Enteroaggregative Escherichia coli as a major etiologic agent in traveler's diarrhea in 3 regions of the world.

Enteroaggregative Escherichia coli (EAEC) has been reported to cause traveler's diarrhea and persistent diarrhea in children in developing countries and in immunocompromised patients. To clarify the prevalence of EAEC in traveler's diarrhea, we studied 636 US, Canadian, or European travelers with diarrhea: 218 in Guadalajara, Mexico (June--August 1997 and 1998), 125 in Ocho Rios, Jamaica (September 1997--May 1998), and 293 in Goa, India (January 1997--April 1997 and October 1997--February 1998). Stool samples were tested for conventional enteropathogens.

Serum antibody response induced in mice after oral administration of three different antigens of enterotoxigenic Escherichia coli in enteric coated microparticles.

Background: Gastric digestion of these antigens plays an important role, decreasing the ability to deliver antigens to the gut-associated lymphoid tissue. To overcome this obstacle, microencapsulated antigens from enterotoxigenic Escherichia coli (ETEC) were evaluated for oral immunization of mice.

Methods: Four groups of 10 each received 3 series of 3 doses each of (1) B subunit of cholera toxin (CTB), similar to heat-labile toxin of ETEC, (2) formalin-killed whole cell ETEC H10407 (FK-ETEC), (3) crude preparation of colonization factor antigen I (CFA/I), or (4) placebo.

In vitro antimicrobial susceptibility testing of bacterial enteropathogens causing traveler's diarrhea in four geographic regions.

The emergence of resistant enteropathogens has been reported worldwide. Few data are available on the contemporary in vitro activities of commonly used antimicrobial agents against enteropathogens causing traveler's diarrhea (TD). The susceptibility patterns of antimicrobial agents currently available or under evaluation against pathogens causing TD in four different areas of the world were evaluated.

Comparing physical activity assessment methods in the Seasonal Variation of Blood Cholesterol Study.

Purpose: This paper evaluated three measures of physical activity employed in the Seasonal Variation of Blood Cholesterol Study (Seasons), and it had two objectives: 1) To examine the laboratory validity of the Actillume activity monitor, and 2) To examine the relative validity of three 24-h physical activity recalls (24HR) in quantifying short-term physical activity behaviors.

Methods: Nineteen healthy middle-age adults completed seven activity trials (reading, typing, box moving, stepping, and walking (3.5, 4.

Enteroaggregative Escherichia coli as a cause of traveler's diarrhea: clinical response to ciprofloxacin.

The purpose of this study was to determine the role of enteroaggregative Escherichia coli (EAEC) in the development of traveler's diarrhea and the clinical response of patients with EAEC diarrhea following treatment with ciprofloxacin. Sixty-four travelers with diarrhea and no other recognized enteropathogen were enrolled in treatment studies in Jamaica and Mexico from July 1997 to July 1998. EAEC was isolated from 29 travelers (45.

Serum and Intestinal Antitoxin Antibody Responses after Immunization with the Whole-Cell/Recombinant B Subunit (WC/rBS) Oral Cholera Vaccine in North American and Mexican Volunteers.

Background: Immune protection against cholera infection is probably mediated in part by locally produced, intestinal secretory IgA (sIgA) antibodies. We study the kinetics of intestinal (sIgA) and systemic (serum IgG) antitoxin antibody responses after immunization with whole-cell/recombinant B subunit oral cholera vaccine (WC/rBS) in U.S.

Epidemiologic Observations on Diarrhea Developing in U.S. and Mexican Students Living in Guadalajara, Mexico.

Background: A previous study suggested that U.S. students who lived in Mexico for 1 year had a risk of diarrhea intermediate between the rate for newly arrived U.

Effect of Storage Time and Temperature on Fecal Leukocytes and Occult Blood in the Evaluation of Travelers' Diarrhea.

Both the presence of fecal leukocytes and occult blood in stool specimens of travelers with diarrhea have been used as indicators of colonic inflammation due to bacterial infection. This study was conducted to determine if storage temperature of stool specimens can affect the detection of leukocytes and occult blood. Sixteen specimens positive for occult blood and 23 specimens positive for leukocytes were divided into two aliquots.

Diarrhoeal disease: current concepts and future challenges. Antimicrobial therapy and prophylaxis.

Empirical antimicrobial therapy is indicated in patients with diarrhoea who have high fever and systemic toxicity, dysenteric disease, or travellers' diarrhoea. Antimicrobials are essential for those with severe shigellosis and amoebiasis. They are useful or possibly useful for other forms of diarrhoeal disease including amoebiasis (milder forms), campylobacteriosis, cholera, giardiasis, shigellosis, and diarrhoea due to a variety of other laboratory-defined bacterial enteropathogens.

Travellers' diarrhoea. Which antimicrobial?

For those who venture from highly industrialised areas to developing tropical and semitropical areas, the chance of developing diarrhoea is about 40%. In most cases a bacterial pathogen is responsible for the illness. The antimicrobial agents with the greatest activity against these organisms are cotrimoxazole (trimethoprim/sulfamethoxazole) during the summer months in the interior of Mexico (a region where this agent has been studied extensively), and the fluoroquinolones for other places or other times, until data become available to indicate the appropriateness of cotrimoxazole here as well.

The physician as a locus of authority, responsibility, and operational control of medical systems.

Physicians are commonly being excluded from meaningful participation in the planning, implementation, and operation of automated medical systems in hospitals. The authors advocate a rapid shift toward greater physician involvement in such systems, arguing that such a shift is desirable, feasible, and also inevitable. After reviewing the organization of information systems in hospitals, the authors describe the manner in which physician control of medical systems adds to the worth of such systems by enhancing the quality and efficiency of health care delivery.

Epidemiological study of the electrocardiographic diagnosis of left ventricular hypertrophy.

Electrocardiograms from 5,129 examined persons, 2,449 men and 2,680 women, 16 years of age or older, were classified according to the Minnesota code of Blackburn and associates. The R wave amplitude criteria for possible left ventricular hypertrophy were fulfilled in 193 tracings from 135 men and 58 women. Age and sex matched controls were randomly selected from the remainder of the examined population for similar measurement.

AN EPIDEMIC DIARRHEAL DISEASE OF SUCKLING MICE : II. INCLUSIONS IN THE INTESTINAL EPITHELIAL CELLS.

Intranuclear inclusions were found in 75 per cent of young mice suffering from a spontaneous diarrheal disease. They were confined to the epithelial cells of the small intestine, and to the intestinal and mesenteric lymphadenoid tissue. They were seen only between the 10th and 15th days after birth, in apparently healthy control mice of the same age group, they were found in only two of thirty-six animals (5.

EPIDEMIC DIARRHEAL DISEASE OF SUCKLING MICE : I. MANIFESTATIONS, EPIDEMIOLOGY, AND ATTEMPTS TO TRANSMIT THE DISEASE.

1. The disease was almost certainly infectious. 2.

IMMUNITY IN MUMPS : I. EXPERIMENTS WITH MONKEYS (MACACUS MULATTA). THE DEVELOPMENT OF COMPLEMENT-FIXING ANTIBODY FOLLOWING INFECTION AND EXPERIMENTS ON IMMUNIZATION BY MEANS OF INACTIVATED VIRUS AND CONVALESCENT HUMAN SERUM.

Since the experimental data have already been discussed at some length, it is here necessary only to review those observations which appear to be of most significance. The manifestations of the disease we have produced in monkeys have in general been similar to those described by previous workers. It has been found that members of the species M.

IMMUNITY IN MUMPS : III. THE COMPLEMENT FIXATION TEST AS AN AID IN THE DIAGNOSIS OF MUMPS MENINGOENCEPHALITIS.

1. Fifty-one patients exhibiting signs and symptoms compatible with the clinical syndrome of acute aseptic meningoencephalitis have been studied by means of the complement fixation test for the demonstration of antibody reacting with the virus of mumps or its products. 2.

IMMUNITY IN MUMPS : II. THE DEVELOPMENT OF COMPLEMENT-FIXING ANTIBODY AND DERMAL HYPERSENSITIVITY IN HUMAN BEINGS FOLLOWING MUMPS.

1. A specific antibody, demonstrable by the technique of complement fixation, regularly appears, or increases in concentration, in the sera of human beings during an attack of mumps or during convalescence. 2.