Results of endoscopic carpal tunnel release relative to surgeon experience with the Agee technique.

Purpose: To establish the rate of iatrogenic injury after endoscopic carpal tunnel release (ECTR) for a surgeon in the first 2 years of practice; to report the rate of conversion from ECTR to open carpal tunnel release (OCTR), the reason for conversion, and any increase in morbidity found in patients converted to OCTR; and to determine whether the conversion rate decreased with increasing surgeon experience.

Methods: We conducted a retrospective review of patients undergoing ECTR by a single surgeon in the first 2 years of practice. Data collected or calculated included symptom relief, rate of conversion to OCTR, reason for conversion, and neurovascular complications.

CTX-M-15-producing Escherichia coli clinical isolates in Cairo (Egypt), including isolates of clonal complex ST10 and clones ST131, ST73, and ST405 in both community and hospital settings.

In Egypt, little is known about the genetic background of Escherichia coli isolates harboring extended-spectrum β-lactamase (ESBL). Five hundred twenty Enterobacteriaceae were prospectively collected (May 2007-August 2008) at the Theodor Bilharz Research Institute (Cairo). Among the collected Enterobacteriaceae, 56% (n=291) were E.

Pitfalls of wrist MR imaging.

The radiologist serves as an indispensable consultant for those patients with wrist pain, by determining the causes of the pain and severity of the injury, helping to determine treatment options, and providing preoperative guidance for surgery, if planned. This article reviews normal anatomic variants and potential danger areas encountered by the radiologist when interpreting magnetic resonance imaging of the wrist.

Detection of gyrA mutation among clinical isolates of Campylobacter jejuni isolated in Egypt by MAMA-PCR.

Introduction: Campylobacter spp are the major cause of enteritis in humans and more than 90% of reported infections are caused by Campylobacter jejuni. Fluoroquinolones such as ciprofloxacin are the antibiotics of choice for treatment. An increase in the frequency of ciprofloxacin-resistant Campylobacter has been reported globally due to a single base mutation (C-257 to T) in codon 86 of the quinolone resistance determining region (QRDR) of the gyrA gene altering the amino acid sequence from threonine at position 86 to isoleucine (Thr-86 to Ile).

Incidence of scapholunate ligament dissociation in patients with aspiration-confirmed gout.

Purpose: To determine the incidence of scapholunate (SL) dissociation in patients with aspiration-confirmed gout of the wrist and aspiration-confirmed gout in any joint excluding the wrist.

Methods: Geisinger Medical Center uses the EPIC electronic medical record system, which maintains International Classification of Diseases, 9th Revision, Clinical Modification and Current Procedural Terminology coding information for every patient encounter in our hospital system. We queried this electronic medical record system from 1998 to 2008 using the International Classification of Diseases, 9th Revision, Clinical Modification codes for gout as well as Current Procedural Terminology codes for aspiration of a minor, intermediate, or major joint.

Design and validation of a multiplex polymerase chain reaction for the identification of enterotoxigenic Escherichia coli and associated colonization factor antigens.

Development of a genetic tool for the detection of genes encoding enterotoxins and colonization factors would greatly enhance enterotoxigenic Escherichia coli (ETEC) surveillance. Oligonucleotide primers were designed to amplify genes encoding human ST, porcine ST, LT and the structural genes of colonization factor antigen (CFA)/I, CS1 to CS8, CS12 to CS15, CS17 to CS22, and PCFO71. Screening 89 ETEC isolates phenotypically expressing a known CFA showed that, without exception, the multiplex polymerase chain reaction (mPCR) detected the structural gene of the expressed CFA, in addition to CS21 in 22.

Enterotoxigenic Escherichia coli multilocus sequence types in Guatemala and Mexico.

The genetic backgrounds of 24 enterotoxigenic Escherichia coli (ETEC) strains from Mexico and Guatemala expressing heat-stable toxin (ST) and coli surface antigen 6 (CS6) were analyzed. US travelers to these countries and resident children in Guatemala were infected by ETEC strains of sequence type 398, expressing STp and carrying genetically identical CS6 sequences.

Enteric fever in Mediterranean north Africa.

Typhoid fever is endemic in the Mediterranean North African countries (Morocco, Algeria, Tunisia, Libya, and Egypt) with an estimated incidence of 10-100 cases per 100,000 persons. Outbreaks caused by Salmonella enterica serovar Typhi are common and mainly due to the consumption of untreated or sewage-contaminated water. Salmonella enterica Paratyphi B is more commonly involved in nosocomial cases of enteric fever in North Africa than expected and leads to high mortality rates among infants with congenital anomalies.

Preliminary development and validation of a real-time reverse transcription PCR assay for the semi-quantification of viable Campylobacter jejuni in water samples.

A TaqMan-based real-time reverse transcription PCR (RT-PCR) assay was developed for semi-quantification of viable Campylobacter jejuni in water samples. This preliminary assay is based on measuring the heat-shock induction of groEL messenger RNA (mRNA); the logic being that only viable cells can synthesise new mRNA. A 128-bp C.

Sentinel hospital-based surveillance of rotavirus diarrhea in iran.

Background: Rotavirus is the most common causes of severe, acute diarrhea during childhood and is an important cause of morbidity and mortality in developing countries. We established active hospital-based surveillance of childhood diarrhea to assess the scope of severe rotavirus disease in Iran.

Methods: From May 2006 through April 2007, prospective surveillance of rotavirus diarrhea among children aged <5 years was conducted in 5 sentinel hospitals in Iran.

Epidemiology of rotavirus gastroenteritis among children <5 years of age in Morocco during 1 year of sentinel hospital surveillance, June 2006-May 2007.

Background: In anticipation of vaccine introduction, we assessed the epidemiology, burden, and genotype of infecting strains of rotavirus disease among Moroccan children hospitalized for acute gastroenteritis.

Methods: From June 2006 through May 2007, 345 children <5 years of age who had acute gastroenteritis and were admitted to 4 sentinel hospitals in different regions of Morocco were enrolled in this surveillance study, and stool specimens were tested for the presence of rotavirus with use of enzyme immunoassay. RNA from positive samples was genotyped by reverse-transcriptase polymerase chain reaction.

Considerations for introduction of a rotavirus vaccine in Oman: rotavirus disease and economic burden.

Rotavirus is the most common cause of fatal childhood diarrhea worldwide. We provide the first estimates of the health care and economic burden of severe rotavirus disease in Oman. We conducted active, hospital-based surveillance of rotavirus disease at 11 regional public hospitals in Oman, using the guidelines suggested by the generic World Health Organization protocol.

Molecular characterization of ESBL-producing Shigella sonnei isolates from patients with bacilliary dysentery in Lebanon.

Background: Emergence of extended-spectrum beta-lactamases (ESBLs) in Shigella species imparting resistance to third-generation cephalosporins is a growing concern worldwide. The aim of this study is to molecularly characterize the newly emerging beta-lactam resistant Shigella sonnei, specifically ESBLs in Lebanon, and compare them to beta-lactam sensitive isolates.

Methodology: We compared five beta-lactam-resistant S.

Uropathogens from diabetic patients in Libya: virulence factors and phylogenetic groups of Escherichia coli isolates.

Urinary tract infections (UTIs) in patients with diabetes mellitus (DM) are reported mainly from developed countries. In addition to this underreporting from developing countries, there is a lack of information pertaining to the virulence factors (VFs) and phylogenetic grouping of uropathogenic Escherichia coli (UPEC) from DM and non-DM patients in developing countries. Between July 2005 and June 2006, urine specimens were collected from 135 DM and 164 non-DM patients, all with clinically diagnosed UTIs, attending Elkhadra Hospital and the Diabetic Center in Tripoli, Libya.

Comparison of two multiple-locus variable-number tandem-repeat analysis methods for molecular strain typing of human Brucella melitensis isolates from the Middle East.

Brucella species are highly monomorphic, with minimal genetic variation among species, hindering the development of reliable subtyping tools for epidemiologic and phylogenetic analyses. Our objective was to compare two distinct multiple-locus variable-number tandem-repeat analysis (MLVA) subtyping methods on a collection of 101 Brucella melitensis isolates from sporadic human cases of brucellosis in Egypt (n = 83), Qatar (n = 17), and Libya (n = 1). A gel-based MLVA technique, MLVA-15(IGM), was compared to an automated capillary electrophoresis-based method, MLVA-15(NAU), with each MLVA scheme examining a unique set of variable-number tandem repeats.

Distribution of the Escherichia coli common pilus among diverse strains of human enterotoxigenic E. coli.

The Escherichia coli common pilus (ECP) is produced by commensal and pathogenic E. coli strains. This pilus is unrelated to any of the known colonization factors (CFs) of enterotoxigenic E.

Epidemiology and risk factors for serogroup X meningococcal meningitis during an outbreak in western Kenya, 2005-2006.

The epidemiology of serogroup X meningococcal meningitis in Africa is unknown. During a serogroup X meningococcus outbreak in Kenya, case finding involved record review at health facilities and interviews with health workers and community leaders in West Pokot district. An age- and location-matched case-control study for risk factors was done.

Proximal row carpectomy: role of a radiocarpal interposition lateral meniscal allograft.

Purpose: The purpose of this study was to determine whether use of a lateral meniscal interposition allograft combined with proximal row carpectomy would reduce the peak joint contact pressures and increase the contact area when compared with proximal row carpectomy alone.

Methods: Six cadaver wrists were cyclically moved through flexion-extension and radioulnar deviation ranges of motion. Joint contact pressure was measured with the carpus intact, after proximal row carpectomy, and after insertion of a lateral meniscal allograft.

Efficacy of monotherapies and artesunate-based combination therapies in children with uncomplicated malaria in Somalia.

In order to guide the antimalarial treatment policy of Somalia, we conducted therapeutic efficacy studies of routinely used antimalarial monotherapies as well as artemisinin-based combination therapies (ACTs) for uncomplicated malaria in three sentinel sites during 2003-2006. Therapeutic efficacy of chloroquine (CQ), amodiaquine (AQ) and sulfadoxine/pyrimetahmine (SP) monotherapies, and artesunate plus SP (AS+SP) or AQ (AS+AQ) were evaluated in children 6 months to 10 years old with uncomplicated malaria. For the assessment of the monotherapies, 2003 WHO protocol with 14-day follow-up was used while the 2005 WHO protocol with 28-day follow-up was used for testing the ACTs.

Phenotypic and genotypic analysis of enterotoxigenic Escherichia coli in samples obtained from Egyptian children presenting to referral hospitals.

Hospital surveillance was established in the Nile River Delta to increase the understanding of the epidemiology of diarrheal disease among Egyptian children. Between September 2000 and August 2003, samples obtained from children less than 5 years of age who had diarrhea and who were seeking hospital care were cultured for enteric bacteria. Colonies from each culture with a morphology typical of that of Escherichia coli were tested for the heat-labile (LT) and heat-stable (ST) toxins by a GM-1-specific enzyme-linked immunosorbent assay and colonization factor (CF) antigens by an immunodot blot assay.

Surveillance and genotyping of Enterobacter sakazakii suggest its potential transmission from milk powder into imitation recombined soft cheese.

Aims: To examine the presence of Enterobacter sakazakii in milk and milk-related products produced/distributed under Egyptian conditions and to probe possible transmission routes of the pathogen during the preparation of dairy products.

Methods And Results: One hundred and thirty-seven samples of milk and milk-related products were randomly collected from Egyptian markets and examined for the presence of Ent. sakazakii.

Human dendritic cell-specific intercellular adhesion molecule-grabbing nonintegrin (CD209) is a receptor for Yersinia pestis that promotes phagocytosis by dendritic cells.

Yersinia pestis is the etiologic agent of bubonic and pneumonic plagues. It is speculated that Y. pestis hijacks antigen-presenting cells (APCs), such as dendritic cells (DCs) and alveolar macrophages, in order to be delivered to lymph nodes.

Aeromonas-associated infections in developing countries.

Although their role in gastroenteritis is controversial, Aeromonas species are recognized as etiological agents of a wide spectrum of diseases in man and animals. In developing countries, potentially pathogenic Aeromonas sp. are very common in drinking water and in different types of foods, particularly seafood.

Statistical comparison of Campylobacter jejuni subtypes from human cases and environmental sources.

Aim: To analyse Campylobacter jejuni typing data to define statistically which potential reservoirs and transmission sources contain isolates that are most similar to one another and to isolates from human infections.

Methods And Results: Serotyping and SmaI macrorestriction profiling data for C. jejuni isolates from human campylobacteriosis cases, chicken carcass rinses, duck, sheep, dairy and beef cattle faeces, river water, and sheep, beef and pork offal obtained from a defined rural area of New Zealand were compared using the Czekanowski proportional similarity index.