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Begaj T, Sobrin L. Ophthalmic Consequences of Syphilis. Int Ophthalmol Clin 2022; 62:251-268. [PMID: 35325922 DOI: 10.1097/iio.0000000000000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zanello M, Roux A, Gavaret M, Bartolomei F, Huberfeld G, Charlier P, Georges-Zimmermann P, Carron R, Pallud J. King Charles VIII of France's Death: From an Unsubstantiated Traumatic Brain Injury to More Realistic Hypotheses. World Neurosurg 2021; 156:60-67. [PMID: 34537407 DOI: 10.1016/j.wneu.2021.09.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/09/2021] [Accepted: 09/11/2021] [Indexed: 10/20/2022]
Abstract
On April 7, 1498, Charles VIII, King of France, attended a game of palm in the ditches of the Château d'Amboise. The 27-year-old King suddenly collapsed and became comatose. He laid down, almost on his own, on a straw mat that was hastily arranged, and he died 9 hours later. His contemporaries perceived his death as a perfect reminder of fatality: a king could die alone in a miserable gallery. All who looked into this curious death had dwelled on the frontal blow to head that the king had sustained right before his demise and had not considered alternative scenarios. The present study, still with limited available evidence, aimed to reexamine the historical account of his death in light of modern medical knowledge. It is virtually impossible that a minor bump with low kinetic energy could kill a 27-year-old man. Many historical accounts of Charles VIII's life and death, including Italian ambassadors' letters, led us to reconsider the commonly held version and to propose an alternative hypothesis. We have concluded that Charles VIII had experienced an acute consciousness disorder with language impairment that could have been related to an epileptic condition secondary to neurosyphilis. We have discussed whether a more accurate diagnosis for the cause of death could be obtained by a pathological analysis of the King's remains.
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Affiliation(s)
- Marc Zanello
- Department of Neurosurgery, GHU Paris - Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université de Paris, Paris, France; INSERM UMR 1266, IMA-BRAIN, Institute of Psychiatry and Neurosciences of Paris, Paris, France.
| | - Alexandre Roux
- Department of Neurosurgery, GHU Paris - Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université de Paris, Paris, France; INSERM UMR 1266, IMA-BRAIN, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Martine Gavaret
- Université de Paris, Paris, France; Neurophysiology Department, GHU Paris Psychiatrie et Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Fabrice Bartolomei
- Epileptology and Cerebral Rythmology, APHM-Timone University Hospital, Marseille, France; Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France
| | - Gilles Huberfeld
- Clinical Neurophysiology Department, Pitie-Salpetriere Hospital, Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Paris, France; Neuroglial Interactions in Cerebral Physiopathology, Center for Interdisciplinary Research in Biology, Collège de France, CNRS UMR 7241, INSERM U1050, Labex Memolife, PSL Research University, Paris, France
| | - Philippe Charlier
- Department of Research and Higher Education, Musée du quai Branly-Jacques Chirac, Paris, France; Laboratory Anthropology, Archaeology, Biology, Paris-Saclay University, UFR of Health Sciences, Montigny-Le-Bretonneux, France
| | | | - Romain Carron
- Aix Marseille Université, INSERM, INS, Institut de Neurosciences des Systèmes, Marseille, France; Department of Functional and Stereotactic Neurosurgery, APHM-Timone University Hospital, Marseille, France
| | - Johan Pallud
- Department of Neurosurgery, GHU Paris - Psychiatrie et Neurosciences, Hôpital Sainte-Anne, Paris, France; Université de Paris, Paris, France; INSERM UMR 1266, IMA-BRAIN, Institute of Psychiatry and Neurosciences of Paris, Paris, France
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Thakrar P, Aclimandos W, Goldmeier D, Setterfield JF. Oral ulcers as a presentation of secondary syphilis. Clin Exp Dermatol 2018; 43:868-875. [PMID: 30039628 DOI: 10.1111/ced.13640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2017] [Indexed: 12/01/2022]
Abstract
The incidence of syphilis is increasing, and it typically presents in patients with known risk factors, often to genitourinary physicians. Patients presenting to a dermatologist or ophthalmologist will more likely have secondary syphilis, with the potential for having the associated complications. Early recognition is therefore vital to limit both the disease and risk of further contact spread. In this review, we include two case histories demonstrating the value of recognizing oral signs. Additionally, we review the currently accepted diagnostic and therapeutic recommendations.
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Affiliation(s)
- P Thakrar
- Department of Oral Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - W Aclimandos
- Department of Ophthalmology, King's College Hospital, London, UK
| | - D Goldmeier
- Department of Genitourinary medicine, Imperial College NHS Healthcare Trust, London, UK
| | - J F Setterfield
- Department of Oral Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Mucosal and Salivary Division, Dental Institute, King's College, London, UK
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Reinehr CPH, Kalil CLPV, Reinehr VPH. Secondary syphilis: The great imitator can't be forgotten. Rev Assoc Med Bras (1992) 2017; 63:481-483. [DOI: 10.1590/1806-9282.63.06.481] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 12/04/2016] [Indexed: 11/21/2022] Open
Abstract
Summary Syphilis is an infection caused by Treponema pallidum, mainly transmitted by sexual contact. Since 2001, primary and secondary syphilis rates started to rise, with an epidemic resurgence. The authors describe an exuberant case of secondary syphilis, presenting with annular and lichen planus-like lesions, as well as one mucocutaneous lesion. Physicians must be aware of syphilis in daily practice, since the vast spectrum of its cutaneous manifestations is rising worldwide.
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Golušin Z, Jovanović M, Matić M, Vujanović L, Roš T, Jeremić B. Serological Tests for Acquired Syphilis in Immuno-competent Patients. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2017. [DOI: 10.1515/sjdv-2016-0007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Serological tests represent a valuable tool for the diagnosis and monitoring the syphilis treatment. Non-treponemal antibodies are nonspecific to detect the infection, but antibody titers are used to monitor the effects of syphilis treatment. A definitive diagnosis of syphilis is made using treponemal tests, because they detect specific antibodies to the treponemal strains or treponemal fragments, which cause syphilis. These tests may remain reactive for years, sometimes for life, regardless of the therapy outcome. Even after successful treatment, approximately 85% of patients remain positive for treponemal antibodies for the rest of their lives. However, treponemal tests cannot differentiate past infections from a current infection. Therefore, we use a combination of specific and non-specific tests, the two most frequently used diagnostic algorithms. The traditional algorithm begins with a non-treponemal assay, and if it is positive, the treponemal test is done. A positive treponemal test indicates syphilis. The reverse serology algorithm detects early, primary, and treated syphilis that may be missed with traditional screening. However, non-treponemal test is necessary to detect patients with active syphilis.
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Affiliation(s)
- Zoran Golušin
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Marina Jovanović
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Milan Matić
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Ljuba Vujanović
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Tatjana Roš
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Biljana Jeremić
- Faculty of Medicine, University of Novi Sad, Serbia
- Clinic of Dermatovenereology Diseases, Clinical Center of Vojvodina, Novi Sad, Serbia
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Disease dynamics and costly punishment can foster socially imposed monogamy. Nat Commun 2016; 7:11219. [PMID: 27044573 PMCID: PMC4832056 DOI: 10.1038/ncomms11219] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 03/01/2016] [Indexed: 11/24/2022] Open
Abstract
Socially imposed monogamy in humans is an evolutionary puzzle because it requires costly punishment by those who impose the norm. Moreover, most societies were—and are—polygynous; yet many larger human societies transitioned from polygyny to socially imposed monogamy beginning with the advent of agriculture and larger residential groups. We use a simulation model to explore how interactions between group size, sexually transmitted infection (STI) dynamics and social norms can explain the timing and emergence of socially imposed monogamy. Polygyny dominates when groups are too small to sustain STIs. However, in larger groups, STIs become endemic (especially in concurrent polygynist networks) and have an impact on fertility, thereby mediating multilevel selection. Punishment of polygynists improves monogamist fitness within groups by reducing their STI exposure, and between groups by enabling punishing monogamist groups to outcompete polygynists. This suggests pathways for the emergence of socially imposed monogamy, and enriches our understanding of costly punishment evolution. Many human societies transitioned from polygyny to socially imposed monogamy as group sizes increased. Using a simulation model, the authors show that sexually transmitted infections impose heavier fitness penalties on polygynists as group size grows, enabling monogamists who punish polygyny to thrive in large groups.
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8
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Strings S. Obese Black Women as “Social Dead Weight”: Reinventing the “Diseased Black Woman”. SIGNS 2015. [DOI: 10.1086/681773] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Quintero CA, Tudela JG, Damiani MT. Rho GTPases as pathogen targets: Focus on curable sexually transmitted infections. Small GTPases 2015; 6:108-18. [PMID: 26023809 DOI: 10.4161/21541248.2014.991233] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Pathogens have evolved highly specialized mechanisms to infect hosts. Several microorganisms modulate the eukaryotic cell surface to facilitate their engulfment. Once internalized, they hijack the molecular machinery of the infected cell for their own benefit. At different stages of phagocytosis, particularly during invasion, certain pathogens manipulate pathways governed by small GTPases. In this review, we focus on the role of Rho proteins on curable, sexually transmitted infections caused by Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis and Treponema pallidum. Despite the high, worldwide frequencies of these sexually-transmitted diseases, very little is known about the strategies developed by these microorganisms to usurp key eukaryotic proteins that control intracellular signaling and actin dynamics. Improved knowledge of these molecular mechanisms will contribute to the elucidation of how these clinically important pathogens manipulate intracellular processes and parasitize their hosts.
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Affiliation(s)
- Cristián A Quintero
- a Laboratory of Phagocytosis and Intracellular Trafficking; IHEM-CONICET; School of Medicine; University of Cuyo ; Mendoza , Argentina
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Morshed MG. Current trend on syphilis diagnosis: issues and challenges. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 808:51-64. [PMID: 24595610 DOI: 10.1007/978-81-322-1774-9_5] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Syphilis is a century old sexually transmitted infection transmitted worldwide. WHO reports 12 million new cases that were identified in 1999, with over 90% of these infections reported from patients from low-income countries. This case number of syphilis is on the rise globally in the Men have sex with Men (MSM) population. Dark field microscopy (DFM) and direct fluorescence assay (DFA) have been used in clinical laboratories for decades to demonstrate Treponema pallidum in acutely infected human tissue and/or body fluids. Molecular technologies allow detecting T. pallidum and also determine drug resistance (by identifying DNA point mutation). It is evident from the published literature that PCR is useful as an adjunct test to DFA and DFM, and is useful in confirming syphilis in genital ulcer, tissue, and other body fluid samples, providing even more sensitive detection algorithm. Serological tests remain the mainstay tests since T. pallidum is nonculturable and also because blood collection is easy. The practice of serological testing is changing rapidly from traditional nontreponemal screening followed by confirmatory treponemal testing to screening by treponemal tests referred to as "Reverse Algorithm" followed by nontreponemal testing to determine active infections. Special and further complex algorithms are essential to deal with complex issues such as neurosyphilis or congenital syphilis. Due to the huge surge of syphilis in developing countries where access to medical care is not optimal, point of care or rapid tests may play an important role. This author took an attempt to summarize the current trend of syphilis diagnosis and challenges from a global perspective.
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Affiliation(s)
- Muhammad G Morshed
- Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia; BC Public Health Microbiology and Reference Laboratory, Provincial Health Services Authority, 655 West 12th Avenue, Vancouver, BC, V5Z 4R4, Canada,
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Scythes JB, Jones CM. Syphilis in the AIDS era: diagnostic dilemma and therapeutic challenge. Acta Microbiol Immunol Hung 2013; 60:93-116. [PMID: 23827743 DOI: 10.1556/amicr.60.2013.2.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This review argues that syphilis has been underdiagnosed and undertreated, a problem that goes back to the beginning of the Wassermann era, and indeed long before. Non-treponemal tests do not detect the larger pool of persons with latent syphilis, the immunological consequences of which have not been systematically investigated in the context of HIV infection and progression to AIDS. Recent efforts to confirm the prevalence of syphilis in high-risk patients by reverse sequence screening, i.e. using a treponemal test first, as the screening test, have revealed untreated syphilis at higher rates than expected. Further testing using PCR discovered even more previously undetected cases. We suggest that latent syphilis is a chronic active immunological condition that drives the AIDS process and cannot be managed with the older Wassermann-based algorithm, and that non-treponemal tests have failed to associate syphilis with immune suppression since this screening concept was developed in 1906. In light of the overwhelming association between a past history of syphilis and HIV seroconversion, more sensitive tools, including recombinant antigen-based immunological tests and direct detection (PCR) technology, are needed to adequately assess the role of latent syphilis in persons with HIV/AIDS. Repeating older syphilis reinoculation studies may help establish a successful animal model for AIDS, and resolve many paradoxes in HIV science.
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Affiliation(s)
- John B Scythes
- Community Initiative for AIDS Research, Toronto, Canada.
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