Automatic Assessment of the 2-Minute Walk Distance for Remote Monitoring of People with Multiple Sclerosis

The aim of this study was to investigate the feasibility of automatically assessing the 2-Minute Walk Distance (2MWD) for monitoring people with multiple sclerosis (pwMS). For 154 pwMS, MS-related clinical outcomes as well as the 2MWDs as evaluated by clinicians and derived from accelerometer data were collected from a total of 323 periodic clinical visits. Accelerometer data from a wearable device during 100 home-based 2MWD assessments were also acquired. The error in estimating the 2MWD was validated for walk tests performed at hospital, and then the correlation (r) between clinical outcomes and home-based 2MWD assessments was evaluated. Robust performance in estimating the 2MWD from the wearable device was obtained, yielding an error of less than 10% in about two-thirds of clinical visits. Correlation analysis showed that there is a strong association between the actual and the estimated 2MWD obtained either at hospital (r = 0.71) or at home (r = 0.58). Furthermore, the estimated 2MWD exhibits moderate-to-strong correlation with various MS-related clinical outcomes, including disability and fatigue severity scores. Automatic assessment of the 2MWD in pwMS is feasible with the usage of a consumer-friendly wearable device in clinical and non-clinical settings. Wearable devices can also enhance the assessment of MS-related clinical outcomes.

Development, characterization and sterilisation of Nanocellulose-alginate-(hyaluronic acid)- bioinks and 3D bioprinted scaffolds for tissue engineering

3D-bioprinting is an emerging technology of high potential in tissue engineering (TE), since it shows effective control over scaffold fabrication and cell distribution. Biopolymers such as alginate (Alg), nanofibrillated cellulose (NC) and hyaluronic acid (HA) offer excellent characteristics for use as bioinks due to their excellent biocompatibility and rheological properties. Cell incorporation into the bioink requires sterilisation assurance, and autoclave, β-radiation and γ-radiation are widely used sterilisation techniques in biomedicine; however, their use in 3D-bioprinting for bioinks sterilisation is still in their early stages. In this study, different sterilisation procedures were applied on NC-Alg and NC-Alg-HA bioinks and their effect on several parameters was evaluated. Results demonstrated that NC-Alg and NC-Alg-HA bioinks suffered relevant rheological and physicochemical modifications after sterilisation; yet, it can be concluded that the short cycle autoclave is the best option to sterilise both NC-Alg based cell-free bioinks, and that the incorporation of HA to the NC-Alg bioink improves its characteristics. Additionally, 3D scaffolds were bioprinted and specifically characterized as well as the D1 mesenchymal stromal cells (D1-MSCs) embedded for cell viability analysis. Notably, the addition of HA demonstrates better scaffold properties, together with higher biocompatibility and cell viability in comparison with the NC-Alg scaffolds. Thus, the use of MSCs containing NC-Alg based scaffolds may become a feasible tissue engineering approach for regenerative medicine.

Influence of social cognition as a mediator between cognitive reserve and psychosocial functioning in patients with first episode psychosis

BACKGROUND

Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years.

METHODS

The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis.

RESULTS

At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively).

CONCLUSIONS

Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.

Protective Effect of a Lactobacillus salivarius Strain of Human Origin

The protective effect of a Lactobacillus salivariusstrain from human faeces (HA8) was evaluated against the cytotoxicity of N-nitrosodimethylamine (NDMA), N-nitrosopyrrolidine (NPYR), N-nitrosodibutylamine (NDBA) and N-nitrosopiperidine (NPIP) by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. L. salivariusHA8 strain showed a moderate protective effect against NPYR and weak against NDBA and NPIP. No protective effect against cytotoxicity of NDMA was observed at the bacterial population used. To test the effect of L. salivariusHA8 on cytokine production (interleukin-1 ± (IL-1 ±), interleukin-8 (IL-8) and tumour necrosis factor alpha (TNF-≥)), the human macrophage cell line (THP-1) was cultured in the presence and absence of lipopolysaccharide (LPS). L. salivariusHA8 induced IL-1 ±, IL-8 and TNF-≥ releases when cells were stimulating with and without LPS.

An integrated view of data quality in Earth observation

Data quality is a difficult notion to define precisely, and different communities have different views and understandings of the subject. This causes confusion, a lack of harmonization of data across communities and omission of vital quality information. For some existing data infrastructures, data quality standards cannot address the problem adequately and cannot fulfil all user needs or cover all concepts of data quality. In this study, we discuss some philosophical issues on data quality. We identify actual user needs on data quality, review existing standards and specifications on data quality, and propose an integrated model for data quality in the field of Earth observation (EO). We also propose a practical mechanism for applying the integrated quality information model to a large number of datasets through metadata inheritance. While our data quality management approach is in the domain of EO, we believe that the ideas and methodologies for data quality management can be applied to wider domains and disciplines to facilitate quality-enabled scientific research.

Management of chylous fistula as a complication of neck dissection: a 10-year retrospective review

Chylous fistula is a serious complication of neck surgery. The aim of this study was to analyse the incidence, treatment and evolution of chylous fistula in neck dissection. We conducted a retrospective study of 304 patients, 295 (97.03%) men and nine (2.97%) women. Ages ranged from 24 to 80 years (mean = 59.28 years, SD = 6.02) and they had all undergone neck dissection. Chylous fistula occurred in four cases (1.31%). Incidence was 1.83% in laryngeal cancer and 2.7% in oral cavity and oropharyngeal cancer. No statistically significant correlation was found between tumoral stage and fistula occurrence. Radiotherapy prior to surgery was a risk factor although the association was not statistically significant. The incidence rates for radical and functional neck dissection were 3.3% and 0.46%, respectively, statistically significant (P = 0.042). The fistulas were located on the left side in all cases. One of the four patients required surgical intervention and another one died. The occurrence of chylous fistula increased significantly the length of hospital stay (P = 0.01). Chylous fistulas appear on the left side, radiotherapy prior to surgery is a risk factor and there is not correlation with tumoral stage. Chylous fistulas are significantly more common in radical than in functional dissections and increase significantly the length of hospital stay.

Specificity of Cognitive Deficits in Psychosis; Initial Presentation and Course of Alterations among Different Diagnoses

Objective:

To describe possible differences in the initial cognitive profile between schizophrenia and non-schizophrenia first episode psychosis patients.

Method:

We assessed attention, working memory, and executive functioning in 57 first episode psychosis patients at baseline and at a one-year follow-up.

Results:

No significant differences were detected in the cognitive profile among schizophrenia (n=20) and non-schizophrenia (n=37) patients at baseline or at the one-year follow-up. For the overall group, significant reductions in the percentage of omission and commission errors for the sustained attention task (p< 0.001 and p=0.001 respectively), in the total time to complete the Stroop-I task (p< 0.001), in the percentage of omission errors for the working memory task (p=0.001), and in the percentage of perseverative errors for the WCST (p< 0.001) were detected, as well as a significant increase in the number of categories completed in the WCST (p< 0.001). The other cognitive variables analyzed remained stable (4 of the 10 variables tested). The pattern of change was similar for schizophrenia and non-schizophrenia patients in the areas of attention and working memory. For executive functioning, the non-schizophrenia group showed a more beneficial pattern of change.

Conclusions:

Our results indicate a lack of specificity of cognitive alterations related to the degree of affectation, at least during the first year after instauration of treatment. The course of cognitive deficits in first episode psychosis showed significant improvements over this period, being the patter of change in executive functioning slightly more beneficial for patients with a non-schizophrenia psychosis.

[Epidemiology of notifiable diseases in Navarre, 2006]

Epidemiological vigilance in Navarre (601,874 inhabitants) in 2006 included 34 diseases whose notification is compulsory and epidemic outbreaks. Notification is carried out on a weekly basis by the doctors from paediatrics, primary care and specialised care facing any suspicion of these processes, and is completed with microbiological diagnoses. In 2006 the incidence of influenza reached 16.8 cases per 1,000 inhabitants (Epidemic Index, EI: 0.46), showing a late seasonal peak (March) of low dimensions. The incidence of respiratory tuberculosis was 11.3 cases per 100,000 inhabitants, and that of non-respiratory tuberculosis was 2.3; both at similar levels to recent years. Seven cases of tuberculosis occurred in three aggregates amongst cohabitants, and another 7 in non-cohabiting persons resident in the same municipality. Six percent of the cases were coinfected with HIV, and 37% occurred in immigrants. The incidence of meningococcal disease rose to 19 cases (3.2 cases per 100,000 inhabitants; EI 1.46), all of them sporadic. Neisseria meningitidis serogroup B was isolated in 16 cases. There was one case of serogroup C, in a child who had received 3 doses of combined vaccine. In two cases (11%) death occurred. The incidence of legionnaire's disease rose to 28 cases per 100,000 inhabitants (EI:4.88), due to a community outbreak that affected 146 people. Excluding this outbreak, incidence was similar to previous years (3.3 per 100,000 inhabitants). In August an outbreak of parotitis began, and 911 cases had been counted until the end of 2006; and it has continued during 2007. Eleven cases of malaria were registered, all imported. Notifications of toxic food infections has continued to fall (IE:0.48).

Quantitative gas chromatographic method for the analysis of cis-9, trans-11 and trans-10, cis-12 isomers of the conjugated linoleic acid in liver

A quantitative GC method for conjugated linoleic acid (CLA) isomers of physiological significance (cis-9, trans-11 CLA and trans-10, cis-12 CLA) as non-esterified fatty acids (NEFA) or triacylglycerols (TAG) was developed. Furthermore, the effect of the internal standard addition point (sample or fat extract) was studied. Response linearity, recovery and precision assays, detection and quantification limits were determined. Linearity was demonstrated over a range from 0.1 to 10 microg/mL. When CLA isomers were present as NEFA, the recovery significantly decreased (P< or =0.05) from 76% to 27.1% (cis-9, trans-11 CLA) and 28.5% (trans-10, cis-12 CLA) when the standards were added to the fat extract or to the initial tissue, respectively. As an application, liver samples from hamsters fed a diet supplemented with both CLA isomers were analyzed. The CLA isomers in liver samples were detected with reasonable reproducibility.

Effects of cis-9, trans-11 and trans-10, cis-12 CLA isomers on liver and adipose tissue fatty acid profile in hamsters

The aim of the present study was to investigate the effect of cis-9,trans-11 and trans-10,cis-12 CLA on FA composition of TAG in epididymal adipose tissue and liver, and of hepatic phospholipids PL. Twenty-four Syrian Golden hamsters were randomly divided into three groups of eight animals each and fed semipurified atherogenic diets supplemented with either 0.5 g/100 g diet of linoleic acid or cis-9,trans-11 or trans-12,cis-9 CLA for 6 wk. Total lipids were extracted, and TAG and PL were separated by TLC. FA profile in lipid species from liver and adipose tissue, as well as in feces, was determined by GC. Trans-10,cis-12 CLA feeding significantly reduced linoleic and linolenic acids in TAG from both tissues, leading to reduced total PUFA content. Moreover, in the epididymal adipose tissue docosenoic and arachidonic acids were significantly increased. In liver PL, although no changes in individual FA were observed, total saturated FA (SFA) were decreased. No changes in TAG and PL FA profiles were induced by the cis-9,trans-11 CLA. TAG and PL incorporated cis-9,trans-11 more readily than trans-10,cis-12 CLA. This difference was not due to differential intestinal absorption, as shown by the analysis of feces. We concluded that only trans-10,cis-12 CLA induces changes in FA composition. Whereas increased PUFA content was observed in either liver or adipose tissue TAG, decreased SFA were found in liver PL. Incorporation of cis-9,trans-11 CLA in TAG is greater than that of trans-10,cis-12 CLA, but this is not due to differences in intestinal absorption.

MDMA and serotonin: based on two cases

3,4-methylenedioxyamphetamine (MDMA) or "ecstasy" damages serotonin neurons in all animal species and there is growing evidence that this finding also applies to humans. This fact, together with the increasing extended use in the young population, has important repercussions in the appearance of specific psychopathologic and cognitive disturbances associated to its use. The authors present two clinical cases, in which psychopathological and cognitive symptoms are detected in MDMA users that support this hypothesis. Problems in the diagnosis of psychiatric disorders associated to MDMA and its clinical and therapeutic implications are discussed.

[Communicable disease surveillance in Navarre, 2004]

Epidemiological surveillance in Navarre (584,734 inhabitants) covers 34 transmissible diseases, whose notification is compulsory, and epidemic outbreaks of any aetiology. Notification is carried out on a weekly basis by the doctors from paediatrics, primary care and specialised care. In 2004, 75.8% of all the possible notification reports (a weekly report for each doctor) were received, a percentage that has improved in the last five year period. Flu only reached 14.4 cases per 1,000 inhabitants (Epidemic Index, EI: 0.30), due to the advance of the epidemic peak for the 2003-2004 season to the month of November. The rate of respiratory tuberculosis fell to 11.6 cases per 100,000 inhabitants, and the rate of non-respiratory tuberculosis rose to 2.7 per 100,000. Ten cases of tuberculosis (11.9%) were grouped into four outbreaks that affected adolescents and young adults. Thirty percent of the cases were produced in immigrants and 4.8% in persons coinfected with HIV, proportions that are similar to those of the previous year. Eleven cases of meningococcal disease were reported, (1.9 cases per 100,000 inhabitants; EI 0.73), but only in 8 cases was the clinical form sepsis and/or meningitis. Neisseria meningitidis serogroup B was isolated in 8 cases, and serogroup C in 2 cases, the latter 2 were adults and were not vaccinated. The incidence of immunopreventable diseases continues to fall, and for the fifth consecutive year no case of measles has been reported. Legionnaire's disease, which is detected through the systematic determination of the antigen in urine, rose to 5.8 cases per 100,000 inhabitants (EI: 1.42), without any epidemiological relation between them. The incidence of imported diseases rose, with 12 cases of malaria, 8 of shigellosis, 5 of hepatitis A and 2 of legionnaire's disease acquired outside Spain.

[Compulsory Diseases Notification (CDN) in Navarre 2003]

Epidemiological vigilance in Navarre covers 34 transmissible diseases, whose notification is compulsory, and epidemic outbreaks of any aetiology. Notification is carried out on a weekly basis by the doctors from paediatrics, primary and specialised level who suspect or diagnose any of these diseases. In 2003, 75.0% of all the possible notification reports (a weekly report for each doctor) were received, a percentage that has improved in the last five year period. In 2003, Influenza reached a rate of 48.9 cases per 1,000 inhabitants (Epidemic Index, EI: 0.91), showing an epidemic peak in January and another in November. The rate of respiratory tuberculosis was 11.76 cases per 100,000 inhabitants, and the rate of non-respiratory tuberculosis was 1.90, with a continuous trend to decrease in both cases. Five cases of tuberculosis occurred in two small family outbreaks. Thirty percent of the cases were produced in immigrants. The cases coinfected with HIV have fallen from 21% in 1996 to 2.5% in 2003. Fifteen cases of meningococcal disease were reported, (2.6 cases per 100,000 inhabitants), appearing in a sporadic form. Neisseria meningitidis serogroup B was isolated in 10 cases, and serogroup C in 5 cases. Eighty percent appeared in the form of sepsis, and death occurred in one case (6.7%). All of the cases younger than six years of age were vaccinated and belonged to serogroup B. The incidence of Legionnaire's disease was 3.8 cases per 100,000 inhabitants (EI: 0.92), without any epidemiological relation between them. There were 7 cases of malaria, all imported. The incidence of food borne infections has fallen (EI: 0.71).

Effects of conjugated linoleic acid on body fat accumulation and serum lipids in hamsters fed an atherogenic diet

Conjugated linoleic acid (CLA) refers to a mixture of naturally occurring positional and geometric isomers of linoleic acid that exist in dairy products and meat. The aim of the present work was to study the effects of c-9,t-11 and t-10,c-12 CLA isomers on body fat accumulation and serum lipids in hamsters fed an atherogenic diet. Hamsters were divided in four groups: one group was fed a chow diet (control) and the other three groups were given semi-purified atherogenic diets with 0.5% linoleic acid (LA), c-9,t-11 or t-10,c-12 CLA. Body weight and food intake were measured daily. After 6 weeks, adipose tissues from different anatomical locations and liver were dissected and weighed. Serum glucose, total cholesterol, HDL-c, LDL-c and triacylglycerol levels, as well as total and free cholesterol, triacylglycerol and phospholipid content in liver were determined by enzymatic methods. No differences in either energy intake or final body weight were found. The addition of t-10,c-12 CLA reduced fat accumulation and led to lower serum cholesterol, as compared with LA group. Nevertheless the level remained higher than in the control animals. The reduction in serum cholesterol was limited to LDL-c. This isomer also reduced triacylglycerol content in liver but did not modify serum triacylglycerol level. In summary, the present study demonstrates that t-10,c-12 CLA is the biologically active agent when anti-obesity and hypocholesterolaemic properties of CLA are considered. In contrast, the isomer c-9,t-11 has no effect on lipid metabolism in hamsters.

[Diseases of Compulsory Notification (DCN) in Navarra. 2002]

Since 1998, the Epidemiological Survelliance System of Navarra has included the notification of 34 transmissible infectious diseases, to which are added epidemic outbreaks of any aetiology and cause. Reporting to the system is carried out on a weekly basis by every doctor who suspects, or diagnoses, any of these processes. In our autonomous community, Diseases of Compulsory Notification (DCN) are reported using standardised forms on a weekly basis to the Section of Infectious Diseases and Control of Outbreaks of the Public Health Institute. Notification is made by the doctors and/or paediatricians of Primary Care and by certain services of Specialised Care. Subsequently, the information is sent to the National Epidemiology Centre where data from the Autonomous Communities is centralised and diffused. The year 2002 marks the fifth year of the new Epidemiological Vigilance System. In these five years there have been 74,814 notifications of disease, 17,184 in the year 2002, which provides a balance of notification of 74.07% for this year. In 2002, under the heading of respiratory transmitted diseases, 24,870 cases of Inluenza were reported, Epidemic Index (EI: 0.80). 58% of total annual cases were reported in the first nine weeks of the year, with a maximum in week 4 when 3,277 cases were reported. 16 cases of Meningococcal Disease were reported to the system (EI: 1.07). All the cases were confirmed microbiologically and all appeared in a sporadic way. With respect to the causative serogroup, on 12 occasions Neisseria meningitidis serogroup B was isolated and in the 4 remaining cases serogroup C was isolated. One case was notified in infants of less than 2 years of age (Rate: 10.52 cases per 100,000), another case in children between 2 and 5 years (5.52 cases per 100,000), 5 cases in the age group of 6 to 19 years (Rate: 5.86 cases per 100,000) and the remaining nine cases in the age group of persons aged 20 years or over (2.2 per 100,000). 70 cases of Legionellosis were declared in 2002 (EI: 4.67), all but one under the clinical form of pneumonia. Twenty-two of the cases were presented in the context of two outbreaks with a community origin, which affected 17 and 5 persons respectively. Similarly, there was a notable increase in the declaration of cases of bacillary dysentery, with 6 cases (EI: 2.00), brucellosis, with 10 cases (EI: 1.67) and chickenpox, with 4,346 notified cases (EI: 1.61).

[Surveillance report on Diseases of Compulsory Declaration (DCD) in Navarra. 2001]

The Epidemiologic Surveillance System of Navarra includes the notification of 34 communicable diseases, to which are added epidemic outbreaks of any aetiology and cause. Every doctor who suspects, or diagnoses, any of the processes carries out reporting to the system on a weekly basis. In 2001, under the heading of diseases of respiratory transmission, 7,779 cases of Flu were reported (EI: 0.20), with the particular circumstance that the winter epidemic peak did not occur; 48% of total annual cases were reported in the first 12 weeks of the year, with a maximum in week 4 when only 449 cases were reported. 10 cases of Meningococcal Disease were reported to the system (EI: 0.59), a figure that is considered to be an historical minimum. Nine cases were confirmed microbiologically and all appeared in a sporadic way. With respect to the causative serogroup, on 6 occasions Neisseria meningitidis serogroup B was isolated and in the 3 remaining cases serogroup C was isolated. By age groups, 3 cases were declared in infants of less than 2 years of age (Rate: 34.6 cases per 100,000), 2 cases in children between 2 and 5 years (11.0 cases per 100,000), 4 cases in the age group of 6 to 10 years (Rate: 4.7 per 100,000) and the remaining case in the age group of persons aged 20 years or over (0.24 per 100,000). 42 cases of Legionellosis were declared in 2001, all under the clinical form of pneumonia. Twenty-five of them were presented in a context of outbreak; three community outbreaks and one with a nosocomial origin, which affected 19 persons. Similarly, there was a notable increase in the declaration of cases of Hepatitis A, with 33 cases (EI: 2.06), brucellosis, with 9 cases (EI: 0.81) and above all parotiditis, with 267 notified cases (EI: 8.34).

Anti-proliferative effect of two lactic acid bacteria strains of human origin on the growth of a myeloma cell line

AIMS

Twenty lactic acid bacteria strains were isolated from human faeces and tested by MTT assay for stimulation or inhibition of the proliferation of Vero and myeloma cells.

METHODS AND RESULTS

None of the strains significantly affected the proliferation of Vero cells. However, two isolates (HN1 and HA8) showed a strong inhibition of myeloma cell proliferation (16.7 and 5.0%, respectively) by MTT assay.

CONCLUSION

Both strains have an anti-proliferative effect on a tumoral cell line.

SIGNIFICANCE AND IMPACT OF THE STUDY

The beneficial effect of LAB cancer therapy has been linked to their ability for immunomodulation.

Anagallis arvensis poisoning in cattle and sheep in Uruguay

Outbreaks of Anagallis arvensis poisoning were observed from 1994 to 1998 in cattle and sheep in Uruguay during December and January. Cattle morbidity varied between 3.2 and 53.2% and lethality 42.6 and 100%. Sheep morbidity was 2.8 to 42.9% and lethality 81.3 to 100%. Nine outbreaks occurred on barley and wheat stubble, and 1 in a field previousy ploughed but not cultivated. Clinical signs were weakness, staggers, diarrhea (sometimes bloody), coma, and death. Serum levels of creatinine and urea were elevated. Gross lesions were characterized by sc petechiae, fluid in body cavities, mesenteric and perirenal edema, yellowish or pale kidneys with petechiae on the cortex, esophageal erosive lesions or ulcers, and hemorrhagic abomasitis and enteritis. Severe nephrosis was observed histologically. The green plant collected in a field where an outbreak occurred was administered to 2 sheep at doses of 160 and 224 g/kg bw and produced clinical signs and pathology similar to those observed in field cases.

Risk of diarrheal disease in Ecuadorian day-care centers

To determine the risk for diarrheal disease (DD) in day-care centers (DCC) for children residing in a poor urban slum area of Quito, Ecuador, compared with that for children from the same environment but cared for in their own residential home (RH), a prospective age-, sex- and locale-controlled study of DD was conducted, including 115 children in DCC and 115 in RH, ages 12 to 42 months. The overall incidence of DD was 46/1000 child weeks. Diarrhea was more common in DCC than in RH (relative risk (RR), 1.75; 95% confidence interval (CI), 1.38 to 2.22; P < 0.001). Poor hygienic practices were more prevalent in DCC than in RH. The use of reused water for child handwashing before eating and for washing raw vegetables was associated with a higher risk of DD in DCC than in RH (RR = 4.08, CI 2.93 to 5.67, P < 0.001; RR = 3.90, CI 2.79 to 5.44, P < 0.001, respectively). These two practices were risk factors in the DCC (RR = 2.74, CI 2.08 to 3.68, P < 0.001; RR = 2.05, CI 1.55 to 2.71, P < 0.001, respectively) when compared with their absence in the same DCC. Shigella (RR = 3.58, CI 1.19 to 10.78, P < 0.02), Aeromonas (RR = 10.47, CI 1.35 to 81.05, P < 0.01), rotavirus (RR = 2.86, CI 1.87 to 4.39, P < 0.001) and Giardia (RR = 1.59, CI 1.00 to 2.59, P < 0.05) were more common in DCC than in RH. More than two-fifths of the Shigella and Aeromonas isolates were resistant to trimethoprim-sulfamethoxazole.(ABSTRACT TRUNCATED AT 250 WORDS)