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Lim HG, Bacha EA, Marx GR, Marshall A, Fynn-Thompson F, Mayer JE, Del Nido P, Pigula FA. Biventricular repair in patients with heterotaxy syndrome. J Thorac Cardiovasc Surg 2009; 137:371-379.e3. [PMID: 19185155 DOI: 10.1016/j.jtcvs.2008.10.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2008] [Revised: 10/01/2008] [Accepted: 10/26/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Complex intracardiac and extracardiac anatomy is often confronted during biventricular repair in patients with heterotaxy syndrome. We examined factors affecting surgical outcomes in these patients. METHODS Between January 1990 and July 2007, 371 patients received a diagnosis of heterotaxy syndrome; 91 (91/371, 24.5%) underwent biventricular repair. Left atrial isomerism was present in 73% (66/91) and right atrial isomerism in 10% (9/91), with indeterminate atrial anatomy in 17% (16/91). Median age at biventricular repair was 6.8 months (5 days to 22.3 years). Systemic venous anomalies were present in 75 patients, pulmonary venous anomalies in 26, and endocardial cushion defects in 36. Transposition complexes were present in 15 patients with atrioventricular discordance in 10; 8 underwent double switch, 2 received a physiologic repair, 2 underwent arterial switch, and 3 underwent the Rastelli operation. Other conotruncal anomalies included double-outlet right ventricle in 10 patients, tetralogy of Fallot in 3, and hemitruncus in 2. Separation of systemic from pulmonary venous return included intra-atrial baffling in 48 patients and extracardiac grafting in 2. Combined lesions were common, occurring in 99% (90/91). Statistical analysis with Kaplan-Meier and Cox proportional hazards models were performed. RESULTS Average follow-up was 44.9 +/- 57.5 months (3 days to 189.3 months). Kaplan-Meier estimated survival was 93.4% at 10 years; unbalanced complete atrioventricular canal was the only risk factor for mortality (P = .006). Subsequent procedures were common with a 10-year freedom from reoperation or reintervention of 38% +/- 7.5%. Arrhythmias occurred in 36 (39.6%) patients; bradyarrhythmia in 27 (29.7%) and tachyarrhythmia in 15 (16.5%). Freedom from any arrhythmia was 53.9% +/- 6.7% at 10 years. CONCLUSIONS Excellent survival for patients with heterotaxy undergoing biventricular repair can be expected, even for multiple, complex lesions. Reintervention is common, and arrhythmia is a long-term concern. This experience shows that patients with heterotaxy syndrome and complex cardiac anatomy can be considered for biventricular repair. Patients with unbalanced complete atrioventricular canal are a high-risk group for which selection criteria are particularly important.
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Brackett MG, Marshall A, Lockwood PE, Lewis JB, Messer RLW, Bouillaguet S, Wataha JC. Cytotoxicity of endodontic materials over 6-weeksex vivo. Int Endod J 2008; 41:1072-8. [DOI: 10.1111/j.1365-2591.2008.01471.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Biswas S, Wrigley J, East C, Hern A, Marshall A, Dunn J, Lorigan P, Middleton M, Corrie P. A randomised trial evaluating bevacizumab as adjuvant therapy following resection of AJCC stage IIB, IIC and III cutaneous melanoma: an update. Ecancermedicalscience 2008; 2:108. [PMID: 22275984 PMCID: PMC3234061 DOI: 10.3332/ecancer.2008.108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2008] [Indexed: 11/06/2022] Open
Abstract
At present, there are no standard therapies for the adjuvant treatment of malignant melanoma. Patients with primary tumours with a high-Breslow thickness (stages IIB and IIC) or with resected loco-regional nodal disease (stage III) are at high risk of developing metastasis and subsequent disease-related death. Given this, it is important that novel therapies are investigated in the adjuvant melanoma setting. Since angiogenesis is essential for primary tumour growth and the development of metastasis, anti-angiogenic agents are attractive potential therapeutic candidates for clinical trials in the adjuvant setting. Therefore, we initiated a phase II trial in resected high-risk cutaneous melanoma, assessing the efficacy of bevacizumab versus observation.In the interim safety data analysis, we demonstrate that bevacizumab is a safe therapy in the adjuvant melanoma setting with no apparent increase in the surgical complication rate after either primary tumour resection and/or loco-regional lymphadenectomy.
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Douangamath A, Brandao-Neto J, Marshall A, Williams J, Preece G, O'Hea J, Dent A, Duke E, Grant A, Gregory S, Johnson L, McDonald B, Woolliscroft R. A monochromatic station for macromolecular crystallography at Diamond Light Source. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308094488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Wroe SJ, Yeates AB, Marshall A. Long-term safety and efficacy of zonisamide in patients with refractory partial-onset epilepsy. Acta Neurol Scand 2008; 118:87-93. [PMID: 18547272 DOI: 10.1111/j.1600-0404.2008.01055.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate whether zonisamide remains effective and well tolerated in the treatment of refractory partial epilepsy during long-term treatment and with flexible dosing in clinical practice. MATERIALS AND METHODS Patients with refractory partial epilepsy who completed a fixed-dose, randomized, double-blind clinical trial were recruited in an open-label extension study with adjustment of zonisamide and other antiepileptic drug dosage according to the treating physician's usual clinical practice. RESULTS An intention-to-treat analysis of 317 patients showed that zonisamide was well tolerated with a predictable safety profile. Patient retention rates at 1, 2 and 3 years were 65.3%, 44.5% and 28.8%, respectively. Zonisamide treatment was associated with a maintained reduction in seizure frequency, with some patients achieving prolonged periods of seizure freedom. CONCLUSIONS Flexible dosing with zonisamide demonstrated a good safety profile and sustained efficacy in the long-term adjunctive treatment of refractory partial epilepsy.
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Marshall A, Rogers H. A review of CF-related diabetes (CFRD) management – a patients perspective. J Cyst Fibros 2008. [DOI: 10.1016/s1569-1993(08)60323-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gray RG, Rea DW, Handley K, Marshall A, Pritchard MG, Perry P, Earl HM, Poole CJ, Salman A, Lee M. aTTom (adjuvant Tamoxifen—To offer more?): Randomized trial of 10 versus 5 years of adjuvant tamoxifen among 6,934 women with estrogen receptor-positive (ER+) or ER untested breast cancer—Preliminary results. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.513] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jones RJ, Young O, Renshaw L, Jacobs V, Fennell M, Marshall A, Green TP, Elvin P, Womack C, Clack G, Dixon JM. Src inhibitors in early breast cancer: a methodology, feasibility and variability study. Breast Cancer Res Treat 2008; 114:211-21. [PMID: 18409068 DOI: 10.1007/s10549-008-9997-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 03/28/2008] [Indexed: 11/30/2022]
Abstract
Early clinical trials of anticancer agents may be enriched by robust biomarkers of activity. Surrogate measures used in trials of cytotoxic agents, such as tumor size regression, may not be informative when investigating targeted agents that act principally to inhibit invasion or proliferation. This study aimed to determine the validity of invasion-related biomarkers of activity for AZD0530, a potent Src inhibitor currently in clinical development. Focal adhesion kinase (FAK) and paxillin are downstream phosphorylation substrates of Src and mediate tumor cell adhesion and invasiveness. These were therefore selected as biologically relevant markers of Src inhibition. Early breast cancer was chosen as a model as multiple samples can be collected during standard treatment and there is an intervening period in which experimental intervention can be applied. Tumor tissue was collected from diagnostic core biopsies and subsequent surgical tumor excision samples in 29 women with early breast cancer attending a single center. Protein levels were assessed quantitatively by Luminex and qualitatively by immunohistochemistry. AZD0530 inhibited tumor growth in a manner independent of dose and inhibited phosphorylation of FAK and paxillin in a dose-dependent manner in a Calu-6 xenograft model. In the clinical study, agreement of within-visit and also of between-visit measurements was high and the estimated number of patients required to detect a drug effect would be low enough to allow use of these markers as endpoints in future dose selection studies.
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Moore MJ, Hamilton AJ, Cairns KJ, Marshall A, Glover BM, McCann CJ, Jordan J, Kee F, Adgey AAJ. The Northern Ireland Public Access Defibrillation (NIPAD) study: effectiveness in urban and rural populations. Heart 2008; 94:1614-9. [PMID: 18230637 DOI: 10.1136/hrt.2007.130534] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the impact of mobile automated external defibrillators (AEDs) on out-of-hospital cardiac arrests (OHCAs) in urban and rural populations. DESIGN Prospective before and after intervention, population study. SETTING Urban and rural areas of 160,000 each. Patients, interventions and MAIN OUTCOME MEASURES In 2004-6 the demographics of OHCAs were assessed. In 2005-6 AEDs were deployed (29 urban, 53 rural): 335 urban first responders (FRs) and 493 rural FRs were trained in AED use and dispatched to OHCAs. Call-to-response interval (CRI), resuscitation and survival-to-discharge rates for OHCA were compared. RESULTS In 2004 there were 163 urban OHCAs and the emergency medical services (EMS) attended 158 (ventricular fibrillation (VF) 27/158 (17.1%)). In 2005-6 there were 226 OHCAs, EMS attended 216 (VF 30/216 (13.9%)). In 2005-6 FRs were paged to 128 OHCAs (56.6%), FRs attended 88/128 (68.8%): 18/128 (14.1%) reached before the EMS. The best combined FR/EMS mean (SD) CRI in 2005-6 (5 min 56 s (4)) was better than the EMS alone in 2004 (7 min (3); p = 0.002). Survival rate was 5.1% in 2004, 1.4% in 2005-6 (p = NS). In 2004 there were 131 rural OHCAs, EMS attended 121 (VF 19/121 (15.7%)). In 2005-6 there were 122 OHCAs, EMS attended 114 (VF 19/114 (16.7%)). In 2005-6 FRs were paged to 49 OHCAs, FRs attended 42/49 (85.7%): 23/49 (46.9%) reached before the EMS. The best combined FR/EMS mean (SD) CRI in 2005-6 (9 min 22 s (6)) was better than the EMS alone in 2004 (11 min 2 s (6); p = 0.018). Survival rate was 2.5% in 2004, 3.5% in 2005-6 (p = NS). CONCLUSIONS Despite improvement in CRI there was no impact on survival (witnessed arrest 32.8%, VF 15.6%). TRIAL REGISTRATION NUMBER ISRCTN07286796.
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Kerr T, Marshall A, Walsh J, Palepu A, Tyndall M, Montaner J, Hogg R, Wood E. Determinants of HAART discontinuation among injection drug users. AIDS Care 2007; 17:539-49. [PMID: 16036240 DOI: 10.1080/09540120412331319778] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The objective of this study was to identify psychosocial determinants of, and self-reported reasons for, HAART discontinuation among HIV-positive injection drug users (IDUs). We examined correlates between sociodemographic characteristics, drug use and risk behaviors, outcome expectations, adherence self-efficacy, social support and HAART discontinuation among 160 HIV-positive participants in the Vancouver Injection Drug Users' Study (VIDUS). Logistic regression was used to identify the factors independently associated with discontinuation of HAART. Seventy-one (44%) study participants discontinued HAART during the study period. Factors independently associated with discontinuation of HAART included recent incarceration (OR = 4.84, p = 0.022), negative outcome expectations (OR = 1.41, p = 0.001), adherence efficacy expectations (OR = 0.70, p = 0.003) and self-regulatory efficacy (OR = 0.86, p = 0.050). The most frequently cited reasons provided for discontinuing HAART were being in jail (44%) and medication side effects (41%). The results of this study suggest that psychological constructs derived from self-efficacy theory are highly germane to the understanding of HAART discontinuation behavior and interventions that may change it. Incarceration may result in interruptions in HAART among IDUs, and programmatic changes may be needed to promote optimal retention on HAART among incarcerated HIV-infected IDUs.
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Marshall A, Børresen B, Hagen G, Sunde S, Tsypkin M, Tunold R. Iridium oxide-based nanocrystalline particles as oxygen evolution electrocatalysts. RUSS J ELECTROCHEM+ 2006. [DOI: 10.1134/s1023193506100223] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Bissonnette JP, Blackburn H, Marshall A, Chan B, Bezjak A, Warde P. 45 A pilot study on reducing radiation therapy planning timelines. Radiother Oncol 2006. [DOI: 10.1016/s0167-8140(06)80786-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Young O, Jones RJ, Clack G, Jacobs V, Marshall A, Fennell M, Green T, Dixon JM. Src kinase activity in early breast cancer (EBC): A quantitative luminometric and immunohistochemical (IHC) approach. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.13010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
13010 Background: Src kinase expression and activity is increased in many solid tumors including breast cancer, and Src kinase has a role in the regulation of cancer cell invasion. Thus, Src kinase is a potential therapeutic target. Targeting cancer cell invasion may be of particular value in early disease, although drug effects are unlikely to be measurable by conventional endpoints, for example tumor regression. This prospective study aimed to establish robust measures of Src activity in invasion-related pathways in tissue derived from EBC and to assess the variability between these measures, in order to establish a methodology for pharmacodynamic assessment of Src inhibition in clinical disease. Methods: Duplicate sets of core biopsies were taken from 30 patients, both at diagnosis and surgery. Biopsies were fixed immediately in either liquid nitrogen (luminometric analysis) or pre-cooled isopentane (IHC analysis). Formalin-fixed, paraffin-embedded tissue (FFPET) was also collected at the time of diagnosis. Levels of phospho-paxillin, phospho-focal adhesion kinase (FAK), total phosphotyrosine and total paxillin were measured in lysed tumor tissue using the Luminex system. Expression of activated Src, phospho-paxillin, phospho-FAK, total paxillin and total FAK was determined in sections of frozen tissue and FFPET, and assessed semi-quantitatively by visual examination. An analysis of variance (ANOVA) model was fitted to the Luminex data ( Table ). Results: All tumors expressed active Src, and there was a high level of expression, but low variability, of paxillin, FAK, phospho-paxillin and phospho-FAK. The subcellular localization of these markers could also be assessed in FFPET sections. Conclusion: The results indicate the feasibility of assessing the effect of a Src inhibitor on invasion-related endpoints in women awaiting surgery for EBC. [Table: see text] [Table: see text]
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Cyarto E, Brown W, Marshall A. 212 Have A Try! A community-based progressive resistance training program designed for older australians. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30708-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Armit C, Brown W, Marshall A, Ritchie C. 215 Predictors of increased physical activity levels following participation in a general practice based intervention. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Smith B, Marshall A, Huang N. 214 Assessing physical activity in general practice: Evaluating the feasibility, reliability and validity of two short instruments. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30710-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ferney S, Marshall A, Owen N, Eakin E, Leslie E. 378 Adopting a user-centred approach to developing a physical activity website. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Armit C, Brown W, Marshall A, Ritchie C. 263 Changes in cardiovascular health, well-being and physical activity: results from a 12-week general practice based intervention. J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30759-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Cyarto E, Dickinson R, Marshall A, Brown W. 158 Is the CHAMPS physical activity questionnaire for older adults reliable in an older Australian sample? J Sci Med Sport 2005. [DOI: 10.1016/s1440-2440(17)30653-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Herbert Z, Weigel S, Sendemir E, Marshall A, Caldwell JD, Petrusz P, Peuckert C, Jirikowski GF. Androgen-binding protein is co-expressed with oxytocin in the male reproductive tract. Anat Histol Embryol 2005; 34:286-93. [PMID: 16159369 DOI: 10.1111/j.1439-0264.2005.00605.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Androgen-binding protein (ABP) and the posterior lobe hormone oxytocin (OT) were co-localized in male rat reproductive organs. Immunostaining of serial semi-thin sections revealed a high rate of coexistence of both antigens in Sertoli cells and in the epithelial cells of the prostate. There was a considerably less co-localization of OT and ABP in epithelial cells of the epididymis, and in the different tissues of the ductus deferens. In situ hybridization with synthetic oligonucleotides complementary to a fragment of ABP mRNA showed specific staining in the same sites that were immunostained for ABP. ABP was isolated by affinity chromatography from homogenates of testis, epididymis, prostate and the content of the prostate lumen. Identical protein patterns could be shown with surface-enhanced laser desorption/ionization time-of-flight mass spectrometry in all samples except for the epididymis indicating that ABP structure is similar in all these tissues. ABP seems to be expressed in specified cells throughout the male rat reproductive tract. Most of these cells appear to be oxytocinergic. ABP and OT have previously been detected in the ejaculate. The observed epithelial cells are likely to be their source.
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Howe L, Marshall A, O'Donoghue GM, McConachie NS. Posterior Inferior Cerebellar Artery Aneurysm Presenting As a Facial Nerve Palsy. Otol Neurotol 2005; 26:1083-4. [PMID: 16151362 DOI: 10.1097/01.mao.0000185067.42952.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Eastell R, Hannon RA, Gallagher N, Clack G, Macpherson M, Marshall A. The effect of AZD0530, a highly selective, orally available Src/Abl kinase inhibitor, on biomarkers of bone resorption in healthy males. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.3041] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Marshall A. Cunning nets. Sci Justice 2005. [DOI: 10.1016/s1355-0306(05)71624-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Icasiano F, Hewson P, Machet P, Cooper C, Marshall A. Childhood autism spectrum disorder in the Barwon region: a community based study. J Paediatr Child Health 2004; 40:696-701. [PMID: 15569287 DOI: 10.1111/j.1440-1754.2004.00513.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To establish a community database for children with autism spectrum disorder (ASD) to determine prevalence and identify subgroups based on key intellectual, clinical and family parameters. METHODS Data were collected for children previously diagnosed with an ASD in the Barwon region using parental interview and review of the child's paediatric and psychological records. Preschool diagnoses were typically made by specialist psychologists and school-age diagnoses made by a multidisciplinary team. RESULTS One hundred and seventy-seven children in the Barwon region were identified as having ASD (82% response rate). The prevalence of ASD was one per 255 children aged two to 17 years. The prevalence increased 10 fold over a 16-year period and this increase was relatively even across all levels of child intellectual functioning. Forty-two percent of children were intellectually disabled (IQ < 70) and performance IQ was significantly higher than verbal IQ but typical block design-comprehension subtest patterns were not common. Nine sibling pair families were identified, 24% were labelled as having attention deficit hyperactivity disorder (ADHD), 6% had epilepsy, and 18.3% were macrocephalic where data were available. Family difficulty was associated with the degree of obsessions/rituals, frequency and intensity of anger/aggression, and ADHD but overall was not associated with the child's intellectual status. CONCLUSIONS The relatively rapid increase in prevalence is consistent with overseas studies and suggests significant changes in diagnostic criteria, increasing community awareness and the need for support at all levels of intellectual functioning. Increased occurrence in siblings and relatives gives further evidence for a genetic cause.
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Phongsavan P, Merom D, Marshall A, Bauman A. Estimating physical activity level: the role of domestic activities. J Epidemiol Community Health 2004; 58:466-7. [PMID: 15143113 PMCID: PMC1732802 DOI: 10.1136/jech.2003.012096] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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