Natural history of placebo treatment in adults acquiring travelers' diarrhea in Mexico

The natural history of placebo treated travelers' diarrhea and the prognostic factors of recovery from diarrhea were evaluated using 9 groups of placebo treated subjects from 9 clinical trial studies conducted since 1975, for use as a historical control in the future clinical trial of antidiarrheal agents. All of these studies were done by the same group of investigators in one site (Guadalajara, Mexico). The studies are similar in terms of population, measured parameters, microbiologic identification of enteropathogens and definitions of parameters. The studies had two different durations of followup. In some studies, subjects were followed for two days, and in some they were followed for five days.^ Using definitions established by the Infectious Diseases society of America and the Food and Drug Administration, the following efficacy parameters were evaluated: Time to last unformed stool (TLUS), number of unformed stools post-initiation of placebo treatment for five consecutive days of followup, microbiologic cure, and improvement of diarrhea. Among the groups that were followed for five days, the mean TLUS ranged from 59.1 to 83.5 hours. Fifty percent to 78% had diarrhea lasting more than 48 hours and 25% had diarrhea more than five days. The mean number of unformed stools passed on the first day post-initiation of therapy ranged from 3.6 to 5.8 and, for the fifth day ranged from 0.5 to 1.5. By the end of followup, diarrhea improved in 82.6% to 90% of the subjects. Subjects with enterotoxigenic E. coli had 21.6% to 90.0% microbiologic cure; and subjects with shigella species experienced 14.3% to 60.0% microbiologic cure.^ In evaluating the prognostic factors of recovery from diarrhea (primary efficacy parameter in evaluating the efficacy of antidiarrheal agents against travelers' diarrhea). The subjects from five studies were pooled and the Cox proportional hazard model was used to evaluate the predictors of prolonged diarrhea. After adjusting for design characteristics of each trial, fever with a rate ratio (RR) of 0.40, presence of invasive pathogens with a RR of 0.41, presence of severe abdominal pain and cramps with a RR of 0.50, number of watery stools more than five with a RR of 0.60, and presence of non-invasive pathogens with a RR of 0.84 predicted a longer duration of diarrhea. Severe vomiting with a RR of 2.53 predicted a shorter duration of diarrhea. The number of soft stools, presence of fecal leukocytes, presence of nausea, and duration of diarrhea before enrollment were not associated with duration of diarrhea. ^

DIAGNOSTIC ANTIGENS FOR SCHISTOSOMIASIS MANSONI: PRODUCTION, CHARACTERIZATION AND PURIFICATION OF MONOCLONAL ANTIBODIES, AND AFFINITY PURIFICATION OF ANTIGENS

Attempts have been made in this dissertation to develop a purified antigen with high sensitivity and specificity for diagnosis of Schistosoma mansoni (Sm) infection by using the hybridoma technique.^ Spleen cells, obtained from mice immunized by infection with Sm and boosted by cercarial antigens, or by injection of circulating antigen (CA) in serum from infected mice, were fused with Sp2/0 myeloma cells. The active infection resulted a higher number of hybridomas (100%) than by CA (20%), and higher levels of antibody reactivity as measured by ELISA.^ The IgM and IgG monoclonal antibodies (MCAbs) were purified respectively by gel filtration, DE 52 ion exchange column and proteinase A affinity column. The cercarial and egg antigens were purified by affinity chromatography through MCAb/affi-gel column. The reactivity of the purified antigens were then monitored by ELISA, SDS-PAGE silver stain and EITB.^ The respective MCAbs recognized varying antigenic determinants (AD) present in adult, cercaria and egg stages. By EITB the MCAbs IgM and IgG, when reacted with nine antigens from the various stages, revealed identical bands, suggesting that the two MCAb classes originated from identical AD. By ELISA and COPT, the MCAbs from thirteen cell lines gave same results. But by CHR, two MCAbs showed negative results while eleven other MCAbs showed strong positive. It is assumed that the AD in the immunogen that ilicited the MCAbs were immunochemically closely related.^ One egg purified by immunoaffinity indicated that the epitopes recognized by MCAb were present on four antigenic components with molecular weights (Mr) of approximately 19, 25, 60 and >224 kd, respectively. By EITB the Mr 19 doublet appeared to be species specific; the Mr 25 kd genus specific. They reacted with mouse serum from 13-16 weeks after infection. In monkey serum Mr 19 doublet appeared 8-10 weeks after infection and disappeared at 8-12 weeks after Droncit treatment, paralleled to the disappearance of fecal egg. The Mr 60 and >224 kd bands were also demonstrated with S. japonicum, S. haematobium and Trichinella spiralis infection sera and may be the cause of cross-reaction in conventional serological test. ^

POPULATION ASSESSMENTS OF INFECTION WITH SCHISTOSOMA MANSONI: EFFECTS OF BIAS CAUSED BY THE RELATIVE SENSITIVITY OF DIAGNOSTIC TECHNIQUES (PUERTO RICO)

This study establishes the extent and relevance of bias of population estimates of prevalence, incidence, and intensity of infection with Schistosoma mansoni caused by the relative sensitivity of stool examination techniques. The population studied was Parcelas de Boqueron in Las Piedras, Puerto Rico, where the Centers for Disease Control, had undertaken a prospective community-based study of infection with S. mansoni in 1972. During each January of the succeeding years stool specimens from this population were processed according to the modified Ritchie concentration (MRC) technique. During January 1979 additional stool specimens were collected from 30 individuals selected on the basis of their mean S. mansoni egg output during previous years. Each specimen was divided into ten 1-gm aliquots and three 42-mg aliquots. The relationship of egg counts obtained with the Kato-Katz (KK) thick smear technique as a function of the mean of ten counts obtained with the MRC technique was established by means of regression analysis. Additionally, the effect of fecal sample size and egg excretion level on technique sensitivity was evaluated during a blind assessment of single stool specimen samples, using both examination methods, from 125 residents with documented S. mansoni infections. The regression equation was: Ln KK = 2.3324 + 0.6319 Ln MRC, and the coefficient of determination (r('2)) was 0.73. The regression equation was then utilized to correct the term "m" for sample size in the expression P ((GREATERTHEQ) 1 egg) = 1 - e('-ms), which estimates the probability P of finding at least one egg as a function of the mean S. mansoni egg output "m" of the population and the effective stool sample size "s" utilized by the coprological technique. This algorithm closely approximated the observed sensitivity of the KK and MRC tests when these were utilized to blindly screen a population of known parasitologic status for infection with S. mansoni. In addition, the algorithm was utilized to adjust the apparent prevalence of infection for the degree of functional sensitivity exhibited by the diagnostic test. This permitted the estimation of true prevalence of infection and, hence, a means for correcting estimates of incidence of infection. ^

The evidence for groundwater as a source of enteric illness in developing countries: A systematic review of the literature

Groundwater constitutes approximately 30% of freshwater globally and serves as a source of drinking water in many regions. Groundwater sources are subject to contamination with human pathogens (viruses, bacteria and protozoa) from a variety of sources that can cause diarrhea and contribute to the devastating global burden of this disease. To attempt to describe the extent of this public health concern in developing countries, a systematic review of the evidence for groundwater microbially-contaminated at its source as risk factor for enteric illness under endemic (non-outbreak) conditions in these countries was conducted. Epidemiologic studies published in English language journals between January 2000 and January 2011, and meeting certain other criteria, were selected, resulting in eleven studies reviewed. Data were extracted on microbes detected (and their concentrations if reported) and on associations measured between microbial quality of, or consumption of, groundwater and enteric illness; other relevant findings are also reported. In groundwater samples, several studies found bacterial indicators of fecal contamination (total coliforms, fecal coliforms, fecal streptococci, enterococci and E. coli), all in a wide range of concentrations. Rotavirus and a number of enteropathogenic bacteria and parasites were found in stool samples from study subjects who had consumed groundwater, but no concentrations were reported. Consumption of groundwater was associated with increased risk of diarrhea, with odds ratios ranging from 1.9 to 6.1. However, limitations of the selected studies, especially potential confounding factors, limited the conclusions that could be drawn from them. These results support the contention that microbial contamination of groundwater reservoirs—including with human enteropathogens and from a variety of sources—is a reality in developing countries. While microbially-contaminated groundwaters pose risk for diarrhea, other factors are also important, including water treatment, water storage practices, consumption of other water sources, water quantity and access to it, sanitation and hygiene, housing conditions, and socio-economic status. Further understanding of the interrelationships between, and the relative contributions to disease risk of, the various sources of microbial contamination of groundwater can guide the allocation of resources to interventions with the greatest public health benefit. Several recommendations for future research, and for practitioners and policymakers, are presented.^

Acid-soluble sulfides in upper layer bottom sediments from the Tsemess and Gelendzhik bays and adjacent shelf area of the Black Sea

Contents of labile (acid-soluble) sulfides were determined in the upper layer of bottom sediments at 80 stations on the Caucasian shelf of the Black Sea. Maximum values of this parameter occurred in black mud accumulated in zones of intense pollution in the Gelendzhik and Tsemess bays and in shelf areas adjacent to large health resort objects and to seaports. Contents of acid-soluble sulfides in sediments varied from 400 to 900 mg S/dm**3 of wet mud. In zones of moderate pollution they varied from 200 to 400 mg S/dm**3. Rate of sulfate reduction was 10-40 mg S/dm**3 of wet sediment per day. Obtained data show that accumulation of labile sulfides in the upper layer of shelf bottom sediments is directly related to anthropogenic pollution and is one of the most hazardous environmental aftereffects.

Fecal pellets flux at DYFAMED sediment traps

Because zooplankton feces represent a potentially important transport pathway of surface-derived organic carbon in the ocean, we must understand the patterns of fecal pellet abundance and carbon mobilization over a variety of spatial and temporal scales. To assess depth-specific water column variations of fecal pellets on a seasonal scale, vertical fluxes of zooplankton fecal pellets were quantified and their contribution to mass and particulate carbon were computed during 1990 at 200, 500, 1000, and 2000 m depths in the open northwestern Mediterranean Sea as part of the French-JGOFS DYFAMED Program. Depth-averaged daily fecal pellet flux was temporally variable, ranging from 3.04 * 10**4 pellets m**2/d in May to a low of 6.98 * 10**2 pellets m**2/d in September. The peak flux accounted for 50% of the integrated annual flux of fecal pellets and 62% of pellet carbon during only two months in mid-spring (April and May). Highest numerical fluxes were encountered at 1000 m, suggesting fecal pellet generation well below the euphotic zone. However, there was a trend toward lower pellet carbon with increasing depth, suggesting bacterial degradation or in situ repackaging as pellets sink through the water column. At 500 m, both the lowest pellet numerical abundance and carbon flux were evident during the spring peak. Combined with data indicating that numerical and carbon fluxes are dominated at 500 m by a distinct type of pellet found uniquely at this depth, these trends suggest the presence of an undescribed mid-water macro-zooplankton or micro-nekton community. Fecal pellet carbon flux was highest at 200 m and varied with depth independently of overall particulate carbon, which was greatest at 500 m. Morphologically distinct types of pellets dominated the numerical and carbon fluxes. Small elliptical and spherical pellets accounted for 88% of the numerical flux, while larger cylindrical pellets, although relatively rare (<10%), accounted for almost 40% of the overall pellet carbon flux. Cylindrical pellets dominated the pellet carbon flux at all depths except 500 m, where a large subtype of elliptical pellet, found only at that depth, was responsible for the majority of pellet carbon flux. Overall during 1990, fecal pellets were responsible for a depth-integrated annual average flux of 1.03 mgC/m**2/d, representing 18% of the total carbon flux. The proportion of vertical carbon flux attributed to fecal pellets varied from 3 to 35%, with higher values occurring during periods when the water column was vertically mixed. Especially during these times, fecal pellets are a critical conveyor of carbon to the deep sea in this region.

Chlorophyll a and carbon fluxes, and characteristics of the water column during summer 2008 in the Beaufort Sea

Following the extreme low ice year of 2007, primary production and the sinking export of particulate and gel-like organic material, using short-term particle interceptor traps deployed at 100 m, were measured in the southeastern Beaufort Sea during summer 2008. The combined influence of early ice retreat and coastal upwelling contributed to exceptionally high primary production (500 ± 312 mg C/m**2/day, n = 7), dominated by large cells (>5 µm, 73% ± 15%, n = 7). However, except for one station located north of Cape Bathurst, the sinking export of particulate organic carbon (POC) was relatively low (range: 38-104 mg C/m**2/day, n = 12) compared to other productive Arctic shelves. Estimates indicate that 80% ± 20% of the primary production was cycled through large copepods or the microbial food web. Exopolymeric substances were abundant in the sinking material but did not appear to accelerate POC sinking export. The use of isotopic signatures (d13C, d15N) and carbon/nitrogen ratios to identify sources of the sinking material was successful only at two stations with a strong marine or terrestrial signature, indicating the limitations of this approach in hydrographically and biologically complex Arctic coastal waters such as in the Beaufort Sea. At these two stations influenced by either coastal upwelling or erosion, the composition and magnitude of particulate sinking fluxes were markedly different from other stations visited during the study. These observations underscore the fundamental role of mesoscale circulation patterns and hydrodynamic singularities on the export of particulate organic material on Arctic shelves.

Ambulacral length with number of pore pairs/tubercles for both species of sea urchins and for six sampling sites to quantify fluctuating asymmetry

The surroundings of the Cortiou sewage are among the most polluted environments of the French Mediterranean Sea (Marseilles, France). So far, no studies have precisely quantified the impact of pollution on the development of organisms in this area.Methods: We used a fluctuating asymmetry (FA) measure of developmental instability (DI) to assess environmental stress in two species of radially symmetric sea urchins (Arbacia lixula and Paracentrotus lividus). For six sampling sites (Cortiou, Riou, Maire, East Maire, Mejean, and Niolon), levels of FA were calculated from continuous and discrete skeletal measures of ambulacral length, number of pore pairs and primary tubercles.Results: For both species, the most polluted sampling site, Cortiou, displayed the highest level of FA, while the Maire and East Maire sampling sites displayed the lowest levels. A. lixula revealed systematic differences in FA among sampling sites for all characters and P. lividus showed differences in FA for the number of primary tubercles.Conclusions: Statistical analyses of FA show a concordance between the spatial patterns of FA among sampling sites and the spatial distribution of sewage discharge pollutants in the Cortiou area. High developmental stress in these sampling sites is associated with exposure to high concentrations of heavy metals and many harmful organic substances contained in wastewater. FA estimated from structures with complex symmetry appears to be a fast and reliable tool to detect subtle differences in FA. Its use in biomonitoring programs for inferring anthropogenic and natural environmental stress is suggested.

Physical properties and AMS characteristics of ODP Site 185-1149 sediments

During Ocean Drilling Program Leg 185, we studied progressive changes of microfabrics of unconsolidated pelagic and hemipelagic sediments in Holes 1149A and 1149B in the northwest Pacific at 5818 m water depth. We paid particular attention to the early consolidation and diagenetic processes without tectonic deformation before the Pacific plate subduction at the Izu-Bonin Trench. Shape, size, and arrangement of pores were analyzed by scanning electron microscope (SEM) and were compared to anisotropy of magnetic susceptibility (AMS) data. The microfabric in Unit I is nondirectional fabric and is characterized by large peds of ~10-100 µm diameter, which are made up of clay platelets (mainly illite) and siliceous biogenic fragments. They are ovoid in shape and are mechanically packed by benthic animals. Porosity decreases from 0 to 60 meters below seafloor (mbsf) in Unit I (from 60% to 50%) in association with macropore size decreases. The microfabric of coarser grain particles other than clay in Unit II is characterized by horizontal preferred orientation because of depositional processes in Subunit IIA and burial compaction in Subunit IIB. On the other hand, small peds, which are probably made of fragments of fecal pellets and are composed of smectite and illite (3-30 µm diameter), are characterized by random orientation of clay platelets. The clay platelets in the small peds in Subunit IIA are in low-angle edge-to-face (EF) or face-to-face (FF) contact. These peds are electrostatically connected by long-chained clay platelets, which are interconnected by high-angle EF contact. Breaking of these long chains by overburden pressure diminishes the macropores, and the clay platelets in the peds become FF in contact, resulting in decreases in the volume of the micropores between clay platelets. Thus, porosity in Subunits IIA and IIB decreases remarkably downward. The AMS indicates random fabric and horizontal preferred orientation fabric in Units I and II, respectively. This result corresponds to that of SEM microfabric observations.In Subunit IIB, pressure solutions around radiolarian tests and clinoptilolite veins with normal displacement sense are seen distinctively below ~170 mbsf, probably in correspondence to the transition zone from opal-A to opal-CT.

Geochemistry and petrography of organic matter at DSDP Site 93-603

A series of 22 sediment samples of Cretaceous and Cenozoic age from DSDP Holes 603, 603B, and 603C at the continental rise off the northeastern American coast near Cape Hatteras was investigated by organic geochemical methods including organic carbon determination, Rock-Eval pyrolysis, gas chromatography and combined gas chromatography/mass spectrometry of extractable hydrocarbons, and kerogen microscopy. An abundance of terrigenous organic matter, including larger coal particles (almost exclusively consisting of huminite/vitrinite macerals), is the dominant characteristic of the organofacies types at Site 603. Marine organic matter, mostly structurally degraded and in the form of fecal pellets, was preserved in the Valanginian laminated marls and in Cenomanian black claystone turbidites. Long-chain nalkanes reflect the terrigenous imprint in the nonaromatic hydrocarbon fractions, whereas a second maximum at lower carbon numbers in most cases is caused by the presence of more mature recycled organic matter. Abundant isoprenoid and steroid hydrocarbons were found in sediments containing mainly marine organic matter, whereas hopanoids reflect the ubiquitous microbial activity. The organic matter in the Site 603 sediments, in so far as it is not recycled, is thermally immature.

Hydrocarbons in surface waters of the Atlantic and Indian Oceans

Results of investigation of various forms of oil pollution, i.e. oil films, tar, and hydrocarbons in the Northeast Atlantic Ocean and North Indian Ocean during October-December 1980 and February-May 1981 are presented. Oil pollution was found only in regions of the heaviest ship traffic and was somewhat less than in 1976-1977. Background concentration of non-polar hydrocarbons was 8-10 ?g/l in surface waters and 14 ?g/l in the shelf zone. Infrared spectroscopy and gas-liquid chromatography indicate that hydrocarbons occurring at concentrations exceeding 50 ?g/l have composition differing from background hydrocarbons. There is considerable accumulation of hydrocarbons in the thin surface layer, and they exist in different forms close to pollution sources.

Weather conditions and phosphorus speciation in waters of the Western Sargasso Sea in October-November 1977

Forms of phosphorus were determined for the first time in the area under study. Based on the ratio between organic and inorganic forms of phosphorus, it is concluded that sorption processes in the thin surface layer and photosynthetic processes in surface water are of the same intensity. Extremely high values of total phosphorus in the thin layer may be indicators of water pollution.

(Table 2) Concentrations and composition of aliphatic hydrocarbons in bottom sediments of the Sakhalin shelf

Aliphatic and polycyclic aromatic hydrocarbons were examined in the surface layer of bottom sediments from the eastern part of the Sakhalin Island shelf (materials were sampled in summer 2002). Concentrations of hydrocarbons were determined to know changed since beginning of development of oil fields (compared with earlier years). According to distribution of markers in hydrocarbon compositions, bottom sediments are dominated by allochthonous (terrigenous) hydrocarbons that are the most stable compounds. Occurrence of transformed anthropogenic oil alkanes that have never been found before may be indicative of increasing pollution in the region.