978 resultados para Incontinència fecal
Resumo:
El agua es una fuente importante de diseminación de agentes virales que se transmiten por vía fecal-oral y que genéricamente se denominan virus entéricos. Nuestro país constituye una zona endémica para algunos de estos virus (hepatitis A (HAV), rotavirus, adenovirus, astrovirus, norovirus, enterovirus no polio) y por lo tanto la excreción fecal de estos virus puede considerarse permanente. Asimismo, los individuos infectados con virus entéricos emergentes, como es el virus de hepatitis E (HEV) y picobirnavirus, también los eliminan por materia fecal. De este modo, las aguas residuales constituyen una matriz hídrica con alta carga viral. En las últimas décadas se ha incrementado la fragilidad de los sistemas hídricos, reflejada en las dificultades para la evacuación de aguas residuales y la contaminación de espacios acuáticos destinados a recreación. En este marco, se vería favorecida la diseminación de virus entéricos en matrices acuosas superficiales, constituyendo éstas aguas un riesgo de infección para la población expuesta. La legislación vigente establece, para el control de la contaminación microbiana de las aguas, el uso de indicadores estándares bacterianos. Sin embargo, recientes estudios han demostrado que estos indicadores no revelan satisfactoriamente la calidad viral de las aguas, por lo que el monitoreo específico de los virus humanos en aguas superficiales cobra particular importancia. El objetivo general: llevar adelante un proyecto de desarrollo y transferencia de tecnologías, basado en una gestión integrada en red de investigación, para la recuperación, identificación, cuantificación y caracterización molecular de virus responsables de enfermedades de transmisión hídrica con impacto en la salud pública, en aguas del Río Suquía de la Provincia de Córdoba. Los objetivos específicos planteados son: -Implementar metodologías para concentración de virus a partir de muestras de aguas y para la extracción de los ácidos nucleicos de los concentrados.-Desarrollar e Implementar métodos moleculares para detección de rotavirus, norovirus, astrovirus, enterovirus, HAV, HEV, picovirnavirus y poliomavirus en aguas del río Suquía.-Caracterizar molecularmente los aislamientos virales (secuenciamiento y análisis filogenéticos).-Cuantificar rotavirus y enterovirus viable en las aguas analizadas.-Determinar la correlación genómica/serológica y las relaciones filogenéticas entre los virus detectados en aguas del Río, en cloacas (circulación poblacional de virus) y en población humana y animal, específicamente para HEV.-Evaluar la correlación entre los parámetros fisicoquímicos y bacteriológicos utilizados como indicadores de la calidad de agua y la detección cualitativa y cuantitativa viral. -Confeccionar mapas que reflejen la contaminación viral estacional del Río Suquía. -Evaluar el riesgo de transmisión hídrica de virus entéricos a población expuesta.-Consolidar la red de investigación a través de la formación de recursos humanos y la divulgación de las actividades y resultados obtenidos. Resultados esperados: Se pretende como producto del desarrollo de este proyecto describir la calidad virológica de las aguas del Río Suquía y arribar a una propuesta para el monitoreo viral de aguas superficiales y la evaluación de riesgo de transmisión hídrica de virus entéricos a población expuesta. Importancia del proyecto: Aportar información a los programas sanitarios de la región sobre la situación de contaminación viral del Río Suquía, a fin de reforzar el sistema de saneamiento ambiental, mejorar el diagnóstico de calidad microbiológica de aguas superficiales e impulsar a programas de control para atenuar la diseminación de virus entéricos en nuestro medio. Los datos sobre el virus HEV serán los primeros disponibles para la región.
Resumo:
Recent studies have shown that septic tank systems are a major source of groundwater pollution. Many public health workers feel that the most cri^cal aspect of the use of septic tanks as a means of sewage disposal is the contamination of private water wells with attendant human health hazards. In this study the movement and attenuation of septic tank effluents in a range of soil/overburden types and hydrogeological situations was investigated. The suitability of a number of chemical and biological tracer materials to monitor the movement of septic tank effluent constituents to groundwater sources was also examined. The investigation was divided into three separate but inteiTelated sections. In the first section of the study the movement of septic tank effluent from two soil treatment systems was investigated by direct measurements of soil nutrient concentrations and enteric bacterial numbers in the soil beneath and downgradient of the test systems. Two sites with different soil types and hydrogeological characteristics were used. The results indicated that the attenuation of the effluent in both of the treatment systems was incomplete. Migration of nitrate, ammonium, phosphate and fecal bacteria to a depth of 50 cm beneath the inverts of the distribution tiles was demonstrated on all sampling occasions. The lateral migration of the pollutants was less pronounced, although on occasions high nutrients levels and fecal bacterial numbers were detected at a lateral distance of 4.0 m downgradient of the test systems. There was evidence that the degree and extent of effluent migration was increased after periods of heavy or prolonged rainfall when the attenuating properties of the treatment systems were reduced as a result of saturation of the soil. The second part of the study examined the contamination of groundwaters downgradient of septic tank soil treatment systems. Three test sites were used in the investigation. The sites were chosen because of differences in the thicknesses and nature of the unsaturated zone available for effluent attenuation at each of the locations. A series of groundwater monitoring boreholes were installed downgradient of the test systems at each of the sites and these were sampled regularly to assess the efficiency of the overburden material in reducing the polluting potential of the wastewater. Effluent attenuation in the septic tank treatment systems was shown to be incomplete, resulting in chemical and microbiological contamination of the groundwaters downgradient of the systems. The nature and severity of groundwater contamination was dependent on the composition and thickness of the unsaturated zone and the extent of weathering in the underlying saturated bedrock. The movement of septic tank effluent through soil/overburdens to groundwater sources was investigated by adding a range of chemical and biological tracer materials to the three septic tank systems used in section two of the study. The results demonstrated that a single tracer type cannot be used to accurately monitor the movement of all effluent constituents through soils to groundwater. The combined use of lithium bromide and endospores of Bacillus globigii was found to give an accurate indication of the movement of both the chemical and biological effluent constituents.
Resumo:
Fundamento: O hipertireoidismo (Hi) exerce um amplo leque de influências em diversos parâmetros fisiológicos. Seu efeito perturbador sobre o sistema cardiovascular é um de seus impactos mais importantes. Além disso, o Hi foi clinicamente associado com o estresse induzido pela hiperativação do eixo hipotalâmico-pituitário-adrenal. Objetivo: Avaliar o impacto do Hi de curto prazo sobre o desempenho cardíaco e a atividade adrenal de ratos. Métodos: A indução de Hi em ratos Wistar através de injeções de T3 (150 μg/kg) por 10 dias (grupo com hipertireoidismo - GH) ou veículo (grupo controle). O desempenho cardiovascular foi avaliado por: ecocardiograma (ECO); razão peso do coração/peso corporal (mg/gr); contratilidade de músculos papilares isolados (MPI) e mensuração direta da pressão arterial. A atividade adrenal foi avaliada pela razão peso adrenal/ peso corporal (mg/gr) e níveis de 24 horas de corticosterona fecal (CF) no 1º, 5º e 10º dias de tratamento com T3. Resultados: No GH, o ECO mostrou redução dos Volumes Finais Sistólico e Diastólico, Tempos de Ejeção, Relaxamento Isovolumétrico e Diastólico Total, Áreas Sistólicas e Diastólica e razão E/A. Aumentaram a frequência cardíaca, a fração de ejeção e o débito cardíaco. A razão peso corporal/peso do coração foi maior. Da mesma forma, nos MPI, a taxa máxima de degradação da força durante o relaxamento foi maior em todas as concentrações extracelulares de cálcio. Os níveis de pressão arterial sistólica (PAS) foram maiores. (p ≤ 0,05). Por outro lado, não houve diferença na razão peso das adrenais/peso corporal ou níveis de 24 horas de CF. Conclusões: O Hi induz efeitos inotrópicos, cronotrópicos e lusitrópicos positivos no coração através de efeito direto do T3, e aumenta a PAS. Essas alterações não estão correlacionadas com as alterações na atividade adrenal.
Resumo:
O bagaço de cana-de-açúcar "in natura" (BIN) associado ou não ao bicarbonato de sódio foi testado como substituto do feno de gramínea como fonte de fibra longa para rações de ruminantes balanceadas com altas proporções de bagaço auto-hidrolisado (BAH). A ração básica (I) continha 54% BAH; 10% milho grão; 25% farelo de algodão; 8% feno de gramínea; 0,9% calcáreo; 0,5% uréia; e 1,5% premix mineral, base seca. As rações II e III continham BIN e BIN mais bicarbonato de sódio (1,1%, base seca) respectivamente em substituição ao feno de gramínea da ração I. Foram usados bovinos Nelore machos não castrados e fêmeas (18 de cada sexo) em crescimento com médias iniciais de peso vivo e idade de 199 kg e 11 meses. O delineamento estatístico usado foi um fatorial com 3 rações e dois sexos, com dois animais por parcela. O período de adaptação foi de 15 dias e o experimental de 87 dias. Os dados para GPV (kg/dia); ingestão de MS (% PV); conversão alimentar (kg MS/Kg GPV); e pH fecal foram de: 0,909; 2,79; 7,41; e 6,46 para a ração I; 0,867; 2,65; 7,24; e 6,57 para a ração II; e 1,019; 2,88; 7,03 e 6,73 para a ração III. A ração III foi superior rações I e II para ganho de peso (P < 0,05), e apresentou um pH fecal maior do que o da ração I (P < 0,05). Os machos foram superiores às fêmeas em ganho de peso (1,044 vs 0,820; P < 0,01) e conversão alimentar (6,7vs7,7kg MS/Kg GPV; P < 0,01). Foi observada uma correlação negativa signi ficativa (P < 0,05) entre conversão alimentar e pH fecal (r =-0,50). Os elevados níveis de consumo (2,8% PV), o baixo pH do BAH (2,9 a 3,4), e a aparente baixa atividade de ruminação observados sugerem que o pH, a nível de rume e de trato digestivo inferior, é um fator limitante em dietas com altas proporções de BAH.
Resumo:
The only breeding record of Spartonoica maluroides (d'Orbigny & Lafresnaye, 1837) for Brazil is based on the observation of a fledgling in southern Rio Grande do Sul in January 1976. On 7 December 2005 we discovered a nest containing three nestlings at the southeastern end of Lagoa Pequena, municipality of Pelotas, Rio Grande do Sul. The nest was concealed at the base of a cavity in a Spartina densiflora (Poaceae) tussock located at the edge of a saltmarsh. The nest was built of fine pieces of dead Scirpus olneyi (Cyperaceae) and S. densiflora leaves firmly interlaced to the internal leaves of the tussock. Live leaves of S. densiflora lining the cavity comprised a substantial part of the nest's architecture, forming most of its upper lateral walls and roof. The lower section was more elaborate, resembling a deep cup and forming a distinct incubation chamber. Adults reached the nest's interior through an irregular apical opening amidst the leaves. The nest was 244 mm high and 140 mm wide. The incubation chamber had an external diameter of 138.5 mm, an internal diameter of 79.4 mm and was 86 mm deep. It was lined with fine leaves and white plant fibers. Nestlings were five to six days old. A total of 107 neossoptiles restricted to the capital, spinal and alar tracts were recorded in one nestling. The distribution of neossoptiles in the ocular region of S. maluroides forms a distinct pattern which can be typical of Furnariidae and related families. Two adults attended the nest, bringing small insects to the nestlings and removing fecal sacs. We recorded at least 74 visits to the nest during a ca. 6 h period during an afternoon. The average number of visits per hour was 12.8 ± 1.3. An adult bird spent on average 0.7 ± 0.56 minutes inside the nest attending nestlings. The nest remained unattended on average for 3.61 ± 3.13 minutes. The hour of the day had no influence on the amount of time spent by an adult in the nest or away from it. We returned to the area on 15 December 2005 and found the nest abandoned. Observations confirm that S. maluroides is a resident breeder in southern Brazil and that the saltmarshes of the Lagoa do Patos estuary are an important year-round habitat for the species. A nestling and the nest were collected to document the record.
Resumo:
El context social i sanitari del nostre país mostra una resposta insuficient a les creixents necessitats i demandes sociosanitàries de les persones grans. La planificació d’ estratègies en els serveis sanitaris i socials dedicats a l atenció de les persones grans han de ser considerats a partir de criteris racionals i eficients. És un bon mètode la analitzar la situació amb una estratègia qualitativa ? La participació de la gent gran en la definició de problemes aporta alguna perspectiva novedosa?. Per a la gestió sanitària, manquen a la seu anàlisi i avaluació dissenys innovadors útils i de fàcil aplicació. Els objectius de l’ estudi són: 1.-Identificar , definir i prioritzar els problemes socials i sanitaris de les persones majors de 70 anys del municipi de Roda de Ter ( Barcelona), emprant la tècnica de Grup Nominal. 2.-Avaluar una dinàmica de participació ciutadana per la detecció de problemes i necessitats. Metodologia. S’organitza un grup nominal per a la identificació, definició i priorització dels problemes de salut. El grup està constituït per 11 persones clau, persones especialment implicades en el context social del municipi , entre els que hi ha els profesionals dels serveis socials i sanitaris. Resultats. Es varen identificar 15 problemes i es varen prioritzar en 3 grups, de major a menor importància. En el primer grup: la soledat, manca i dificultat d’ accés a l’ informació, problemes d’ ordre fisiològic: limitacions físiques,incontinència urinària y el dolor, les barreres rquitectòniques en el domicili, el soport als cuidadors, la manca de serveis d’ ajuda a domicili. El segon grup: diners, la qualitat de les relacions familiars, l’ automedicació, la manca de coneixement del que significa ser gran per part dels fills i barreres arquitectòniques al carrer. En el tercer grup: disposar d’ajudar de confiança per als tràmits i gestions econòmiques administratives, disposar de companyia per anar als llocs i manca de mitjans de transport per anar als llocs. Discussió. La anàlisi dels resultats suggereix seguir les següents línees d’ actuació: 1.Promoció de la qualitat de les relacions familiars i socials. 2.Elaborar programes específics per : atenció al dolor crònic, rehabilitació i manteniment físic, diagnòstic i tractament de la vista i oïda, reeducació de la presa de medicaments, programa de reeducació vesical. 3.Creació d’ estratègies de comunicació eficients dirigides a persones grans. 4.Allargar l’ estada en el domicili fomentant l’ autonomia individual mitjançant: serveis a domicili, ajudes tècniques,reeducació d’ activitats de la vida diària i adaptació de l’habitatge. 5.Atenció i suport al cuidador de persones dependents. 6.Creació de serveis d’assessoria legal, administrativa i financera. 7.Reivindicació de l’ acompliment de la llei de supressió de barreres arquitectòniques. La dinàmica interdisciplinar, la participació ciutadana y la utilització d’una estratègia d’investigació qualitativa com el grup nominal, s’ha valorat com unes eines útils per a la planificació en l’àmbit sociosanitari. Des de el punt de vista dels professionals dels serveis implicats, s’ha introduit canvis importants en la definicó dels conceptes sobre la salut i la qualitat de vida de les persones grans. En conjunt, hem contrastat les possibilitats d’ una altra forma d’analitzar els problemes de salut de les persones grans y ens ha permès pensar en accions futures d’una forma diferent a la realitzada fins al moment, basada principalment en estratègies quantitatives, per a l’ abordatge de la qualitat de vida.
Resumo:
São relatadas as observações a respeito dos hábitos de defecação e de sucção em 6 espécies de hemípteros hematófagos. O quadro abaixo reúne os resultados mais gerais obtidos, apreciados em conjunto: Espécies de exemplares utilizados; % de insetos que defecaram durante ou logo após a picada; N.º médio de defecações nas 3 primeiras horas após o repasto; Duração média de sucção (minutos); % de insetos que sugaram sem interromper a picada. R. prolixus 2 machos, 8 fêmeas e 10 ninfas (50,0; 13,7; 14,2; 20,0). R. neglectus 2 machos, 8 fêmeas e 10 ninfas (30,0; 9,6; 18,5; 20,0). T. infestans 2 machos, 11 fêmeas e 20 ninfas (30,0; 7,1; 15,5; 47,5). P. megistus 6 machos, 10 fêmeas e 12 ninfas (22,7; 3,4; 22,7; 82,1). T. sordida 13 machos e 11 ninfas (12,5; 4,5; 20,0; 79,2). T. vitticeps 11 ninfas (0; 6,2; 26,8; 90,9). De modo geral, a capacidade de defecar no ato da picada mostrou-se diretamente proporcional ao número de defecações (nas três primeiras horas) e à freqüência das interrupções da picada, e inversamente proporcional ao tempo de duração da sucção. Os barbeiros adultos se mostraram mais aptos a defecar no ato da picada do que em fase de ninfa, as fêmeas mais do que os machos. Das espécies observadas, o R. prolixus foi a que melhores condições demonstrou para realizar a contaminação fecal do hospedeiro vertebrado. Sugere-se que um estudo mais aprofundado sôbre a eficácia contaminativa dos diversos transmissores do S. cruzi seja feito de preferência no verão e à noite, em zonas onde grassa endêmicamente a doença de Chagas.
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In order to upgrade the reliability of xenodiagnosis, attention has been directed towards population dynamics of the parasite, with particular interest for the following factors: 1. Parasite density which by itself is not a research objective, but by giving an accurate portrayal of parasite development and multiplication, has been incorporated in screening of bugs for xenodiagnosis. 2. On the assumption that food availability might increase parasite density, bugs from xenodiagnosis have been refed at biweekly intervals on chicken blood. 3. Infectivity rates and positives harbouring large parasite yields were based on gut infections, in which the parasite population comprised of all developmental forms was more abundant and easier to detect than in fecal infections, thus minimizing the probability of recording false negatives. 4. Since parasite density, low in the first 15 days of infection, increases rapidly in the following 30 days, the interval of 45 days has been adopted for routine examination of bugs from xenodiagnosis. By following the enumerated measures, all aiming to reduce false negative cases, we are getting closer to a reliable xenodiagnostic procedure. Upgrading the efficacy of xenodiagnosis is also dependent on the xenodiagnostic agent. Of 9 investigated vector species, Panstrongylus megistus deserves top priority as a xenodiagnostic agent. Its extraordinary capability to support fast development and vigorous multiplication of the few parasites, ingested from the host with chronic Chagas' disease, has been revealed by the strikingly close infectivity rates of 91.2% vs. 96.4% among bugs engorged from the same host in the chronic and acute phase of the disease respectively (Table V), the latter comporting an estimated number of 12.3 x 10[raised to the power of 3] parasites in the circulation at the time of xenodiagnosis, as reported previously by the authors (1982).
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La distribución de frecuencias del número de huevos por gramo de heces tanto de Ascaris lumbricoides como de Trichuris trichiura en humanos infestados en una zona endémica se corresponde con una ley binomial negativa y la disposición espacial de dichos huevos en la materia fecal, resultó ser en agregados, independientemente de que los hospedadores sean mayores o menores de 15 años. Estos resultados nos indican que solamente unos pocos hospedadores son los responsables de la mayor contaminación del medio ambiente y que esos individuos no pertenecen a ningún grupo etario en particular.
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INTRODUCTION AND HYPOTHESIS: This study aims to estimate fecal, urinary incontinence, and sexual function 6 years after an obstetrical anal sphincter tear. METHODS: Among 13,213 women who had a vaginal delivery of a cephalic singleton at term, 196 women sustained an anal sphincter tear. They were matched to 588 controls. Validated questionnaires grading fecal and urinary incontinence, and sexual dysfunction were completed by the participants. RESULTS: Severe fecal incontinence was more frequently reported by women who had sustained an anal sphincter tear compared to the controls. Women with an anal sphincter tear had no increased risk of urinary incontinence, but reported significantly more pain, difficulty with vaginal lubrication, and difficulty achieving orgasm compared to the controls. A fetal occiput posterior position during childbirth was an independent risk factor for both severe urinary incontinence and severe sexual dysfunction. CONCLUSIONS: Fecal incontinence is strongly associated with an anal sphincter tear. A fetal occiput posterior position represents a risk factor for urinary incontinence and sexual dysfunction.
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The findings of intestinal helminths and protozoans parasites from the Yanomâmi indians of the Roraima State in Brazil are reported. The fecal samples were collected before these communities started a permanent contact with non-indians. Comments are made on the possible ecological and evolutionary factors responsible for the patterns of parasitism observed.
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Prevalence of Toxocara canis antibodies was studied in a poor community of Bogotá, Colombia. Two-hundred-sevem patients, from both sexes and all age groups, were studied. Positive Elisa titers were found in 47.5% of the population, a high prevalence compared with reports from developed countries. T. canis ova were positive in 43.6% of fecal samples from dog puppies. An endemic pattern of the disease is described: socioeconomic status, weathers, pollution, poor hygiene and a significant population of infected dogs. Neither the physical examination nor Elisa titers could detect any case of T. canis disease.
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PURPOSE: Transanal endoscopic microsurgery provides a minimally invasive alternative to radical surgery for excision of benign and malignant rectal tumors. The purpose of this study was to review our experience with transanal endoscopic microsurgery to clarify its role in the treatment of different types of rectal pathology. METHODS: A prospective database documented all patients undergoing transanal endoscopic microsurgery from October 1996 through June 2008. We analyzed patient and operative factors, complications, and tumor recurrence. For recurrence analysis, we excluded patients with fewer than 6 months of follow-up, previous excisions, known metastases at initial presentation, and those who underwent immediate radical resection following transanal endoscopic microsurgery. RESULTS: Two hundred sixty-nine patients underwent transanal endoscopic microsurgery for benign (n = 158) and malignant (n = 111) tumors. Procedure-related complications (21%) included urinary retention (10.8%), fecal incontinence (4.1%), fever (3.8%), suture line dehiscence (1.5%), and bleeding (1.5%). Local recurrence rates for 121 benign and 83 malignant tumors were 5% for adenomas, 9.8% for T1 adenocarcinoma, 23.5% for T2 adenocarcinoma, 100% for T3 adenocarcinoma, and 0% for carcinoid tumors. All 6 (100%) recurrent adenomas were retreated with endoscopic techniques, and 8 of 17 (47%) recurrent adenocarcinomas underwent salvage procedures with curative intent. CONCLUSIONS: Transanal endoscopic microsurgery is a safe and effective method for excision of benign and malignant rectal tumors. Transanal endoscopic microsurgery can be offered for (1) curative resection of benign tumors, carcinoid tumors, and select T1 adenocarcinomas, (2) histopathologic staging in indeterminate cases, and (3) palliative resection in patients medically unfit or unwilling to undergo radical resection.
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Mussels (Mytilus edulis) were exposed to cultures of the toxic dinoflagellate Alexandrium fundyense or the non-toxic alga Rhodomonas sp. to evaluate the effects of the harmful alga on the mussels and to study recovery after discontinuation of the A. fundyense exposure. Mussels were exposed for 9 days to the different algae and then all were fed Rhodomonas sp. for 6 more days. Samples of hemolymph for hemocyte analyses and tissues for histology were collected before the exposure and periodically during exposure and recovery periods. Mussels filtered and ingested both microalgal cultures, producing fecal pellets containing degraded, partially degraded, and intact cells of both algae. Mussels exposed to A. fundyense had an inflammatory response consisting of degranulation and diapedesis of hemocytes into the alimentary canal and, as the exposure continued, hemocyte migration into the connective tissue between the gonadal follicles. Evidence of lipid peroxidation, similar to the detoxification pathway described for various xenobiotics, was found; insoluble lipofuchsin granules formed (ceroidosis), and hemocytes carried the granules to the alimentary canal, thus eliminating putative dinoflagellate toxins in feces. As the number of circulating hemocytes in A. fundyense-exposed mussels became depleted, mussels were immunocompromised, and pathological changes followed, i.e., increased prevalences of ceroidosis and trematodes after 9 days of exposure. Moreover, the total number of pathological changes increased from the beginning of the exposure until the last day (day 9). After 6 days of the exposure, mussels in one of the three tanks exposed to A. fundyense mass spawned; these mussels showed more severe effects of the toxic algae than non-spawning mussels exposed to A. fundyense. No significant differences were found between the two treatments during the recovery period, indicating rapid homeostatic processes in tissues and circulating hemocytes.
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Of 126 infants under 2 years, enrolled in a study on the etiology of acute diarrhea in Recife, Brazil, we selected 37 from whom no recognized enteropathogens, except classic enteropathogenic Escherichia coli, were identified. For comparison, we also examined 37 matched-control infants without diarrhea seen at the same hospital setting. This paper had the purpose to determine the prevalence of localized, diffuse, and aggregative-adhering E. coli strains in both groups. Three to five fecal E. coli colonies, of each case and control, were tested individually for adherence to HeLa cells by using the one step 3-h incubation assay. Strains of E. coli showing localized adherence were found significantly more often in patients (37.8%) than in controls (13.5%), p < 0.02, and they were pratically confined to EPEC serovars 055:H-, 0111:H2, and 119:H6. In contrast, E. coli isolates exhibiting the diffuse or aggregative patterns of adherence were restricted to non-EPEC serogroups and were more frequently encountred among controls.