RESUMEN
A study of acute diarrhea was conducted from 1985 to 1987 among U.S. military personnel participating in routine shipboard exercises in South America and West Africa and ground troops deployed to coastal Ecuador. An enteropathogen was identified in 146 (51%) of 289 acute cases of diarrhea. Enterotoxigenic Escherichia coli, found in 50 (17%) patients with diarrhea, was the most commonly identified enteropathogen. Viral enteropathogens were also found in a high percentage of acute cases of diarrhea: rotavirus was detected in 11% of the patients and Norwalk virus infection in 10%. Most enteric pathogens were acquired in equal frequencies in South America and West Africa, except for rotavirus infection which was identified more often in West Africa and enteroaggregative E. coli infection which was identified more often in South America. Bacterial enteropathogens were frequently resistant to trimethoprim/sulfamethoxazole, but no resistance to quinolone drugs was observed, indicating that quinolone drugs have become important agents for the treatment of diarrhea in South America and West Africa.
Asunto(s)
Diarrea/etiología , Personal Militar , Enfermedad Aguda , África Occidental , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Diarrea/microbiología , Diarrea/parasitología , Farmacorresistencia Microbiana , Escherichia coli/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/etiología , Infecciones por Escherichia coli/microbiología , Heces/química , Heces/microbiología , Heces/parasitología , Humanos , Virus Norwalk/aislamiento & purificación , Rotavirus/aislamiento & purificación , Infecciones por Rotavirus/etiología , Infecciones por Rotavirus/microbiología , América del Sur , Viaje , Estados Unidos , Virosis/etiología , Virosis/microbiologíaRESUMEN
A randomized treatment trial of travelers' diarrhea was carried out among U.S. military personnel participating in routine exercises in several port cities in South America and West Africa. A 5-day, twice daily course of either norfloxacin (400 mg) or trimethoprim/sulfamethoxazole (TMP/SMX, 160/800 mg) was given to 142 volunteers. At the end of 5 days of treatment, diarrhea had resolved in 100% of 73 patients receiving norfloxacin and 97.1% (67/69) receiving TMP/SMX. A probable bacterial pathogen was determined in 44% of 142 subjects: 49% of the norfloxacin group and 39% of the TMP/SMX group. The most common pathogens detected were enterotoxigenic Escherichia coli in 20% of cases and rotavirus in 15%. Resistance to TMP/SMX was present in 20 (27%) bacterial isolates, while no resistance to norfloxacin was found. Eight of 10 patients in the TMP/SMX treatment group who had TMP/SMX-resistant bacterial enteropathogens improved clinically. Both norfloxacin and TMP/SMX were clinically effective in the treatment of travelers' diarrhea in this military population.
Asunto(s)
Diarrea/tratamiento farmacológico , Personal Militar , Norfloxacino/uso terapéutico , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Enfermedad Aguda , Adolescente , Adulto , África Occidental , Infecciones Bacterianas/tratamiento farmacológico , Infecciones por Escherichia coli/tratamiento farmacológico , Heces/microbiología , Humanos , Masculino , Persona de Mediana Edad , América del Sur , Encuestas y Cuestionarios , Viaje , Estados Unidos , Virosis/tratamiento farmacológicoRESUMEN
This paper examines similarities between rhesus macaques and humans in growth and remodeling of the long bones of the extremities. Cross-sectional moments of inertia were measured in three locations of the femur, humerus and tibia of M. mulatta using photon absorptiometry. Differences between males and females were evaluated with respect to age and weight. Remodeling was assessed from histologic sections at the same locations. Sex differences in structural properties of the long bones occur only at mid-diaphysis. Differences reflect the greater need for powerful hindlimb propulsion in males. The growth rate in males is twice as fast as that in females. Several periods of growth acceleration were detected in both males and females. Intracortical remodeling in growing macaques is relatively slow and may be more like that in elderly humans than that in growing children.
Asunto(s)
Desarrollo Óseo , Macaca mulatta/fisiología , Macaca/fisiología , Academias e Institutos , Animales , Fenómenos Biomecánicos , Huesos/fisiología , Femenino , Masculino , Puerto Rico , Medio SocialRESUMEN
Several studies have demonstrated the usefulness of 32P-labeled recombinant DNA probes for identifying enterotoxigenic Escherichia coli (ETEC). The use of radioisotopes and X-ray development, however, severely handicaps the utility of DNA probes in most clinical laboratories. In this study, enzyme-labeled oligonucleotide probes for ETEC LT (heat-labile toxin) and ST (heat-stable toxin) genes were compared with the standard Y1 adrenal cell and suckling mouse assays for their ability to identify ETEC in a population of American adults experiencing acute episodes of diarrhea in South America and West Africa. The LT probe hybridized with 12% (64 of 529) of the E. coli colonies tested, whereas 11% (57 of 529) were positive by Y1 adrenal cell assay. DNA from 9% (47 of 529) of the E. coli colonies tested hybridized with the ST probe, whereas only 5% (28 of 529) produced ST as measured by the suckling mouse bioassay. For the patient samples tested, correlation between probe and bioassay for LT was 97%, or three discrepancies in 111 patients tested. Overall concordance of the ST probe and bioassay was 95%, or five discrepancies in 111 patients. Enzyme-labeled oligonucleotide probes represent a major advance in the diagnosis of ETEC-associated diarrheal disease and may be used in laboratories with minimal equipment.