BACKGROUND: The cerebrospinal fluid (CSF)-Venereal Disease Research Laboratory (VDRL) test is only 27% sensitive for diagnosing neurosyphilis. Discriminant analysis, used on 124 patients, shows that other commonly used laboratory tests can, in combination, identify 87% of patients with neurosyphilis with 94% specificity. STUDY DESIGN: The insensitivity of the CSF-VDRL (27% in persons with neurosyphilis) and the foreseen greater need to identify and treat neurosyphilis in the era of human immunodeficiency virus caused us to analyze the serum and cerebrospinal fluid results of 73 patients with syphilis and of 51 patients with clinically diagnosed neurosyphilis. Discriminant analysis was applied to different sets of laboratory tests to find the combination of test results best able to predict retrospectively the clinical diagnosis of syphilis or neurosyphilis, without reference to the CSF-VDRL. RESULTS: The predicting function averages 94% specificity and 87% sensitivity. Test result variables considered together are: CSF-FTA-ABS, serum FTA-ABS, CSF-TPHA, serum TPHA, and CSF cells. CONCLUSIONS: The authors conclude that clinicians or laboratories can, independently of the CSF-VDRL, compute a score showing whether the results of a set of commonly used tests suggest neurosyphilis in a patient.

Cardiolipins↗

PubMedDate not supplied

[The skin in the elderly].

Skin changes in advanced age consist mainly of an atrophy of the epidermis and of the appendices as well as of degeneration within the corium which cause asteatosis, purpura, de and hyperpigmentation and elastosis. The regulation of the body-temperature is altered. The influence of light leads up to actinic keratoses and to skin cancer. Diseases of the sebaceous glands and seborrheic dermatoses are rarely seen in the aged. Tumors of the skin occur in about 4% of persons in their forties but in 20% at 70 years of age. Systemic treatment has to take into consideration an increased inclination to complications and frequently also a reduced effect due to decreased blood circulation in the skin. Ointment bases consisting of oil/water emulgations with addition of fat or water are usually well tolerated. The use of soap and detergents should be restricted. The application of ointments containing UV filter substances is recommended at sun exposure.

Aged↗

PubMedDate not supplied

[Lack of effect of aging on dopaminergic inhibition of aldosterone and prolactin increase].

Because of the decreased dopamine concentration in the elderly brain an alteration of the dopaminergic suppression of aldosterone and prolactin incretion was postulated. In contrast, the application of the dopamine D2-antagonist metoclopramide showed no significant difference as to the blockade of this dopaminergic suppression in two groups of patients with a mean age of 40 and 80 years. Subsequently aldosterone and prolactin incretion was equally stimulated in both groups.

Adult↗

PubMedDate not supplied

The origin of syphilis. Clinical and epidemiologic considerations on the Columbian theory.

It is an unpleasant vogue of our day to soil the image of outstanding personalities. Christopher Columbus is blamed for the crimes and cruelties that were committed in the New World after his landing in San Salvador as well as for the import of syphilis from West India to Europe. Attempts to trace the origin of the pandemic of syphilis at the verge of the fifteenth century concluded with the myth that the disease was contracted in Haiti by members of Columbus' crew who later joined the army of Charles VIII of France and participated in the siege of Naples. The surrender of the town on February 22, 1495, at 4 pm (natal hour of syphilis) was followed by orgies, which led to infection of all participants, particularly of all soldiers, who then spread the disease on their journey back to France. This story is refuted on the ground of epidemiologic and clinical facts. Most of the crew of Columbus' first trip joined the admiral in his second expedition, too, left Europe on February 24, 1494, and did not return before June 11, 1496 (87 days, or 12.4 weeks). With not more than approximately 10 persons arriving in Naples for such a short stay, an endemic of syphilis of such grave proportions could not have occurred. The disease has an incubation period of 4 weeks and a contagiosity rate of approximately 30%. In addition, 2 years and 47 days had passed between the departure from Haiti and the arrival in Naples.(ABSTRACT TRUNCATED AT 250 WORDS)

Disease Outbreaks↗