Prevention of Travelers' Diarrhea by Nonantibiotic Drugs

Travelers have resorted to a variety of drugs for prevention of diarrhea. No beneficial prophylactic effect has been confirmed for halogenated hydroxyquinolines, lactobacilli, antimotility drugs, ethacridine, and various other agents. In contrast, bismuth subsalicyate (BSS) in liquid form reduced the incidence of diarrhea in students from the United States living in Mexico and in tablet form in volunteers challenged by enterotoxigenic Escherichia coli. In tourists visiting various developing countries, a randomized, double-blind study was conducted in which 390 persons received a total of 2.1 or 1.05 g of BSS daily or placebo in tablet form in two doses. BSS reduced the incidence of diarrhea by 41% in the high-dose group and by 35% in the low-dose group without causing important adverse reaction

Five year outcomes in a cohort study of physicians treated for substance use disorders in the United States

Objective To evaluate the effectiveness of US state physician health programmes in treating physicians with substance use disorders

Markers of Inflammation in Bacterial Diarrhea among Travelers, with a Focus on Enteroaggregative Escherichia coli Pathogenicity

The intestinal inflammatory response of traveler's diarrhea acquired in Goa, India, and Guadalajara, Mexico, was studied. Fecal lactoferrin was found in stool samples in which enteroaggregative Escherichia coli (EAEC), enterotoxigenic E. coli, or Salmonella or Shigella species were isolated, with Shigella-positive cases showing the highest level. Samples from cases of Shigella-associated diarrhea had the highest concentrations of fecal cytokines. Travelers to India who had EAEC-associated diarrhea showed elevated levels of interleukin (IL)-8 (median, 341.15 pg/mL) and IL-1β (median, 749.90 pg/mL). Although 15 travelers to Mexico who had EAEC-associated diarrhea had a median concentration of 0 pg/mL for both IL-8 and IL-1β, 2 had high levels of IL-8 (1853 and 11,786 pg/mL), and 5 showed elevated levels of IL-1β (1-1240 pg/mL). Samples from patients in India who had pathogen-negative diarrhea or from patients in Mexico who had asymptomatic EAEC infection were negative for cytokines. Bacterial pathogens causing traveler's diarrhea commonly produce intestinal inflammation, although a subset of patients with EAEC-associated diarrhea fail to develop an inflammatory respons

Mesozoic-Cenozoic evolution of the Xining-Minhe and Dangchang basins, northeastern Tibetan Plateau: Magnetostratigraphic and biostratigraphic results

Accurate stratigraphic ages are crucial to understanding the deformation history of the Tibetan Plateau prior to and during the Indo-Asian collision. Efforts to quantify Mesozoic-Cenozoic ages are hindered by limited fossils and a paucity of volcanic horizons and regionally correlative strata. Magnetostratigraphic and biostratigraphic results from the Xining-Minhe-Longzhong basin complex and Dangchang basin provide an improved chronology of nonmarine basin development over a large region of the northeastern Tibetan Plateau (34–37°N, 101–105°E). Analyses of 171 magnetostratigraphic levels and 24 palynological assemblages (\u3e120 species) indicate Late Jurassic-Early Cretaceous to mid-Tertiary deposition. Although magnetic polarity zonation is incomplete, independent palynological age control partially restricts possible correlations to the Geomagnetic Polarity Timescale. The sediment accumulation record, basin provenance, structural geology, and published thermochronological data support a history of Jurassic exhumation, Late Jurassic-Early Cretaceous fault-related basin initiation, and Cretaceous-Paleogene reduced accumulation. These patterns, which are compatible with Late Jurassic-Early Cretaceous extension and Cretaceous-Paleogene postrift thermal subsidence, were disrupted at about 40–30 Ma, when shortening related to the Indo-Asian collision induced localized range uplift, vertical axis rotation, and amplified subsidence

The ovarian follicle of ruminants: The path from conceptus to adult

This review resulted from an international workshop and presents a consensus view of critical advances over the past decade in our understanding of follicle function in ruminants. The major concepts covered include: (1) the value of major genes; (2) the dynamics of fetal ovarian development and its sensitivity to nutritional and environmental influences; (3) the concept of an ovarian follicle reserve, aligned with the rise of anti-Müllerian hormone as a controller of ovarian processes; (4) renewed recognition of the diverse and important roles of theca cells; (5) the importance of follicular fluid as a microenvironment that determines oocyte quality; (6) the \u27adipokinome\u27 as a key concept linking metabolic inputs with follicle development; and (7) the contribution of follicle development to the success of conception. These concepts are important because, in sheep and cattle, ovulation rate is tightly regulated and, as the primary determinant of litter size, it is a major component of reproductive efficiency and therefore productivity. Nowadays, reproductive efficiency is also a target for improving the \u27methane efficiency\u27 of livestock enterprises, increasing the need to understand the processes of ovarian development and folliculogenesis, while avoiding detrimental trade-offs as greater performance is sought

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. EAEC strains were identified by use of the HEp-2 assay. EAEC was isolated in 26% of cases of traveler's diarrhea (ranging from 19% in Goa to 33% in Guadalajara) and was second only to enterotoxigenic E. coli as the most common enteropathogen in all areas. Identification of EAEC reduced the number of cases for which the pathogen was unknown from 327 (51%) to 237 (37%) and explained 28% of cases with unknown etiology. EAEC was a major cause of traveler's diarrhea in 3 geographically distinct study area