser433Tyr)]. To our knowledge, the mutation has never been reported previously. The variant was located distal to the nucleotide binding domain (NBD), in which previously-reported variants in CDCBM3 patients have been located. The computational structural analysis showed the p.433 forms the pocket with NBD. Variants in KIF2A have been reported in the NBD for CDCBM3, in the kinesin motor 3 domain, but not in the NBD in epilepsy, and outside of the kinesin motor domain in autism spectrum syndrome, respectively. Our patient has a variant, that is not in the NBD but at the pocket with the NBD, resulting in a clinical features of CDCBM3 with mild symptoms. The clinical findings of patients with KIF2A variants appear restricted to the central nervous system and facial anomalies. We can call this spectrum "KIF2A syndrome" with variable severity.The geographic location and heterogeneous multi-ethnic population of Dubai (United Arab Emirates; UAE) provide a unique setting to explore the global molecular epidemiology of SARS-CoV-2 and relationship between different viral strains and disease severity. We systematically selected (i.e. every 100th individual in the central Dubai COVID-19 database) 256 patients by age, sex, disease severity and month to provide a representative sample of laboratory-confirmed COVID-19 patients (nasopharyngeal swab PCR positive) during the first wave of the UAE outbreak (January to June 2020). Sociodemographic and clinical data were extracted from medical records and full SARS-CoV-2 genome sequences extracted from nasopharyngeal swabs were analysed. Older age was significantly associated with COVID-19-associated hospital admission and mortality. Overweight/obese or diabetic patients were 3-4 times more likely to be admitted to hospital and intensive care unit (ICU). selleck compound Sequencing data showed multiple independent viral introduct continued community-based transmission of the European strains in the Dubai population and highlight new mutations that might be associated with severe disease in otherwise healthy adults.
Coexisting of atrial fibrillation (AF) in patients with heart failure with preserved ejection fraction (HFpEF) could increase the risk of mortality. In this study, we aimed to assess the values of the CHADS2, R2CHADS2, and CHA2DS2-VASc scores for AF prediction in HFpEF patients.
We performed a retrospective analysis on symptomatic HFpEF patients in the TOPCAT (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist) trial. Associations of the CHADS2, R2CHADS2, and CHA2DS2-VASc scores with the risk of incident AF in HFpEF patients without baseline AF (n=2202) were assessed using the multivariable competing risk regression models. The discriminatory performances of these scores were calculated using the C-index. During a median follow-up of 3.3years, the average incidence of AF was 1.80 per 100 patient-years in HFpEF patients. When score was analysed as a continuous variable, per 1-point increase in the CHADS2 (hazard ratio [HR]=1.42, 95% confidence interval [CI] 1.20-1.68, C-index 0.71), R2CHADS2 (HR=1.25, 95% CI 1.10-1.42, C-index 0.69), or CHA2DS2-VASc (HR=1.30, 95% CI 1.16-1.46, C-index 0.70) scores was associated with an increased risk of incident AF. When score was analysed as a categorical variable, patients with CHADS2≥3 (HR=2.62, 95% CI 1.70-4.04), R2CHADS2≥3 (HR=2.55, 95% CI 1.56-4.17), or CHA2DS2-VASc≥4 (HR=2.54, 95% CI 1.59-4.07) had a higher risk of incident AF compared with the corresponding controls.
Our data first suggest that the CHADS2, R2CHADS2, and CHA2DS2-VASc scores could predict the risk of incident AF in HFpEF patients with modest predictive abilities.
Our data first suggest that the CHADS2, R2CHADS2, and CHA2DS2-VASc scores could predict the risk of incident AF in HFpEF patients with modest predictive abilities.Researchers have speculated that vaccines to prevent coronavirus disease 2019 (COVID-19) may be less effective for individuals with obesity, a major risk factor for mortality and morbidity from COVID-19. Initial results from the Pfizer-BioNTech and Moderna COVID-19 vaccine trials, though limited by inadequate power to compare subgroups and incomplete stratification of high-risk groups, appear to have similar efficacy among individuals with and without obesity. Careful follow-up in placebo-controlled studies is required to generate data on long-term vaccine immunogenicity, particularly in high-risk groups. Subsequent analyses should stratify safety and efficacy results by each class of obesity. Speculation about variable effectiveness of COVID-19 vaccines in obesity likely increases vaccine hesitancy among individuals with obesity, who face not only a higher risk of severe outcomes from COVID-19 but also weight stigma, which reduces health care engagement at baseline. Clinical and public health messaging must be data driven, transparent, and sensitive to these biological and sociological vulnerabilities.Exosomes are extracellular vesicles that primarily exist in bodily fluids such as blood. Autophagy is an intracellular degradation process, which, along with exosomes, can significantly influence human health and has therefore attracted considerable attention in recent years. Exosomes have been shown to regulate the intracellular autophagic process, which, in turn, affects the circulating exosomes. However, crosstalk between exosomal and autophagic pathways is highly complex, depends primarily on the environment, and varies greatly in different diseases. In addition, studies have demonstrated that exosomes, from specific cell, can mitigate several diseases by regulating autophagy, which can also affect the excessive release of some harmful exosomes. This phenomenon lays a theoretical foundation for the improvement of many diseases. Herein, we review the mechanisms and clinical significance of the association and regulation of exosomes and autophagy, in order to provide a new perspective for the prevention and treatment of associated diseases.