Turin’s breakdown: Nietzsche’s pathographies and medical rationalities
Resumo Aos 44 anos, ap ós sofrer um colapso em Turim, o filósofo Friedrich Nietzsche recebeu o diagnóstico médico de neurossífilis. Devido à ausência de autópsia em seu corpo, tal diagnóstico médico vem sendo questionado historicamente. Realizou-se a revisão da literatura disponível sobre o diagnóstico médic o de Nietzsche. Destacam-se três gêneros patográficos que emergiram sucessivamente como explicações para o colapso de Turim: (1) narrativas sobre a sífilis ( “ demon íaco-patológicas ” ); (2) narrativas sobre as psicoses funcionais ( “ heroico-prof éticas ” ); (3) narrativas sobre outras doen ças orgânicas, distintas da sífilis ( “ cient ífico-realistas ” ). Estas últimas – que correspondem ao nosso objeto de estudo propriamente dito neste trabalho – empreendem diagn ósticos retrospectivos, buscando extrair a “ verdade ” subjacente à doença e elucidar o “ caso Nietzsche ” . Questionamos tal ímpeto detetivesco, exponenciado atualmente pela “ medicina baseada em evid ência ” , e denunciamos seu anacronismo. A s ífilis tornou-se um fato científico somente após a morte de Nietzsche. Conclui-se que o diagnóstico por ele recebido mostra-se consis...
Conclusion: In HIV-infected patients, histological confirmation of cavernous sinus pathology is not readily available for various reasons. In resource-limited settings, one should first actively search for extracranial evidence of tuberculosis, lymphoma, syphilis and primary malignancy and manage appropriatel y. Only if such evidence is lacking should a referral for biopsy be considered.
Abstract Syphilis, a sexually transmitted infection caused by the bacterium Treponema palladium, is experiencing a worldwide resurgence. The risk of syphilis infection is particularly high in men who have sex with men (MSM), especially those who are human immunodeficiency virus (HIV)-positive. Untreated syphilis can lead to rare but severe late-stage complications, including syphilitic aortitis. Herein, we present an autopsy case of a ruptured thoracic aneurysm that resulted from an undetected case of syphilitic aortitis in an HIV-positive Japanese MSM with undiagnosed syphilis. Although no syphilitic skin lesions...
In conclusion, early detection of maternal syphilis has been remarkably improved. More emphasis is required on the development of pro-vulnerable policies and the implementation of tailored health education to improve the accessibility of routine antenatal care and awareness of syphilis prevention.
CONCLUSIONS: Several characteristics of FSWs were identified, which reinforce the need for measures guaranteeing their health and protection.
Publication date: April 2019Source: The Lancet Global Health, Volume 7, Issue 4Author(s): Shabir A Madhi, Carmen Briner, Salome Maswime, Simpiwe Mose, Philiswa Mlandu, Richard Chawana, Jeannette Wadula, Yasmin Adam, Alane Izu, Clare L CutlandSummaryBackgroundAbout 2·6 million third-trimester stillbirths occur annually worldwide, mostly in low-income and middle-income countries, where the causes of these deaths are rarely investigated.MethodsWe did a prospective, hospital-based, observational study in Soweto, South Africa, to investigate the causes of stillbirths in fetuses of at least 22 weeks' gestational age or wi...
Conclusions Syphilis PS allowed MSDH to interact with 1592 men who have sex with men over a 30-month period and was effective for identifying people newly infected with early syphilis and HIV. Increasing HIV testing among partners of syphilis case patients could increase HIV case finding in Mississippi.
Conclusions Our survey found high prevalence of syphilis in indigenous women in Paraguay, in association with transactional sex and multiple partners. Interventions to reduce sexual behaviors associated with an increased risk of sexually transmitted infections (STI) in indigenous women must be carried out with programs aimed at addressing transactional sex, appropriately framed to respect interculturality and an indigenous worldview.
Conclusions The SHC on whole blood appears to be sensitive at detecting patients likely to have syphilis and could be an option for testing among high-risk populations. However, given challenges in interpreting SHC test results, adequate training of persons performing testing and ongoing quality assurance measures are key.
Conclusions Local health care providers should offer PrEP to MSM diagnosed with syphilis or gonorrhea and to non-MSM with a previous gonorrhea diagnosis at time of a syphilis or gonorrhea diagnosis. The high proportion and short time to an HIV diagnosis among MSM after a syphilis or gonorrhea diagnosis suggest immediate PrEP initiation.