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McKenzie F, Mina K, Callewaert B, Beyens A, Dickinson JE, Jevon G, Papadimitriou J, Diness BR, Steensberg JN, Ek J, Baynam G. Severe congenital cutis laxa: Identification of novel homozygous LOX gene variants in two families. Clin Genet 2021; 100:168-175. [PMID: 33866545 DOI: 10.1111/cge.13969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 11/28/2022]
Abstract
We report three babies from two families with a severe lethal form of congenital cutis laxa. All three had redundant and doughy-textured skin and two siblings from one family had facial dysmorphism. Echocardiograms showed thickened and poorly contractile hearts, arterial dilatation and tortuosity. Post-mortem examination in two of the babies further revealed widespread ectasia and tortuosity of medium and large sized arteries, myocardial hypertrophy, rib and skull fractures. The presence of fractures initially suggested a diagnosis of osteogenesis imperfecta. Under light microscopy bony matrices were abnormal and arterial wall architecture was grossly abnormal showing fragmented elastic fibres. Molecular analysis of known cutis laxa genes did not yield any pathogenic defects. Whole exome sequencing of DNA following informed consent identified two separate homozygous variants in the LOX (Lysyl Oxidase) gene. LOX belongs to the 5-lysyl oxidase gene family involved in initiation of cross-linking of elastin and collagen. A mouse model of a different variant in this gene recapitulates the phenotype seen in the three babies. Our findings suggest that the LOX gene is a novel cause of severe congenital cutis laxa with arterial tortuosity, bone fragility and respiratory failure.
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Affiliation(s)
- Fiona McKenzie
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Kym Mina
- Department of Diagnostic Genomics, PathWest, Perth, Western Australia, Australia
| | - Bert Callewaert
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.,Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Aude Beyens
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium.,Department of Biomolecular Medicine, Ghent University, Ghent, Belgium.,Department of Dermatology, Ghent University Hospital, Ghent, Belgium
| | - Jan E Dickinson
- Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia.,Division of Obstetrics and Gynaecology, The University of Western Australia, Perth, Western Australia, Australia
| | - Gareth Jevon
- Department of Paediatric Pathology, PathWest, Perth Children's Hospital, Perth, Western Australia, Australia
| | - John Papadimitriou
- Centre for Orthopaedic Translational Research, Medical School, University of Western Australia, Nedlands, Western Australia, Australia.,Pathwest Laboratories, Perth, Western Australia, Australia
| | - Birgitte Rode Diness
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Clinical Medicine, Copenhagen University, Copenhagen, Denmark
| | | | - Jakob Ek
- Department of Clinical Genetics, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Gareth Baynam
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Western Australia, Australia.,The Western Australia Register of Developmental Anomalies, Department of Health, Government of Western Australia, Perth, Western Australia, Australia.,School of Medicine, Division of Paediatrics and Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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2
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Beecroft SJ, Yau KS, Allcock RJN, Mina K, Gooding R, Faiz F, Atkinson VJ, Wise C, Sivadorai P, Trajanoski D, Kresoje N, Ong R, Duff RM, Cabrera-Serrano M, Nowak KJ, Pachter N, Ravenscroft G, Lamont PJ, Davis MR, Laing NG. Targeted gene panel use in 2249 neuromuscular patients: the Australasian referral center experience. Ann Clin Transl Neurol 2020; 7:353-362. [PMID: 32153140 PMCID: PMC7086001 DOI: 10.1002/acn3.51002] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 01/28/2020] [Accepted: 02/06/2020] [Indexed: 12/12/2022] Open
Abstract
Objective To develop, test, and iterate a comprehensive neuromuscular targeted gene panel in a national referral center. Methods We designed two iterations of a comprehensive targeted gene panel for neuromuscular disorders. Version 1 included 336 genes, which was increased to 464 genes in Version 2. Both panels used TargetSeqTM probe‐based hybridization for target enrichment followed by Ion Torrent sequencing. Targeted high‐coverage sequencing and analysis was performed on 2249 neurology patients from Australia and New Zealand (1054 Version 1, 1195 Version 2) from 2012 to 2015. No selection criteria were used other than referral from a suitable medical specialist (e.g., neurologist or clinical geneticist). Patients were classified into 15 clinical categories based on the clinical diagnosis from the referring clinician. Results Six hundred and sixty‐five patients received a genetic diagnosis (30%). Diagnosed patients were significantly younger that undiagnosed patients (26.4 and 32.5 years, respectively; P = 4.6326E‐9). The diagnostic success varied markedly between disease categories. Pathogenic variants in 10 genes explained 38% of the disease burden. Unexpected phenotypic expansions were discovered in multiple cases. Triage of unsolved cases for research exome testing led to the discovery of six new disease genes. Interpretation A comprehensive targeted diagnostic panel was an effective method for neuromuscular disease diagnosis within the context of an Australasian referral center. Use of smaller disease‐specific panels would have precluded diagnosis in many patients and increased cost. Analysis through a centralized laboratory facilitated detection of recurrent, but under‐recognized pathogenic variants.
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Affiliation(s)
- Sarah J Beecroft
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Kyle S Yau
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Richard J N Allcock
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Kym Mina
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Rebecca Gooding
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Fathimath Faiz
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Vanessa J Atkinson
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia.,Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Cheryl Wise
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Padma Sivadorai
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Daniel Trajanoski
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Nina Kresoje
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Royston Ong
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Rachael M Duff
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Macarena Cabrera-Serrano
- Department of Neurology, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla, CSIC, Universidad de Sevilla, Sevilla, Spain
| | - Kristen J Nowak
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia.,Public and Aboriginal Health Division, Department of Health, Office of Population Health Genomics, Perth, Western Australia, Australia
| | - Nicholas Pachter
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia
| | - Gianina Ravenscroft
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Phillipa J Lamont
- Neurogenetic Unit, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Mark R Davis
- Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Nigel G Laing
- Centre for Medical Research, University of Western Australia, Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, Western Australia, Australia.,Department of Diagnostic Genomics, Department of Health, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
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3
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Poulton C, Pathak G, Mina K, Lassman T, Azmanov DN, McCormack E, Broley S, Dreyer L, Gration D, Taylor E, OSullivan M, Siafarikis A, Ravikumara M, Dawkins H, Pachter N, Baynam G. Tricho-hepatic-enteric syndrome (THES) without intractable diarrhoea. Gene 2019; 699:110-114. [PMID: 30844479 DOI: 10.1016/j.gene.2019.02.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 02/08/2019] [Accepted: 02/09/2019] [Indexed: 01/15/2023]
Abstract
Tricho-hepatic-enteric syndrome (THES) is a genetically heterogeneous rare syndrome (OMIM: 222470 (THES1) and 614602 (THES2)) that typically presents in the neonatal period with intractable diarrhoea, intra-uterine growth retardation (IUGR), facial dysmorphism, and hair and skin changes. THES is associated with pathogenic variants in either TTC37 or SKIV2L; both are components of the human SKI complex, an RNA exosome cofactor. We report an 8 year old girl who was diagnosed with THES by the Undiagnosed Disease Program-WA with compound heterozygous pathogenic variants in SKIV2L. While THES was considered in the differential diagnosis, the absence of protracted diarrhoea delayed definitive diagnosis. We therefore suggest that SKIV2L testing should be considered in cases otherwise suggestive of THES, but without the characteristic diarrhoea. We expand the phenotypic spectrum while reviewing the current knowledge on SKIV2L.
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Affiliation(s)
- C Poulton
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia; Undiagnosed Disease Program, Perth Children's Hospital Foundation, Nedlands, Australia.
| | - G Pathak
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia
| | - K Mina
- Douglass Hanly Moir Pathology, Macquarie Park, New South Wales, Australia
| | - T Lassman
- Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - D N Azmanov
- Department of Diagnostic Genomics, PathWest Laboratory Medicine Western Australia, Nedlands, Western Australia, Australia
| | - E McCormack
- Faculty of Science, Doctor of Medicine Program, University of Western Australia, Perth, Western Australia, Australia
| | - S Broley
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia; Undiagnosed Disease Program, Perth Children's Hospital Foundation, Nedlands, Australia
| | - L Dreyer
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia; Undiagnosed Disease Program, Perth Children's Hospital Foundation, Nedlands, Australia
| | - D Gration
- Western Australia Register for Developmental Abnormalities, King Edward Memorial Hospital for Women Perth, Australia
| | - E Taylor
- Department of Paediatrics, Perth Children's Hospital Foundation, Nedlands, Australia
| | - M OSullivan
- Department of Immunology, Perth Children's Hospital Foundation, Nedlands, Australia
| | - A Siafarikis
- Department of Endocrinology, Perth Children's Hospital Foundation, Nedlands, Australia
| | - M Ravikumara
- Department of Gastroenterology, Perth Children's Hospital Foundation, Nedlands, Australia
| | - H Dawkins
- Centre for Population Health Research, Curtin University of Technology, Bentley, Australia
| | - N Pachter
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia
| | - G Baynam
- Genetic Services of Western Australia, King Edward Memorial Hospital, Perth, Australia; Undiagnosed Disease Program, Perth Children's Hospital Foundation, Nedlands, Australia; School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia
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Baynam G, Broley S, Bauskis A, Pachter N, McKenzie F, Townshend S, Slee J, Kiraly-Borri C, Vasudevan A, Hawkins A, Schofield L, Helmholz P, Palmer R, Kung S, Walker CE, Molster C, Lewis B, Mina K, Beilby J, Pathak G, Poulton C, Groza T, Zankl A, Roscioli T, Dinger ME, Mattick JS, Gahl W, Groft S, Tifft C, Taruscio D, Lasko P, Kosaki K, Wilhelm H, Melegh B, Carapetis J, Jana S, Chaney G, Johns A, Owen PW, Daly F, Weeramanthri T, Dawkins H, Goldblatt J. Initiating an undiagnosed diseases program in the Western Australian public health system. Orphanet J Rare Dis 2017; 12:83. [PMID: 28468665 PMCID: PMC5415708 DOI: 10.1186/s13023-017-0619-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 03/26/2017] [Indexed: 02/02/2023] Open
Abstract
Background New approaches are required to address the needs of complex undiagnosed diseases patients. These approaches include clinical genomic diagnostic pipelines, utilizing intra- and multi-disciplinary platforms, as well as specialty-specific genomic clinics. Both are advancing diagnostic rates. However, complementary cross-disciplinary approaches are also critical to address those patients with multisystem disorders who traverse the bounds of multiple specialties and remain undiagnosed despite existing intra-specialty and genomic-focused approaches. The diagnostic possibilities of undiagnosed diseases include genetic and non-genetic conditions. The focus on genetic diseases addresses some of these disorders, however a cross-disciplinary approach is needed that also simultaneously addresses other disorder types. Herein, we describe the initiation and summary outcomes of a public health system approach for complex undiagnosed patients - the Undiagnosed Diseases Program-Western Australia (UDP-WA). Results Briefly the UDP-WA is: i) one of a complementary suite of approaches that is being delivered within health service, and with community engagement, to address the needs of those with severe undiagnosed diseases; ii) delivered within a public health system to support equitable access to health care, including for those from remote and regional areas; iii) providing diagnoses and improved patient care; iv) delivering a platform for in-service and real time genomic and phenomic education for clinicians that traverses a diverse range of specialties; v) retaining and recapturing clinical expertise; vi) supporting the education of junior and more senior medical staff; vii) designed to integrate with clinical translational research; and viii) is supporting greater connectedness for patients, families and medical staff. Conclusion The UDP-WA has been initiated in the public health system to complement existing clinical genomic approaches; it has been targeted to those with a specific diagnostic need, and initiated by redirecting existing clinical and financial resources. The UDP-WA supports the provision of equitable and sustainable diagnostics and simultaneously supports capacity building in clinical care and translational research, for those with undiagnosed, typically rare, conditions. Electronic supplementary material The online version of this article (doi:10.1186/s13023-017-0619-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gareth Baynam
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia. .,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia. .,Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, WA, Australia. .,Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia. .,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia. .,Western Australian Register of Developmental Anomalies, Perth, WA, Australia. .,School of Spatial Sciences, Curtin University, Perth, WA, Australia.
| | - Stephanie Broley
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Alicia Bauskis
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Nicholas Pachter
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
| | - Fiona McKenzie
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
| | - Sharron Townshend
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Jennie Slee
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Cathy Kiraly-Borri
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Anand Vasudevan
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Anne Hawkins
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Lyn Schofield
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia
| | - Petra Helmholz
- School of Spatial Sciences, Curtin University, Perth, WA, Australia.,Cooperative Research Centre for Spatial Information, Perth, WA, Australia
| | - Richard Palmer
- School of Spatial Sciences, Curtin University, Perth, WA, Australia.,Cooperative Research Centre for Spatial Information, Perth, WA, Australia
| | - Stefanie Kung
- School of Spatial Sciences, Curtin University, Perth, WA, Australia.,Cooperative Research Centre for Spatial Information, Perth, WA, Australia
| | - Caroline E Walker
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Caron Molster
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Barry Lewis
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Kym Mina
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - John Beilby
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | | | | | - Tudor Groza
- Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, Australia
| | - Andreas Zankl
- Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Darlinghurst, NSW, Australia.,The Children's Hospital at Westmead, Clinical Genetics Service, Westmead, NSW, Australia
| | - Tony Roscioli
- Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, Australia
| | - Marcel E Dinger
- Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Darlinghurst, NSW, Australia
| | - John S Mattick
- Kinghorn Centre for Clinical Genomics, Garvan Institute for Medical Research, Darlinghurst, NSW, Australia.,St. Vincent's Clinical School, Faculty of Medicine, University of New South Wales, Darlinghurst, NSW, Australia
| | - William Gahl
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Rockville, MD, USA.,Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, Rockville, MD, USA
| | - Stephen Groft
- National Centre for Advancing Translational Sciences, National Institutes of Health, Bethesda, Maryland, USA
| | - Cynthia Tifft
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Rockville, MD, USA.,Undiagnosed Diseases Program, Common Fund, Office of the Director, National Institutes of Health, Bethesda, Rockville, MD, USA
| | - Domenica Taruscio
- Instituto Superiore di Sanità, National Center for Rare Diseases, Rome, Italy
| | - Paul Lasko
- Canadian Institutes of Health Research, Institute of Genetics, Montreal, Canada
| | | | | | - Bela Melegh
- Department of Medical Genetics, University of Pécs, Pécs, Hungary
| | - Jonathan Carapetis
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Perth Children's Hospital, Perth, WA, Australia
| | - Sayanta Jana
- King Edward Memorial Hospital, Perth, WA, Australia
| | | | | | | | - Frank Daly
- Perth Children's Hospital, Perth, WA, Australia
| | - Tarun Weeramanthri
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Hugh Dawkins
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, WA, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia.,Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia
| | - Jack Goldblatt
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
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Mesbah Ardakani N, Thomas C, Robinson C, Mina K, Harvey NT, Amanuel B, Wood BA. Detection of copy number variations in melanocytic lesions utilising array based comparative genomic hybridisation. Pathology 2017; 49:285-291. [DOI: 10.1016/j.pathol.2016.11.008] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 10/24/2016] [Accepted: 11/07/2016] [Indexed: 11/25/2022]
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Au PYB, Huang L, Broley S, Gallagher L, Creede E, Lahey D, Ordorica S, Mina K, Boycott KM, Baynam G, Dyment DA. Two females with mutations in USP9X highlight the variable expressivity of the intellectual disability syndrome. Eur J Med Genet 2017; 60:359-364. [PMID: 28377321 DOI: 10.1016/j.ejmg.2017.03.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 03/28/2017] [Accepted: 03/31/2017] [Indexed: 01/02/2023]
Abstract
The genetic causes of intellectual disability (ID) are heterogeneous and include both chromosomal and monogenic etiologies. The X-chromosome is known to contain many ID-related genes and males show a marked predominance for intellectual disability. Here we report two females with syndromic intellectual disability. The first individual was relatively mild in her presentation with mild-moderate intellectual disability, hydronephrosis and altered pigmentation along the lines of Blaschko without additional congenital anomalies. A second female presented shortly after birth with dysmorphic facial features, post-axial polydactyly and, on follow-up assessment, demonstrated moderate intellectual disability. Chromosomal studies for Individual 1 identified an X-chromosome deletion due to a de novo pericentric inversion; the inversion breakpoint was associated with deletion of the 5'UTR of the USP9X, a gene which has been implicated in a syndromic intellectual disability affecting females. The second individual had a de novo frameshift mutation detected by whole-exome sequencing that was predicted to be deleterious, NM_001039590.2 (USP9X): c.4104_4105del (p.(Arg1368Serfs*2)). Haploinsufficiency of USP9X in females has been associated with ID and congenital malformations that include heart defects, scoliosis, dental abnormalities, anal atresia, polydactyly, Dandy Walker malformation and hypoplastic corpus callosum. The extent of the congenital malformations observed in Individual 1 was less striking than Individual 2 and other individuals previously reported in the literature, and suggests that USP9X mutations in females can have a wider spectrum of presentation than previously appreciated.
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Affiliation(s)
- P Y B Au
- Department of Medical Genetics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, AB, Canada
| | - L Huang
- Department of Pathology, University of British Columbia Women and Children's Hospital, Vancouver, Canada
| | - S Broley
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Subiaco, Australia
| | - L Gallagher
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - E Creede
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - D Lahey
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - S Ordorica
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - K Mina
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, WA, Australia
| | - K M Boycott
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - G Baynam
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Subiaco, Australia; School of Paediatrics and Child Health, The University of Western Australia, Crawley, Australia; Institute for Immunology and Infectious Diseases, Murdoch University, Murdoch, Australia; Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, East Perth, Australia; Telethon Kids Institute, University of Western Australia, Subiaco, Australia; Western Australian Register of Developmental Anomalies, Subiaco, Australia; School of Spatial Sciences, Curtin University, Bentley, Australia
| | - D A Dyment
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.
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Kamien B, Dadd T, Buckman M, Ronan A, Dudding T, Meldrum C, Scott R, Mina K. Somatic-gonadal mosaicism causing Sotos syndrome. Am J Med Genet A 2016; 170:3360-3362. [DOI: 10.1002/ajmg.a.37867] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 06/23/2016] [Indexed: 12/17/2022]
Affiliation(s)
- Benjamin Kamien
- Hunter Genetics; Newcastle New South Wales Australia
- School of Medicine and Public Health; The University of Newcastle; Newcastle New South Wales Australia
- School of Biomedical Sciences and Pharmacy; The University of Newcastle; Newcastle New South Wales Australia
| | - Tessa Dadd
- Department of Diagnostic Genomics; PathWest Laboratory Medicine Western Australia; Perth Western Australia Australia
| | - Melissa Buckman
- Tamworth Community Health Centre; Genetic Counselling Service; Tamworth New South Wales Australia
| | - Anne Ronan
- Hunter Genetics; Newcastle New South Wales Australia
- School of Medicine and Public Health; The University of Newcastle; Newcastle New South Wales Australia
| | - Tracy Dudding
- Hunter Genetics; Newcastle New South Wales Australia
- School of Medicine and Public Health; The University of Newcastle; Newcastle New South Wales Australia
| | - Cliff Meldrum
- Molecular Medicine; Pathology North; Newcastle New South Wales Australia
| | - Rodney Scott
- School of Biomedical Sciences and Pharmacy; The University of Newcastle; Newcastle New South Wales Australia
- Molecular Medicine; Pathology North; Newcastle New South Wales Australia
| | - Kym Mina
- Department of Diagnostic Genomics; PathWest Laboratory Medicine Western Australia; Perth Western Australia Australia
- School of Pathology and Laboratory Medicine; The University of Western Australia; Perth Western Australia Australia
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Baynam G, Pachter N, McKenzie F, Townshend S, Slee J, Kiraly-Borri C, Vasudevan A, Hawkins A, Broley S, Schofield L, Verhoef H, Walker CE, Molster C, Blackwell JM, Jamieson S, Tang D, Lassmann T, Mina K, Beilby J, Davis M, Laing N, Murphy L, Weeramanthri T, Dawkins H, Goldblatt J. The rare and undiagnosed diseases diagnostic service - application of massively parallel sequencing in a state-wide clinical service. Orphanet J Rare Dis 2016; 11:77. [PMID: 27287197 PMCID: PMC4902909 DOI: 10.1186/s13023-016-0462-7] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
Background The Rare and Undiagnosed Diseases Diagnostic Service (RUDDS) refers to a genomic diagnostic platform operating within the Western Australian Government clinical services delivered through Genetic Services of Western Australia (GSWA). GSWA has provided a state-wide service for clinical genetic care for 28 years and it serves a population of 2.5 million people across a geographical area of 2.5milion Km2. Within this context, GSWA has established a clinically integrated genomic diagnostic platform in partnership with other public health system managers and service providers, including but not limited to the Office of Population Health Genomics, Diagnostic Genomics (PathWest Laboratories) and with executive level support from the Department of Health. Herein we describe report presents the components of this service that are most relevant to the heterogeneity of paediatric clinical genetic care. Results Briefly the platform : i) offers multiple options including non-genetic testing; monogenic and genomic (targeted in silico filtered and whole exome) analysis; and matchmaking; ii) is delivered in a patient-centric manner that is resonant with the patient journey, it has multiple points for entry, exit and re-entry to allow people access to information they can use, when they want to receive it; iii) is synchronous with precision phenotyping methods; iv) captures new knowledge, including multiple expert review; v) is integrated with current translational genomic research activities and best practice; and vi) is designed for flexibility for interactive generation of, and integration with, clinical research for diagnostics, community engagement, policy and models of care. Conclusion The RUDDS has been established as part of routine clinical genetic services and is thus sustainable, equitably managed and seeks to translate new knowledge into efficient diagnostics and improved health for the whole community.
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Affiliation(s)
- Gareth Baynam
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia. .,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia. .,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia. .,Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia. .,Telethon Kids Institute, University of Western Australia, Perth, WA, Australia. .,Western Australian Register of Developmental Anomalies, Perth, WA, Australia.
| | - Nicholas Pachter
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
| | - Fiona McKenzie
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
| | - Sharon Townshend
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Jennie Slee
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Cathy Kiraly-Borri
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Medical Research, Harry Perkins Institute of Medical Research, QEII Medical Centre, University of Western Australia, Perth, WA, Australia
| | - Anand Vasudevan
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Anne Hawkins
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Stephanie Broley
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Lyn Schofield
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia
| | - Hedwig Verhoef
- School of Spatial Sciences, Curtin University, Perth, WA, Australia.,Cooperative Research Centre for Spatial Information, Perth, WA, Australia
| | - Caroline E Walker
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Caron Molster
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Jenefer M Blackwell
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Sarra Jamieson
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Dave Tang
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Timo Lassmann
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Kym Mina
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia
| | - John Beilby
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Mark Davis
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Nigel Laing
- Diagnostic Genomics, PathWest, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Medical Research, Harry Perkins Institute of Medical Research, QEII Medical Centre, University of Western Australia, Perth, WA, Australia
| | - Lesley Murphy
- Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia.,Rare Voices Australia, Sydney, Australia
| | - Tarun Weeramanthri
- Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia
| | - Hugh Dawkins
- Office of Population Health Genomics, Public Health Division, Department of Health, Government of Western Australia, Perth, WA, Australia.,Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, WA, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA, Australia.,Centre for Comparative Genomics, Murdoch University, Perth, WA, Australia
| | - Jack Goldblatt
- Genetic Services of Western Australia, Department of Health, Government of Western Australia, Perth, WA, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
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Baynam G, Overkov A, Davis M, Mina K, Schofield L, Allcock R, Laing N, Cook M, Dawkins H, Goldblatt J. A germline MTOR mutation in Aboriginal Australian siblings with intellectual disability, dysmorphism, macrocephaly, and small thoraces. Am J Med Genet A 2015; 167:1659-67. [PMID: 25851998 DOI: 10.1002/ajmg.a.37070] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 03/06/2015] [Indexed: 11/07/2022]
Abstract
We report on three Aboriginal Australian siblings with a unique phenotype which overlaps with known megalencephaly syndromes and RASopathies, including Costello syndrome. A gain-of-function mutation in MTOR was identified and represents the first reported human condition due to a germline, familial MTOR mutation. We describe the findings in this family to highlight that (i) the path to determination of pathogenicity was confounded by the lack of genomic reference data for Australian Aboriginals and that (ii) the disease biology, functional analyses in this family, and studies on the tuberous sclerosis complex support consideration of an mTOR inhibitor as a therapeutic agent.
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Affiliation(s)
- Gareth Baynam
- Genetic Services of Western Australia, Princess Margaret and King Edward Memorial Hospitals, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,Office of Population Health Genomics, Department of Health, Public Health and Clinical Services Division, Government of Western Australia, Perth, Western Australia, Australia.,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia.,Telethon Kids Institute, Perth, Western Australia, Australia
| | - Angela Overkov
- Genetic Services of Western Australia, Princess Margaret and King Edward Memorial Hospitals, Perth, Western Australia, Australia
| | - Mark Davis
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.,Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia
| | - Kym Mina
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.,Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia
| | - Lyn Schofield
- Genetic Services of Western Australia, Princess Margaret and King Edward Memorial Hospitals, Perth, Western Australia, Australia.,Institute for Immunology and Infectious Diseases, Murdoch University, Perth, Western Australia, Australia
| | - Richard Allcock
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.,Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Western Australia, Australia
| | - Nigel Laing
- Harry Perkins Institute of Medical Research, Perth, Western Australia, Australia
| | - Matthew Cook
- Department of Immunology, John Curtin School of Medical Research, Australian National University, Canberra, Australian Capital Territory, Australia.,Australia and Translational Research Unit, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Hugh Dawkins
- School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, Australia.,Centre for Comparative Genomics, Murdoch University, Perth, Western Australia, Australia.,Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University of Technology, Perth, Western Australia, Australia
| | - Jack Goldblatt
- Genetic Services of Western Australia, Princess Margaret and King Edward Memorial Hospitals, Perth, Western Australia, Australia.,School of Paediatrics and Child Health, University of Western Australia, Perth, Western Australia, Australia.,Office of Population Health Genomics, Department of Health, Public Health and Clinical Services Division, Government of Western Australia, Perth, Western Australia, Australia
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Yau K, Allcock R, Mina K, Ravenscroft G, Cabrera M, Gooding R, Wise C, Sivadorai P, Trajanoski D, Atkinson V, Wagner S, Nowak K, Duff R, Lamont P, Davis M, Laing N. G.P.18. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Memarpour M, Rahimi M, Bagheri A, Mina K. Unerupted primary molar teeth positioned inferior to the permanent premolar: a case report. J Dent (Tehran) 2012; 9:79-82. [PMID: 22924106 PMCID: PMC3422068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 01/21/2012] [Indexed: 11/08/2022]
Abstract
Primary tooth impaction is a rare finding during the development of primary dentition. Several factors contribute to the impaction of a deciduous tooth. This report describes the diagnosis and treatment of a 10-year-old boy who presented an impacted second primary mandibular molar. This tooth, located inferior to the second premolar together with an odontoma, was positioned superior to the premolar teeth. Treatment consisted of surgical removal of the impacted deciduous tooth and odontoma and placement of a passive lower lingual holding arch. Periodic examination was indicated for follow-up. Early intervention was recommended to manage orofacial disfigurement and to avoid consequent problems.
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Affiliation(s)
- M. Memarpour
- Associate Professor, Pediatric Dentistry Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - M. Rahimi
- Assistant Professor, Pediatric Dentistry Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - A. Bagheri
- Assistant Professor, Oral and Maxillofacial Surgery Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Kumar KR, Needham M, Mina K, Davis M, Brewer J, Staples C, Ng K, Sue CM, Mastaglia FL. Two Australian families with inclusion-body myopathy, Paget’s disease of bone and frontotemporal dementia: Novel clinical and genetic findings. Neuromuscul Disord 2010; 20:330-4. [DOI: 10.1016/j.nmd.2010.03.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2009] [Revised: 02/03/2010] [Accepted: 03/01/2010] [Indexed: 12/01/2022]
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Mina K, Fritschi L, Johnson K, Group TCCRE. An Inverse Association Between Preserved Fish and Prostate Cancer: Results From a Population-Based Case-Control Study in Canada. Nutr Cancer 2008; 60:222-6. [DOI: 10.1080/01635580701684864] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
AbstractObjectiveTo compare intake estimates, validity and reliability of two summary questions to measure fish consumption with information from a detailed semi-quantitative food-frequency questionnaire (FFQ) on fish consumption.DesignPopulation-based, cross-sectional study. Participants completed an FFQ and provided blood samples for erythrocyte membrane eicosapentaenoic acid (EPA) analysis. Aggregate measures of consumption of fresh/frozen/canned fish (fresh fish) and smoked/salted/dried fish (preserved fish) were generated from the FFQ and were compared with responses to the summary questions regarding intakes of similar items. Both methods were tested for validity, using correlation and linear regression techniques with EPA, and retest reliability.SettingPerth metropolitan area, Western Australia.SubjectsOne hundred and nine healthy volunteers of both sexes, aged 21–75 years.ResultsThe summary fresh fish measure underestimated frequency and grams per week given by the aggregate question by about 50%, while estimates from the summary preserved fish measure were approximately three times that of the aggregate measure. Multiple linear regression analysis suggested that the aggregates accounted for more of the variation in EPA levels, but the difference was minimal. Intra-class correlations confirmed that both methods were reliable.ConclusionsOur study indicates that extensive questioning results in different absolute intakes of fish compared with brief questioning, but does not add any information if ranking individuals according to overall consumption of fish.
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Affiliation(s)
- Kym Mina
- School of Population Health M431, The University of Western Australia, 35 Stirling Highway, Crawley, Western Australia 6009, Australia.
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16
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Abstract
OBJECTIVE To validate a detailed semiquantitative food frequency questionnaire designed to measure habitual fish and seafood consumption. DESIGN Cross-sectional validation study using an independent biomarker of fish consumption. SETTING Perth metropolitan area, Western Australia. SUBJECTS Ninety-one healthy volunteers of both sexes aged 21-75 years. METHODS Participants completed the questionnaire and provided a fasting blood sample for erythrocyte membrane omega-3 fatty acid (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) analysis. The questionnaire was then validated by linear regression analysis of EPA and DHA levels on categories of fish and seafood and overall consumption, adjusted for age, sex, smoking status, body mass index (BMI) and alcohol intake. RESULTS Regression coefficients were statistically significant for most fish and seafood items with both EPA and DHA. The strongest association was observed between oily fish and EPA, whereas no significant association was observed between lean fish and omega-3 fatty acids. Variation in omega-3 fatty acids was best accounted for by a model containing variables representing different categories of fish and seafood consumption (R (2) 0.484), rather than a single variable representing overall fish and seafood consumption (R (2) 0.313). CONCLUSIONS This study confirms that the varying content of omega-3 fatty acids in foods are reflected in omega-3 biomarkers, and that the questionnaire is a valid measure of fish consumption that enables differentiation between cooking and processing methods and oily versus lean fish intake.
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Affiliation(s)
- K Mina
- School of Population Health, The University of Western Australia, Perth, Western Australia, Australia.
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Mina K, Byrne MJ, Ryan G, Fritschi L, Newman M, Joseph D, Harper C, Bayliss E, Kolybaba M, Jamrozik K. Surgical management of lung cancer in Western Australia in 1996 and its outcomes. ANZ J Surg 2004; 74:1076-81. [PMID: 15574152 DOI: 10.1111/j.1445-1433.2004.03271.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND All cases of lung cancer diagnosed in Western Australia in 1996 in which surgery was the primary treatment, were reviewed. Reported herein are the characteristics of the patients, the treatment outcomes and a comparison of the management undertaken with that recommended by international guidelines. METHODS All patients with a new diagnosis of lung cancer in Western Australia in the calendar year of 1996 were identified using two different population-based registration systems: the Western Australian (WA) Cancer Registry and the WA Hospital Morbidity Data System. A structured questionnaire on the diagnosis and management was completed for each case. Date of death was determined through the WA Cancer Registry. RESULTS Six hundred and sixty-eight patients with lung cancer were identified; 132 (20%) were treated with surgery. Lobectomy was the most frequently performed procedure (71%), followed by pneumonectomy (19%). Major complications affected 23% of patients. Postoperative mortality was 6% (3% lobectomy, 12% pneumonectomy). At 5 years the absolute survival was as follows for stage I, II, IIIA, IIIB, respectively: 51%, 45%, 12%, 5%. CONCLUSIONS Investigations and choice of surgery in WA in 1996 reflect current international guidelines. The survival of patients with resectable lung cancer remains unsatisfactory.
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Affiliation(s)
- Kym Mina
- School of Population Health, University of Western Australia, Australia
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18
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Freeny S, Kieburtz R, Mina K, Tewksbury S. Design of digital filters for an all digital frequency division multiplex-time division multiplex translator. ACTA ACUST UNITED AC 1971. [DOI: 10.1109/tct.1971.1083369] [Citation(s) in RCA: 47] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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