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The American Journal of Tropical... Nov 2015Pinta is a neglected, chronic skin disease that was first described in the sixteenth century in Mexico. The World Health Organization lists 15 countries in Latin America...
Pinta is a neglected, chronic skin disease that was first described in the sixteenth century in Mexico. The World Health Organization lists 15 countries in Latin America where pinta was previously endemic. However, the current prevalence of pinta is unknown due to the lack of surveillance data. The etiological agent of pinta, Treponema carateum, cannot be distinguished morphologically or serologically from the not-yet-cultivable Treponema pallidum subspecies that cause venereal syphilis, yaws, and bejel. Although genomic sequencing has enabled the development of molecular techniques to differentiate the T. pallidum subspecies, comparable information is not available for T. carateum. Because of the influx of migrants and refugees from Latin America, U.S. physicians should consider pinta in the differential diagnosis of skin diseases in children and adolescents who come from areas where pinta was previously endemic and have a positive reaction in serological tests for syphilis. All stages of pinta are treatable with a single intramuscular injection of penicillin.
Topics: Anti-Bacterial Agents; Humans; Latin America; Neglected Diseases; Penicillin G Benzathine; Phylogeny; Pinta; Treponema
PubMed: 26304920
DOI: 10.4269/ajtmh.15-0329 -
The New England Journal of Medicine May 2015In previous phase 1-2 clinical trials involving older adults, a subunit vaccine containing varicella-zoster virus glycoprotein E and the AS01B adjuvant system (called... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In previous phase 1-2 clinical trials involving older adults, a subunit vaccine containing varicella-zoster virus glycoprotein E and the AS01B adjuvant system (called HZ/su) had a clinically acceptable safety profile and elicited a robust immune response.
METHODS
We conducted a randomized, placebo-controlled, phase 3 study in 18 countries to evaluate the efficacy and safety of HZ/su in older adults (≥50 years of age), stratified according to age group (50 to 59, 60 to 69, and ≥70 years). Participants received two intramuscular doses of the vaccine or placebo 2 months apart. The primary objective was to assess the efficacy of the vaccine, as compared with placebo, in reducing the risk of herpes zoster in older adults.
RESULTS
A total of 15,411 participants who could be evaluated received either the vaccine (7698 participants) or placebo (7713 participants). During a mean follow-up of 3.2 years, herpes zoster was confirmed in 6 participants in the vaccine group and in 210 participants in the placebo group (incidence rate, 0.3 vs. 9.1 per 1000 person-years) in the modified vaccinated cohort. Overall vaccine efficacy against herpes zoster was 97.2% (95% confidence interval [CI], 93.7 to 99.0; P<0.001). Vaccine efficacy was between 96.6% and 97.9% for all age groups. Solicited reports of injection-site and systemic reactions within 7 days after vaccination were more frequent in the vaccine group. There were solicited or unsolicited reports of grade 3 symptoms in 17.0% of vaccine recipients and 3.2% of placebo recipients. The proportions of participants who had serious adverse events or potential immune-mediated diseases or who died were similar in the two groups.
CONCLUSIONS
The HZ/su vaccine significantly reduced the risk of herpes zoster in adults who were 50 years of age or older. Vaccine efficacy in adults who were 70 years of age or older was similar to that in the other two age groups. (Funded by GlaxoSmithKline Biologicals; ZOE-50 ClinicalTrials.gov number, NCT01165177.).
Topics: Adjuvants, Immunologic; Aged; Double-Blind Method; Female; Herpes Zoster; Herpes Zoster Vaccine; Humans; Injections, Intramuscular; Male; Middle Aged; Treatment Outcome; Vaccines, Subunit
PubMed: 25916341
DOI: 10.1056/NEJMoa1501184 -
Cutis Jun 1993
Review
Topics: Adult; Brazil; Child; Female; Humans; Hyperpigmentation; Hypopigmentation; Indians, South American; Male; Pinta
PubMed: 8519186
DOI: No ID Found -
Medical Oncology (Northwood, London,... Nov 2020Stereotactic Body Radiotherapy (SBRT) is a technique for delivering high doses of radiation to tumors while preserving the normal tissues located around this area. Bone... (Review)
Review
Stereotactic Body Radiotherapy (SBRT) is a technique for delivering high doses of radiation to tumors while preserving the normal tissues located around this area. Bone metastases are frequent in cancer patients. They can be distressingly painful or may cause pathological fractures. Radiation therapy is a fundamental aspect of treatment for bone metastases. The objective of this study is to analyze the literature on non-spine bone metastasis treated with SBRT, including immobilization, volume delineation, dose and fractionation, local control, side effects, and assessment of response after treatment. Full-text articles written in English language and published in the last 10 years were included in this review and were accessible on PubMed and MEDLINE. We examined 78 articles. A total of 40 studies were included in this review. Most were retrospective studies. The articles included were evaluated for content and validation. The immobilization systems and imaging tests used for tumor delimitation were variable between studies. The use of CTV (Clinical Target Volume) has not been defined. Doses and fractions were variable from 15 to 24 Gy/1 fraction to 24-50 Gy in 3-5 fractions, with local control being around 90% with a low rate of side effects. We review state of the art in SBRT non-spine metastases. SBRT can result in better local control and pain management in non-spine bone metastases patients. We need more research in volume delineation determining whether or not to use CTV and the role of MRI in volume contouring, optimal doses, and fractionation according to histology and a reliable response assessment tool. Studies that compare SBRT to conventional radiotherapy in local control and pain control are needed.
Topics: Bone Neoplasms; Humans; Magnetic Resonance Imaging; Radiosurgery; Tomography, X-Ray Computed
PubMed: 33221952
DOI: 10.1007/s12032-020-01442-1 -
International Journal of Dermatology Jan 2021
Topics: Brazil; Humans; Pinta
PubMed: 33151546
DOI: 10.1111/ijd.15264 -
Journal of the American Academy of... Oct 1993The nonvenereal treponematoses--yaws, endemic syphilis, and pinta--constitute a major health concern for many third world countries. These diseases are caused by an... (Review)
Review
The nonvenereal treponematoses--yaws, endemic syphilis, and pinta--constitute a major health concern for many third world countries. These diseases are caused by an organism that is morphologically and antigenically identical to the causative agent of venereal syphilis, Treponema pallidum. Nonvenereal treponematoses differ significantly in their modes of transmission, epidemiology, and clinical presentation from venereal syphilis. Like venereal syphilis, they have a chronic relapsing course and have prominent cutaneous manifestations. Recently, several cases of imported yaws and endemic syphilis have been described in Europe. With the escalating U.S. military presence in many remote areas of the world and ever-increasing world-wide travel, the diagnosis of the nonvenereal treponematoses must be considered in appropriate clinical and historical situations.
Topics: Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; Developing Countries; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Pinta; Prevalence; Syphilis, Cutaneous; Yaws
PubMed: 8408787
DOI: 10.1016/0190-9622(93)70217-h -
The American Journal of Psychiatry Feb 2015
Topics: Hospitalization; Humans; Mental Disorders; Prisons
PubMed: 25640937
DOI: 10.1176/appi.ajp.2014.14101294r -
International Journal of Dermatology Apr 1991
Review
Topics: Africa; Central America; Humans; Pinta; South America; Syphilis; Treponema
PubMed: 2050446
DOI: 10.1111/j.1365-4362.1991.tb04626.x -
PLoS Neglected Tropical Diseases 2013Improved understanding of the differential diagnosis of endemic treponematoses is needed to inform clinical practice and to ensure the best outcome for a new global... (Review)
Review
Improved understanding of the differential diagnosis of endemic treponematoses is needed to inform clinical practice and to ensure the best outcome for a new global initiative for the eradication of yaws, bejel, and pinta. Traditionally, the human treponematoses have been differentiated based upon their clinical manifestations and epidemiologic characteristics because the etiologic agents are indistinguishable in the laboratory. Serological tests are still considered standard laboratory methods for the diagnosis of endemic treponematoses and new rapid point-of-care treponemal tests have become available which are extremely useful in low-resource settings. In the past ten years, there has been an increasing effort to apply polymerase chain reaction to treponematoses and whole genome fingerprinting techniques have identified genetic signatures that can differentiate the existing treponemal strains; however, definitive diagnosis is also hampered by widespread unavailability of molecular diagnostics. We review the dilemmas in the diagnosis of endemic treponematoses, and advances in the discovery of new diagnostic tools.
Topics: Bacteriological Techniques; Clinical Medicine; Endemic Diseases; Humans; Molecular Diagnostic Techniques; Pinta; Treponemal Infections; Yaws
PubMed: 24205410
DOI: 10.1371/journal.pntd.0002283 -
International Journal of Epidemiology Dec 1977Three treponemal infections of man have coexisted in Colombia, South America for centuries. In former years, Colombia and Mexico were the world's most highly endemic...
Three treponemal infections of man have coexisted in Colombia, South America for centuries. In former years, Colombia and Mexico were the world's most highly endemic countries for pinta. Within Colombia, highest rates of infection with pinta occurred among the mestizo and Indian populations in the Andean and Caribbean departments of Huila, Tolima, Antiochia, Magdalena and Cesar. Yaws occurred primarily in rural areas along the Pacific coast among descendants of African slaves. Infectious syphilis is most often reported from the three largest urban areas, and from three other densely populated departments in the Andean region. During the 21-year period from 1954 to 1974, almost four times as many cases of pinta as yaws were reported. The incidence rates of yaws and pinta have declined almost in parallel in Colombia, even though there has been a national campaign against yaws, but not against pinta. The incidence of primary and secondary syphilis increased only slightly during the same period. The total burden of reported treponematoses (excluding tertiary and congenital syphilis) declinded by over 40 per cent, while the ratios of reported yaws, pinta and infectious syphilis rose from 1:3:4 in 1954 to 1:7:975 in 1974.
Topics: Colombia; History, 16th Century; History, 20th Century; Humans; Pinta; Syphilis; Yaws
PubMed: 344243
DOI: 10.1093/ije/6.4.349