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Determination of chloroquine and its desethyl metabolite in whole blood: an application for samples collected in capillary tubes and dried on filter paper.

A high performance liquid chromatography method for analysis of chloroquine and desethylchloroquine was adapted for 75 microliters aliquots of whole blood obtained by finger-prick and dried on filter paper. The precision of the method was satisfactory at whole blood concentrations of 40 nmol/L (coefficient of variation, 5%). The dried samples were stable for at least 7 weeks at 20 degrees C. The concentrations in venous whole blood and in dried samples correlated well. The correlation coefficient was 0.99 for chloroquine and 0.97 for desethylchloroquine. Chloroquine concentrations were marginally but significantly higher in venous whole blood. When fitted to a linear equation (y = bx + a) the relationship was y = 0.96x + 0.03. Desethylchloroquine concentrations did not differ significantly in venous whole blood and in finger-prick blood dried on filter paper. The method is specific and sensitive enough for pharmacokinetic studies and can be used in areas with limited technical facilities.

Blood Specimen Collection↗

Mortality among pulp and paper workers.

Mortality among 2,113 U.S. and Canadian members of the Pulp, Sulfite, and Paper Workers' Union, 1935 through 1964, was studied using a proportionate mortality analysis. Mortality due to gastric cancer was found to be elevated in all jurisdictions, but only in mills using sulfate or sulfite pulping. An excess of mortality due to kidney cancer was limited to mills in Oregon and Washington. Excesses of deaths due to leukemia, Hodgkin's disease, and lymphosarcoma were observed only in mills in Oregon, Washington, and Wisconsin and the province of Quebec. Based on small numbers, excesses of deaths due to cancers of rectum, pancreas, kidney, and lymphosarcoma were seen primarily among sulfite process workers, while Hodgkin's disease deaths occurred primarily in sulfate (kraft) process workers. These findings suggest that cancer mortality in pulp and paper workers may be related both to pulping process and to tree species processed.

Canada↗

Variations in respiratory disease morbidity among pulp and paper mill town residents.

This study investigated whether occupational exposure in pulp and paper mills or geographic proximity to mills was associated with an increase in risk for respiratory disease hospitalizations. Three years (1980 to 1982) of 100% age- and sex-adjusted hospital admission rates for selected respiratory diagnoses were calculated for 66 Maine towns located between 0 and 15 miles for seven Kraft mills and four groundwood pulp and paper mills. Additional data collected for each town included the number of production workers at each mill, mill proximity, insurance coverage, hospital distance, bed size, full-time equivalent physicians, unemployment and income rates. Regression results provide evidence that occupational exposure may be a significant factor in hospitalizations for respiratory infections, bronchitis and asthma, and respiratory signs and symptoms, although potential confounders (smoking, commercial health insurance) need to be examined.

Aged↗

Patterns of mortality in pulp and paper workers.

A proportionate mortality ratio (PMR) analysis utilizing death certificates and work histories was performed on 201 white male decedents who had been employed in pulp and paper production plants and had died between 1970 and 1984. PMRs for all malignant neoplasms (PMR = 131) and lung cancer (PMR = 151) were significantly elevated, whereas PMRs for lymphopoietic system cancer (PMR = 190) and cancer of the large intestine (PMR = 147) showed nonsignificant excesses. Most of the excess cancers of the lung and large intestine were limited to those with greater than 30 years between initial employment in a pulp and paper plant and death. Excess lung and lymphopoietic system cancers have been found in other studies of paperworker mortality, although this study failed to support previous findings of excess stomach cancer. These results continue to raise concerns that paperworkers are at elevated risk for some occupational cancers.

Cause of Death↗

Occupational health and safety management systems in the Canadian pulp and paper industry: methods of auditing.

The Canadian Pulp and Paper Association has developed eight "Guiding Principles for Management of Occupational Health and Safety" (OH&S) for its member companies. As part of a study to assess member companies' OH&S activities, an on-site audit was performed for 11 sites. The audit assessed five key components of a management system for a number of OH&S activities. Management-system components more likely to be in place included system ownership and goals and procedures, whereas measures of performance, a review of measures, and corrective action were less likely to be present. Environmental surveillance and injury reduction were most actively monitored, as indicated by the number of measures of performance relating to these activities. The auditing process demonstrated leadership and communicated the OH&S priorities of the Canadian Pulp and Paper Association to the sites.

Canada↗

Exposure to asbestos and lung and pleural cancer mortality among pulp and paper industry workers.

We studied the mortality from lung and pleural cancers in a cohort of 62,937 male workers employed for at least 1 year in the pulp and paper industry in 13 countries during 1945 to 1996. Mill departments were classified according to probability and level of exposure to asbestos on the basis of available dust measurements and mill-specific information on exposure circumstances. Thirty-six percent of workers were classified as ever exposed to asbestos. Standardized mortality ratios of lung cancer were 0.99 (95% confidence interval [CI], 0.90 to 1.08) among unexposed and 1.00 (95% CI, 0.90 to 1.11) among ever exposed workers. The number of pleural cancer deaths among unexposed workers was 10; that among exposed workers was 14, most of which occurred among maintenance workers. In internal analyses, a trend in mortality from either neoplasm was suggested for estimated cumulative exposure to asbestos, weighted for the individual probability of exposure within the department and for duration of exposure (relative risk for lung cancer for 0.78+ f/cc-years, as compared with < or = 0.01 f/cc-years: 1.44; 95% CI, 0.85 to 2.45; corresponding relative risk for pleural cancer: 2.43; 95% CI, 0.43 to 13.63). Despite a possible nondifferential misclassification of exposure and outcome, this study suggests that the carcinogenic effect of asbestos can be detected among workers employed in industries such as the pulp and paper industry, in which it is not considered to be a major hazard.

Air Pollutants, Occupational↗

Detection of human immunodeficiency virus-1 nucleic acid on inactivated filter paper disks by polymerase chain reaction and microtiter plate assay.

Human immunodeficiency virus type 1 (HIV-1) in cultured cells, peripheral blood samples and sera were adsorbed on filter paper disks and inactivated by heat or ethanol. Two procedures, the polymerase chain reaction (PCR) and microtiter plate assay (HMPA) were used to detect the nucleic acid. The sensitivity after different heat treatments with nested PCR for HIV-1 DNA (or nested reverse transcription-PCR for HIV-1 RNA) was identical regardless of whether the samples were examined immediately or one month later. Inactivation by ethanol treatment resulted in a slight loss of sensitivity. The HMPA proved to be as reliable and specific as the conventional PCR technique. We conclude that the heat-treated filter paper disk assay is suitable for identifying HIV nucleic acid in clinical samples sent to the laboratory from a distance, e.g. in an envelope.

Base Sequence↗

The hypercholesterolaemic factor in boiled coffee is retained by a paper filter.

In order to study the effects of filtering on the serum cholesterol-elevating effect of boiled coffee, 20 healthy volunteers consumed, in random order, 6-10 dl d-1 of strong boiled coffee (BC) and similarly boiled coffee that had been passed through a conventional paper filter (BFC), for periods of 4 weeks in a crossover design. During periods of BC consumption serum total cholesterol and LDL-cholesterol levels (P less than 0.05), as well as serum triglyceride and apoprotein B concentrations and the LDL/HDL ratio (P less than 0.01), were significantly higher than during BFC periods. Serum HDL-cholesterol and apoprotein A-I levels remained unchanged. Filtering removed more than 80% of the lipid-soluble substance that was present in boiled coffee. The results indicate that the hypercholesterolaemic factor in boiled coffee, which is presumably lipid-soluble, is retained by the paper filter. They also suggest that boiling is not essential for the previously observed difference between the effects on serum lipoproteins of boiled coffee and filtered coffee.

Adult↗

Detection and serotyping of Actinobacillus actinomycetemcomitans isolates on nitrocellulose paper blots with monoclonal antibodies.

A combination of blotting of bacterial colonies on nitrocellulose paper discs and immunoenzymatic detection of bound antigens with specific monoclonal antibodies was used to detect and serotype Actinobacillus actinomycetemcomitans directly off the initial agar culture dish. The A. actinomycetemcomitans antigens, representative of specific colonies, were identified immunoenzymatically using monoclonal antibody specific for a species-specific antigen. The serotype of the bacteria in colonies was identified by dividing the blotting paper into sections and immunoenzymatically identifying the serotype antigens with serotype-specific monoclonal antibodies. This procedure provides for simple, rapid, sensitive and accurate identification and characterization of A. actinomycetemcomitans isolates from the initial isolation agar plates.

Actinobacillus↗

Methodological considerations in GCF sampling with paper strips: poor recovery of uncomplexed elastase.

The purpose of this study was to assess the recovery of certain proteins from paper strips used for sampling of gingival crevicular fluid (GCF). During a period of 60 min, proteins were eluent in isotonic phosphate-buffered saline, pH 7.4, without detergent. This eluent did not lyse neutrophils applied to the strips, which might otherwise contribute intracellular substances-, e.g., elastase to the GCF samples. The proteins applied (MW 12-725 kD) were satisfactorily recovered (about 90%). However, free neutrophil elastase, unlike elastase complexed with alpha-2-macroglobulin, could not be recovered from the paper strips. Strips made of polyvinylidene difluoride (Durapore) were also tested and 31% of the applied pure elastase was recovered from them. A comparison of measurements made with a Periotron 6000 on Periopaper and Durapore strips, showed that the values obtained with Durapore were too low for accurate measurements of small volumes of fluid. On the whole, when the elution was made in isotonic buffers at neutral pH and without detergents, the recovery of most proteins was satisfactory and reproducible, and independent of MW in the tested range. However, the study also showed poor recovery of uncomplexed elastase.

Buffers↗

Source and extent of Klebsiella pneumoniae in the paper industry.

Three pulp and paper mill processing plants were evaluated for fecal coliform and Klebsiella pneumoniae bacterial concentrations. Freshwater consumed by paper industries contained minimum detectable levels of K. pneumoniae, less than 10 organisms per 100 ml. Elevated concentrations of K. pneumoniae could be traced from early pulping stages to water processing reuse systems. Concentrations of K. pneumoniae (thermotolerant and thermointolerant) ranged from 40,000 organisms per 100 ml to an estimated 3 x 10(6) organisms per 100 ml. K. pneumoniae biotyping provided evidence for the selective growth and persistence of K. pneumoniae from the initial wood washing stages through to the final effluent discharge. Wastewater treatment had limited effects in reducing K. pneumoniae concentrations. K. pneumoniae levels ranged from 40 organisms per 100 ml to an estimated 10(6) organisms per 100 ml. The presence of K. pneumoniae in water indicates degraded water quality, and its significance with regard to human health effects has yet to be examined.

Bacteriocins↗

Paper chromatographic techniques for the determination of cephalothin and desacetylcephalothin in body fluids.

Paper chromatographic procedures may be used to detect cephalothin and its metabolite desacetylcephalothin in urine, plasma, synovial fluid, and cerebrospinal fluid. Protein-bound antibiotics are released from plasma, cerebrospinal fluid, and synovial fluid by dilution with an equal volume of dimethylformamide. Data are presented on the sample preparation, paper chromatographic system, and other specific techniques.

Bacillus subtilis↗

Microbial penetration of muslin- and paper-wrapped sterile packs stored on open shelves and in closed cabinets.

Microbial penetration of sterile packs was studied using single-wrap (two layers) muslin, double-wrap (four layers) muslin, and two-way crepe paper (single layer) to wrap 20 gauze sponges (2 by 2 inch). These packs were stored in the central sterile supply departments of two hospitals and processed for sterility at predetermined intervals. Microorganisms penetrated single-wrap muslin as early as 3 days and double-wrap muslin and single-wrap two-way crepe paper in 21 to 28 days stored in open shelves. The time required for microbial penetration was at least twice as long when closed cabinets were used. Single-wrap muslin packs stored in sealed, impervious plastic bags remained sterile for at least 9 months. All sterile materials in pervious wrappers should be handled as little as possible and then only with extreme care and caution. Closed cabinets offer more protection than open shelves, and single wrappers are not recommended.

Bacteria↗

Detection of rubella virus immunoglobulin G (IgG) and IgM antibodies in whole blood on Whatman paper: comparison with detection in sera.

We compared detection of rubella virus hemagglutination inhibition (HI) antibody and rubella virus-specific immunoglobulin M (IgM) in dried whole blood spotted onto Whatman filter paper and serum samples, both of which were obtained from the same subject by venipuncture. Of 1,000 paired serum samples obtained to study HI antibodies, 807 dried blood samples had HI titers identical to those of the corresponding serum samples, and 193 dried blood samples showed 1 dilution difference. Storage of dried blood at room temperature for 28 days did not affect the HI antibodies. In a study of specific IgM by a solid-phase immunosorbent HI test done with blood from healthy subjects and patients with rubella, the result of the presence, positive or negative, of specific IgM from both blood sample sources corresponded when the dried blood samples were stored at room temperature from 5 h to 38 days. This study demonstrated that the use of Whatman filter paper as a transport medium for blood samples for the determination of rubella virus immunity and the diagnosis of rubella virus infection is possible.

Antibodies, Viral↗

Filter paper cortisol profiles in secondary adrenocortical insufficiency.

The use of filter paper four point 24 hour cortisol profiles in the diagnosis and management of secondary adrenocortical deficiency was examined. Eighteen children with familial short stature and isolated growth hormone deficiency had normal 24 hour and morning plasma cortisol concentrations measured. Eight of 11 children with multiple pituitary hormone deficiencies had evidence of hypocorticalism despite previously normal baseline cortisols or responses to insulin hypoglycaemia or tetracosactrin. Nine of 11 children with hypopituitarism on replacement treatment (4.9-12.5 mg/m2/day) had satisfactory concentrations of cortisol, though morning cortisols were often low. Filter paper profiles are a simple, inexpensive, and relatively non-invasive way of managing children with suspected hypocorticalism and of monitoring their treatment.

Adolescent↗

Determination of antimicrobial MIC by paper diffusion method.

Because they are cumbersome, tests to determine the quantitative susceptibility of organisms to antimicrobial drugs are not performed routinely in many diagnostic laboratories. This paper describes a simple method of incorporating the antimicrobial drug in agar. It is an adaptation of the Rolinson and Russell technique which allows the determination of minimum inhibitory concentrations (MIC) of antimicrobial drugs for a large number of organisms. Results are comparable with those obtained when the standard agar dilution method is used. Strains of aerobic Gram-negative bacilli were tested by both methods using ampicillin (86 strains), cephaloridine (72 strains), trimethoprim (72 strains), and gentamicin (72 strains). Of the 302 tests thus performed, a difference in MIC of more than one double dilution was noted in only 11 tests. With one strain of Pseudomonas aeruginosa, however, it was not possible to detect ampicillin resistance by the method described in this paper.

Ampicillin↗

Helicobacter pylori serology using specimens collected on filter paper.

A simple method for the collection of blood specimens on filter paper for serology of Helicobacter pylori was devised. Blood was freshly applied to small Whatman 3 mm filter paper and allowed to dry. Serological activity, as measured by reactivity to H pylori antigens (AMRAD, Australia), was retained after storage for one month at both room temperature and at 4 degrees C. This technique eliminates formal venepuncture, separation of sera, and arduous packaging of specimens to be sent to the laboratory.

Antibodies, Bacterial↗

The paper punched disc technique for lead in blood samples with abnormal haemoglobin values.

A series of 15 blood samples with haemoglobin levels ranging from 4-6--16-1 g/dl were spotted on to Whatman No. 4 filter paper. Blood samples with low haemoglobin concentrations spread over a greater area of the filter paper than did those with high haemoglobin concentrations. This was further investigated by studying the performance of laboratory-prepared samples, and any effect on the estimation of blood lead value. Blood lead values assayed by the punched disc method on blood samples with low haemoglobin values were unreliable unless the estimated value was adjusted with respect to the area over which the blood had spread.

Hematocrit↗