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Arashiro A, McPherson M, Andaya R, Rivada D, Olowokure B. WPSAR after 14 volumes: achievements and future directions. Western Pac Surveill Response J 2023; 14:1-3. [PMID: 38230252 PMCID: PMC10789723 DOI: 10.5365/wpsar.2023.14.4.1136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024] Open
Affiliation(s)
- Ashley Arashiro
- WPSAR Editorial Team, WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Michelle McPherson
- WPSAR Editorial Team, WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Roxanne Andaya
- WPSAR Editorial Team, WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Don Rivada
- WPSAR Editorial Team, WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Babatunde Olowokure
- WPSAR Editorial Team, WHO Health Emergencies Programme, World Health Organization Regional Office for the Western Pacific, Manila, Philippines
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Meinhardt AL, McPherson M, Berg C, Cai D, Blumenfrucht M, Chang V, Zhong F. PP01.69 NSCLC with Testicular Metastasis: A Case Report. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.095] [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: 01/30/2023]
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McPherson M, Stephens N, Smith KJ, Marfori MT, Sheel M, Cooley L, McEwan B, Veitch M, Johnston FH. Serology study of healthcare workers following a hospital-based outbreak of COVID-19 in North West Tasmania, Australia, 2020. Commun Dis Intell (2018) 2023; 47. [PMID: 36654505 DOI: 10.33321/cdi.2023.47.6] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Introduction Healthcare facilities are high-risk settings for coronavirus disease 2019 (COVID-19) transmission. Early in the COVID-19 pandemic, the first large healthcare-associated outbreak within Australia occurred in Tasmania. Several operational research studies were conducted amongst workers from the implicated hospital campus, to learn more about COVID-19 transmission. Methods Healthcare workers (HCWs) from the implicated hospital campus were invited to complete an online survey and participate in a serology study. Blood samples for serological testing were collected at approximately 12 weeks (round one) and eight months (round two) after the outbreak. A descriptive analysis was conducted of participant characteristics, serology results, and longevity of antibodies. Results There were 261 HCWs in round one, of whom 44 (17%) were polymerase chain reaction (PCR) confirmed outbreak cases; 129 of the 261 (49%) participated in round two, of whom 34 (27%) were outbreak cases. The prevalence of positive antibodies at round one was 15% (n = 38) and at round two was 12% (n = 15). There were 15 participants (12%) who were seropositive in both rounds, with a further 9% (n = 12) of round two participants having equivocal results after previously being seropositive. Six HCWs not identified as cases during the outbreak were seropositive in round one, with three still seropositive in round two. Of those who participated in both rounds, 68% (n = 88) were seronegative at both time points. Discussion Our findings demonstrate that serological testing after this large healthcare-associated COVID-19 outbreak complemented the findings of earlier diagnostic testing, with evidence of additional infections to those diagnosed when use of PCR testing had been restricted. The results also provide evidence of persisting SARS-CoV-2 antibody response eight months after an outbreak in an unvaccinated population. The high proportion of HCWs who remained seronegative is consistent with low community transmission in Tasmania after this outbreak.
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Affiliation(s)
- Michelle McPherson
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.,Public Health Services, Department of Health, Tasmania, Australia
| | - Nicola Stephens
- Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia.,Public Health Services, Department of Health, Tasmania, Australia
| | - Kylie J Smith
- Public Health Services, Department of Health, Tasmania, Australia.,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - M Therese Marfori
- Public Health Services, Department of Health, Tasmania, Australia.,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | - Meru Sheel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, New South Wales Australia
| | | | | | - Mark Veitch
- Public Health Services, Department of Health, Tasmania, Australia
| | - Fay H Johnston
- Public Health Services, Department of Health, Tasmania, Australia.,Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
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McPherson M, Bettiol S, Stephens N. Upskilling the public health workforce in communicable disease control. Commun Dis Intell (2018) 2022; 46. [PMID: 36384432 DOI: 10.33321/cdi.2022.46.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Michelle McPherson
- Graduate Certificate in Health Protection Team, Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Silvana Bettiol
- Graduate Certificate in Health Protection Team, Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Nicola Stephens
- Graduate Certificate in Health Protection Team, Tasmanian School of Medicine, University of Tasmania, Hobart, Tasmania, Australia
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Moody R, Sonda S, Johnston FH, Smith KJ, Stephens N, McPherson M, Flanagan KL, Plebanski M. Antibodies against Spike protein correlate with broad autoantigen recognition 8 months post SARS-CoV-2 exposure, and anti-calprotectin autoantibodies associated with better clinical outcomes. Front Immunol 2022; 13:945021. [PMID: 36032086 PMCID: PMC9403331 DOI: 10.3389/fimmu.2022.945021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
Autoantibodies to multiple targets are found during acute COVID-19. Whether all, or some, persist after 6 months, and their correlation with sustained anti-SARS-CoV-2 immunity, is still controversial. Herein, we measured antibodies to multiple SARS-CoV-2 antigens (Wuhan-Hu-1 nucleoprotein (NP), whole spike (S), spike subunits (S1, S2 and receptor binding domain (RBD)) and Omicron spike) and 102 human proteins with known autoimmune associations, in plasma from healthcare workers 8 months post-exposure to SARS-CoV-2 (n=31 with confirmed COVID-19 disease and n=21 uninfected controls (PCR and anti-SARS-CoV-2 negative) at baseline). IgG antibody responses to SARS-CoV-2 antigens were significantly higher in the convalescent cohort than the healthy cohort, highlighting lasting antibody responses up to 8 months post-infection. These were also shown to be cross-reactive to the Omicron variant spike protein at a similar level to lasting anti-RBD antibodies (correlation r=0.89). Individuals post COVID-19 infection recognised a common set of autoantigens, specific to this group in comparison to the healthy controls. Moreover, the long-term level of anti-Spike IgG was associated with the breadth of autoreactivity post-COVID-19. There were further moderate positive correlations between anti-SARS-CoV-2 responses and 11 specific autoantigens. The most commonly recognised autoantigens were found in the COVID-19 convalescent cohort. Although there was no overall correlation in self-reported symptom severity and anti-SARS-CoV-2 antibody levels, anti-calprotectin antibodies were associated with return to healthy normal life 8 months post infection. Calprotectin was also the most common target for autoantibodies, recognized by 22.6% of the overall convalescent cohort. Future studies may address whether, counter-intuitively, such autoantibodies may play a protective role in the pathology of long-COVID-19.
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Affiliation(s)
- Rhiane Moody
- School of Health and Biomedical Science, STEM College, RMIT University, Bundoora, VIC, Australia
| | - Sabrina Sonda
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia
- School of Health Sciences and School of Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Fay H. Johnston
- Public Health Services, Department of Health, Tasmania, TAS, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Kylie J. Smith
- Public Health Services, Department of Health, Tasmania, TAS, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Nicola Stephens
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Michelle McPherson
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS, Australia
| | - Katie L. Flanagan
- School of Health and Biomedical Science, STEM College, RMIT University, Bundoora, VIC, Australia
- Tasmanian Vaccine Trial Centre, Clifford Craig Foundation, Launceston General Hospital, Launceston, TAS, Australia
- School of Health Sciences and School of Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Magdalena Plebanski
- School of Health and Biomedical Science, STEM College, RMIT University, Bundoora, VIC, Australia
- *Correspondence: Magdalena Plebanski,
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Coates A, Warren KT, Henderson C, McPherson M, Obubah O, Graaff P, Acharya S. The World Health Organization's Frontline Support to Countries During the COVID-19 Pandemic in 2020. Front Public Health 2022; 10:850260. [PMID: 35372256 PMCID: PMC8971552 DOI: 10.3389/fpubh.2022.850260] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
The World Health Organization (WHO) declared the SARS-CoV-2 outbreak a Public Health Emergency of International Concern (PHEIC) on January 30, 2020. WHO rapidly scaled up its response including through its 149 country offices to support Member States prepare for and respond to the COVID-19 pandemic. This article describes the frontline role of the WHO Country Offices (WCOs) and demonstrates that WHO utilized its existing country presence to deliver its global program of work during this unprecedented emergency. Using data collected from the 2020 WHO COVID-19 Strategic Preparedness and Response Plan monitoring and evaluation framework assessments, plus data collected in a quantitative survey completed by 149 WCOs during 2020, this article describes how WHO supported national authorities and partners through leadership, policy dialogue, strategic support, technical assistance, and service delivery, in line with WHO's current 5-year strategic plan, the WHO 13th General Programme of Work 2019–2023. Country level case studies were used to further illustrate actions taken by WCOs. WHO's achievements notwithstanding, the Organization faced several key challenges in the first year of the response. Recommendations to enhance WHO presence in countries for future emergency prevention, preparedness and response, from several independent reviews, were presented to the World Health Assembly in May 2021 and relevant recommendations are presented in this article.
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Affiliation(s)
- Amy Coates
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
- *Correspondence: Amy Coates
| | - Kathleen Taylor Warren
- COVID-19 Country Technical Support, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Corey Henderson
- COVID-19 Country Technical Support, Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | | | - Offeibea Obubah
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Peter Graaff
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Shambhu Acharya
- Country Strategy and Support, World Health Organization, Geneva, Switzerland
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Samaan G, McPherson M, Eidman J, Obubah O, Baptiste JP, Kuppens L, Von Harbou K, Sembiring MF, Acharya S, Graaff P. The World Health Organization's Actions Within the United Nations System to Facilitate a Whole-of-Society Response to COVID-19 at Country Level. Front Public Health 2022; 9:831220. [PMID: 35118047 PMCID: PMC8804283 DOI: 10.3389/fpubh.2021.831220] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/23/2021] [Indexed: 11/15/2022] Open
Abstract
The coronavirus disease (COVID-19) pandemic highlighted that managing health emergencies requires more than an effective health response, but that operationalizing a whole-of-society approach is challenging. The World Health Organization (WHO), as the lead agency for health within the United Nations (UN), led the UN response at the global level through the Crisis Management Team, and at the country level through the UN Country Teams (UNCTs) in accordance with its mandate. Three case studies—Mali, Cox's Bazar in Bangladesh, and Uzbekistan—provide examples of how WHO contributed to the whole-of-society response for COVID-19 at the country level. Interviews with WHO staff, supplemented by internal and external published reports, highlighted that the action of WHO comprised technical expertise to ensure an effective whole-of-society response and to minimize social disruption, including those affecting peacekeeping in Mali, livelihood sectors in Cox's Bazar, and the education sector in Uzbekistan. Leveraging local level volunteers from various sectors led to both a stronger public health response and the continuation of other sectoral work. Risk communication and community engagement (RCCE) emerged as a key theme for UN engagement at country level. These collective efforts of operationalizing whole-of-society response at the country level need to continue for the COVID-19 response, but also in preparedness for other health and non-health emergencies. Building resilience for future emergencies requires developing and exercising multi-sectoral preparedness plans and benefits from collective UN support to countries. Coronavirus disease had many impacts outside of health, and therefore emergency preparedness needs to occur outside of health too.
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Affiliation(s)
- Gina Samaan
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
- *Correspondence: Gina Samaan
| | - Michelle McPherson
- Department of Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Johan Eidman
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
| | - Offeibea Obubah
- Department of Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | | | | | | | | | - Shambhu Acharya
- Department of Country Strategy and Support, World Health Organization, Geneva, Switzerland
| | - Peter Graaff
- Health Emergencies Programme, World Health Organization, Geneva, Switzerland
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Stoffel B, McPherson M, Hernandez A, Goess C, Mathieu S, Waegell W, Bryant S, Hobson A, Ruzek M, Pang Y, Kupper H, D’Cunha R, Parmentier J, Radstake T. POS0365 ANTI-TNF GLUCOCORTICOID RECEPTOR MODULATOR ANTIBODY DRUG CONJUGATE FOR THE TREATMENT OF AUTOIMMUNE DISEASES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.2213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Glucocorticoids (GC) are potent drugs used for treating many inflammatory diseases. While GCs are effective in many immune diseases, dose and duration of administration is limited due to significant side effects. Resting immune cells have very little TNF expression on the cell surface and it is only in an activated state that TNF expression is upregulated. Upon immune cell stimulation, TNF is upregulated and although a significant amount of TNF is cleaved from an activated cell, a portion remains on the cell surface. We have observed that anti-TNF antibodies bind to transmembrane TNF (tmTNF) and undergo endocytosis to the lysosome (1). We have developed a stable antibody drug conjugate (ADC), ABBV-3373, that has a proprietary, highly potent, glucocorticoid receptor modulator (GRM) payload linked to an anti-TNF monoclonal antibody (mAb) that is able to deliver the GC payload to activated immune cells.Objectives:We hypothesized that a TNF ADC with a GRM payload would be able to deliver increased efficacy through both TNF inhibition and targeted GRM payload delivery to activated immune cells while sparing systemic glucocorticoid side effects.Methods:A mouse surrogate TNF GRM ADC was characterized in an acute in vivo contact hypersensitivity model of inflammation (CHS) and in a mouse model of collagen induced arthritis (mCIA). Additionally, the human anti-TNF GRM ADC, ABBV-3373 has been characterized in healthy volunteers.Results:In the CHS model the anti-TNF GRM ADC significantly inhibited the inflammatory response with minimal effect on systemic GC biomarkers. In mCIA a single dose of an anti-TNF GRM ADC, administered at disease onset, was able to completely inhibit arthritis for greater than 30 days while an anti-TNF mAb only partially inhibited disease. ABBV-3373, a human anti-TNF GRM ADC with a GC payload, was evaluated in a Phase 1 study in healthy volunteers. ABBV-3373 demonstrated antibody-like PK profile and ABBV-3373 did not impact cortisol levels at predicted efficacious doses while control subjects that received a single oral dose of 10 mg prednisone demonstrated expected decreases in cortisol levels.Conclusion:These data suggest that an anti-TNF ADC delivering a GRM payload into activated immune cells may provide improved efficacy in immune mediated diseases, while minimizing systemic side effects associated with standard GC treatment.References:[1]Deora, A. et al. MABs. 2017;9(4):680-695.Disclosure of Interests:Bob Stoffel Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Michael McPherson Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Axel Hernandez Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Christian Goess Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Suzanne Mathieu Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Wendy Waegell Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Shaughn Bryant Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Adrian Hobson Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Melanie Ruzek Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Yinuo Pang Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Hartmut Kupper Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Ronilda D’Cunha Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Julie Parmentier Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie, Timothy Radstake Shareholder of: AbbVie, Grant/research support from: AbbVie, Employee of: AbbVie
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Burton GA, Cervi EC, Rosen G, Colvin M, Chadwick B, Hayman N, Allan SE, DiPinto LM, Adams R, McPherson M, Scharberg E. Tracking and Assessing Oil Spill Toxicity to Aquatic Organisms: A Novel Approach. Environ Toxicol Chem 2021; 40:1452-1462. [PMID: 33512743 DOI: 10.1002/etc.5000] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/26/2020] [Accepted: 01/27/2021] [Indexed: 06/12/2023]
Abstract
An in situ exposure and effects bioassay system was developed for assessing the toxicity of oil spills to aquatic organisms. The assessment tool combines components of 2 previously developed systems, the sediment ecotoxicity assessment ring (SEA Ring) and the drifting particle simulator. The integrated drifting exposure and effects assessment ring (DEEAR) is comprised of a Global Positioning System (GPS) float, a drifter drogue, the SEA Ring, and the Cyclops-7 fluorescent sensor. Polyethylene passive sampling devices (PED) were mounted for an additional means to characterize water quality conditions and exposures. The DEEAR is optimized for evaluating oil exposure and toxicity in the shallow surface mixing layer of marine waters. A short-term preliminary test was conducted in San Diego, California, USA, to verify the operation of the GPS tracking, the iridium communications, and the integrated SEA Ring exposure system. Further, a proof-of-concept demonstration was conducted offshore in the Santa Barbara Channel, where natural oil seeps produce surface slicks and sheens. Two DEEAR units were deployed for 24 h-one within the oil slick and one in an area outside observable slicks. An aerial drone provided tracking of the surface oil and optimal sites for deployment. The DEEAR proof-of-concept demonstrated integrated real-time tracking and characterization of oil exposures by grab samples, PED, and fluorescent sensors. Oil exposures were directly linked to toxic responses in fish and mysids. This novel integrated system shows promise for use in a variety of aquatic sites to more accurately determine in situ oil exposure and toxicity. Environ Toxicol Chem 2021;40:1452-1462. © 2021 SETAC.
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Affiliation(s)
- G A Burton
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, USA
| | - E C Cervi
- School for Environment and Sustainability, University of Michigan, Ann Arbor, Michigan, USA
| | - G Rosen
- Coastal Monitoring Associates, San Diego, California, USA
| | - M Colvin
- Coastal Monitoring Associates, San Diego, California, USA
| | - B Chadwick
- Coastal Monitoring Associates, San Diego, California, USA
| | - N Hayman
- Naval Information Warfare Center Pacific, United States Navy, San Diego, California, USA
| | - S E Allan
- Office of Response and Restoration, National Oceanic and Atmospheric Administration, Washington, DC, USA
| | - L M DiPinto
- Office of Response and Restoration, National Oceanic and Atmospheric Administration, Washington, DC, USA
| | - R Adams
- Department of Civil Engineering and Environmental Science, Loyola Marymount University, Los Angeles, California, USA
| | - M McPherson
- Department of Civil Engineering and Environmental Science, Loyola Marymount University, Los Angeles, California, USA
| | - E Scharberg
- Department of Civil Engineering and Environmental Science, Loyola Marymount University, Los Angeles, California, USA
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Fielding G, McPherson M, Hansen-Ketchum P, MacDougall D, Beltrami H, Dunn J. Climate change projections and public health systems: Building evidence-informed connections. One Health 2017; 2:152-154. [PMID: 28616491 PMCID: PMC5441313 DOI: 10.1016/j.onehlt.2016.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 06/15/2016] [Accepted: 07/31/2016] [Indexed: 12/03/2022] Open
Affiliation(s)
- Gillian Fielding
- Climate & Atmospheric Sciences Institute, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Michelle McPherson
- Climate & Atmospheric Sciences Institute, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Patti Hansen-Ketchum
- School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Donna MacDougall
- School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.,Canadian Center for Vaccinology, Dalhousie University, IWK Health Center, & Nova Scotia Health Authority, Canada
| | - Hugo Beltrami
- Climate & Atmospheric Sciences Institute, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.,Department of Earth Sciences, St. Francis Xavier University, Antigonish, Nova Scotia, Canada.,Centre pour l'étude et la simulation du climat à l'échelle régionale (ESCER), Université du Québec à Montréal, Montréal, Québec, Canada
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McPherson M, García-García A, Cuesta-Valero FJ, Beltrami H, Hansen-Ketchum P, MacDougall D, Ogden NH. Expansion of the Lyme Disease Vector Ixodes Scapularis in Canada Inferred from CMIP5 Climate Projections. Environ Health Perspect 2017; 125:057008. [PMID: 28599266 PMCID: PMC5730520 DOI: 10.1289/ehp57] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/26/2016] [Accepted: 08/30/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND A number of studies have assessed possible climate change impacts on the Lyme disease vector, Ixodes scapularis. However, most have used surface air temperature from only one climate model simulation and/or one emission scenario, representing only one possible climate future. OBJECTIVES We quantified effects of different Representative Concentration Pathway (RCP) and climate model outputs on the projected future changes in the basic reproduction number (R0) of I. scapularis to explore uncertainties in future R0 estimates. METHODS We used surface air temperature generated by a complete set of General Circulation Models from the Coupled Model Intercomparison Project Phase 5 (CMIP5) to hindcast historical (1971-2000), and to forecast future effects of climate change on the R0 of I. scapularis for the periods 2011-2040 and 2041-2070. RESULTS Increases in the multimodel mean values estimated for both future periods, relative to 1971-2000, were statistically significant under all RCP scenarios for all of Nova Scotia, areas of New Brunswick and Quebec, Ontario south of 47°N, and Manitoba south of 52°N. When comparing RCP scenarios, only the estimated R0 mean values between RCP6.0 and RCP8.5 showed statistically significant differences for any future time period. CONCLUSION Our results highlight the potential for climate change to have an effect on future Lyme disease risk in Canada even if the Paris Agreement's goal to keep global warming below 2°C is achieved, although mitigation reducing emissions from RCP8.5 levels to those of RCP6.0 or less would be expected to slow tick invasion after the 2030s. https://doi.org/10.1289/EHP57.
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Affiliation(s)
- Michelle McPherson
- Climate & Atmospheric Sciences Institute and Dept. of Earth Sciences, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Almudena García-García
- Climate & Atmospheric Sciences Institute and Dept. of Earth Sciences, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Francisco José Cuesta-Valero
- Climate & Atmospheric Sciences Institute and Dept. of Earth Sciences, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Hugo Beltrami
- Climate & Atmospheric Sciences Institute and Dept. of Earth Sciences, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
- Centre pour l’étude et la simulation du climat à l’échelle régionale (ESCER), Université du Québec à Montréal
| | - Patti Hansen-Ketchum
- School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Donna MacDougall
- School of Nursing, St. Francis Xavier University, Antigonish, Nova Scotia, Canada
- Canadian Center for Vaccinology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nicholas Hume Ogden
- National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
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Kent L, McPherson M, Higgins N. A positive association between cryptosporidiosis notifications and ambient temperature, Victoria, Australia, 2001-2009. J Water Health 2015; 13:1039-1047. [PMID: 26608765 DOI: 10.2166/wh.2015.130] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Increased temperatures provide optimal conditions for pathogen survival, virulence and replication as well as increased opportunities for human-pathogen interaction. This paper examined the relationship between notifications of cryptosporidiosis and temperature in metropolitan and rural areas of Victoria, Australia between 2001 and 2009. A negative binomial regression model was used to analyse monthly average maximum and minimum temperatures, rainfall and the monthly count of cryptosporidiosis notifications. In the metropolitan area, a 1 °C increase in monthly average minimum temperature of the current month was associated with a 22% increase in cryptosporidiosis notifications (incident rate ratio (IRR) 1.22; 95% confidence interval (CI) 1.13-1.31). In the rural area, a 1 °C increase in monthly average minimum temperature, lagged by 3 months, was associated with a 9% decrease in cryptosporidiosis notifications (IRR 0.91; 95% CI 0.86-0.97). Rainfall was not associated with notifications in either area. These relationships should be considered when planning public health response to ecological risks as well as when developing policies involving climate change. Rising ambient temperature may be an early warning signal for intensifying prevention efforts, including appropriate education for pool users about cryptosporidiosis infection and management, which might become more important as temperatures are projected to increase as a result of climate change.
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Affiliation(s)
- Lillian Kent
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia E-mail:
| | - Michelle McPherson
- Western Pacific Region Office, World Health Organization, Manila, Philippines
| | - Nasra Higgins
- Communicable Disease Prevention and Control Unit, Victorian Government Department of Health, Melbourne, Victoria, Australia
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Sharma V, Jadhav ST, Harcombe AA, Kelly PA, Mozid A, Bagnall A, Richardson J, Egred M, McEntegart M, Shaukat A, Oldroyd K, Vishwanathan G, Rana O, Talwar S, McPherson M, Strange JW, Hanratty CG, Walsh SJ, Spratt JC, Smith WHT. Impact of proctoring on success rates for percutaneous revascularisation of coronary chronic total occlusions. Open Heart 2015; 2:e000228. [PMID: 25852949 PMCID: PMC4379886 DOI: 10.1136/openhrt-2014-000228] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 01/30/2015] [Accepted: 03/04/2015] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To assess the impact of proctoring for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in six UK centres. METHODS We retrospectively analysed 587 CTO procedures from six UK centres and compared success rates of operators who had received proctorship with success rates of the same operators before proctorship (pre-proctored) and operators in the same institutions who had not been proctored (non-proctored). There were 232 patients in the pre-proctored/non-proctored group and 355 patients in the post-proctored group. Complexity was assessed by calculating the Japanese CTO (JCTO) score for each case. RESULTS CTO PCI success was greater in the post-proctored compared with the pre-proctored/non-proctored group (77.5% vs 62.1%, p<0.0001). In more complex cases where JCTO≥2, the difference in success was greater (70.7% vs 49.5%, p=0.0003). After proctoring, there was an increase in CTO PCI activity in centres from 2.5% to 3.5%, p<0.0001 (as a proportion of total PCI), and the proportion of very difficult cases with JCTO score ≥3 increased from 15.3% (35/229) to 29.7% (105/354), p<0.0001. CONCLUSIONS Proctoring resulted in an increase in procedural success for CTO PCI, an increase in complex CTO PCI and an increase in total CTO PCI activity. Proctoring may be a valuable way to improve access to CTO PCI and the likelihood of procedural success.
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Affiliation(s)
- Vinoda Sharma
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - S T Jadhav
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - A A Harcombe
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
| | - P A Kelly
- The Essex Cardiothoracic Centre , Essex , UK
| | - A Mozid
- The Essex Cardiothoracic Centre , Essex , UK
| | - A Bagnall
- Freeman Hospital , Newcastle upon Tyne , UK
| | | | - M Egred
- Freeman Hospital , Newcastle upon Tyne , UK
| | - M McEntegart
- Golden Jubilee National Hospital , Clydebank , UK
| | - A Shaukat
- Golden Jubilee National Hospital , Clydebank , UK
| | - K Oldroyd
- Golden Jubilee National Hospital , Clydebank , UK
| | | | - O Rana
- Royal Bournemouth Hospital , Bournemouth , UK
| | - S Talwar
- Royal Bournemouth Hospital , Bournemouth , UK
| | | | | | | | - S J Walsh
- Belfast City Hospital , Belfast , UK
| | - J C Spratt
- Forth Valley Royal Hospital , Larbert , UK
| | - W H T Smith
- Trent Cardiac Centre, Nottingham City Hospital , Nottingham , UK
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Dwyer D, Barr I, Hurt A, Kelso A, Reading P, Sullivan S, Buchy P, Yu H, Zheng J, Shu Y, Wang D, Lam, Aguon A, Oliva RQ, Odagiri T, Tashiro M, Verasahib K, Yusof MA, Nymadawa P, Alexander B, Gourinat AC, Grangeon JP, Jennings L, Huang S, Horwood P, Lucero M, Roque V, Lee Suy L, Cardon P, Tandoc A, Olveda RM, Kang C, Young-Joon P, Cutter J, Lin R, Low C, Mai LTQ, Balish A, Kile J, Mei S, Mcfarland J, Moen A, Olsen S, Samaan G, Xiyan X, Chea N, Diorditsa S, Feldon K, Fox K, Jamsran M, Konings F, Lewis HC, McPherson M, Nilles E, Olowokure B, Partridge J. Seasonal influenza vaccine policies, recommendations and use in the World Health Organization's Western Pacific Region. Western Pac Surveill Response J 2013; 4:51-9. [PMID: 24319615 PMCID: PMC3851365 DOI: 10.5365/wpsar.2013.4.1.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE Vaccination is the most effective way to prevent seasonal influenza and its severe outcomes. The objective of our study was to synthesize information on seasonal influenza vaccination policies, recommendations and practices in place in 2011 for all countries and areas in the Western Pacific Region of the World Health Organization (WHO). METHODS Data were collected via a questionnaire on seasonal influenza vaccination policies, recommendations and practices in place in 2011. RESULTS Thirty-six of the 37 countries and areas (97%) responded to the survey. Eighteen (50%) reported having established seasonal influenza vaccination policies, an additional seven (19%) reported having recommendations for risk groups for seasonal influenza vaccination only and 11 (30%) reported having no policies or recommendations in place. Of the 25 countries and areas with policies or recommendations, health-care workers and the elderly were most frequently recommended for vaccination; 24 (96%) countries and areas recommended vaccinating these groups, followed by pregnant women (19 [76%]), people with chronic illness (18 [72%]) and children (15 [60%]). Twenty-six (72%) countries and areas reported having seasonal influenza vaccines available through public funding, private market purchase or both. Most of these countries and areas purchased only enough vaccine to cover 25% or less of their populations. DISCUSSION In light of the new WHO position paper on influenza vaccines published in 2012 and the increasing availability of country-specific data, countries and areas should consider reviewing or developing their seasonal influenza vaccination policies to reduce morbidity and mortality associated with annual epidemics and as part of ongoing efforts for pandemic preparedness.
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Chung K, Rozumov E, Kaminsky D, Anderson P, Cook P, Sawka W, McPherson M, Buescher T. Development of Electrically Controlled Energetic Materials (ECEM). ACTA ACUST UNITED AC 2013. [DOI: 10.1149/05040.0059ecst] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Moloi S, McPherson M. Capacitance–voltage behaviour of Schottky diodes fabricated on p-type silicon for radiation-hard detectors. Radiat Phys Chem Oxf Engl 1993 2013. [DOI: 10.1016/j.radphyschem.2012.12.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zhong F, Kim K, Chang V, Gonzalez ML, Quainoo C, McPherson M, Crump B, Einhorn J, Kalwar T, Kasimis B. Comparison of outcomes of patients with hepatocellular carcinoma (HCC) over 2 consecutive decades for a VA population. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e14536] [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: 11/20/2022] Open
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Kasimis B, Chang VT, Gonzalez ML, Srinivas S, Zhong F, Duque L, McPherson M, Einhorn J, Crump B, Blumenfrucht M. The Gleason score (GS) as a predictor of survival in stage D2 and D3 prostate cancer (PC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e15141] [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: 11/20/2022] Open
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Srinivas S, Paulin R, Abanonu C, Kim K, Soriano L, Tufail M, Kasimis B, Chang VT, Duque L, Crump B, McPherson M. Clinical characteristics of multiple myeloma (MM) in Vietnam-era (V) and non–Vietnam-era veterans (Non V). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18579] [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: 11/20/2022] Open
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McPherson M, Kirk MD, Raupach J, Combs B, Butler JR. Economic Costs of Shiga Toxin–Producing Escherichia coli Infection in Australia. Foodborne Pathog Dis 2011; 8:55-62. [DOI: 10.1089/fpd.2010.0608] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Martyn D. Kirk
- OzFoodNet, Office of Health Protection, Department of Health and Ageing, Canberra, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia
| | - Jane Raupach
- OzFoodNet, Department of Health, Adelaide, South Australia, Australia
| | - Barry Combs
- Department of Health, Perth, Western Australia, Australia
| | - Jim R.G. Butler
- Australian Centre for Economic Research on Health, The Australian National University, Canberra, Australia
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Reed N, Taha T, Keightley M, Duggan C, McAuliffe J, Cubos J, Baker J, Faught B, McPherson M, Montelpare W. Measurement of Head Impacts in Youth Ice Hockey Players. Int J Sports Med 2010; 31:826-33. [DOI: 10.1055/s-0030-1263103] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Zhong F, Chang VT, Gonzalez ML, Chodos A, Abanonu C, Duque L, McPherson M, Crump B, Cogswell J, Kasimis B. Comorbidity and survival of esophageal carcinoma patients at a VA medical center. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14642] [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: 11/20/2022] Open
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Kasimis B, Chang V, Cogswell J, Gonzalez M, Srinivas S, Zhong F, Duque L, Crump B, McPherson M, Sullivan M. Changes of the lung cancer histology, diagnostic modality, stage, and smoking status among veterans over the past 20 years. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e12054] [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: 11/20/2022] Open
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Kim K, Kalwar T, Barry M, Srinivas S, Chang VT, Toomey K, Gonzalez ML, Duque L, McPherson M, Kasimis B. Myelodysplastic syndrome (MDS) patients at a VA medical center: Comorbidity and survival. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.6611] [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: 11/20/2022] Open
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Chang VT, Scott CB, Yan H, Gonzalez ML, Einhorn J, Zhou B, Cogswell J, Crump B, McPherson M, Kasimis B. Patient-reported outcomes for determining prognostic groups in veterans with advanced cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9040] [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: 11/20/2022] Open
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McPherson M, Lalor K, Combs B, Raupach J, Stafford R, Kirk MD. Serogroup-specific risk factors for Shiga toxin-producing Escherichia coli infection in Australia. Clin Infect Dis 2009; 49:249-56. [PMID: 19522658 DOI: 10.1086/599370] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Shiga toxin-producing Escherichia coli (STEC) is an important cause of foodborne illness. In Australia, risk factors for STEC infection have not been examined at a national level. METHODS We conducted a case-control study in 6 Australian jurisdictions from 2003 through 2007. A case patient was defined as a person from whom STEC was isolated or toxin production genes were detected in stool. Case patients were recruited from notifiable disease registers, and 3 control subjects frequency matched by age were selected from databases of controls. Using structured questionnaires, interviewers collected data on clinical illness, foods consumed, and exposures to potential environmental sources. RESULTS We recruited 43 case patients infected with STEC serogroup O157, 71 case patients infected with non-O157 serogroups, and 304 control subjects. One patient infected with serogroup O157 and 7 infected with non-O157 serogroups developed hemolytic uremic syndrome. Compared with control subjects, case patients infected with STEC O157 were more likely to eat hamburgers, visit restaurants, have previously used antibiotics, or have family occupational exposure to red meat. Case patients infected with non-O157 STEC were more likely to eat sliced chicken meat or corned beef from a delicatessen, camp in the bush, eat catered meals, or have family occupational exposure to animals. Negative associations were observed for certain foods, particularly homegrown vegetables, fruits, or herbs. CONCLUSION This study of risk factors for STEC infection by serogroup highlights risks associated with eating hamburgers and occupational handling of raw meat. To prevent infection, hamburgers must be cooked thoroughly, and people handling raw meat or who have close contact with animals must ensure adequate hygiene.
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McPherson M, Foster A, Goodman E. Defining physician advocacy for adolescent reproductive health: results from a mixed methods study with adolescent medicine physicians. Contraception 2009. [DOI: 10.1016/j.contraception.2009.05.111] [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: 11/30/2022]
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Zhong F, Oliphant T, Chang VT, Crump B, Gonzalez ML, McPherson M, Morales E, Duque L, Einhorn J, Kasimis B. Comorbidity and survival of hepatocellular carcinoma patients at a VA medical canter. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15682 Background: To determine whether comorbidity indices predict survival in hepatocellular carcinoma (HCC) pts. Methods: In an IRB approved protocol, we reviewed the records of pts with tissue diagnosis of HCC seen at a VA Medical Center between 1/1/1999 to 12/31/2008. Comorbidity was assessed with four comorbidity indices, the Charlson Comorbidity Index (CMI), the Kaplan- Feinstein Index (KFI), the Cumulative Illness Rating Scale (CIRS), and VA Comorbidity Scale (VACS). Demographics, ECOG PS, stage, alpha-fetoprotein (AFP) at diagnosis, hepatitis B (HBV) and C (HCV) status, alcohol use, and iron overload were also reviewed. Cox survival regression analysis was performed. Results: There were 44 pts. All pts were men. The median (M) age at diagnosis was 60.5 years (range 35–86). The overall M survival was 230 days (4–2784). There were Stage I 12 (27%) pts, Stage II 7 (16%) pts, Stage III 14 (32%) pts, and Stage IV 11 (25%) pts. The M ECOG PS was 1.0 (0–4), stage 3 (1–4), CMI 5.75 (1–16), CIRS15 3.0 (1–5), CIRS16 6.0 (1–14), CIRS17 2.0 (0.83–5.0), CIRS18 0 (0–2), CIRS19 0 (0–1), KFI 3.0 (1–3), VACS 6.0 (2–9), and AFP 56.35 (1.1–379567). HBV was positive in 10 pts (23%), HCV 26 (59%) pts, alcohol use 37 (84%) pts, and iron overload 11 (25%) pts. In univariate survival analysis, stage (p<.038), ECOG PS (p<.001), AFP (p<.009), presence of iron overload (p<.006), and CMI (p<.019) were significant in predicting survival. However, age, HBV, HCV, alcohol use, CIRS15, CIRS16, CIRS17, CIRS18, KFI, and VACS were not significant for survival. In multivariate survival analyses that included stage and a comorbidity index, the CMI approaches significance (p<.077). Conclusions: In this sample, the CMI was a predictor for survival in pts with HCC. Further analysis in a larger sample is needed to provide a more definitive conclusion. This was supported by the New Jersey Commission for Cancer Research 09–1133-CCR-EO. No significant financial relationships to disclose.
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Affiliation(s)
- F. Zhong
- VA New Jersey Healthcare System, East Orange, NJ
| | - T. Oliphant
- VA New Jersey Healthcare System, East Orange, NJ
| | - V. T. Chang
- VA New Jersey Healthcare System, East Orange, NJ
| | - B. Crump
- VA New Jersey Healthcare System, East Orange, NJ
| | | | - M. McPherson
- VA New Jersey Healthcare System, East Orange, NJ
| | - E. Morales
- VA New Jersey Healthcare System, East Orange, NJ
| | - L. Duque
- VA New Jersey Healthcare System, East Orange, NJ
| | - J. Einhorn
- VA New Jersey Healthcare System, East Orange, NJ
| | - B. Kasimis
- VA New Jersey Healthcare System, East Orange, NJ
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McPherson M, Kirk M, Raupach J, Koehler A. Risk Factors of Sporadic Human Infection of Shiga Toxin Producing Escherichia coli O157 and Non-O157 in Australia. Int J Infect Dis 2008. [DOI: 10.1016/j.ijid.2008.05.539] [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: 11/28/2022] Open
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Cholankeril M, Srinivas S, Chang VT, Demissie K, Gonzalez ML, Zhong F, Crump B, McPherson M, Einhorn J, Kasimis BS. Non-Hodgkin’s lymphoma patients at a VA medical center: Co-morbidity and its impact on survival. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.19502] [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: 11/20/2022] Open
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Chang VT, Bhatty MU, Hoover D, Sikder MA, Gounder S, Gonzalez ML, McPherson M, Zhong F, Nazha NT, Kasimis BS. End-of-life quality-of-care indicators for medical oncology patients at a VA medical center. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.20580] [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: 11/20/2022] Open
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Knowles P, Kurtis C, Murray J, Saysell C, Tambyrajah W, Wilmot C, McPherson M, Phillips S, Dooley D, Brown D, Rogers M, Mure M. Hydrazine and amphetamine binding to amine oxidases: old drugs with new prospects. J Neural Transm (Vienna) 2007; 114:743-6. [PMID: 17406963 DOI: 10.1007/s00702-007-0681-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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] [Received: 10/03/2006] [Accepted: 11/01/2006] [Indexed: 12/24/2022]
Abstract
Tranylcypromine (TCP), an amphetamine, is a reversible inhibitor of copper-containing amine oxidases. We have solved the structure of the complex of TCP with the amine oxidase from E. coli (ECAO) and shown that only the (+)-enantiomer of TCP binds. Kinetic studies on 2-phenylethylamine and TCP binding to wild-type ECAO and mutational variants fully support the model in which binding of the protonated amine is the first step in the catalytic cycle. Hydrazines are irreversible inhibitors of copper-containing amine oxidases. Binding of hydrazines leads to an adduct ("Adduct 1") with a chromophore at 430 nm which converts at higher pH to another adduct ("Adduct 2") with a chromophore at 520 nm. We have determined the structures of Adduct 1 and 2 for 2-hydrazinopyridine reacted with ECAO. It has been found that Adduct 1 corresponds to the hydrazone and azo tautomers whilst Adduct 2 corresponds to the azo tautomer coordinated to the active site copper. The implications of these results in developing more specific drugs are discussed.
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Affiliation(s)
- P Knowles
- Astbury Centre for Structural Biology, University of Leeds, Leeds, UK.
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Baade PD, English DR, Youl PH, McPherson M, Elwood JM, Aitken JF. The relationship between melanoma thickness and time to diagnosis in a large population-based study. ACTA ACUST UNITED AC 2006; 142:1422-7. [PMID: 17116832 DOI: 10.1001/archderm.142.11.1422] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [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: 11/14/2022]
Abstract
OBJECTIVE To examine the relationship between melanoma thickness and reported time from first recognition and from first physician contact to the diagnosis of invasive melanoma. DESIGN Telephone survey of patients recently diagnosed as having melanoma, combined with relevant pathological data (including melanoma thickness and morphologic structure) from the population-based Queensland Cancer Registry. A test-retest study (n = 176) was also conducted. SETTING Population-based study in Queensland. PARTICIPANTS Residents of Queensland (n = 3772) who had been diagnosed as having invasive melanoma between January 1, 2000, and December 31, 2003. MAIN OUTCOME MEASURES Prepresentation time (time between first noticing a suspicious spot and the first physician visit), postpresentation time (time between the first physician visit and diagnosis), and total time to diagnosis (time from initial detection of the melanoma to diagnosis). RESULTS With 1 exception, we found no significant association between melanoma thickness and reported time to diagnosis for all melanomas combined, superficial spreading melanomas, or nodular melanomas. The exception was a positive association between melanoma thickness and postpresentation delay of physician-detected nodular melanomas. The reliability study gave intraclass correlation coefficients of 0.85 to 0.90 for the measures of intervals. CONCLUSIONS This large study demonstrates no clear relationship between the melanoma thickness when diagnosed and the time from first recognition of changes or from first physician examination to diagnosis. This may be because of varying biological characteristics of melanomas, as well as methodological limitations of retrospective studies when trying to measure this complex association.
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Affiliation(s)
- Peter D Baade
- Queensland Cancer Fund, University of Queensland, Brisbane, Australia.
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McPherson M, Elwood M, English DR, Baade PD, Youl PH, Aitken JF. Presentation and detection of invasive melanoma in a high-risk population. J Am Acad Dermatol 2006; 54:783-92. [PMID: 16635658 DOI: 10.1016/j.jaad.2005.08.065] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2005] [Revised: 07/26/2005] [Accepted: 08/04/2005] [Indexed: 11/19/2022]
Abstract
BACKGROUND Early detection of melanoma has been encouraged in Queensland for many years, yet little is known about the patterns of detection and the way in which they relate to tumor thickness. OBJECTIVE Our purpose was to describe current patterns of melanoma detection in Queensland. METHODS This was a population-based study, comprising 3772 Queensland residents diagnosed with a histologically confirmed melanoma between 2000 and 2003. RESULTS Almost half (44.0%) of the melanomas were detected by the patients themselves, with physicians detecting one fourth (25.3%) and partners one fifth (18.6%). Melanomas detected by doctors were more likely to be thin (<0.75 mm) than those detected by the patient or other layperson. Melanomas detected during a deliberate skin examination were thinner than those detected incidentally. LIMITATIONS Although a participation rate of 78% was achieved, as in any survey, nonresponse bias cannot be completely excluded, and the ability of the results to be generalized to other geographical areas is unknown. CONCLUSION There are clear differences in the depth distribution of melanoma in terms of method of detection and who detects the lesions that are consistent with, but do not automatically lead to, the conclusion that promoting active methods of detection may be beneficial.
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Abstract
OBJECTIVE To quantify the non-suicidal mortality subsequent to hospital treated self-poisoning, and to identify risk factors for non-suicidal death. METHOD A prospective longitudinal cohort design was used, with data-linkage between the Hunter Area Toxicology Service database and the National Death Index. All patients with deliberate self-poisoning for a 10-year period (1991-2000) were studied and the first episode in the period was used as the index episode. The outcomes were: accidental, 'natural' and non-suicidal death, with follow-up for the study duration. RESULTS There were 4044 patients studied, and 170 (4.2%) of these had non-suicidal death; 64 were accidental and 106 were 'natural' cause deaths. The standardized mortality ratio (95% CI) for non-suicidal death for males, females and combined were 4.98 (4.08-6.07), 3.78 (3.0-4.75) and 4.20 (3.62-4.88), respectively. The increased mortality was apparent for both males and females, and was more marked in the younger age groups. For non-suicidal death the adjusted hazard ratio (95% CI) for increased risk were: increasing age 1.07 (1.06-1.08), male gender 1.77 (1.24-2.52), psychiatric diagnosis of substance related disorder 1.49 (1.03-2.16), prescription of a respiratory drug 2.69 (1.31-5.55), and prescription of an anti-diabetic drug 1.95 (0.93-4.07), while psychiatric diagnosis of adjustment disorder 0.64 (0.38-1.053) was associated with decreased risk. CONCLUSIONS Patients who present with self-poisoning have increased mortality from accidental and 'natural' causes. Long-term treatment goals for these patients need to address non-suicide mortality in addition to suicide mortality.
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Affiliation(s)
- Greg Carter
- Children's Pavillion, Dunedin Public Hospital, Dunedin, New Zealand
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Abstract
BACKGROUND Prediction of suicide risk is difficult in clinical practice. AIMS To identify changes in clinical presentation predictive of suicide in patients treated for repeated episodes of self-poisoning. METHOD A nested case-control study used the Hunter Area Toxicology Service database to identify exposure variables and the National Death Index to identify suicide. Cases were patients who had hospital treatment on more than one occasion between 15 January 1987 and 31 December 2000. RESULTS There were 31 cases, for which 93 controls were selected. Study variables associated with an increased risk of subsequent suicide were an increase in the number of drugs ingested (odds ratio 2.59, 95% CI 1.48-4.51), an increase in the dose ingested (OR 1.33, 95% CI 1.01-1.76), an increase in coma score (OR 1.71, 95% CI 1.11-2.66), a decrease in Glasgow Coma Score (OR 1.21, 95% CI 1.03-1.43) and an increase in drug or alcohol misuse (OR 2.33, 95% CI 1.06-5.10). CONCLUSIONS Patients who have escalating severity of self-poisoning episodes are at high risk of completed suicide.
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Affiliation(s)
- Greg Carter
- Faculty of Medicine and Health Services, Suicide Prevention Research Unit, Centre for Mental Health Studies, University of Newcastle, Newcastle, New South Wales, Australia
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37
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Abstract
OBJECTIVE To quantify the non-suicidal mortality subsequent to hospital treated self-poisoning, and to identify risk factors for non-suicidal death. METHOD A prospective longitudinal cohort design was used, with data-linkage between the Hunter Area Toxicology Service database and the National Death Index. All patients with deliberate self-poisoning for a 10-year period (1991-2000) were studied and the first episode in the period was used as the index episode. The outcomes were: accidental, 'natural' and non-suicidal death, with follow-up for the study duration. RESULTS There were 4044 patients studied, and 170 (4.2%) of these had non-suicidal death; 64 were accidental and 106 were 'natural' cause deaths. The standardized mortality ratio (95% CI) for non-suicidal death for males, females and combined were 4.98 (4.08-6.07), 3.78 (3.0-4.75) and 4.20 (3.62-4.88), respectively. The increased mortality was apparent for both males and females, and was more marked in the younger age groups. For non-suicidal death the adjusted hazard ratio (95% CI) for increased risk were: increasing age 1.07 (1.06-1.08), male gender 1.77 (1.24-2.52), psychiatric diagnosis of substance related disorder 1.49 (1.03-2.16), prescription of a respiratory drug 2.69 (1.31-5.55), and prescription of an anti-diabetic drug 1.95 (0.93-4.07), while psychiatric diagnosis of adjustment disorder 0.64 (0.38-1.053) was associated with decreased risk. CONCLUSIONS Patients who present with self-poisoning have increased mortality from accidental and 'natural' causes. Long-term treatment goals for these patients need to address non-suicide mortality in addition to suicide mortality.
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Affiliation(s)
- Greg Carter
- Children's Pavillion, Dunedin Public Hospital, Dunedin, New Zealand
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Immel CC, McPherson M, Hay SN, Braddy LR, Brecher ME. Severe hemolytic anemia due to auto anti-N. Immunohematology 2005; 21:63-5. [PMID: 15954806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Auto anti-N is infrequently encountered and, in most reported cases, does not cause clinical hemolysis. This case reports an auto anti-N associated with severe hemolytic anemia (Hb=2.7 g/dL) in a 6-year-old Caucasian girl with a history of vomiting, fever, and abdominal pain. Upon admission, she was found to have a metabolic acidosis, secondary to her severe anemia, with abnormal liver function tests. As in three other case reports, the autoimmune hemolytic anemia resolved, with disappearance of the auto anti-N, after corticosteroid therapy.
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Affiliation(s)
- C C Immel
- Transfusion Medicine Service, UNC Hospitals, 1021 East Wing, 101 Manning Drive, Chapel Hill, NC 27514, USA
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Abstract
OBJECTIVE To analyze the risk factors for suicide, premature death and all-cause death in a representative population of hospital-treated deliberate self-poisoning patients. METHOD A prospective cohort study using data-linkage between the Hunter Area Toxicology Service Database and the National Death Index of the Australian Institute of Health and Welfare, from January 1991 to December 2000. RESULTS There were 4105 subjects, of whom 228 (5.6%) died, 122 (2.9%) by premature death and 58 (1.4%) by suicide. The probability of suicide after 10 years follow-up was 2%. The adjusted hazard ratios (95% CI) for suicide were: 'disorders usually diagnosed in infancy, childhood and adolescence', 5.28 (95% CI = 2.04-13.65): male gender, 4.25 (95% CI = 2.21-8.14); discharge to involuntary psychiatric hospital admission, 3.20 (95% CI = 1.78-5.76); and increasing age, 1.02 (95% CI = 1.01-1.04). Men and women showed different patterns of multivariate risks, although increased risk with increasing age and discharge to an involuntary psychiatric admission was true for both. The standardized all-cause mortality ratio (95% CI) was: for men, 6.42 (95% CI = 5.44-7.57), and for women 4.39 (95% CI = 3.56-5.41). The standardized suicide mortality ratio (95% CI) was: for men, 20.55 (95% CI = 15.24-27.73), and for women 22.95 (95% CI = 13.82-38.11). CONCLUSIONS Men and women have different risk factors for subsequent suicide after self-poisoning. Hospital-treated self-poisoning patients have increased risk of subsequent suicide, premature and all-cause death. Psychiatric assessment, leading to discharge decisions, is worthwhile in identifying patients at long-term risk of suicide, premature and all-cause death.
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Affiliation(s)
- David M Reith
- Discipline Of Paediatrics, University of Otago and Children's Pavilion, Dunedin Public Hospital, Great King St, Dunedin, New Zealand.
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Reith DM, Whyte I, Carter G, McPherson M. Adolescent self-poisoning: a cohort study of subsequent suicide and premature deaths. Crisis 2003; 24:79-84. [PMID: 12880226 DOI: 10.1027/0227-5910.24.2.79] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) forpremature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.
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Affiliation(s)
- David M Reith
- Dunedin School of Medicine, University of Otago, New Zealand.
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41
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Abstract
Abstract: Previous self-harm has been identified as a risk factor for subsequent suicide by adolescents. The objective of the study was to identify further risk factors for subsequent premature death and suicide in a population of adolescents presenting with self-poisoning. A longitudinal cohort design using data-linkage of consecutive adolescent patients presenting to the Hunter Area Toxicology Service, a regional toxicology service for Newcastle, Australia, with the National Death Index of the Australian Institute of Health and Welfare was used. A total of 441 adolescents aged 10 to 19 years presented with self-poisoning over 5 years from January 1991 to December 1995, with follow-up to March 2001. There were 14 deaths total, eight of which were likely suicides. There was a 22-fold increase in suicide rate for males and a 14-fold increase for females compared with age-normalized population rates. Adjusted hazard ratios (95% CI) for premature death were male gender 3.77 (1.11-12.78), nonaffective psychotic disorders 16.3 (3.83-69.34) and the mental illnesses of childhood 6.12 (1.68-22.23). There was a similar pattern for suicide: Male gender, nonaffective psychotic disorders, and the mental illnesses of childhood confer greater risk for subsequent suicide or premature death in this population.
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Affiliation(s)
- David M. Reith
- Dunedin School of Medicine, University of Otago, New Zealand
| | - Ian Whyte
- School of Population Health Sciences, Faculty of Medicine and Health Sciences, University of Newcastle, Australia
| | - Greg Carter
- Faculty of Medicine and Health Sciences, University of Newcastle and Suicide Prevention Research Unit, Centre for Mental Health Studies, Newcastle, Australia
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Abstract
OBJECTIVE To evaluate the efficacy and safety of venlafaxine, a new-generation antidepressant that selectively inhibits serotonin and norepinephrine reuptake, in the treatment of premenstrual dysphoric disorder (PMDD). METHOD We conducted a randomized, double-blind, placebo-controlled, parallel-group, flexible-dose trial. After three screening cycles, including a single-blind placebo cycle, 164 women were randomly assigned to double-blind treatment with venlafaxine (50-200 mg/day) or placebo for four menstrual cycles. Primary outcome measures were the total premenstrual symptom scores as assessed by a daily symptom report (DSR) and the Hamilton Rating Scale for Depression. RESULTS Venlafaxine was significantly more effective than placebo in reducing PMDD symptoms as assessed by DSR scores (P <.001 for last observation carried forward and observed analyses). Sixty percent of venlafaxine versus 35% of placebo subjects improved >50% (P =.003). Forty-three percent of venlafaxine subjects versus 25% of placebo subjects experienced symptom remission, defined as reduction of DSR scores to the postmenstrual level (P =.034). Venlafaxine treatment was significantly better than placebo for all statistically derived DSR factors (mood, function, pain, and physical symptoms). Improvement was relatively swift, with approximately 80% symptom reduction in the first treatment cycle. Mean venlafaxine doses ranged from 50 mg/day in the first treatment cycle to 130 mg/day in the fourth treatment cycle. Adverse events such as nausea, insomnia, and dizziness were mild and transient. CONCLUSIONS Venlafaxine is significantly more efficacious than placebo for PMDD treatment. Response to treatment can occur in the first treatment cycle, and venlafaxine is well tolerated. Further studies are needed to evaluate the potential of intermittent (luteal phase) dosing for this cyclic disorder and the efficacy of long-term maintenance treatment with venlafaxine.
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Affiliation(s)
- E W Freeman
- Department of Obstetrics/Gynecology, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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Zaman K, McPherson M, Vaughan J, Hunt J, Mendes F, Gaston B, Palmer LA. S-nitrosoglutathione increases cystic fibrosis transmembrane regulator maturation. Biochem Biophys Res Commun 2001; 284:65-70. [PMID: 11374871 DOI: 10.1006/bbrc.2001.4935] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.4] [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: 11/22/2022]
Abstract
Endogenous S-nitrosoglutathione (GSNO) is known to increase the expression of certain proteins at concentrations present in the normal human airway. We hypothesized that GSNO would increase expression and maturation of the cystic fibrosis transmembrane conductance regulator (CFTR). Cells expressing DeltaF508 and wild type CFTR were exposed to GSNO and analyzed for expression and maturation by Western blot analysis. Physiologically relevant concentrations of GSNO resulted in dose- and time-dependent increases in expression. The GSNO-induced increases were eliminated by cycloheximide, suggesting a posttranscriptional effect. Unlike proteasome inhibitors, GSNO resulted in an increase CFTR maturation. The GSNO effect could be reversed by dithiothreitol and inhibited by acivicin, a gamma glutamyl transpeptidase inhibitor. These observations suggest that GSNO leads to maturation of mutated DeltaF508 CFTR, a process associated with restoration of CFTR function. Because endogenous levels of GSNO are low in the cystic fibrosis (CF) airway, these results raise the possibility that GSNO replacement therapy could be an effective treatment for CF.
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Affiliation(s)
- K Zaman
- Department of Pediatrics, University of Virginia, Charlottesville, Virgina 22908, USA
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44
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Rohrbach KG, Christopher D, Hu J, Paull R, Sipes B, Nagai C, Moore P, McPherson M, Atkinson H, Levesley A, Oda C, Fleisch H, McLean M. MANAGEMENT OF A MULTIPLE GOAL PINEAPPLE GENETIC ENGINEERING PROGRAM. ACTA ACUST UNITED AC 2000. [DOI: 10.17660/actahortic.2000.529.12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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45
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McPherson M, Shostak AW, Samuel WM. Climbing simulated vegetation to heights of ungulate hosts by larvae of Dermacentor albipictus (Acari: Ixodidae). J Med Entomol 2000; 37:114-120. [PMID: 15218914 DOI: 10.1603/0022-2585-37.1.114] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Larvae of winter ticks, Dermacentor albipictus (Packard), ascend vegetation in autumn and form clumps that attach to passing ungulate hosts. We tested the hypothesis that vegetation height determines the height of clumps. During the vegetation-to-ungulate transmission period (early September to mid-November), larvae were released at the base of simulated vegetation (nylon rods 245 cm tall) in outdoor and laboratory trials and in the absence of host cues. Rod height exceeded the height of the tallest ungulate host, which is the moose, Alces alces (L.). Most larvae stopped climbing and formed clumps 50-190 cm above ground, which coincided with torso heights of moose; elk, Cervus elaphus L.; and deer, Odocoileus spp. Rafinesque. More clumps formed in outdoor trials than in laboratory trials and clump heights tended to increase over the course of the experiment, but clump number, size, and height did not correlate with weather conditions. Winter tick larvae appear to determine their height above ground in the absence of external cues, but this mechanism may be modified by external conditions.
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Affiliation(s)
- M McPherson
- Department of Biological Sciences, University of Alberta, Edmonton, Canada
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46
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Ziring PR, Brazdziunas D, Cooley WC, Kastner TA, Kummer ME, Gonzalez de Pijem L, Quint RD, Ruppert ES, Sandler AD, Anderson WC, Arango P, Burgan P, Garner C, McPherson M, Michaud L, Yeargin-Allsopp M, Johnson CP, Wheeler LS, Nackashi J, Perrin JM. American Academy of Pediatrics. Committee on Children With Disabilities. Care coordination: integrating health and related systems of care for children with special health care needs. Pediatrics 1999; 104:978-81. [PMID: 10506246] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
Care coordination is a process that links children with special health care needs and their families to services and resources in a coordinated effort to maximize the potential of the children and provide them with optimal health care. Care coordination often is complicated because there is no single entry point to multiple systems of care, and complex criteria determine the availability of funding and services among public and private payers. Economic and sociocultural barriers to coordination of care exist and affect families and health care professionals. In their important role of providing a medical home for all children, primary care pediatricians have a vital role in the process of care coordination, in concert with the family.
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Haddon L, Heason J, Fay T, McPherson M, Carlin EM, Jushuf IH. Managing STIs identified after testing outside genitourinary medicine departments: one model of care. Sex Transm Infect 1998; 74:256-7. [PMID: 9924464 PMCID: PMC1758121 DOI: 10.1136/sti.74.4.256] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [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: 11/04/2022] Open
Abstract
OBJECTIVES To develop a local strategy for managing cases of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) which have been identified in the departments of obstetrics and gynaecology (O&G). METHODS Weekly notification from the local microbiology laboratory to genitourinary medicine (GUM) departments of all positive CT and GC results generated by tests performed in the two local O&G departments. Direct contact made by GUM departments to index patients identified and "fast track" appointments made. Data recorded for future audit include numbers attending, details of health adviser input, and success of contact tracing. RESULTS Over 18 months, 294 women were identified and 231 (78%) attended GUM departments; 142 (48%) had received antibiotics before attending GUM departments and of these, 58 (41%) had risked reinfection by an untreated partner and 48 (20%) were found on screening to have a previously undiagnosed genital infection. Over 90% were interviewed by a health adviser. Appropriate follow up was achieved in 87% of index cases. Of the contacts, 194 were treated--150 in the local GUM department. Of these 150 men, 99 (66%) had an identifiable genital infection and 84% of those with CT/non-gonococcal urethritis were asymptomatic. There have been no complaints either formal or informal, by women managed by this system. CONCLUSIONS GUM clinics are the ideal setting to achieve successful treatment of patients with sexually acquired infections, which must include notification and treatment of their partners if reinfection is to be avoided. For patients with infections diagnosed on other settings, such as O&G, a system of direct notification of results to GUM departments by an agreed protocol can be highly successful. For such a system to work, close cooperation and trust between departments is essential.
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Affiliation(s)
- L Haddon
- Department of Genitourinary Medicine, Nottingham City Hospital
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48
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Newacheck PW, Strickland B, Shonkoff JP, Perrin JM, McPherson M, McManus M, Lauver C, Fox H, Arango P. An epidemiologic profile of children with special health care needs. Pediatrics 1998; 102:117-23. [PMID: 9651423 DOI: 10.1542/peds.102.1.117] [Citation(s) in RCA: 386] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To present an epidemiologic profile of children with special health care needs using a new definition of the population developed by the federal Maternal and Child Health Bureau. METHODS We operationalized the new definition using the recently released 1994 National Health Interview Survey on Disability. Estimates are based on 30 032 completed interviews for children <18 years old. The overall response rate was 87%. RESULTS Eighteen percent of US children <18 years old in 1994, or 12.6 million children nationally, had a chronic physical, developmental, behavioral, or emotional condition and required health and related services of a type or amount beyond that required by children generally. This estimate includes children with existing special health care needs but excludes the at-risk population. Prevalence was higher for older children, boys, African-Americans, and children from low-income and single-parent households. Children with existing special health care needs had three times as many bed days and school absence days as other children. An estimated 11% of children with existing special health care needs were uninsured, 6% were without a usual source of health care, 18% were reported as dissatisfied with one or more aspects of care received at their usual source of care, and 13% had one or more unmet health needs in the past year. CONCLUSIONS A substantial minority of US children were identified as having an existing special health care need using national survey data. Children with existing special health care needs are disproportionately poor and socially disadvantaged. Moreover, many of these children face significant barriers to health care.
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Affiliation(s)
- P W Newacheck
- Department of Pediatrics and Institute for Health Policy Studies, University of California, San Francisco 94109, USA
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McPherson M, Arango P, Fox H, Lauver C, McManus M, Newacheck PW, Perrin JM, Shonkoff JP, Strickland B. A new definition of children with special health care needs. Pediatrics 1998; 102:137-40. [PMID: 9714637 DOI: 10.1542/peds.102.1.137] [Citation(s) in RCA: 789] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- M McPherson
- Division of Services for Children with Special Health Care Needs, Maternal and Child Health Bureau, Rockville, MD 20857, USA
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50
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Chuck JA, McPherson M, Huang H, Jacobsen JR, Khosla C, Cane DE. Molecular recognition of diketide substrates by a beta-ketoacyl-acyl carrier protein synthase domain within a bimodular polyketide synthase. Chem Biol 1997; 4:757-66. [PMID: 9375254 DOI: 10.1016/s1074-5521(97)90314-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Modular polyketide synthases (PKSs) are large multifunctional proteins that catalyze the biosynthesis of structurally complex bioactive products. The modular organization of PKSs has allowed the application of a combinatorial approach to the synthesis of novel polyketides via the manipulation of these biocatalysts at the genetic level. The inherent specificity of PKSs for their natural substrates, however, may place limits on the spectrum of molecular diversity that can be achieved in polyketide products. With the aim of further understanding PKS specificity, as a route to exploiting PKSs in combinatorial synthesis, we chose to examine the substrate specificity of a single intact domain within a bimodular PKS to investigate its capacity to utilize unnatural substrates. RESULTS We used a blocked mutant of a bimodular PKS in which formation of the triketide product could occur only via uptake and processing of a synthetic diketide intermediate. By introducing systematic changes in the native diketide structure, by means of the synthesis of unnatural diketide analogs, we have shown that the ketosynthase domain of module 2 (KS2 domain) in 6-deoxyerythronolide B synthase (DEBS) tolerates a broad range of variations in substrate structure, but it strongly discriminates against some others. CONCLUSIONS Defining the boundaries of substrate recognition within PKS domains is crucial to the rationally engineered biosynthesis of novel polyketide products, many of which could be prepared only with great difficulty, if at all, by direct chemical synthesis or semi-synthesis. Our results suggest that the KS2 domain of DEBS1 has a relatively relaxed specificity that can be exploited for the design and synthesis of medicinally important polyketide products.
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Affiliation(s)
- J A Chuck
- Department of Chemistry, Brown University, Providence, RI 02912-9108, USA
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