- Comparative study of CD4 and CD45RO T cells and CD20 B cells in cerebrospinal fluid of syphilitic meningitis and tuberculous meningitis patients. [JOURNAL ARTICLE]
- APMIS 2016 Jul 28.
This study was to investigate the differences of lymphocyte in the cerebrospinal fluid (CSF) of patients with syphilis meningitis (SM) and tuberculous meningitis (TBM) for new diagnostic insights. Totally, 79 cases of SM and 45 cases of TBM were enrolled. In the CSF, the CD4, CD45RO or CD20 positive lymphocytes were detected by immunohistochemistry. The proportion of CD4 T cells in the CSF lymphocytes in patients with SM was significantly higher than that in patients with TBM (p < 0.05). After medical therapy, there was a significantly decline trend of the CD4 T-cell proportion in both groups (p < 0.05). The proportion of CD45RO T cells in CSF lymphocytes of patients with SM was less than that of patients with TBM (p < 0.05). After medical therapy, the positive ratio of CD45RO T cells was increased in the CSF of both group patients (p < 0.05). The proportion of CD20B cells in the CSF lymphocytes was not obviously different between the two groups during every stage. In conclusion, there are strong differences of CD4 and CD45RO T-cell ratio, but not the CD20 B cells in the meningitis. CD4 and CD45RO T cells in CSF are a useful complement in differentially diagnosing SM and TBM; it contributes to further understand the pathogenesis and prognosis of SM and TBM.
- A Focus on the Epidemiology of Uveitis. [JOURNAL ARTICLE]
- Ocul Immunol Inflamm 2016 Jul 28.:1-15.
Uveitis is a common, sight-threatening inflammatory ocular disease and includes multiple heterogeneous clinical entities. The prevalence of various types of uveitis depends upon multiple factors, such as age, sex, race, geographic distribution, environmental influence, genetics, and social habits. Epidemiologic research of uveitis is necessary to understand the etiology and immunopathogenesis of this group of diseases. The present study attempts to concentrate on the most recent information on the epidemiology of uveitis and compare it with previous knowledge.An extensive literature search was performed in the Medline database (PubMed) and included surveys completed until 2015. Articles that reported prevalence and incidence were studied. References cited in the articles were also studied.The incidence and prevalence of uveitis differs based on age, anatomic location of the inflammatory process (anterior, intermediate, posterior uveitis, panuveitis), gender, histopathology (granulomatous, non-granulomatous), type of inflammatory process (acute, chronic, recurrent), and etiology (infectious, non-infectious). Prevalence differs by geographic location. Idiopathic anterior uveitis is the most common form of uveitis in the community. Infectious causes are common (30-60%) in the developing countries. Herpes and toxoplasmosis are the leading infectious causes of uveitis. Non-infectious uveitic conditions are generally more common in the developed world. An increase in the prevalence of infectious etiologies, including tuberculosis and syphilis, has been seen in developed countries. Introduction of new treatment options has also changed patterns of disease.Introduction of new uveitis entities, changes in the incidence of already known disease and increased availability of diagnostic testing have all altered the epidemiology of uveitis in recent years. Knowledge of regional patterns of disease is essential. A more detailed classification of uveitis with the establishment of uniform diagnostic criteria and prospective population based studies would certainly benefit epidemiologic research and clinical practice.
- High Resistance to Azithromycin in Clinical Samples from Patients with Sexually Transmitted Diseases in Guangxi Zhuang Autonomous Region, China. [JOURNAL ARTICLE]
- PLoS One 2016; 11(7):e0159787.
Azithromycin is used as an alternative medicine in patients with syphilis who are intolerant to penicillin. Nevertheless, the report of treatment failure of azithromycin for patients with syphilis has raised concerns in China in the past years. In this study, 178 patients with early syphilis, who were treated in sexually transmitted infections clinics in four cities in Guangxi Zhuang Autonomous Region were enrolled to investigate the regional prevalence of Treponema pallidum strain resistant to azithromycin. Nested PCR was performed to amplify the 23S ribosomal RNA (23SrRNA) gene. The point mutation of A2058G in 23SrRNA, which confers Treponema pallidum resistance to azithromycin, was measured by endonuclease digestion of PCR amplification products using MboII. A2058G point mutation was detected in 91.0% (162/178; 95% CI, 86.8%, 95.2%) of the specimens, but no difference in prevalence of azithromycin resistance was found between the patients who had taken antibiotics before enrollment and the patients who had not (91.8% vs. 89.4%), nor between the patients with and without past sexually transmitted infections (87.1% vs. 93.1%). We concluded that azithromycin may not be suitable for syphilis as a treatment option in Guangxi Zhuang Autonomous Region because of the extremely high prevalence of resistance in the general syphilis population.
- Therapeutic potential of Benincasa cerifera: A review. [REVIEW, JOURNAL ARTICLE]
- Chin J Integr Med 2016 Jul 28.
Benincasa cerifera (Savi.), belonging to Cucurbitaceae, is an annual creepy wine that posses highm edicinal value and istraditionally used as fruit and medicine throughout India. In Indian system of medicine, its fruit is used as nutritive, tonic, diuretic, aphrodisiac, styptic, vermifuge and in various diseases and disorders like asthma, bronchitis, insanity, epilepsy, dry cough, fever, urethrorrhea, syphilis, hyperdipsia and vitiated conditions of pitta, etc. Phytochemically the plant is found to contain lupeol, β-sitosterol, cucurbitacin B, iso-vitexin, etc. It has been demonstrated to posses numerous pharmacological activities such as antiepileptic, hepatoprotective, antioxidant, analgesic, immunopotentiator and anxiolytic, etc. In the present review there is a detailed description of its botany, phytochemistry, ethno-botany and pharmacological activities.
- Neurosyphilis as a great imitator: a case report. [Journal Article]
- BMC Res Notes 2016; 9(1):372.
Neurosyphilis is defined as any involvement of the central nervous system by the bacterium Treponema pallidum. Movement disorders as manifestations of syphilis have been reported quite rarely.We report a case of a 42-year-old Russian man living in Estonia with rapidly progressive dementia and movement disorders manifesting as myoclonus, cerebellar ataxia and parkinsonism. The mini mental state examination score was 12/30. After excluding different neurodegenerative causes, further diagnostic testing was consistent with neurosyphilis. Treatment with penicillin was started and 6 months later his mini mental state examination score was 25/30 and he had no myoclonus, parkinsonism or cerebellar dysfunction.Since syphilis is easily diagnosed and treatable, it should be considered and tested in patients with cognitive impairment and movement disorders.
- Serologic Evaluation of Cornea Donors and Microbiologic Evaluation of Cornea Storage Media in an Eye Bank from Izmir, Turkey. [JOURNAL ARTICLE]
- Exp Clin Transplant 2016 Jul 22.
Our objective was to evaluate the serologic positivity of cornea donors and microbiologic positivity of cornea storage media at the Ege University Tissue and Cornea Bank, Izmir, Turkey.We retrospectively investigated the serologic blood sample and microbiological culture media analysis results of all cornea donors at Ege University Tissue and Cornea Bank between 2007 and 2015 with reference to age, sex, and cause of death of each donor.Mean age of the 955 deceased donors was 43.19 ± 15.89 years (range, 2-65 y). The mean postmortem time to blood sample removal and excision of the cornea tissue was 8.4 hours (range, 4-12 h). Serologic analyses showed that 855 donors (89.5%) were seronegative. The remaining donors were seropositive for hepatitis B (54 donors; 5.7%), human immunodeficiency (27 donors; 2.8%), hepatitis C (14 donors; 1.5%), and syphilis (5 donors; 0.5%) virus infections. Microbiologic analyses of the storage media were negative, with no microorganisms shown in 855 samples (89.5%). Candida species (32 donors; 3.4%), Escherichia coli (14 donors; 1.5%), Pseudomonas aeruginosa (11 donors; 1.2%), methicillin-resistant Staphylococcus aureus (11 donors; 1.2%), Enterobacter species (11 donors; 1.2%), Klebsiella pneumoniae (7 donors; 0.7%), Acinetobacter baumannii (6 donors; 0.6%), Proteus species (5 donors; 0.5%), and Corynebacterium species (3 donors; 0.3%) were the detected microorganisms in the infected storage media.False-positive serologic results among cornea donors were high. The incidence of false-positive results might be decreased by earlier blood removal from deceased donors and testing of all potential donors in intensive care units. Although rare, endophthalmitis after keratoplasty might be a devastating problem. In addition to serologic testing, microbiologic analyses of cornea storage media before transplant may be an effective way to prevent postoperative infectious complications.
- Global burden of maternal and congenital syphilis in 2008 and 2012: a health systems modelling study. [Journal Article]
- Lancet Glob Health 2016 Aug; 4(8):e525-33.
In 2007, WHO launched a global initiative for the elimination of mother-to-child transmission of syphilis (congenital syphilis). An important aspect of the initiative is strengthening surveillance to monitor progress towards elimination. In 2008, using a health systems model with country data inputs, WHO estimated that 1·4 million maternal syphilis infections caused 520 000 adverse pregnancy outcomes. To assess progress, we updated the 2008 estimates and estimated the 2012 global prevalence and cases of maternal and congenital syphilis.We used a health systems model approved by the Child Health Epidemiology Reference Group. WHO and UN databases provided inputs on livebirths, antenatal care coverage, and syphilis testing, seropositivity, and treatment in antenatal care. For 2012 estimates, we used data collected between 2009 and 2012. We updated the 2008 estimates using data collected between 2000 and 2008, compared these with 2012 estimates using data collected between 2009 and 2012, and performed subanalyses to validate results.In 2012, an estimated 930 000 maternal syphilis infections caused 350 000 adverse pregnancy outcomes including 143 000 early fetal deaths and stillbirths, 62 000 neonatal deaths, 44 000 preterm or low weight births, and 102 000 infected infants worldwide. Nearly 80% of adverse outcomes (274 000) occurred in women who received antenatal care at least once. Comparing the updated 2008 estimates with the 2012 estimates, maternal syphilis decreased by 38% (from 1 488 394 cases in 2008 to 927 936 cases in 2012) and congenital syphilis decreased by 39% (from 576 784 to 350 915). India represented 65% of the decrease. Analysis excluding India still showed an 18% decrease in maternal and congenital cases of syphilis worldwide.Maternal and congenital syphilis decreased worldwide from 2008 to 2012, which suggests progress towards the elimination of mother-to-child transmission of syphilis. Nonetheless, maternal syphilis caused substantial adverse pregnancy outcomes, even in women receiving antenatal care. Improved access to quality antenatal care, including syphilis testing and treatment, and robust data are all important for achieving the elimination of mother-to-child transmission of syphilis.The UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction in WHO, and the US Centers for Disease Control and Prevention.
- Celebrating the decline in syphilis in pregnancy: a sobering reminder of what's left to do. [Journal Article]
- Lancet Glob Health 2016 Aug; 4(8):e503-4.
- Optimizing Partner Notification Programs for Men Who Have Sex with Men: Factorial Survey Results from South China. [JOURNAL ARTICLE]
- PLoS One 2016; 11(7):e0157749.
Syphilis is prevalent among men who have sex with men (MSM) in China. Syphilis partner notification (PN) programs targeting MSM has been considered as one of effective strategies to prevention and control of the infection in the population. We examined willingness and preferences for PN among MSM to measure feasibility and optimize uptake.Participation in a syphilis PN program was measured using a factorial survey from both the perspective of the index patient and the partner. Respondents were recruited from April-July 2011 using convenience sampling at two sites-a MSM sexually transmitted disease (STD) clinic and a MSM community based organization (CBO). Respondents first evaluated three factorial survey vignettes to measure probability of participation and then an anonymous sociodemographic questionnaire. A two-level mixed linear model was fitted for the factorial survey analysis.In 372 respondents with mean age (± SD) 28.5 (± 6.0) years, most were single (82.0%) and closeted gays (66.7%). The Internet was the most frequent place to search for sex. Few (31.2%) had legal names for casual partners, but most had instant messenger (86.5%) and mobile phone numbers (77.7%). The mean probability of participation in a syphilis PN program was 64.5% (± 32.4%) for index patients and 63.7% (± 32.6%) for partners. Referral of the partner to a private clinic or MSM CBO for follow-up decreased participation compared to the local Center for Disease Control and Prevention (CDC) or public STD clinic.Enhanced PN services may be feasible among MSM in South China. Internet and mobile phone PN may contact partners untraceable by traditional PN. Referral of partners to the local CDC or public STD clinic may maximize PN participation.
- [Atypical acute syphilitic posterior placoid chorioretinitis]. [JOURNAL ARTICLE, ENGLISH ABSTRACT]
- Ophthalmologe 2016 Jul 26.
Syphilis is an infectious disease that can cause a wide variety of ocular signs. One of the rarest manifestations of ocular syphilis is acute syphilitic posterior placoid chorioretinitis (ASPPC). We report the case of an immunocompetent 38-year-old woman diagnosed with unilateral, atypical, acute syphilitic posterior placoid chorioretinitis. Fundoscopic examination revealed a yellow-white, subretinal, placoid lesion at the posterior pole, which is typical sign of ASPPC. In the periphery of the retina, multifocal choroiditis was also found. Fundus and angiographic changes in ASPPC may mimic other chorioretinal diseases. Accurate diagnosis of ASPPC as a presenting sign of syphilis is important for the prompt initiation of systemic antibiotic treatment.