Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.
(Article, p. 857; Editorial, p. 923.)
Travelers' diarrhea is the scourge of travelers to locales where hygiene is poor. This study suggests another possible source for travelers' diarrhea. A study found that 41 of 71 tabletop hot sauces in 36 popular tourist restaurants in Guadalajara, Mexico, and 10 of 25 sauces from 12 popular Mexican-style, non-chain restaurants in Houston, Texas, were contaminated with E. coli bacteria (Brief Communication, p. 884). Since E. coli is a common cause of "travelers' diarrhea," the findings suggest that eating contaminated hot sauces may lead to travelers' diarrhea. The sauces from Guadalajara more frequently contained E Coli contaminants and the median level of contamination was more than 1,000 times greater than that of the sauces from Houston. In both cities, guacamole was more frequently contaminated than green sauces or red sauces. In Guadalajara, the sauces were usually sitting at room temperature on the restaurant table. In Houston, the servers brought all the sauces to the table after researchers were seated, and the sauces were cool, indicating that they probably had been refrigerated.
Arteriosclerosis of the leg arteries affects 10 percent of older adults, many of whom experience severe leg pain during exercise. A new study shows that comparing blood pressure in the arm and lower leg is a better indicator of peripheral arterial disease (PAD) than leg pain (Article, p. 873). In the study, only 33 percent of participants with PAD had leg pain. The authors say that the simple, noninvasive ankle-arm relationship (called the ankle-brachial index) predicts which patients are unable to carry out normal activities because of PAD.