Military medicine
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During 1984-1989, 655 diarrheic and 287 nondiarrheic stool specimens from adult U. S. citizens living in Lima, Peru were tested for presence of bacterial enteropathogens. Frequencies of isolation among diarrheic specimens were: Shigella 9.8%; Campylobacter 6.1%; enterotoxigenic Escherichia coli (ETEC) 6.0%; Plesiomonas 2.0%; Salmonella 1.4%; and Vibrio 0.6%. ⋯ Aeromonas, an unproven cause of diarrhea, was isolated from 9.2% of cases and 3.5% of controls. Disease occurrence was strongly associated with isolation of Shigella, ETEC, Campylobacter, or Aeromonas (p less than or equal to 0.01). During the 6-year period of study, shifts in the dominant phenotypes of Shigella and Campylobacter occurred which may have important implications for vaccine development and intervention strategies.
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Review Case Reports
Case reports Rhizopus brain abscess: report of a case and review of the literature.
The case of a 34-year-old intravenous drug abuser who survived brain abscess due to Rhizopus arrhizus is presented. The diagnosis was made by brain biopsy. ⋯ Phycomycetes cause venous thrombosis and infarction of brain tissue. Medical versus surgical options are discussed.
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In an attempt to determine whether selective, nonoperative management of hepatic trauma might be efficacious, a retrospective review of liver injuries was undertaken. Of the 48 patients with liver injuries identified, there were 34 men and 14 women with an average age of 28.5 years. Mechanism of injury consisted of blunt trauma in 23 patients, stab wounds in 14 patients, and 11 patients had gunshot wounds. ⋯ However, 17 of 25 patients with penetrating wounds had associated abdominal injuries which required operative treatment. Based on the information obtained in this review, it is recommended that stable patients with isolated hepatic injuries, secondary to blunt trauma confirmed by CT scan, may be managed nonoperatively. Due to the high frequency of associated injuries found in patients with penetrating trauma, nonoperative therapy is not advised.
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We followed 295 young infantry recruits during their first 14 weeks of basic training. The prevalence of smoking increased by 50%. About half of this increase was accounted for by ex-smokers, 57% of whom had resumed the habit. ⋯ These relationships were not demonstrated among resuming ex-smokers. The rise in the smoking rate accounts for most of the known rise during full military service. We suggest early preventive measures, especially for the two groups at risk.