Identification of a novel frameshift mutation in the giant muscle filament titin in a large Australian family with dilated cardiomyopathy

Dilated cardiomyopathy (DCM) is an etiologically heterogeneous cardiac disease characterized by left ventricular dilation and systolic dysfunction. Approximately 25-30% of DCM patients show a family history of mainly autosomal dominant inheritance. We and others have previously demonstrated that mutations in the giant muscle filament titin (TTN) can cause DCM. However, the prevalence of titin mutations in familial DCM is unknown. In this paper, we report a novel heterozygous 1-bp deletion mutation (c.62890delG) in TTN that cosegregates with DCM in a large Australian pedigree (A3). The TTN deletion mutation c.62890delG causes a frameshift, thereby generating a truncated A-band titin due to a premature stop codon (p.E20963KfsX10) and the addition of ten novel amino acid residues. The clinical phenotype of DCM in kindred A3 demonstrates incomplete penetrance and variable expressivity. Finally, protein analysis of a skeletal muscle biopsy sample from an affected member did not reveal the predicted truncated titin isoform although the aberrant mRNA was present, suggesting posttranslational modification and degradation of the truncated protein. The identification of a novel disease-causing mutation in the giant titin gene in a third large family with DCM indicates that mutations in titin may account for a significant portion of the genetic etiology in familial DCM.

Perceptions of the influence of prescription medicine samples on prescribing by family physicians

Background: The provision of free prescription medicine samples is a common and traditional marketing strategy used by pharmaceutical companies, but concerns have been raised about their influence on physician prescribing behavior and patient safety. Objective: We sought to investigate the knowledge, attitudes, and behaviors of Australian family physicians regarding the use of sample prescription medications. Methods: Qualitative and quantitative techniques were used, including (1) mailed questionnaires to family physicians, (2) semistructured interviews with family physicians, and (3) sample cupboard inventories. Results: A number of issues about samples were identified by the questionnaires (208) and interviews (17 doctors), including insufficient labeling, poor record keeping, diversion of stock (personal use by doctors.. their families, practice staff and pharmaceutical representatives), and wasting of expired stock. Prescription medicine samples also influenced prescribing behavior. Australian doctors were less likely to provide samples to patients on financial grounds compared with a previous study in the United States on medical residents. Six sample cupboards were inventoried. Median wholesale value of sample cupboards was AUD $4959 (range $2395-$8709), with 6% of stock expired. Very little generic medicine was included in the sample cupboards. Conclusions: Better methods are needed to meet legislative requirements and to ensure quality use of medicines (and optimal public health) with respect to prescription medicine samples. Doctors and practice staff require training on the appropriate handling and storage of prescription medications. Alternative ways for distribution of sample medications need to be investigated.

Desperately seeking donors: The 'saviour siblings' decision in quintaville v human fertilisation embryology authority (UK)

The recent House of Lords decision in Quintavalle v Human Fertilisation and Embryology Authority has raised difficult and complex issues regarding the extent to which embryo selection and reproductive technology can be used as a means of rectifying genetic disorders and treating critically ill children. This comment outlines the facts of Quintavalle and explores how the House of Lords approached the legal, ethical and policy issues that arose out of the Human Fertilisation and Embryology Authority's (UK) decision to allow reproductive and embryo technology to be used to produce a 'saviour sibling' whose tissue could be used to save the life of a critically ill child. Particular attention will be given to the implications of the decision in Quintavalle for Australian family and medical law and policy. As part of this focus, the comment explores the current Australian legislative and policy framework regarding the use of genetic and reproductive technology as a mechanism through which to assist critically ill siblings. It is argued that the present Australian framework would appear to impose significant limits on the medical uses of genetic technology and, in this context, would seem to reflect many of the principles that were articulated by the House of Lords in Quintavalle.

Further evidence of linkage at 7p22 with familial hyperaldosteronism type II

Primary aldosteronism (PAL) is caused by the autonomous over-production of aldosterone. Once thought rare, it is now reported to be responsible for 5–10% of hypertension. Familial hyperaldosteronism type II (FH-II), unlike familial hyperaldosteronism type I, is not glucocorticoid-remediable and not associated with the hybrid CYP11B1/CYP11B2 gene mutation. At least five times more common than FH-I, FH-II is clinically, biochemically and morphologically indistinguishable from apparently sporadic PAL, suggesting that its incidence maybe even higher. Studies performed in collaboration with C Stratakis (NIH, Bethesda) on our largest Australian FH-II family (eight affected members) demonstrated linkage at chromosome 7p22. Similar linkage at this region was also found in a South American FH-II family (DNA provided by MI New, Presbyterian Hospital, New York). Mutations in the exons and intron/exon boundaries of the PRKARIB gene (which resides at 7p22 and is closely related to PRKARIA gene mutated in Carney complex) have been excluded in our largest Australian FH-II family. Using more finely spaced markers, we have confirmed linkage at 7p22 in these 2 families, and identified a second Australian family with evidence of linkage at this locus. The combined multipoint LOD score for these 3 families is 4.87 (θ=0) with markers D7S462 and D7S2424, which exceeds the critical threshold for genome-wide significance suggested by Lander and Kruglyak (1995), providing strong support for this locus harbouring mutations responsible for FH-II. A newly identified recombination event in our largest Australian family has narrowed the region of linkage by 1.8 Mb, permitting exclusion of approximately half the genes residing in the original reported 5Mb linked locus. In addition, we have strongly excluded linkage to these key markers in two Australian families (maximum multipoint LOD scores −3.51 and −2.77), supporting the notion that FH-II may be genetically heterogeneous. In order to identify candidate genes at 7p22, more closely spaced markers will be used to refine the locus, as well as single nucleotide polymorphism analysis.

Further evidence of linkage at 7p22 with familial hyperaldosteronism type II and exclusion of genetic defects in the RBAK coding regions

Once thought rare, primary aldosteronism (PAL) is now reported to be responsible for 5–10% of hypertension. Unlike familial hyperaldosteronism type I (FH-I), FH-II is not glucocorticoidremediable and not associated with the hybrid CYP11B1/CYP11B2 gene mutation. At least five times more common than FH-I, FH-II is clinically indistinguishable from apparently sporadic PAL, suggesting an even higher incidence. Studies performed in collaboration with C Stratakis (NIH, Bethesda) on our largest Australian family (eight affected members) demonstrated linkage at chromosome 7p22. Linkage at this region was also found in a South American family (DNA provided by MI New, Mount Sinai School of Medicine, New York) and in a second Australian family. The combined multipoint LOD score for these 3 families is 4.61 (q = 0) with markers D7S462 and D7S517, providing strong support for this locus harbouring mutations responsible for FH-II. A newly identified recombination event in our largest Australian family has narrowed the region of linkage by 1.8 Mb, permitting exclusion of approximately half the genes residing in the originally reported 5 Mb linked locus. Candidate genes that are involved in cell cycle control are of interest as adrenal hyperplasia and adrenal adenomas are common in FH-II patients. A novel candidate gene in this linked region produces the retinoblastoma-associated Kruppel-associated box protein (RBaK) which interacts with the retinoblastoma gene product to repress the expression of genes activated by members of the E2F family of transcription factors.

Family, work and health - The impact of marriage, parenthood and employment on self-reported health of Australian men and women

We investigate multiple-burden and multiple-attachment hypotheses for the association among marriage, parenthood, employment and health for Australian men and women. Using longitudinal data from the Australian panel survey, 'Negotiating the Lifecourse', we find that men and women employed full time report better health than those employed part time or not employed. Previously married women report worse health than married women, but there is no association between marital status and health for men. We also find that men with preschool children in the household report worse health than men with older children, whereas women with preschool children report better health than women with older children. In addition for women we find evidence of a role-burden where combining full-time employment and children has a negative impact on health, but combining children with part-time or no employment has a beneficial health effect. There are no health effects of combining roles for men.

The cell wall galactans from Australian representatives of the genus Meristotheca (solieriaceae, rhodophyta)

The Solieriaceae, has the largest number of genera (16-18) of any family in the carrageenophyte order Gigartinales. One of these genera, Meristotheca, consists of three or four species of foliose, erect to prostrate plants sporadically recorded from the tropics of both hemispheres. The hot-water-soluble polysaccharides from Australian representatives of the type species, M. papulosa, and M. procumbens from Lord Howe Island have been characterized by compositional assays, linkage analysis, and Fourier transform infrared and C-13-nuclear magnetic resonance spectroscopy. The results show that polysaccharides from both species are similar, being predominantly composed of 4-linked 3,6-anhydro-alpha-D-galactopyranose 2-sulphate alternating with 3-linked beta-D-galactopyranose 4-sulphate, as is typical of iota-carrageenan. Small proportions of the 3-linked units occur as the pyruvated residue 4,6-O-(1-carboxyethylidene)-beta-D-galactopyranose, and other minor variations from idealized iota-carrageenan were also detected. The polysaccharides from representatives of Meristotheca are comparable to those of other solieriacean algae analysed to date, but the minor structural variations suggest a closer chemotaxonomic affinity with noneucheumoid genera of the Solieriaceae, such as Sarconema, Solieria, and Tikvahiella, than to the eucheumoid genera Eucheuma, Kappaphycus and Betaphycus (tribe Eucheumatoideae) from which most kappa- and iota-carrageenans are commercially extracted.

Cryptic false spider mites: a new genus, Austrolinus, and a review of the family Linotetranidae (Acari : Prostigmata : Tetranychoidea)

The Linotetranidae (Acari: Tetranychoidea) is a poorly known group of cryptic false spider mites associated with grasses and sedges. We review the family at the world level, provide the first phylogenetic analysis of the family, and describe the first Australian representatives: Austrolinus, gen. nov. and two new species: A. arenulus and A. kinnearae. Linotetranidae is redefined, and keys are provided for the families of the Tetranychoidea, and for all described genera and species of Linotetranidae.

Aeropalynology of Australian native arboreal species in Brisbane, Australia

The influence of meteorological parameters on airborne pollen of Australian native arboreal species was investigated in the sub-tropical city of Brisbane, Australia over the five-year period, June 1994–May 1999. Australian native arboreal pollen (ANAP), shed by taxa belonging to the families Cupressaceae, Casuarinaceae and Myrtaceae accounts for 18.4% of the total annual pollen count and is distributed in the atmosphere during the entire year with maximum loads restricted to the months May through November. Daily counts within the range 11–100 grains m–3 occurred over short intervals each year and were recorded on 100 days during the five-year sampling period. Total seasonal ANAP concentrations varied each year, with highest annual values measured for the family Cupressaceae, for which greater seasonal frequencies were shown to be related to pre-seasonal precipitation (r 2 = 0.76, p = 0.05). Seasonal start dates were near consistent for the Cupressaceae and Casuarinaceae. Myrtaceae start dates were variable and established to be directly related to lower average pre-seasonal maximum temperature (r 2 = 0.78, p = 0.04). Associations between daily ANAP loads and weather parameters showed that densities of airborne Cupressaceae and Casuarinaceae pollen were negatively correlated with maximum temperature (p < 0.0001), minimum temperature (p < 0.0001) and precipitation (p < 0.05), whereas associations with daily Myrtaceae pollen counts were not statistically significant. This is the first study to be conducted in Australia that has assessed the relationships between weather parameters and the airborne distribution of pollen emitted by Australian native arboreal species. Pollen shed by Australian native Cupressaceae, Casuarinaceae and Myrtaceae species are considered to be important aeroallergens overseas, however their significance as a sensitising source in Australia remains unclear and requires further investigation.

Spatial inequality in the Australian youth labour market: The role of neighbourhood composition

Australia has experienced a polarization of income and labour market outcomes over the past 20 years (GREGORY and HUNTER, 1995; HARDING, 1996). This has taken an increasingly spatial dimension (HUNTER. 1995a, 1995b), giving rise to concerns that the spatial pooling of disadvantage may hamper the labour market outcomes of youth growing up in poorer residential areas. This paper explores the role that the differential neighbourhood 'quality' of an individual's residential area at age 16 has on their labour market outcomes at age 18 and age 21. Evidence is found that youth who live in poorer quality neighbourhoods face an increased likelihood of being unemployed at both the age of 18 and 21, even after controlling for personal and family characteristics.

Critical relationship between sodium valproate dose and human teratogenicity: results of the Australian register of anti-epileptic drugs in pregnancy

To compare the incidence of foetal malformations (FMs) in pregnant women with epilepsy treated with different anti-epileptic drugs (AED) and doses, and the influence of seizures, family and personal history, and environmental factors. A prospective, observational, community-based cohort study. Methods. A voluntary, Australia-wide, telephone-interview-based register prospectively enrolling three groups of pregnant women: taking AEDs for epilepsy; with epilepsy not taking AEDs; taking AEDs for a non-epileptic indication. Four hundred and fifty eligible women were enrolled over 40 months. Three hundred and ninety six pregnancies had been completed, with 7 sets of twins, for a total of 403 pregnancy outcomes. Results. 354 (87.8%) pregnancy outcomes resulted in a healthy live birth, 26 (6.5%) had a FM, 4 (1%) a death in utero, 1 (0.2%) a premature labour with stillbirth, 14 (3.5%) a spontaneous abortion and 4 lost to follow-up. The FM rate was greater in pregnancies exposed to sodium valproate (VPA) in the first trimester (116.0%) compared with those exposed to all other AEDs (16.0% vs. 2.4%, P < 0.01) or no AEDs (16.0% vs. 3.1 %, P < 0.01). The mean daily dose of VPA taken in pregnancy with FMs was significantly greater than in those without (11975 vs: 1128 mg, P < 0.01). The incidence of FM with VPA doses greater than or equal to 1100 mg was 30.2% vs. 3.2% with doses < 1100 mg (P < 0.01). Conclusions. There is a dose-effect relationship for FM and exposure to VPA during the first trimester of pregnancy, with higher doses of VPA associated with a significantly greater risk than with lower doses or with other AEDs. These results highlight the need to limit, where possible, the dose of VPA in pregnancy. (C) 2004 Elsevier Ltd. All rights reserved.

Clustering of related individuals in a population of the Australian lizard, Egernia frerei

Stable social aggregations are rarely recorded in lizards, but have now been reported from several species in the Australian scincid genus Egernia. Most of those examples come from species using rock crevice refuges that are relatively easy to observe. But for many other Egernia species that occupy different habitats and are more secretive, it is hard to gather the observational data needed to deduce their social structure. Therefore, we used genotypes at six polymorphic microsatellite DNA loci of 229 individuals of Egernia frerei, trapped in 22 sampling sites over 3500 ha of eucalypt forest on Fraser Island, Australia. Each sampling site contained 15 trap locations in a 100 x 50 m grid. We estimated relatedness among pairs of individuals and found that relatedness was higher within than between sites. Relatedness of females within sites was higher than relatedness of males, and was higher than relatedness between males and females. Within sites we found that juvenile lizards were highly related to other juveniles and to adults trapped at the same location, or at adjacent locations, but relatedness decreased with increasing trap separation. We interpreted the results as suggesting high natal philopatry among juvenile lizards and adult females. This result is consistent with stable family group structure previously reported in rock dwelling Egernia species, and suggests that social behaviour in this genus is not habitat driven.