scholarly journals Yaws: The forgotten tropical skin disease

2021 ◽  
Vol 16 (3) ◽  
pp. 104-107
Author(s):  
Nadiah Md Alwi ◽  
Rosediani Muhamad ◽  
Azlina Ishak ◽  
Wan Noor Hasbee Wan Abdullah
Keyword(s):  
Skin Disease ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
Incidental Finding ◽  
Venereal Disease ◽  
Lower Limbs ◽  
Physical Contact ◽  
Penicillin G ◽  
The 1960S ◽  
Lab Test

Yaws is a rare skin disease endemic to tropical countries caused by Treponema pertenue. It is highly infectious and spreads through physical contact. In Malaysia, it was presumably eradicated during the 1960s, with the last reported case published in 1985. Due to its rarity, the disease often goes unrecognised and misdiagnosed. Here, we report the case of a 5-year-old aboriginal boy diagnosed with secondary yaws who presented with fever and an incidental finding of chronic painless ulcerated nodules and plaques on his lower limbs and gluteal region. His diagnosis was confirmed serologically with a venereal disease research laboratory lab test and he was successfully treated with a single dose of intramuscular benzathine penicillin G. Primary care physicians should not ignore this disease since its early recognition and appropriate treatment is vital to its eradication, especially in high-risk communities.

Mild cognitive impairment in primary care: a clinical review

2018 ◽  
Vol 94 (1117) ◽  
pp. 647-652 ◽  
Author(s):  
Georges Assaf ◽  
Maria Tanielian
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Review ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
Neuropsychiatric Symptoms ◽  
Evidenced Based

Dementia is projected to become a global health priority but often not diagnosed in its earlier preclinical stage which is mild cognitive impairment (MCI). MCI is generally referred as a transition state between normal cognition and Alzheimer’s disease. Primary care physicians play an important role in its early diagnosis and identification of patients most likely to progress to Alzheimer’s disease while offering evidenced-based interventions that may reverse or halt the progression to further cognitive impairment. The aim of this review is to introduce the concept of MCI in primary care through a case-based clinical review. We discuss the case of a patient with MCI and provide an evidence-based framework for assessment, early recognition and management of MCI while addressing associated risk factors, neuropsychiatric symptoms and prognosis.

Recent Epidemiology of Group A Streptococcal Infections in North America and Abroad: An Overview

PEDIATRICS ◽  
1996 ◽  
Vol 97 (6) ◽  
pp. 945-948
Author(s):  
Edward L. Kaplan
Keyword(s):  
Public Health ◽  
North America ◽  
Primary Care Physicians ◽  
Public Health Problem ◽  
Streptococcal Infections ◽  
Industrialized Countries ◽  
Superficial Skin ◽  
Public Health Authorities ◽  
Group A ◽  
The 1960S

Feared for centuries as a major cause of infection-associated morbidity and mortality among infants, children, and adults, infections caused by the Group A beta-hemolytic streptococcus (Streptococcus pyogenes) and the associated public health problems declined remarkably by the close of the decade of the 1960s. Rather than hospitals being filled with children and adults with rheumatic heart disease or with suppurative sequelae such as mastoiditis, serious Group A streptococcal infections and their sequelae declined to the point where they have almost been considered a "nuisance". There have been relatively rare instances of surgical infections and there have been infrequent epidemics of pharyngitis. However, in North America, Europe, and most of the industrialized countries of Asia, epidemics of serious Group A infections and their sequelae essentially are unheard of. These infections and their suppurative and nonsuppurative sequelae have been much more of a medical and public health problem in many of the developing countries of the world, where few significant changes in their epidemiologic patterns have been evident. The primary manifestations of Group A streptococcal infections have been pharyngitis and superficial skin infections (impetigo) for most industrialized countries. During the past 10 years, however, this has changed remarkably. Serious Group A infections and their suppurative and nonsuppurative sequelae have re-emerged as significant problems for physicians and for public health authorities. For example, mortality has been greater than 30% in some reported series. This fact has placed increasing pressure on primary care physicians to appropriately diagnose and treat these infections. Understanding the epidemiology can beneficially impact patient care and public health policies.

The Ku Klux Klan and the War on Poverty

2020 ◽  
pp. 72-98
Author(s):  
Emma J. Folwell
Keyword(s):  
White Women ◽  
Venereal Disease ◽  
White Men ◽  
Ku Klux Klan ◽  
War On Poverty ◽  
White Supremacist ◽  
Welfare Policies ◽  
History Of ◽  
The 1960S ◽  
Antipoverty Programs

Chapter three traces the history of the Ku Klux Klan in Mississippi from Reconstruction to the 1960s, before exploring the wave of white supremacist violence that exploded across the state of Mississippi in 1967. This renewed wave of Ku Klux Klan attacks was directed at the state’s antipoverty programs, and in particular at white men and women involved in those programs. The chapter traces the rhetoric used in Klan literature in opposing the war on poverty, which claimed the programs were part of a move toward federal dictatorship. The language fused the core myths and fears on which white segregationists drew—miscegenation, the spread of venereal disease, interracial sex, the threat of black power, and liberal welfare policies that benefitted African Americans. It also illustrates how gender shaped both the Klan violence and its ideology, as attacks on white women teaching in Head Start classes intensified.

Sexuality in older persons

2017 ◽  
pp. 1149-1156
Author(s):  
Marcello Maggio ◽  
Fulvio Lauretani ◽  
Gian Paolo Ceda
Keyword(s):  
Quality Of Life ◽  
Sexual Health ◽  
General Health ◽  
Primary Care Physicians ◽  
Older Persons ◽  
Early Recognition ◽  
Sexual Symptoms ◽  
Related Quality ◽  
Public Audience

Sexuality is defined as the dynamic outcome of physical capacity, motivation, attitudes, opportunity for partnership, and sexual conduct. Sexual health in older persons is a topic deserving increasing interest and attention for both a public audience and physicians. Over half of people over 65 years of age, report sexual dysfunction, women more so than men. Since sexual health is dependent on general health and can be considered a mirror of general health, its assessment should be part of the routine clinical assessment, even in older subjects. However, asking about sexual health especially in older persons is often a difficult or embarrassing task for many primary care physicians. In addition, many patients find difficult to raise sexual issues with their doctor. Early recognition of sexual symptoms is the first step to starting multimodal treatments aimed at improving sexual health and related quality of life in older persons.

scholarly journals Bilateral compartment syndrome of the lower limbs after urological surgery in the lithotomy position: a clinical case

2019 ◽  
Vol 18 ◽  
Author(s):  
José Maciel Caldas dos Reis ◽  
Lauro José Mendes Queiroz ◽  
Pablo Ferreira Mello ◽  
Renan Kleber Costa Teixeira ◽  
Fábio de Azevedo Gonçalves
Keyword(s):  
Compartment Syndrome ◽  
Wound Closure ◽  
Early Recognition ◽  
Acute Compartment Syndrome ◽  
Lower Limbs ◽  
Lithotomy Position ◽  
Activity Levels ◽  
Urological Surgery ◽  
Baseline Activity

Abstract Acute compartment syndrome of the lower extremities after urological surgery in the lithotomy position is a rare but potentially devastating clinical and medicolegal problem. We report the case of a 67-year-old male who underwent laparoscopic prostatectomy surgery to treat cancer, spending 180 minutes in surgery. Postoperatively, the patient developed acute compartment syndrome of both legs, needing emergency bilateral four-compartment fasciotomies, with repeated returns to the operating room for second-look procedures. The patient also exhibited delayed wound closure. He regained full function within 6 months, returning to unimpaired baseline activity levels. This report aims to highlight the importance of preoperative awareness of this severe complication which, in conjunction with early recognition and immediate surgical management, may mitigate long-term adverse sequelae and improve postoperative outcomes.

Atypical development of neurosyphilis mimicking limbic encephalitis

2018 ◽  
Vol 30 (2) ◽  
pp. 194-197 ◽  
Author(s):  
Karine Beiruti ◽  
Anan Abu Awad ◽  
Galina Keigler ◽  
Chen Hanna Ryder ◽  
Radi Shahien
Keyword(s):  
Limbic Encephalitis ◽  
Venereal Disease ◽  
Treponema Pallidum ◽  
Penicillin G ◽  
Acute Confusional State ◽  
Gradual Improvement ◽  
Atypical Clinical Presentation ◽  
Magnetic Resonance Imaging Mri ◽  
Atypical Development ◽  
Simplex Virus

A previously healthy 35-year-old man suffering from behavioral and mental deterioration for three months was referred to our facility. On admission, the patient was dysphasic and had tonic-clonic seizures. Neurological examination showed mental confusion, euphoric mood, mania, paranoia, and mild motor dysphasia. Magnetic resonance imaging (MRI) was performed twice but no abnormalities were revealed. His acute confusional state, elevated cerebrospinal fluid (CSF) protein, epileptic seizure and electroencephalogram showing intermittent frontal slowness were all suggestive of encephalitis. The patient was treated with acyclovir without significant improvement in his condition. Testing for herpes simplex virus and human immunodeficiency virus was negative. Limbic encephalitis was suspected and the patient was treated with intravenous immunoglobulin (IVIG) for five days. Venereal disease research laboratory and Treponema pallidum hemagglutination assay were both tested positive in serum and CSF. Neurosyphilis was diagnosed, and the patient received a 14-day course of penicillin G with gradual improvement. Anti-N-methyl-D-aspartate-receptor (anti-NMDAR) antibodies were positive in serum, confirming the presence of encephalitis. The atypical clinical presentation of neurosyphilis with symptomatology mimicking encephalitis and no MRI abnormalities made the diagnosis challenging. Coexistence of neurosyphilis with anti-NMDAR encephalitis has been reported only in one recent study. Our case demonstrates the importance of testing for syphilis in patients with unexplained neurologic deficits and suspected encephalitis.

088 Cryoglobulinemic neuropathy associated with lymphoplasmacytic lymphoma

2018 ◽  
Vol 89 (6) ◽  
pp. A35.3-A36
Author(s):  
Yew Li Dang ◽  
Emma Foster ◽  
Moira Finlay ◽  
Andrew Evans
Keyword(s):  
Peripheral Neuropathy ◽  
Upper Limb ◽  
Early Recognition ◽  
Oral Prednisolone ◽  
Livedo Reticularis ◽  
Lower Limbs ◽  
Lymphoplasmacytic Lymphoma ◽  
Hepatitis C Infection ◽  
Limb Weakness

IntroductionA 64 year old woman presented with livedo reticularis and peripheral neuropathy secondary to Type 1 (IgM paraproteinemia) cryoglobulinemia, associated with lymphoplasmacytic lymphoma. Type 1 cryoglobulinemia is rare and remains poorly studied. However, given the common association of Type 1 cryoglobulinemia with lymphoproliferative diseases, it is important to consider Type 1 cryoglobulinemia as a differential diagnosis in presentations of a rash and peripheral neuropathy, and search for underlying malignancy.CaseOur patient presented with a leukocytoclastic vasculitic rash over bilateral lower limbs, which improved with topical betamethasone and oral prednisolone. Two months later, she had rapidly progressive right upper limb and bilateral lower limb weakness, absent reflexes in these limbs, and right arm reduced sensation. Nerve conduction studies revealed generalised axonal sensorimotor peripheral neuropathy in all four limbs, most prominent in the right upper limb. She then developed a livedo reticularis rash over her right forearm and punch biopsy revealed luminal pseudo-thrombi in small vessels consistent with Type 1 cryoglobulinemia. Her cryoglobulin (1558 mg/L, N 0–50 mg/L) and IgM paraprotein levels (4 g/L, N 0.4–2.3) were elevated. Vasculitic and other infective screens were unremarkable. Computer tomography imaging of chest, abdomen and pelvis found widespread lymphadenopathy. Subsequent lymph node core biopsy and bone marrow aspirate revealed lymphoplasmacytic lymphoma—the likely underlying cause of the Type 1 (IgM paraproteinemia) cryoglobulinemia.ConclusionPeripheral neuropathy is commonly associated with Type 2 and 3 cryoglobulinemia, especially in the presence of hepatitis C infection. However, reports of vasculitic peripheral neuropathy due to Type 1 cryoglobulinemia are limited. Early recognition is essential to allow the identification and treatment of the underlying haematological malignancy, commonly associated with Type 1 cryoglobulinemia. Treatment of the underlying cause indirectly treats the cryoglobulinemia, and avoids or reduces the associated; sometimes severe; cutaneous, neurological, and renal manifestations of this condition.

Comment on "Predator classification by the sea pen Ptilosarcus gurneyi (Cnidaria): role of waterborne chemical cues and physical contact with predatory sea stars"

2003 ◽  
Vol 81 (3) ◽  
pp. 556-558 ◽  
Author(s):  
James E Dalby Jr ◽  
Joel K Elliott
Keyword(s):  
Chemical Cues ◽  
Predator Recognition ◽  
Physical Contact ◽  
Sea Stars ◽  
Behavioural Responses ◽  
The 1960S

In their study of behavioural responses of pennatulaceans to physical contact with asteroids in 2002, Weightman and Arsenault claim to be the first to demonstrate that cnidarians have the ability to distinguish predators from nonpredators. In fact, it has been known since at least the 1960s that cnidarians are capable of predator recognition. We briefly describe some of the abundant literature on this topic, especially studies on anthozoans.

scholarly journals Psychosis or Simply a New Manifestation of Neurosyphilis?

2006 ◽  
Vol 34 (3) ◽  
pp. 335-337 ◽  
Author(s):  
E Kararizou ◽  
C Mitsonis ◽  
N Dimopoulos ◽  
K Gkiatas ◽  
I Markou ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Differential Diagnosis ◽  
Venereal Disease ◽  
Penicillin G ◽  
Rapid Plasma Reagin ◽  
Cerebrospinal Fluid Analysis ◽  
Disease Research ◽  
Fluid Analysis ◽  
Antibody Absorption ◽  
Persistent Headache

The widespread use of antibiotics in recent years has caused a significant reduction in the incidence of neurosyphilis and changes in its clinical features. We present a case that initially presented as persistent headache and untreatable psychosis. Neurosyphilis was diagnosed during the clinical evaluation. Blood serum analyses for syphilis were positive for rapid plasma reagin titres, the Venereal Disease Research Laboratories test and fluorescent treponemal antibody absorption. A lumbar puncture was performed and cerebrospinal fluid analysis resulted in the diagnosis of neurosyphilis. The patient completed a 2-week course of treatment with aqueous crystalline penicillin G and his symptoms subsequently improved. We suggest that neurosyphilis should always be included in the differential diagnosis of untreatable psychosis.

scholarly journals Perceptions of primary care physicians about early diagnosis of rheumatoid arthritis and methotrexate monitoring

2020 ◽  
Vol 7 (5) ◽  
pp. 840
Author(s):  
Alrashdi Mousa N. ◽  
Alrasheedi S. M. ◽  
Alsulmi H. A. ◽  
Alenazi Majed ◽  
Daghasi Hassan ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Saudi Arabia ◽  
Primary Healthcare ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
P Value ◽  
Survey Analysis ◽  
Drug Of Choice ◽  
Level Of Knowledge ◽  
Monitoring Treatment

Background: Current guidelines recommend the early recognition and diagnosis of rheumatoid arthritis and treatment with disease-modifying antirheumatic drugs (DMARDs). Methotrexate is the first drug of choice for most patients with rheumatoid arthritis, but this medication has contraindications and side effects that need monitoring. This survey analysis aims to explore the level of knowledge of primary healthcare physicians towards the early detection of rheumatoid arthritis and monitoring treatment with methotrexate.Methods: A self-administered structured questionnaire was distributed to primary healthcare physicians in the region of Riyadh, Saudi Arabia. The survey consists of sections including the demographics of respondents, knowledge about rheumatoid arthritis, and methotrexate. Data were analyzed using SPSS version 22.Results: In total, 249 physicians responded to the survey. Physicians with more years of experience showed a significantly higher level of knowledge about rheumatoid arthritis and methotrexate monitoring (p-value <0.001). The responses of physicians regarding knowledge about the disease were better than their responses about the drug.Conclusions: The knowledge of primary healthcare physicians in Riyadh, Saudi Arabia, is considered satisfactory in regard to rheumatoid arthritis diagnosis, but the level of knowledge about methotrexate requires improvement.

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