We conducted a double-blind treatment study of 110 adults from the United States who were attending summer classes in Guadalajara, Mexico, and had diarrhea (four or more unformed stools in 24 hours, or three or more unformed stools per eight-hour period plus one or more additional clinical indicators of enteric infection). Thirty-seven patients received trimethoprim/sulfamethoxazole (TMP/SMX) (160 mg of TMP and 800 mg of SMX), 38 were given TMP alone (200 mg), and 35 took a placebo twice daily for five days. By the end of the first 24 hours of treatment, patients taking either TMP/SMX or TMP alone passed fewer unformed stools than did patients given placebo (P = 0.0002 and P = 0.01, respectively). Abdominal pain and nausea were reduced in both treatment groups. The beneficial effect was seen in treatment of Escherichia coli-induced diarrhea, shigellosis, and diarrhea not associated with an enteropathogen. Five per cent of patients given TMP/SMX, 8 per cent of those given TMP, and 49 per cent of those given placebo were considered treatment failures (P less than 0.001 for both active drugs as compared with placebo). Early treatment with TMP/SMX or TMP is an alternative to prophylactic use of drugs for travelers' diarrhea.

what is known already: Over the past decades there has been evidence of a concomitant decline in sperm and diet quality. Yet whether diet composition influences semen quality remains largely unexplored. participants, setting, methods: Men aged 18-22 years were included in this analysis. Diet was assessed via food frequency questionnaire and dietary patterns were identified by factor analysis. Linear regression was used to analyze the relation between diet patterns and conventional semen quality parameters (sperm concentration, progressive motility and morphology) adjusting for abstinence time, multivitamin use, race, smoking status, BMI, recruitment period, moderate-to-intense exercise and total calorie intake.results: Two dietary patterns were identified by factor analysis. The 'Western' pattern was characterized by high intake of red and processed meat, refined grains, pizza, snacks, high-energy drinks and sweets. The 'Prudent' pattern was characterized by high intake of fish, chicken, fruit, vegetables, legumes and whole grains. The Prudent pattern was positively associated with percent progressively motile sperm in multivariate models (P-trend ¼ 0.04). Men in the highest quartile of the Prudent diet had 11.3% (95% CI 1.3, 21.3) higher % progressively motile sperm compared with men in the lowest quartile. The Prudent pattern was unrelated to sperm concentration and morphology. The Western pattern was not associated with any semen parameter.limitations: This was a cross-sectional and observational study, which limited our ability to determine causality of diet on semen quality parameters.wider implications of the findings: Our findings support the suggestion that a diet rich in fruits, vegetables, chicken, fish and whole grains may be an inexpensive and safe way to improve at least one measure of semen quality.

Human semen quality may be declining due to environmental pollutants, occupational exposures or changes in lifestyle. Nonetheless, we still know little about the impact of those factors on male fertility. Some heavy metals, volatile organic compounds or xenoestrogens may compromise reproductive male function. This process could take place along the human life cycle and not only in certain stages of development. We review the main factors that affect human male fertility and their possible influence in current human reproduction.

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Ninety-four U.S. students who acquired diarrhea in Mexico were treated with furazolidone (47 subjects) or ampicillin (47 subjects) on a double-blind random basis. Of 47 students, 26 (55%) who received furazolidone (100 mg four times daily for 5 days) recovered from illness wit-hin 48 h after initiation of therapy, in contrast to 15 of 47 (32%) who received ampicillin (500 mg four times daily for 5 days) (P < 0.05). Altogether, 74% of students treated with furazolidone and 49% of those receiving ampicillin were well within 72 h (P < 0.05). When furazolidone was compared with ampicillin, clinical illness was shortened on the average from 65 to 61 h for enterotoxigenic Escherichia coli diarrhea, from 83 to 58 h for shigellosis, fromn 82 to 51 h for diarrhea unassociated with a detectable agent, and from 72 to 57 h for all cases irrespective of etiology. Although not dramatically effective in the current trial, the broad spectrum of activity of furazolidone is of interest. Because of in vitro activity against Campylobacter strains and known effectiveness in treating giardiasis, furazolidone should be considered in therapy for diarrhea of unknown etiology in certain settings when laboratory processing of stools for etiological agent is not feasible.

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