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Biomedical subjects

P L White

Publications and source records attributed to P L White.

At least 19 recordsLinked to original sources
PubMed2026

Addressing the dual-use of antifungals and fungal antimicrobial resistance (fAMR) through a One Health approach.

Fungal antimicrobial resistance (fAMR) is accelerating, driven in part by the dual-use of antifungal modes of action in agriculture and medicine, threatening therapy. Addressing this challenge requires a unified One Health response that balances agricultural productivity, economic stability, and human and animal health. By focusing on the United Kingdom's policy approach, we argue that current efforts are constrained by fragmented governance, surveillance and regulation. To resolve this, we propose three policy recommendations: 1. a cross-government fAMR body, 2. mandatory environmental and clinical surveillance, and 3. for fungicide approvals to look beyond crop pathogens and integrate risk assessments for potential hotspots of resistance selection in human fungal pathogens. These measures will safeguard current and future antifungals while providing much-needed regulatory clarity and will be translatable to other national and regional contexts.

Journal Article↗
PubMed2006

Re-assessment of risk factors for sporadic Salmonella serotype Enteritidis infections: a case-control study in five FoodNet Sites, 2002-2003.

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.

Adolescent↗
PubMed2003

Polymerase chain reaction aids in the diagnosis of an unusual case of Aspergillus niger endocarditis in a patient with acute myeloid leukaemia.

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.

Aspergillosis↗
PubMed1998

Pathogen Reduction and Hazard Analysis and Critical Control Point (HACCP) systems for meat and poultry. USDA.

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.

Animals↗
PubMed1997

Strategies to control Salmonella and Campylobacter in raw poultry products.

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.

Animals↗
PubMed1996

Salivary, nasal, genital, and systemic antibody responses in monkeys immunized intranasally with a bacterial protein antigen and the Cholera toxin B subunit.

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.

Administration, Intranasal↗
PubMed1993

Establishing a minimally invasive surgery suite.

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.

Hospital Design and Construction↗
PubMed1992

Serum antibody responses to Streptococcus mutans antigens in humans systemically infected with oral streptococci.

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.

Antibodies, Bacterial↗