Etiology of acute diarrhea among United States Embassy personnel and dependents in Cairo, Egypt.

The purpose of this study was to identify the enteropathogens causing acute diarrheal disease in Americans living in the North Africa/Middle East region during a 34-month period from February 12, 1985 to December 30, 1987 to guide preventive and therapeutic measures. Stool specimens were examined and an epidemiologic questionnaire was administered to patients with acute diarrhea at the Outpatient Health Unit of the United States Embassy in Cairo, Egypt. The subjects consisted of 126 American employees and dependents of the U. S. Embassy in Cairo, Egypt with diarrhea of less than two-weeks duration. Subjects received routine medical care administered by the U.S. Embassy Medical staff. A possible etiologic agent was detected in 41% of the subjects. Enteroadherent Escherichia coli was the most commonly isolated enteropathogen. A high degree of antimicrobial resistance was noted among the bacterial isolates, but all were susceptible to the quinolone antibiotics. Episodes of acute diarrhea occurring among American expatriates in Cairo, Egypt were primarily of bacterial etiology, but only a small portion were caused by the bacterial pathogens routinely identified in a standard clinical bacteriology laboratory. Most of the diarrheal episodes were due to noninvasive enteroadherent E. coli that may cause prolonged disease requiring antimicrobial therapy.

Is laser nerve repair comparable to microsuture coaptation?

Efforts to improve functional recovery following nerve injury and repair have included studies of sutureless repairs. The rat sciatic nerve was used as an experimental model to compare the efficacy of laser nerve repairs with standard microsuture repairs. Electrophysiologic (Compound Action Potential), quantitative morphometric, and behavioral (toe spread) measurements were used for assessment, and tensile strength of the repairs was also determined. Electrophysiologic studies showed that microsuture-repaired nerves had significantly faster conduction velocities, but the areas of the waveforms and peak amplitudes showed no significant differences between the two repair groups. Axon counts revealed significant differences in the suture group proximal to the repair site, contrasted with laser repairs. Toe spread evaluations, carried out at three day intervals, demonstrated a significant difference between the two methods of repair in only three out of 22 test dates: in these isolated cases, the suture group measurements were superior. The tensile strength findings confirmed that, at four days, microsuture repair was significantly stronger but thereafter, there was no difference between the two nerve repair techniques.