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Rocchi S, Scherer E, Mengoli C, Alanio A, Botterel F, Bougnoux ME, Bretagne S, Cogliati M, Cornu M, Dalle F, Damiani C, Denis J, Fuchs S, Gits-Muselli M, Hagen F, Halliday C, Hare R, Iriart X, Klaassen C, Lackner M, Lengerova M, Letscher-Bru V, Morio F, Nourrisson C, Posch W, Sendid B, Springer J, Willinger B, White PL, Barnes RA, Cruciani M, Donnelly JP, Loeffler J, Millon L. Interlaboratory evaluation of Mucorales PCR assays for testing serum specimens: A study by the fungal PCR Initiative and the Modimucor study group. Med Mycol 2021; 59:126-138. [PMID: 32534456 DOI: 10.1093/mmy/myaa036] [Citation(s) in RCA: 16] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/14/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022] Open
Abstract
Interlaboratory evaluations of Mucorales qPCR assays were developed to assess the reproducibility and performance of methods currently used. The participants comprised 12 laboratories from French university hospitals (nine of them participating in the Modimucor study) and 11 laboratories participating in the Fungal PCR Initiative. For panel 1, three sera were each spiked with DNA from three different species (Rhizomucor pusillus, Lichtheimia corymbifera, Rhizopus oryzae). For panel 2, six sera with three concentrations of R. pusillus and L. corymbifera (1, 10, and 100 genomes/ml) were prepared. Each panel included a blind negative-control serum. A form was distributed with each panel to collect results and required technical information, including DNA extraction method, sample volume used, DNA elution volume, qPCR method, qPCR template input volume, qPCR total reaction volume, qPCR platform, and qPCR reagents used. For panel 1, assessing 18 different protocols, qualitative results (positive or negative) were correct in 97% of cases (70/72). A very low interlaboratory variability in Cq values (SD = 1.89 cycles) were observed. For panel 2 assessing 26 different protocols, the detection rates were high (77-100%) for 5/6 of spiked serum. There was a significant association between the qPCR platform and performance. However, certain technical steps and optimal combinations of factors may also impact performance. The good reproducibility and performance demonstrated in this study support the use of Mucorales qPCR as part of the diagnostic strategy for mucormycosis.
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Affiliation(s)
- S Rocchi
- Parasitology - Mycology, University Hospital Besançon, Besançon, France.,UMR6249 CNRS Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, Besançon, France
| | - E Scherer
- Parasitology - Mycology, University Hospital Besançon, Besançon, France.,UMR6249 CNRS Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, Besançon, France
| | - C Mengoli
- Molecular Medicine, University of Padova, Padova, Italy
| | - A Alanio
- Institut Pasteur, CNRS, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Molecular Mycology Unit, UMR2000, Paris, France.,Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal hospitals, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, France
| | - F Botterel
- EA Dynamyc 7380 UPEC, ENVA, Faculté de Médecine de Créteil, 8 rue du Général Sarrail 94010 Créteil, France.,Unité de Parasitologie - Mycologie, Département de Virologie, Bactériologie-Hygiène, Mycologie-Parasitologie, DHU VIC, CHU Henri Mondor, AP-HP, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France
| | - M E Bougnoux
- Parasitology-Mycology Unit, Necker Enfants Malades Hospital, APHP, Paris, France.,Fungal Biology and Pathogenicity Unit - INRA USC 2019. Institut Pasteur, Paris, France
| | - S Bretagne
- Institut Pasteur, CNRS, National Reference Center for Invasive Mycoses and Antifungals (NRCMA), Molecular Mycology Unit, UMR2000, Paris, France.,Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal hospitals, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, France
| | - M Cogliati
- Lab. Medical Mycology, Dip. Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - M Cornu
- Inserm U1285, Univ. Lille, UMR CNRS 8576- UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000, Lille, France
| | - F Dalle
- Laboratoire de Parasitologie-Mycologie, Plateforme de Biologie Hospitalo-Universitaire Gérard Mack, Dijon France.,UMR PAM Univ Bourgogne Franche-Comté - AgroSup Dijon - Equipe Vin, Aliment, Microbiologie, Stress, Dijon, France
| | - C Damiani
- Laboratoire de Parasitologie et Mycologie Médicales, Centre de Biologie Humaine, CHU Amiens Picardie, France.,Equipe AGIR: Agents Infectieux, Résistance et Chimiothérapie UR4294, Université de Picardie Jules Verne, Amiens, France
| | - J Denis
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg. 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - S Fuchs
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - M Gits-Muselli
- Parasitology-Mycology Laboratory, Lariboisière Saint-Louis Fernand Widal hospitals, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.,Université de Paris, France
| | - F Hagen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.,Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands.,Laboratory of Medical Mycology, Jining No. 1 People's Hospital, Jining, Shandong, People's Republic of China
| | - C Halliday
- Clinical Mycology Reference Laboratory, Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR, NSW Health Pathology, Westmead, NSW, 2145, Australia
| | - R Hare
- Mycology Unit, Department for Bacteria, Parasites and Fungi, Statens Serum Institut, Copenhagen, Denmark
| | - X Iriart
- Service de Parasitologie-Mycologie, CHU Toulouse, Toulouse, France.,Centre de Physiopathologie de Toulouse Purpan (CPTP), Université de Toulouse, CNRS, INSERM, UPS, Toulouse, France
| | - C Klaassen
- Department of Medical Microbiology & Infectious Diseases, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - M Lackner
- Institut for Hygiene and Medical Microbiology, Medical University of Innsbruck (MUI), Austria
| | - M Lengerova
- Department of Internal Medicine - Hematology and Oncology, University Hospital Brno, Brno, Czech Republic
| | - V Letscher-Bru
- Laboratoire de Parasitologie et de Mycologie Médicale, Hôpitaux Universitaires de Strasbourg. 1 Place de l'Hôpital, 67000 Strasbourg, France
| | - F Morio
- Laboratoire de Parasitologie-Mycologie, CHU Nantes, Nantes, France.,Département de Parasitologie et Mycologie Médicale, EA1155 - IICiMed, Nantes Université, Nantes, France
| | - C Nourrisson
- Laboratoire de Parasitologie-Mycologie, CHU Clermont-Ferrand, 3IHP, France
| | - W Posch
- Institute of Hygiene and Medical Microbiology, Medical University of Innsbruck, Innsbruck, Austria
| | - B Sendid
- Inserm U1285, Univ. Lille, UMR CNRS 8576- UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, F-59000, Lille, France
| | - J Springer
- Department of Internal Medicine II, WÜ4i, University Hospital Wuerzburg, Wuerzburg, Germany
| | - B Willinger
- Division of Clinical Microbiology, Department of Laboratory Medicine, Medical University of Vienna
| | - P L White
- Mycology Reference Laboratory, Public Health Wales Microbiology, Cardiff, United Kingdom
| | - R A Barnes
- Medical Microbiology and Infectious Diseases, Cardiff University School of Medicine, Cardiff, United Kingdom
| | - M Cruciani
- Infectious Diseases Unit, ULSS 20 Verona, Italy
| | - J P Donnelly
- Division of Infectious Diseases, San Antonio Center for Medical Mycology, San Antonio, Texas, United States of America
| | - J Loeffler
- Department of Internal Medicine II, WÜ4i, University Hospital Wuerzburg, Wuerzburg, Germany
| | - L Millon
- Parasitology - Mycology, University Hospital Besançon, Besançon, France.,UMR6249 CNRS Chrono-Environnement, University of Bourgogne Franche-Comté, Besançon, Besançon, France
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Cruciani M, White PL, Mengoli C, Löffler J, Morton CO, Klingspor L, Buchheidt D, Maertens J, Heinz WJ, Rogers TR, Weinbergerova B, Warris A, Lockhart DEA, Jones B, Cordonnier C, Donnelly JP, Barnes RA. The impact of anti-mould prophylaxis on Aspergillus PCR blood testing for the diagnosis of invasive aspergillosis. J Antimicrob Chemother 2021; 76:635-638. [PMID: 33374010 DOI: 10.1093/jac/dkaa498] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/29/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The performance of the galactomannan enzyme immunoassay (GM-EIA) is impaired in patients receiving mould-active antifungal therapy. The impact of mould-active antifungal therapy on Aspergillus PCR testing needs to be determined. OBJECTIVES To determine the influence of anti-mould prophylaxis (AMP) on the performance of PCR blood testing to aid the diagnosis of proven/probable invasive aspergillosis (IA). METHODS As part of the systematic review and meta-analysis of 22 cohort studies investigating Aspergillus PCR blood testing in 2912 patients at risk of IA, subgroup analysis was performed to determine the impact of AMP on the accuracy of Aspergillus PCR. The incidence of IA was calculated in patients receiving and not receiving AMP. The impact of two different positivity thresholds (requiring either a single PCR positive test result or ≥2 consecutive PCR positive test results) on accuracy was evaluated. Meta-analytical pooling of sensitivity and specificity was performed by logistic mixed-model regression. RESULTS In total, 1661 (57%) patients received prophylaxis. The incidence of IA was 14.2%, significantly lower in the prophylaxis group (11%-12%) compared with the non-prophylaxis group (18%-19%) (P < 0.001). The use of AMP did not affect sensitivity, but significantly decreased specificity [single PCR positive result threshold: 26% reduction (P = 0.005); ≥2 consecutive PCR positive results threshold: 12% reduction (P = 0.019)]. CONCLUSIONS Contrary to its influence on GM-EIA, AMP significantly decreases Aspergillus PCR specificity, without affecting sensitivity, possibly as a consequence of AMP limiting the clinical progression of IA and/or leading to false-negative GM-EIA results, preventing the classification of probable IA using the EORTC/MSGERC definitions.
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Affiliation(s)
| | | | | | - J Löffler
- University of Wuerzburg, Wuerzburg, Germany
| | - C O Morton
- Western Sydney University, Sydney, Australia
| | | | | | - J Maertens
- Department of Microbiology, Immunology, and Transplantation, KULeuven, Leuven, Belgium
| | - W J Heinz
- University of Wuerzburg, Wuerzburg, Germany
| | - T R Rogers
- Trinity College Dublin, St James's Hospital Campus, Dublin, Ireland
| | - B Weinbergerova
- Department of Internal Medicine - Haematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - A Warris
- MRC Centre for Medical Mycology, University of Exeter, UK
| | | | - B Jones
- Institute of Infection, Immunity and Inflammation, University of Glasgow, UK
| | | | - J P Donnelly
- University of Nijmegen, Nijmegen, The Netherlands
| | - R A Barnes
- Cardiff University School of Medicine, Cardiff, UK
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3
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Tsitsopoulou A, Posso R, Vale L, Bebb S, Johnson E, White PL. Determination of the Prevalence of Triazole Resistance in Environmental Aspergillus fumigatus Strains Isolated in South Wales, UK. Front Microbiol 2018; 9:1395. [PMID: 29997605 PMCID: PMC6028733 DOI: 10.3389/fmicb.2018.01395] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 04/16/2018] [Accepted: 06/07/2018] [Indexed: 11/17/2022] Open
Abstract
Background/Objectives: Azole resistance in Aspergillus fumigatus associated with the TR34/L98H mutations in the cyp51A gene have been increasingly reported. Determining the environmental resistance rate has been deemed important when considering front-line therapy for invasive aspergillosis. The aim of the study was to determine prevalence of azole resistance in environmental A. fumigatus isolates across South Wales. Methods: Over 5 months in 2015, 513 A. fumigatus isolates were cultured from 671 soil and 44 air samples and were screened for azole resistance using VIPcheck™ agar plates containing itraconazole, voriconazole and posaconazole. Resistance was confirmed by the CLSI M38-A2 methodology. The mechanism of resistance was investigated using the PathoNostics AsperGenius® Assay. Results: Screening by VIPcheck™ plate identified azole-resistance in 30 isolates, most of which (28/30) harbored the TR34/L98H mutation, generating a prevalence of 6.0%. Twenty-five isolates had a MIC of ≥2 mg/L with itraconazole, 23 isolates had a MIC of ≥2 mg/L with voriconazole and seven isolates had a MIC ≥0.25 mg/L with posaconazole. All isolates deemed resistant by VIPcheck™ plates were resistant to at least one azole by reference methodology. Conclusions: There is significant environmental azole resistance (6%) in South Wales, in close proximity to patients susceptible to aspergillosis. Given this environmental reservoir, azole resistance should be routinely screened for in clinical practice and environmental monitoring continued.
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Affiliation(s)
- Alexandra Tsitsopoulou
- Regional Mycology Reference Laboratory, Public Health Wales, Microbiology Cardiff, Cardiff, United Kingdom
| | - Raquel Posso
- Regional Mycology Reference Laboratory, Public Health Wales, Microbiology Cardiff, Cardiff, United Kingdom
| | - Lorna Vale
- Regional Mycology Reference Laboratory, Public Health Wales, Microbiology Cardiff, Cardiff, United Kingdom
| | - Scarlett Bebb
- Regional Mycology Reference Laboratory, Public Health Wales, Microbiology Cardiff, Cardiff, United Kingdom
| | - Elizabeth Johnson
- National Mycology Reference Laboratory, Public Health England, Bristol, United Kingdom
| | - P L White
- Regional Mycology Reference Laboratory, Public Health Wales, Microbiology Cardiff, Cardiff, United Kingdom
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Affiliation(s)
- M Backx
- Specialist Registrar in Infectious Diseases and Medical Microbiology
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Schneider JL, White PL, Weiss J, Norton D, Lidgard J, Gould LH, Yee B, Vugia DJ, Mohle-Boetani J. Multistate outbreak of multidrug-resistant Salmonella newport infections associated with ground beef, October to December 2007. J Food Prot 2011; 74:1315-9. [PMID: 21819658 DOI: 10.4315/0362-028x.jfp-11-046] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In late October 2007, an outbreak of multidrug-resistant Salmonella Newport infections affected 42 case patients in California, Arizona, Idaho, and Nevada. A case-control study implicated ground beef from one chain store. Despite detailed ground beef purchase histories--including shopper card information for several case patients--traceback efforts by both the U.S. Department of Agriculture, Food Safety and Inspection Service and the California Department of Public Health were unable to identify the source of contamination. Case patients consumed multiple types of ground beef products purchased at numerous chain store A retail locations. These stores had received beef products for grinding from multiple beef slaughter-processing establishments. Detailed retail grinding logs and grinding policies that prevent cross-contamination between batches of ground beef products are crucial in the identification of contaminated beef products associated with foodborne illness.
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Affiliation(s)
- J L Schneider
- California Department of Public Health, Division of Communicable Disease Control, Infectious Diseases Branch, Richmond, California 94804, USA.
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6
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Barnes RA, White PL, Bygrave C, Evans N, Healy B, Kell J. Clinical impact of enhanced diagnosis of invasive fungal disease in high-risk haematology and stem cell transplant patients. J Clin Pathol 2008; 62:64-9. [DOI: 10.1136/jcp.2008.058354] [Citation(s) in RCA: 84] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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7
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Noake T, Kuriyama T, White PL, Potts AJC, Lewis MAO, Williams DW, Barnes RA. Antifungal susceptibility of Candida species using the Clinical and Laboratory Standards Institute disk diffusion and broth microdilution methods. J Chemother 2007; 19:283-7. [PMID: 17594923 DOI: 10.1179/joc.2007.19.3.283] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 10/31/2022]
Abstract
There are conflicting reports on the agreement between the Clinical and Laboratory Standards Institute disk diffusion (M44-A) and reference broth microdilution (M27-A) methods for determination of antifungal susceptibility of yeasts. The antifungal susceptibility of 541 yeasts, the majority of which were from the oral cavity, was determined using these two methods and the accuracy of the disk diffusion method assessed for clinical testing of various Candida species. Of the strains tested, Candida albicans predominated (390 out of 541). The classification of susceptibility determined by the disk diffusion method was largely in concordance with that obtained using the broth dilution method, regardless of species within Candida genus. The overall observed agreement between these two methods was 94.7% for fluconazole and 96.7% for voriconazole was with a 'very major' discrepancy level of 1.5% and 1.7% respectively. This study demonstrates a strong agreement of the simple disk diffusion method with the more labour intensive 'gold standard' broth microdilution method. These findings would support the use of the disk diffusion method in a routine mycology service.
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Affiliation(s)
- T Noake
- Department of Medical Microbiology, amd NPHS Cardiff, University Hospital of Wales, Cardiff, UK
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8
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Marcus R, Varma JK, Medus C, Boothe EJ, Anderson BJ, Crume T, Fullerton KE, Moore MR, White PL, Lyszkowicz E, Voetsch AC, Angulo FJ. Re-assessment of risk factors for sporadic Salmonella serotype Enteritidis infections: a case-control study in five FoodNet Sites, 2002-2003. Epidemiol Infect 2007; 135:84-92. [PMID: 16756692 PMCID: PMC2870546 DOI: 10.1017/s0950268806006558] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2006] [Indexed: 11/07/2022] Open
Abstract
Active surveillance for laboratory-confirmed Salmonella serotype Enteritidis (SE) infection revealed a decline in incidence in the 1990s, followed by an increase starting in 2000. We sought to determine if the fluctuation in SE incidence could be explained by changes in foodborne sources of infection. We conducted a population-based case-control study of sporadic SE infection in five of the Foodborne Diseases Active Surveillance Network (FoodNet) sites during a 12-month period in 2002-2003. A total of 218 cases and 742 controls were enrolled. Sixty-seven (31%) of the 218 case-patients and six (1%) of the 742 controls reported travel outside the United States during the 5 days before the case's illness onset (OR 53, 95% CI 23-125). Eighty-one percent of cases with SE phage type 4 travelled internationally. Among persons who did not travel internationally, eating chicken prepared outside the home and undercooked eggs inside the home were associated with SE infections. Contact with birds and reptiles was also associated with SE infections. This study supports the findings of previous case-control studies and identifies risk factors associated with specific phage types and molecular subtypes.
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Affiliation(s)
- R Marcus
- Connecticut Emerging Infections Program, New Haven, CT 06510, USA.
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9
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McCracken D, Barnes R, Poynton C, White PL, Işik N, Cook D. Polymerase chain reaction aids in the diagnosis of an unusual case of Aspergillus niger endocarditis in a patient with acute myeloid leukaemia. J Infect 2003; 47:344-7. [PMID: 14556761 DOI: 10.1016/s0163-4453(03)00084-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [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: 10/27/2022]
Abstract
Endocarditis secondary to Aspergillus niger has not been described in a leukaemic patient. We describe a case of A. niger endocarditis in a patient with acute myeloid leukaemia and refractory fever. The microbiological cause of his endocarditis was initially misdiagnosed because he fulfilled the Duke criteria for enterococcal endocarditis. A polymerase chain reaction test utilizing pan-fungal primers detected a product from an Aspergillus sp. The DNA was subsequently sequenced and was found to have 100% homology with A. niger. A postmortem revealed fungal endocarditis secondary to disseminated aspergillosis, without evidence of bacterial endocarditis. The patient was found to have a lung aspergilloma that was possibly occupationally acquired, and may have been long standing.
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Affiliation(s)
- D McCracken
- Department of Medical Microbiology and NPHS, University Hospital of Wales, Cardiff, UK.
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10
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Hogue AT, White PL, Heminover JA. Pathogen Reduction and Hazard Analysis and Critical Control Point (HACCP) systems for meat and poultry. USDA. Vet Clin North Am Food Anim Pract 1998; 14:151-64. [PMID: 9532674 DOI: 10.1016/s0749-0720(15)30286-3] [Citation(s) in RCA: 11] [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: 02/07/2023] Open
Abstract
The United States Department of Agriculture (USDA) Food Safety Inspection Service (FSIS) adopted Hazard Analysis and Critical Control Point Systems and established finished product standards for Salmonella in slaughter plants to improve food safety for meat and poultry. In order to make significant improvements in food safety, measures must be taken at all points in the farm-to-table chain including production, transportation, slaughter, processing, storage, retail, and food preparation. Since pathogens can be introduced or multiplied anywhere along the continuum, success depends on consideration and comparison of intervention measures throughout the continuum. Food animal and public health veterinarians can create the necessary preventative environment that mitigates risks for food borne pathogen contamination.
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Affiliation(s)
- A T Hogue
- United States Department of Agriculture (USDA), Food Safety and Inspection Service, Emerging Pathogens and Zoonotic Diseases Division, Washington, D.C., USA
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11
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Abstract
Foodborne illness is a major public health concern. The largest number of foodborne illness cases attributed to poultry and poultry products are caused by paratyphoid serotypes of Salmonella and by Campylobacter jejuni. The effective prevention of foodborne disease requires an understanding that contamination can be introduced into foods at numerous points along the food chain. Since multiple entry points exist for foodborne pathogens, multifaceted intervention approaches are required to successfully control contamination of poultry during the various phases of the growth period and processing procedure of broiler chickens. Strategies during the grow-out period (the period during which day-old chicks are raised to six- to seven-week-old broiler chickens) include sanitation, biosecurity, vaccine and drug therapy, and biological control procedures, such as those aimed at preventing colonisation. There are also many critical control points identified in the processing plant which reduce contamination. These include temperature controls (washer and product), chemical interventions, water replacements and counter-flow technology in the scalder and chiller, and equipment maintenance. Transportation and food handling at retail outlets and by the consumer (i.e., storage at the proper temperature and adequate cooking) are the final critical control points in the farm-to-table continuum. It is important to apply risk reduction strategies throughout the food chain. These include: easing the development and implementation of voluntary animal production 'best management practices', implementing in-plant hazard analysis and critical control point systems, developing effective transportation and refrigeration standards, working to facilitate adoption of the model Food Code in all States and providing educational materials and support for public health activities nationwide.
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Affiliation(s)
- P L White
- United States Department of Agriculture, Food Safety and Inspection Service, Washington, DC 20250, USA
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White PL. R-parity violation effects through soft supersymmetry-breaking terms and the renormalization group. Phys Rev D Part Fields 1996; 54:3427-3446. [PMID: 10021015 DOI: 10.1103/physrevd.54.3427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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13
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Russell MW, Moldoveanu Z, White PL, Sibert GJ, Mestecky J, Michalek S M. Salivary, nasal, genital, and systemic antibody responses in monkeys immunized intranasally with a bacterial protein antigen and the Cholera toxin B subunit. Infect Immun 1996; 64:1272-83. [PMID: 8606090 PMCID: PMC173915 DOI: 10.1128/iai.64.4.1272-1283.1996] [Citation(s) in RCA: 156] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Previous attempts to induce mucosal antibodies in rhesus monkeys by enteric immunization have resulted in only modest and short-lived responses, dominated by immunoglobulin M (IgM) antibodies in the plasma. In this study, two groups of rhesus monkeys were immunized intranasally three times at 2-week intervals with a bacterial protein antigen (AgI/II) either chemically coupled to or mixed with the B subunit of cholera toxin (CT), a known potent mucosal immunogen and carrier for other immunogens. Cells secreting antibodies, predominantly of the IgA isotype, to AgI/II and to CT were detected in the peripheral blood 1 week after each immunization, indicating the dissemination of IgA-secreting precursor cells through the mucosal immune system. IgG and, to a lesser extent, IgA antibodies to both proteins were induced in the plasma commencing after the second immunization. Plasma IgE concentrations and IgE antibody levels were not consistently raised during the immunization period. IgA antibodies were found in nasal and vaginal washes. Nasal IgG but not IgA antibodies showed a significant positive correlation with plasma IgG antibody levels, suggesting that they were largely derived by transudation from the circulation. Analysis of the molecular form of vaginal IgA indicated that both secretory and monomeric forms of IgA were present in various proportions. Furthermore, neither IgG nor IgA antibodies in vaginal washes were correlated with plasma antibody responses, suggesting the contribution of locally synthesized antibodies of both isotypes. Comparison of the responses between the two groups of animals showed only sporadic significant differences, indicating that intranasal immunization with AgI/II either coupled to or mixed with the B subunit of CT was equally effective at inducing generalized IgA antibody responses in the mucosal immune system and predominantly IgG antibodies in the plasma.
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Affiliation(s)
- M W Russell
- Department of Microbiology, University of Alabama at Birmingham, 35215, USA
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14
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15
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Abel SA, White PL. Baryogenesis from domain walls in the next-to-minimal supersymmetric standard model. Phys Rev D Part Fields 1995; 52:4371-4379. [PMID: 10019663 DOI: 10.1103/physrevd.52.4371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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16
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King SF, White PL. Resolving the constrained minimal and next-to-minimal supersymmetric standard models. Phys Rev D Part Fields 1995; 52:4183-4216. [PMID: 10019644 DOI: 10.1103/physrevd.52.4183] [Citation(s) in RCA: 168] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
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Elliott T, King SF, White PL. Radiative corrections to Higgs boson masses in the next-to-minimal supersymmetric standard model. Phys Rev D Part Fields 1994; 49:2435-2456. [PMID: 10017233 DOI: 10.1103/physrevd.49.2435] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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18
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White PL. Establishing a minimally invasive surgery suite. Semin Perioper Nurs 1993; 2:139-42. [PMID: 8044163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Establishing an exclusive minimally invasive surgery suite requires a commitment from management, administration, staff, and physicians. A specialized, dedicated staff becomes devoted to perfecting the procedures. There are many rewards associated with this obligation, the most rewarding being improvement in total quality patient care.
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Russell MW, Wu HY, White PL, Kilian M, Henrichsen J. Serum antibody responses to Streptococcus mutans antigens in humans systemically infected with oral streptococci. Oral Microbiol Immunol 1992; 7:321-5. [PMID: 1299798 DOI: 10.1111/j.1399-302x.1992.tb00630.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Sera from patients with subacute bacterial endocarditis (SBE) due to Streptococcus mutans or other oral streptococci and from normal subjects were assayed by enzyme-linked immunosorbent assay for antibodies to defined S. mutans antigens. Antibodies of IgG and IgA isotypes to Ag I/II and Ag III were greatly elevated in S. mutans-SBE sera, and the IgA antibodies in 3 sera included both polymeric and monomeric forms. Elevated IgM and IgG anti-lipoteichoic acid and IgG and IgA anti-serotype c polysaccharide antibodies were also found. The sera of 4 of 6 patients infected with other oral streptococci also displayed antibodies to S. mutans Ag I/II. Sera of 3 patients infected with Streptococcus mitis or Streptococcus oralis, but none of the S. mutans-infected cases, showed elevated antibodies to human heart sarcolemma, and all SBE sera had elevated rheumatoid factor. These results suggest that the known surface protein antigens of S. mutans are immunodominant in humans, and are not likely to be heart cross-reactive.
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Affiliation(s)
- M W Russell
- Department of Microbiology, University of Alabama at Birmingham
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Russell MW, Wu HY, White PL, Takahashi I, Okahashi N, Koga T. Peroral immunization with a cholera toxin-linked bacterial protein antigen and synthetic peptide. Adv Exp Med Biol 1992; 327:199-207. [PMID: 1295340 DOI: 10.1007/978-1-4615-3410-5_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- M W Russell
- Department of Microbiology, University of Alabama, Birmingham 35294
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21
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Goldman DS, White PL, Anheier NC. Miniaturized spectrometer employing planar waveguides and grating couplers for chemical analysis. Appl Opt 1990; 29:4583-4589. [PMID: 20577437 DOI: 10.1364/ao.29.004583] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Polymeric and metal oxide planar waveguides were used to demonstrate the potential of a miniature spectrometer. Multiwavelength light was transmitted through the substrate and coupled into the waveguide through a diffraction grating located at the substrate/waveguide interface. A second diffraction grating spatially dispersed the light propagated through the waveguide into component wavelengths for rapid analysis with a photodiode array detector. These results suggest that planar waveguides can be used to perform attenuated total internal reflection measurements in the visible and near-IR regions for chemical analysis of weak vibrational overtones and combination modes with effective path lengths of several millimeters.
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22
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Shils ME, White PL. Introduction to trace element conference. Bull N Y Acad Med 1984; 60:115-117. [PMID: 19313035 PMCID: PMC1911716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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23
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White PL. Peripheral vascular disease: diet, exercise, or both? JAMA 1983; 249:3355-6. [PMID: 6343650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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24
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Crocco SC, White PL. Public health issues and intervention programs in hypertension. Some public policy concerns in managing hypertension. Hypertension 1982; 4:III160-5. [PMID: 7106946 DOI: 10.1161/01.hyp.4.5_pt_2.iii160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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25
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White PL, Selvey N. Nutrition and the new health awareness. JAMA 1982; 247:2914-6. [PMID: 7087047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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26
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Fowler B, White PL, Holness DE, Wright GR, Ackles KN. The effects of inert gas narcosis on the speed and accuracy of movement. Ergonomics 1982; 25:203-212. [PMID: 7117233 DOI: 10.1080/00140138208924941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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27
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White PL. Once more, with feeding. JAMA 1981; 246:677-8. [PMID: 7253122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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White PL. Contempo '81. Foods and nutrition. JAMA 1981; 245:2239-41. [PMID: 7230444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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White PL. The renaissance of nutrition. Conn Med 1980; 44:755-7. [PMID: 7226781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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White PL, Fomufod AK, Rao MS. Comparative accuracy of recent abbreviated methods of gestational age determination. Clin Pediatr (Phila) 1980; 19:319-21. [PMID: 7363535 DOI: 10.1177/000992288001900501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Fifty healthy newborn infants were studied in an attempt to test the accuracy of several recently reported shortened methods of gestational age determination. The Finnstrom method with seven external characteristics was more accurate than those that contained only five or less criteria. In the statistical analysis it also yielded results that were very similar to those obtained using the original Dubowitz technique which has 21 criteria.
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White PL. Nutritional concepts essential in the education of the medical student. Am J Clin Nutr 1980; 33:731. [PMID: 7361688 DOI: 10.1093/ajcn/33.4.731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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White PL. Nutritional concepts essential in the education of the medical student. Am J Clin Nutr 1980. [DOI: 10.1093/ajcn/33.4.731b] [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: 01/05/2023] Open
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Fowler B, White PL, Wright GR, Ackles KN. Narcotic effects of nitrous oxide and compressed air on memory and auditory perception. Undersea Biomed Res 1980; 7:35-46. [PMID: 7385446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Three experiments were conducted to examine the effects of 35% N2 O (nitrous oxide) on human memory and auditory perception. In Experiment I, dichotic listening performance was found to be impaired. Experiment II used the same technique but was controlled for attenuation of sound transmission in the middle ear. No impairment was found. The perceptual effect found in Experiment I was peripheral, not central, and N2O did not impair short-term memory (STM). Experiment III used one-trial free recall of a word list. The shapes of the serial position curves were interpreted as indicating that N2O impairs long-term memory (LTM) but not STM. Experiment III provided no evidence, using cued recall, that the LTM deficit was due to impaired retrieval. Comparing these results with those for compressed air led to the conclusion that both N2O and hyperbaric nitrogen display an identical pattern of effects. A reason for the decrement found in some N2O STM studies may have been confounding the measurement of STM with that of LTM.
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White PL. Nutrition and the quality of life. Compr Ther 1979; 5:8-11. [PMID: 519968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Fomufod AK, White PL. Perinatal asphyxia II: Clinical management of multisystemic sequelae. J Natl Med Assoc 1979; 71:1065-6. [PMID: 529305 PMCID: PMC2537539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This paper discusses the management of multisystemic sequelae of perinatal asphyxia. Appropriate intrapartum and subsequent adequate neonatal monitoring are an absolute necessity for the early detection of systemic dysfunctions. Prophylactic and therapeutic measures applicable to the various organ malfunctions are described.
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Fomufod AK, Rahbar F, White PL, Holloway AZ, Rampersaud SR, Henry LA. Perinatal asphyxia I: Pathogenesis of multisystemic sequelae. J Natl Med Assoc 1979; 71:939-41. [PMID: 537116 PMCID: PMC2537510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This paper describes the clinical and pathologic sequelae of perinatal asphyxia manifested by 17 neonates treated at Howard University Hospital over an 18-month period. Multiple systemic complications, occurring in 76.5 percent of the patients, were the rule rather than the exception. All vital organs were involved, singly or in combination. Understanding the pathogenesis and extent of these complications is of utmost importance not only to those rendering health care to acutely ill newborns, but also to those responsible for prenatal and maternal intrapartum care.
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White PL. Food faddism. J Kans Med Soc 1979; 80:570-2. [PMID: 512444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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White PL. Continuing medical education. Nutrition. Introduction. Compr Ther 1978; 4:6-9. [PMID: 699512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Leach RH, White PL. Use and wastage of prescribed medicines in the home. J R Coll Gen Pract 1978; 28:32-6. [PMID: 553167 PMCID: PMC2158682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A survey of prescribed medicines was carried out in 192 homes, broadly representative of households in England and Wales. The average home had 3.2 containers of such medicines; 56 per cent were in current use, 16 per cent in occasional use, and 28 per cent were never used. One fifth of all oral antibiotics found in the study were wasted. A rough estimate suggests that pound23 million of prescription products (5.6 per cent of the total) are wasted annually in England and Wales.
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White PL, Kapica-Cyborski C. Clinical nutrition: introduction. Compr Ther 1977; 3:6-8. [PMID: 409585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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White PL. Vitamin preparations: proper use in medical practice. Postgrad Med 1976; 60:204-9. [PMID: 1019066 DOI: 10.1080/00325481.1976.11714458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The prescription of vitamin preparations as dietary supplements should be limited to specific instances of need and should be accompanied by appropriate measures to correct poor diets. Similarly, specific vitamins in therapeutic amounts should be prescribed only in the presence of vitamin deficiencies or increased requirements.
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White PL, Mondeika T. Somewhere under the iceberg. JAMA 1976; 235:1873. [PMID: 946489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Abstract
The concept of "missing" is defined as failure to diagnose cancer before it has spread beyond the organ of origin. Data are presented for the 11 sites at which cancer occurs most frequently in the United States. There is a clear association between the survival of patients with cancer of a particular site and the percentage of cancers of that site diagnosed in a localized stage. However, the reasons for variation in the proportion of cases discovered while localized, which varies from 79% for uterine corpus to 12% for pancreas, appear to be varied and complex. Available data suggest that the nature of the tumor-host relationship and metastatic potential of the neoplasm are probably more important than alertness on the part of the patient and the physician, and probably have a more profound influence on stage of disease at diagnosis than currently available screening techniques.
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White PL. Thoughts on American eating habits. Compr Ther 1975; 1:17-8. [PMID: 1220920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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White PL. Editorial: Megavitamin this and megavitamin that. JAMA 1975; 233:538-9. [PMID: 1173669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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