Podcasts about Treponema

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Treponema pallidum / Syphilis⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠from the Microbiology section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

Hosts: Jake Lancaster MD, Chief Medical Information Officer and Amanda Comer DNP, System Director, Advanced Practice ProvidersGuest: Alex Yoby, PharmacistCME Credit Info:Link to complete brief survey and claim CME credit: https://www.surveymonkey.com/r/C55LKSYCME credit is available for up to 3 years after the stated release dateContact CEOD@bmhcc.org if you have any questions about claiming credit.CDC's Sexually Transmitted Infections (STI) TreatmentGuidelines, 2021Notable updates:These guidelines discuss 1) updated recommendations fortreatment of Neisseria gonorrhoeae, Chlamydia trachomatis, andTrichomonas vaginalis; 2) addition of metronidazole to the recommendedtreatment regimen for pelvic inflammatory disease; 3) alternative treatmentoptions for bacterial vaginosis; 4) management of Mycoplasma genitalium;5) human papillomavirus vaccine recommendations and counseling messages; 6) expanded risk factors for syphilis testingamong pregnant women; 7) one-time testing for hepatitis C infection; 8)evaluation of men who have sex with men after sexual assault; and 9) two-steptesting for serologic diagnosis of genital herpes simplex virusSyphilis LoreIt is postulated that syphilis came to Europe in the 1490s when Columbusarrived in Italy from America. After Italy surrendered to the invading Frenchin 1495, this new disease rapidly spread across Europe. The name"syphilis" comes from the work of Girolamo Fracastoro, a noted poetand physician in Verona, Italy. In 1530, he wrote about a shepherd namedSyphilus who angered Apollo, causing the god to curse the entire populationwith the affliction that we now know as syphilisT. pallidumSyphilis is a systemic, bacterial infection caused byTreponema pallidum. Treponema are thin,Gram-negative, slowly metabolizing spirochetal bacterium, requiring an averageof 30 hours to multiply. It is microaerophilic and cannot grow on standardculture media. Treponema pallidum's outer membrane lacks lipopolysaccharidesand has few surface-exposed unique proteins, making it difficult for the immunesystem to fight the infection. Because of this characteristic, Tpallidum is labeled as a stealth pathogen. T. pallidum is theonly Treponema species that causes sexually transmitted disease.Syphilis is characterized by a wide range of variableclinical symptoms that can resemble other diseases, which make it difficult todiagnose without a test, therefore, it is often referred to as “The GreatImitator”. The infection progresses through multiple stages (primary,secondary, latent, and tertiary) and can affect virtually every organ system inthe body, even many years or even decades after the original infection.Infected people are contagious during the primary and secondary stages ofsyphilis.Stages of syphilisPrimary syphilis: Primary syphilis classicallypresents as a single painless ulcer or chancre at the site of infection but canalso present with multiple, atypical, or painful lesions. A chancre is definedas a firm, round, painless ulcer at the...

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Syphilis is a sexually transmitted infection caused by the bacterium Treponema pallidum. Known for its varied symptoms and potential to progress through multiple stages, syphilis can have serious health consequences if left untreated, affecting organs like the heart, brain and nerves. The infection spreads primarily through direct contact with syphilitic sores, which typically occur on the genital, anal or oral areas. Though syphilis was once thought to be largely under control, its prevalence has resurged in recent years, prompting renewed focus on prevention, early diagnosis and effective treatment. In this episode, Dr Roger Henderson discusses new syphilis guidelines issued by the British Association for Sexual Health and HIV and how these impact treatment in primary care.Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/infectious-disease/ep-133-syphilis.Did you know? With GPnotebook Pro, you can earn CPD credits by tracking the podcast episodes you listen to. Learn more.

O Dr. Portante explica de que maneira é transmitida a sífilis, doença causada pela bactéria Treponema pallidum. Além disso, saiba como o problema em questão se manifesta nas três diferentes fases. E, por fim, conheça suas formas de diagnóstico, prevenção e tratamento.

Dr Herculano Duarte Ramos médico dermatologista HCFMUSP e coordenador dos estágios em IST para médicos residentes no CRT DST - AIDS Prof Dr Edson Bor-Seng-Shu, professor liver docente HCFMUSP Dr Marcelo de Lima Oliveira, doutor pelo departamento de Neurologia HCFMUSP Infecções sexualmente transmissíveis (IST) são aquelas que tem a via de transmissão predominantemente pelo ato sexual. Importante ressaltar que que além do contato sexual, muitas vezes nas preliminares a doença pode ser transmitida e algumas vezes até o beijo pode transmitir um IST como por exemplo a sífilis. Qualquer indivíduo que tenha relação sexual pode encontrar no seu parceiro alguma IST que não manifesta sintomas. Porém, existem grupos onde a incidência aumenta muito como ter relações com múltiplos parceiros e não se protegem na relação, ou seja, tem comportamento de risco. Drogas associadas ao sexo, incluindo bebidas alcóolicas, potencializam o risco para contrair ISTs. O sexo anal é uma atividade sexual de maior risco em decorrência dos pequenos traumas durante a relação. Em dez anos houve aumento de 780% da incidência de sífilis. Na idade média era uma doença grave em decorrência de não haver antibióticos para o tratamento. Dois fatores provocaram o aumento dessa doença: 1) pela redução na proteção da relação sexual e 2) pela redução acentuada no auge do HIV e não se falar mais na doença. Com a melhora no tratamento do HIV e medicações que previnem o HIV as pessoas deixaram de protegerem-se em relações o que aumentou a incidência de sífilis e outras doenças sexualmente transmissíveis. Quando as pessoas entram em contato com o Treponema (bactéria que causa a Siflis) 1/3 se infecta. A sifilis evolui em estágios: 1) a lesão inicial ou cancro duro, indolor, aparece de 10 a 90 dias após o contato. Importante que nesta fase o risco de contrair outras ISTs aumenta em decorrência da lesão da pele. O médico deve ser procurado já nesta fase para diagnóstico e tratamento. 2) Após essa fase os sintomas sistêmicos como dor no corpo, dor de garaganta, lesões em toda pele, entre outros sintomas; nesta fase a doença ainda é transmissível. Ela também “desaparece” espontaneamente sem tratamento; 1/3 pode se curar espontaneamente e o restante pode evoluir para sífilis terciária. Na sifilis terciária pode causar vários sintomas neurológicos como AVCi em decorrência a inflamação das artérias cerebrais, declínio cognitivo, demência, alterações e humor, delírio, perda auditiva, perda visual, inflamação na medula espinhal e crise epiléptica. Na gestação e importante fazer o rastreio de sífilis porque a detecção precoce pode evitar a transmissão da doença da mãe para o feto. Se não tratada a criança pode nascer com sifilis com taxa de mortalidade de 40%. A sífilis latente, ou seja, uma doença não detectada, sem lesões, onde a doença é só detectada pelo exame de sangue (VDRL), pode manifestar-se tardiamente perante a uma redução da imunidade do paciente com diabetes, uso de corticóide, entre outras. A gonorréia e a clamídia são as maiores causas de corrimento uretral, corrimento do colo do útero e corrimento anal. A dor pélvica e dor nas relações sexuais são sintomas importantes também. Diante desses sintomas o tratamento ja deve ser instituído a fim de evitar complicações como esterilidade. HPV é um vírus que causa infecção assintomática e quando provoca sintomas causam o condiloma no penis e na vagina. O tratamento da verruga não elimina a chance de transmissão. Essas lesões são as principais causas de cancer de colo de utero, boca, anus e também podem causar cancer de laringe e faringe. A vacina para HPV pode prevenir a ocorrência dessas feridas e prevenir o cancer. O centros de referencia são importantes para que pessoas com suspeita de ISTs possam ter acesso rápido ao serviço de saúde para rastreio, diagnóstico e tratamento dessas doenças. O tratamento em geral é simples com tratamento simples. #sifilis #gonorrhea #hpviral

In this episode, our guest is Jonathan Dornell, the co-host of the Let's Get Oral podcast. We explore the oral microbiome and how to understand and nurture this vital ecosystem to optimize your brain and body health. You'll learn about key topics like: nitric oxide, neurogastronomy, and how simple habits - like chewing mindfully, eating a balanced diet, and avoiding mouthwash and teeth whitening - can protect your oral microbiome, possibly reducing risks for conditions like caries (cavities), dementia, and heart disease.We also discuss the relationship between bacteria and humans, smell and taste perception, the benefits of slowing down, and the role of prebiotics, probiotics, and postbiotics, as well as how sugar and sweet flavors influence our oral and overall health. RESOURCESBACTERIA - Candida albicans- Lactobacillus - Prevotella- Prevotella intermedia- Porphyromonas gingivalis- Rothia- Streptococcus mutans - Treponema denticola - Veillonella- Veillonella dispar- Veillonella parvula BOOKS- If Your Mouth Could Talk by Kami HossORGANIZATIONS- American Academy for Oral Systemic Health (AAOSH)- The Integrative Dental Medicine Scholar SocietyOTHER VOCAB- Amylase- Arginine- Biofilm- Commensal- Culturomics- Electron micrograph- Lozenge- Neurogastronomy- Nitrates- Periopathogen - Periodontitis- Retronasal smell- Supertaster- XylitolPAPERS- Did the Brain and Oral Microbiota Talk to Each Other? A Review of the Literature- The Oral-Microbiome-Brain Axis and Neuropsychiatric Disorders: An Anthropological Perspective**CONNECT & LEARN MORE**website: letsgetoral.compodcast: Let's Get OralIG: @letsgetoralLinkedIn: /jddornell

Brought to you by Roninbasics.com: Protect yourself from the perils of modern technology with high-quality faraday products designed and developed by yours truly. Podcast overview Dive into the most captivating and controversial topics of our time, blending deep research with a touch of humor and a lot of heart. From bizarre trends and historical horrors to groundbreaking medical theories and conspiracy revelations, we cover it all. Summary of Major Topics: Influencer Insanity: We delve into the bizarre trend of influencers and celebrities shaving their teeth down to nubs for porcelain implants. Discover the dark side of aesthetic trends and the shocking consequences people face for the sake of beauty and uncover the ancient wisdom of meridian energy. Disappearance Mysteries: Dive into the harrowing tales of individuals who have faced unimaginable horrors, from underground bases to mysterious disappearances, this is the chilling case of Gabriela Rico Jimenez. A mexian supermodel who blew the whistle on a elite trafficking ring and then was never seen again. Historical Horrors: Journey back in time to uncover the gruesome and fascinating stories of historical figures like King Geza, whose reign was marked by brutality and human sacrifices. Cultural Collisions: Witness the rapid cultural erosion experienced by remote Amazon tribes upon gaining internet access, and the profound changes it brings to their traditional way of life. Make sure to hit that subscribe button and leave a five-star review. Follow us on YouTube, Substack, and social media to stay updated on our latest episodes. Thank you for your support! All the Links: For easy access to all our podcast-related content and platforms, visit linktr.ee/theaustinjadams.----more---- Full Transcription  Adam's Archive.    Hello, you beautiful people. And welcome to the Adams archive. My name is Austin Adams, and thank you so much for listening today. On today's episode, we have a couple of deep dives. We're going to have a couple other things sprinkled in there too, but a couple of deep dives that we're going to discuss starting with the. Crazy trend that has happened probably over the last, I don't know, five or six years, but even more so recently, the amount of celebrities, the amount of tick tock influencers that are out there getting their teeth shaved down with essentially nail files into nubs, and then getting fake implants of teeth, porcelain implants into their mouth. Now  there's a specific case that brought this up more recently, and it came from TikTok. So we'll discuss that. But what we're really going to talk about there is the idea behind why this is truly a problem, right? There's, there's this fundamental idea behind traditional Chinese medicine, which talks about the meridian.  And so that's what we're going to discuss first. After we talk about that and the horrific things people are putting their bodies through, and we'll actually use a case study here of the, with this woman from tick tock that caused this  topic to be discussed because I saw it recently pop up in one of my feeds. And it's just unbelievable. The amount of people that are doing this without even understanding what the potential side effects could be. So we will talk about that. After we talk about that, we are going to talk about a father in, I believe this was in Mexico, who went on stage at a,  uh, comedian's show and smacked him several times.  And you would go, that's crazy. You should be able to take a joke, right? But there's a lot more to the story. And I think He might be justified in this. So we'll talk about that. Then we will jump into a remote Amazon tribe left hooked on pornography after finally connecting to the internet. Uh, so this tribe essentially got. The internet and the very first thing they did was get absolutely unbelievably, horrifically addicted to pornography. So we will talk about that. Then we will move closer and closer into our real deep dive of the day. But before we jump into that for that last deep dive, we will discuss. A royal tomb of an African king that is actually completely made of human blood? After scientists had recently confirmed.  And then the last thing that we're going to discuss today is the curious case of Gabriela Rico Jimenez, who was a Mexican supermodel who essentially disappeared off the face of the earth.  Going outside of this hotel back in August of 2009,  and she had made these crazy claims. Something about celebrity, elites, billionaires, cannibalism,  and a lot more. She even calls out a few names, one that you'll be familiar with, and if you're not familiar with it, I'll tell you who they are, and why it's important, and who they're tied to.  Spoiler alert! It's the Clintons.  And so we'll talk about that. We'll do a deep dive into that situation. We'll watch a couple clips and we will go from.  So all of that and more, but first I need you to hit that subscribe button. I know it's been a few days, few weeks, even two, three weeks since my last podcast episode. And I apologize, but I appreciate that you're here. I love you. Thank you so much for listening in. I know life comes up for a lot of people on a lot of things and that's what's happened here recently. Anyways, so.  Uh, life comes up, life gets crazy. I have, uh, career, children outside of this, but the goal has always been to consistently put out great content for you guys, and that's what I hope you think about this episode right here. So again, thank you for being here. I appreciate you. Subscribe. Leave a five star review. And if you haven't heard I have a new side project among those other things that I have, including a career and a family and a wife and a hobbies like jujitsu represent. And, uh, all of the different shit that I do, I decided that I was going to start a completely separate business, which is Ronin. And if you haven't listened to the last few episodes, maybe you don't know Ronin is a Faraday Goods company and what Faraday Goods do is they protect you from the harmful effects of modern technology, everything from EMF radiation poisoning that is being emitted constantly from every piece of technology around you all of the time, including the cell phone that you're listening on this to including the car that you're in right now, if you didn't know that most cars today emit EMFs while you're sitting there  driving your vehicle.  And they have unbelievably terrible side effects to your health. And so a few things you can do is you can get Faraday goods and essentially eliminate the effects of those products by having specially lined fabric within things like hats, beanies, um, even like, uh, Faraday backpacks can. Put your laptop, your cell phone inside of it. It will eliminate your digital footprint. It will stop those EMFs from being emitted, and it will even stop the corporations and governments from being able to track you. It eliminates completely all inbound and outbound signals. So go check it out. Ronan basics. com. We are finalizing all of our orders for everything right now. The hats, just like the one that's on my head, right? Now, uh, the first order will be in, in just a couple of weeks. And so I'll be making those first shipments from all of the pre sales from the orders. Uh, backpacks will be following a few weeks after that phone, uh, phone sleeves. After that, I currently have the wallets up there, everything Ronan basics. com. Go check it out. You'll love it. Love it. And that's what I got. Let's go ahead and jump into it.  The  Adams archive.  That's a jam. Every time I hear that, that's a jam. All right, let's go ahead and jump into it. The very first thing that we're going to discuss today is going to be the disgusting trend of influencers and celebrities out there getting their teeth shaved down with nail files so they can look like Gollum from Lord of the Rings, only to have  porcelain implants. The teeth implants implanted into their face after they get their teeth shaved down to little disgusting nubs  all in the name of aesthetics,  right? You know, there's like 80 year olds, 85 year olds, 90 year olds out there who need veneers and that makes perfect sense to me, right? If you don't have teeth, you need to eat. You don't want dentures. You don't want to deal with that. That's okay. Get veneers.  But if you're young and you're healthy,  the hell are you doing? Why in the world would you take something that God gave you, beautiful teeth in your mouth, maybe not so beautiful, but much better than shaving down your teeth  with a file, and then having some dude in Miami shove porcelain into your mouth  like it's not an actual living part of your body.  Your teeth are so much more important to your body than modern medicine, western medicine wants you to believe. And that's what we're going to talk about today. So the very first article that we're going to take a look at  is going to come from Indy 100. One of my favorite new news articles that sources a ton of different articles from all over the world for you. And, uh, Pretty good stuff. So there's a video coming out of the New York Post and this TikTok video that this woman had posted, but let me just show you what we're talking about here. Okay, when we talk about them shaving down your teeth,  this is what we're talking about. Okay,  here we go.  If you're looking at my screen right now,  you will see a woman.  That looks just like Gollum from Lord of the Rings. I have to get this up here for you. There it is. Oh my God. That's terrifying.  How horrific. And to do this to yourself for just aesthetics, like I can get plastic surgery, do your thing, I don't care. It's not my body,  but. Like there was absolutely nothing wrong with this woman's face. Absolutely nothing wrong with her teeth, but she was convinced by society that she had to whittle down her teeth from what they were to turn them into this horrific Frankenstein science experiment, because that's what celebrities do.  So let's go ahead and watch this video. This woman's talking about her veneers and why she decided to do this and all of the terrible things that happened to her sense  here.  Here we go.  I know that I look crazy and it's so embarrassing to come crying on the internet,  but this stuff that I have been dealing with for two years  because of my freaking teeth  is like I don't even know what to do anymore and like the only place I can really go to  is my platforms.  As everybody pretty much knows,  two years ago  I Had, um, dental work done, I smelled Dental Center 32 in Miami and it ruined my life.  Like literally ruined my life  and I'm still dealing with it to this day and  I just left another doctor, another TMJ doctor. This is the third or fourth one that I've gone to  and  I'm just very overwhelmed. Like,  The medical industry, the dental industry in America is like, they literally do not care about what you are going through. Like, everything is about money for them.  And like, I understand like, people have to get paid. But it's like,  the fact that like, I can't,  I can't do anything.  Like, I can't use insurance. I can't do anything. I've already spent 80, 000 pretty much on this whole situation in two years. And I go to another TMJ doctor because I have severe TMJ now because of the veneers that Smile Dental Center did. They, they, they lost my bite. I have severe TMJ. I got my T3 done. It, it didn't fix it.  That was another 30, 000.  It's just like,  I just had an appointment and like, you know, they're telling me like, okay, we could do this, we could do this, and it, you know, it could, it could be a big money pit and, you know, it could be, you know, another 80k and, you know, might not work. Like,  I spent so much money with so many doctors just praying that something works for me.  And nothing works. Nothing ever works.  I don't know what to do anymore. Like, I can't even sue  the freaking dentist. Every, every time I come on here telling my story about what happened, which is a crazy ass story.  I'm like, just sue. Why don't you sue? If I could sue, that would be the first thing I'm, I'm doing. But I can't do that. I can't do that. It's, it's not possible. Like,  can't sue for my sensory issues. My sensory issues are unknown. Every time I go to the doctor.   So let's talk about this real quick. And it's easy to look at this person and say, You're vain. You shouldn't have done that. Your body was perfectly fine. You know, it's easy to laugh at this person and go, You know, play stupid games, win stupid prizes. Right?  But let's, let's put our empathetic hat on. Let's pretend this is your wife. Let's pretend this is your daughter. Let's pretend this And I don't know what she looked like before before she got this done. So let's pretend that maybe she had some little bit of messed up teeth. And you're in Miami. And if you ever been to Miami, like literally 10 percent of the people 20 percent of the people that are there, if they have money, they have these fake veneers.  And so  this woman,  With our empathetic cats on your wife, your daughter is convinced that she would be more beautiful, that people would accept her more, that she would have more friends, that she would seem cooler. Like she would look like, you know, one of those supermodels that she watches on Instagram all day in Miami. And like  to have society convince you  that you need to be anything other than what you were  then to go somewhere that  convinces you that you need to pay them 80, 000 and they'll make you better.  Then to have all your, your teeth essentially whittled down to nubs, this porcelain shoved into your mouth, which is too big for your mouth. You've ever seen people that, that get these done. It's way too big for their mouth. A lot of times they don't look natural. They don't look normal. A lot of times. And when you get that done that way,  And it's not the natural way that your teeth were supposed to sit that your body had gotten used to for, I don't know, in this woman's case, 25, 30 years, maybe  your jaw alignment, your, your teeth all  are meant to be the way that they were.  And so  when she's talking about TMJ,  she's talking about the misalignment of her jaw, causing consistent pain.  throughout the day, causing migraines, causing all these things. I've had TMJ in the past and it's, it's a terrible thing to deal with. And it makes your jaw click and you can't open your mouth as wide. It's, it's not fun at all. And to have it caused by somebody who told you they were going to make you better, that you spent your own money on to have them do it. And then as a result, to have this happen is just, I can't imagine. So keep your empathetic head on while you're watching this and, and maybe. Yeah, maybe it's,  you could roast her a little bit, but right. It's still, it's a terrible situation to find yourself in. So let's finish this out.  After they've never heard of it  and you can't prove that they gave you these issues because there's no way to diagnose it specifically. Like it's just a whole thing.  They offered to give me my money back within the first year. And I told them no, so that I could bring awareness because like,  People are just like, you know, out there getting veneers and whatever the case may be, like, my life is literally ruined because I got my teeth redone. Like, I'm not even joking, like, my, I'm constantly in pain. I can't even close my mouth properly after a retainer every single day. 24 7 pretty much to even close my mouth comfortably. No bite adjustments can fix it. Nothing. I've done a hundred bite adjustments. I've gone to 10 different dentists, four different TMJ doctors. I've done integrative medicine. I've done acupuncture. I've done everything you could possible. I've done hypnosis. I've literally done everything you could possibly do to try to fix these issues. I've been called crazy by my primary care doctor at Kaiser. They told me to therapist. Because I'm wondering what I'm going through  At this point like I just don't know what to do. I'm in severe pain I've gotten freaking acid or Botox twice my fucking face is slim the fuck out Like I look crazy as fuck because I'm in pain 24 7 I Guess my only thing is just don't get fucking veneers and  know that like Something like this can ruin your life like literally and Quite frankly, I'm not giving nobody else 80 fucking bands. Like no, I'm not doing it. Like the fact that these people are so like,  just everything is so money driven. And then like, I understand, but it's like, this shit is like really medical for me. Like why does nobody care  about people?   And so that video had 9 million views. Let's see how many it has now.  Not sure  where to see that on the web app.  But it has 100 or 864, 000 likes.  Let's see what the number one comment is. Veneers and LASIK I'll never do because of the horror stories I have heard.  Somebody said, babe, could it be a trigeminal neuralgia? Basically, the veneers hit the specific nerve.  Interesting.  Veneers are so extreme. I don't know why people have to do it. Try braces or composites when the tooth was hurting. I wanted to walk off the little planet. Yeah, so that's the terrible thing about this is she hasn't even begun to see the real effects of this.  Hasn't begun to see the real effects because the only thing she's dealing with right now is TMJ.  And she probably gets headaches or migraines as a result of the TMJ or even that trigeminal neuralgia, which is, can cause, you know, essentially what they call like these terrible, horrific, uh, types of migraines. And so  she's not even beginning to see the effects of this because what we're about to listen to is the fact that your teeth are tied to the nerves in your body and those nerves  have connections. throughout your entire body. And this isn't something that's like mainstream accepted within modern medicine dentistry within the United States of America, but it is in many, many, many other countries. And so that's what we're about to watch this next clip on, which explains how these types of like each individual one of your  teeth has a specific nerve that it's tied to that affects other parts of your body that causes issues within your body as a whole, whether it's, uh, things like, um,  I don't know, talking about high blood pressure, talking about your, your obesity, talking about all of these different health effects. And we'll actually pull up the map here in a minute and look at it, but let's go ahead and watch this video. It talks about the meridian, uh, essentially the meridian lines in your body and the connection to your teeth and all of the terrible things that can happen from doing something like what we just talked about. And this is coming from  the ultimate human podcast.  Here we go.  Doing the most harm out of any medical profession. It's like, here you go, opiates. What is biologic dentistry? Because it absolutely blew my mind. Each tooth is alive. It's a living organ. Any disease in the mouth can correlate to the rest of the body. You're taking a look at the whole body, not just the oral cavity. We can help people live a lot longer. How quickly can we help a patient heal? We're getting them off of meds. That's a passion of mine. If you're having symptoms, question it.  Hey guys, welcome back to the ultimate human podcast. I'm your host, human biologist, Gary.   Wait, what was I doing? And then you seek out the world's best doctors are knowledgeable in this and it's stuff that's been, it's out there. The literature is out there. The science is out there, but it's, do you believe in it? Do you want to take that step and actually go that road? And it's very hard to talk to all the dentists and all the colleagues like, Hey, there's something else out there. You know, we can actually be causing harm. It's like, do no harm is our first, the Hippocratic oath, right? It's do no harm. But it's actually, when you look at it, we're actually doing dentistry is doing the most harm out of any. Medical profession now leading  dead tissue in the body. Yeah I mean, you just got to wrap your arms around that there's actually dead tissue in the body And it doesn't have a blood supply and what a bacteria like they like dark moist oxygen deprived places anaerobic bacteria That's immune system can't get to and I want to talk specifically about a study that that was just Published in, in July of 2023. So this is only about three months old. It was published in the  journal of microorganisms, but it was a longitudinal study that investigated the association between periodontal disease. and neuroinflammatory disorders. And neuroinflammatory disorders are Parkinson's, Alzheimer's, dementia, all kinds of conditions in the body that are related to inflammation that eventually begins to affect nerves. And we don't correlate dental hygiene or, you know, dental pathologies to Parkinson's, to early onset Alzheimer's, or dementia. And even before these conditions exist, we Memory and cognitive decline, um, exhaustion, fatigue, weight gain, water retention. And what I found really fascinating was that out of the 24 studies they examined, 20 of them  showed a positive correlation between periodontal disease and neurodegenerative disorders with the studies focusing on cognitive function. Demonstrating the most robust effect.  Yes.  So these are all the things that are robbing people of their short term recall, their cognitive function, their waking energy, that they may be chalking up to a consequence of aging, that may actually be a consequence of something going on in their jaw from dental work that they've had done that they've left unaddressed. Correct. And one of those bacteria there, the Treponema  Yes, the Treponema denticola. Yeah, that's me. Sorry, it's one of the five bacterias. Let's just keep it simple. Yeah, one of the five bacterias. That's, that's known for beta amyloid. Producing beta amyloid, which we know is for Alzheimer's. Right. So when it all starts here, if we can actually control it, and it sometimes goes more in depth than doing a, Regular cleaning, sometimes we have to use lasers, sometimes we use ozone gas, sometimes we'll put some medication in the pockets, what we call the periodontal pockets. Right. But if we can cure that, doesn't mean like every tooth needs to come out, right, but if we can hold on to the teeth and we have ways much better than ever before, much better than when I graduated dental school. When you say  keep, to keep your  teeth. Keep the teeth, yeah, we graduated, I graduated in 2009. Keep  your  teeth. How  simple  is that? Keep your teeth, right? And so we'll look at this, this, uh, article. We'll pull it up here. This is  Dr. Rose. com R O Z E and talks about the Chinese Meridian Theory. And so let's talk about that. I was hoping to find it within that video, but I think that was a good point enough is that the health of your body, your cognitive decline, your obesity. High blood pressure, arthritis, all of these things could very well be tied to the dental work that you're getting done by modern dentistry.  Because when you're pulling teeth, or even worse, whittling them down to nothing, only to be replacing them with exterior material that isn't meant to be implanted in your body,  something's going to go wrong.  And so here's a clip about Meridian.  Dentistry or meridian belief system or theory, and let's watch that. Each  tooth is a key. The key is press, and it causes a motion to strike a note, which creates a vibration and a sound. Each key produces a different sound, just like the relationship between the keys and the notes. Our tifa connected by nerves to our brain. These nerves and nerve impulses send messages to specific parts of the body. What does this all mean to you? Well, if you have a bad tooth, the energy flows through the meridian belonging to that tooth, and this flow can affect the health of all the organs on that meridian. For example, tooth number 14, the first molar, is on the same meridian with the kidneys, liver, spleen, stomach and breast. So if this tooth has a problem, it may affect the energy flow through the meridian, and the health of those organs may be affected as well. Your mouth is connected to specific organs in the body. This is something that practitioners of traditional Chinese medicine have known for thousands of years.  The human body is really quite amazing when we listen to its messages.  Sir William Osler, a founding father of modern medicine, said the mouth is the mirror to the body. A vital relationship exists between your teeth and your organs.  Use our bio dental chart available from dr rose. com to see the relationship of your teeth and the rest of your body.  Right, so that's the idea. And when you think about that, and you go, Oh, you know, you hear about traditional Chinese medicine, meridian lines have been a debated topic in modern medicine up until about I think is about two one, one or two years ago, where they actually found the interconnection within the body of these like nerves that are all connected. And so When you look at the traditional Chinese medicine, think of acupuncture, acupuncture utilizes the meridian lines in your body to help, uh, you know, unblock the, the energy flow, the, the nerves connections and the firing of your nerves within your body that, that all speak to each other.  And so  this is, this is how it explains it says in traditional Chinese medicine, meridians are channels that form a network in the body through. Which qi, or qi, I assume, uh, vital energy flows. A blocky Causes pain and illness the flow is restored by using pressure needles suction or heat at hundreds of specific points along The meridians, right? You talk about acupuncture The meridian tooth chart is based on acupuncture meridians pathways of energy that span across interrelated body parts glands and tissues and you have to remember What did she? Say what are the comments say they're like when you have people having terrible horrific what they call like Suicide migraines or that trigeminal neuralgia that she talked about  Acupuncture is one of the only things  My wife actually dealt with that during one of her pregnancies, where she had what we thought was either trigeminal neuralgia, some sort of horrific like, um,  um, like clot in her brain or something. It was horrific, horrific headaches, unlike you could ever imagine in your whole life. And the only thing that helped my wife, The only thing that subsided the pain. We went to the hospital over it multiple times. They literally did nothing for us. Kicked us out with an 8, 000 bill.  The only thing that helped her.  And up until very recently, and even today, right now, the traditional acupuncture is not an accepted form of, of Western medicine. They don't, they don't agree that it's, it's works, but it works. People all over the country get acupuncture done. It's literally the Only thing that she did that helped her with her migraines. Why? Because it has to do with the nerves. It has to do with the meridian lines. It has to do with that flow of that, that firing of, of the nerves, that flow of energy throughout your body. We are electrical beings, your thoughts, your movements, everything that's happening inside of your body is an electrical pulse within these, the, the firing of these nerve endings. And so it makes sense that if you.  use the body to its advantage and understand that rather than trying to impose your will upon it with metal,  uh, you know, types of tools and  medications and pharmaceutical drugs and injections and all of these things that the modern Western medicine tries to impose its will upon the body rather than trying to allow the body to do what it needs to do to correct itself. That is the huge difference between modern medicine. medicine in traditional medicine, holistic medicine.  So it goes on to say the meridian tooth chart is based on acupuncture meridians, pathways of energy that span across interrelated body parts, glands and tissues. Each tooth is associated with a particular meridian through which energy flows.  And so  when you look at this chart here, make sure you're,   So when you look at this chart here and you zoom in on it and  take a look and if this is a chart that you want, I can send you over the link, just go to my Instagram. I'll have a post about this and you can just comment, uh, and I'll DM you it, but it basically outlines all of the teeth and, and what their attachment is to which part of your body and what can result from not Dealing with those issues correctly for that specific tooth. And so it goes through a whole long list of things from migraines and epilepsy from the, so if, so first, I guess it shows the tooth or teeth that are associated with it, then the part of the body. So things like your stomach and spleen, your lungs, your liver, your gallbladder, your bladder, your  lungs and large intestines, stomach, heart, small intestines, um, all of these different parts of your body.  are associated with a different tooth or a different meridian line.  Again, same thing that they deal with with acupuncture. And so the things that this can result from is migraines and epilepsy, rheumatism, migraines, focus issues, sterility and impotence. So even your, even your  Fertility can be affected by your teeth,  um, focus, right? And so each one of these different zones of your mouth can have different negative effects on your body. It says if a weakness of in a particular system or organ exists, the condition of the tooth associated with that area could exacerbate the problem working with our Meridian tooth chart makes us able to assess patients, general state of health and wellness, simply through a review of the oral environment. Each tooth is associated with a particular Meridian through which energy. Flows.  Very interesting. It says the mouth is the mirror to your body. Energy flows through the body along lines known as meridians. These lines associated with specific tissues, organs, and teeth. Health problems manifesting in the tooth may be related to conditions of the associated meridian.  Interesting because this is a specific doctor that kind of specializes in this stuff. And again, it's D R R O Z E dot.  Now, the funny thing about this is I found this article today,  which says there is now a drug to regrow teeth, which has been approved for human trials.  So, on the back of that, maybe you don't need to get all of your teeth pulled and get veneers. Maybe you just need this other pharmaceutical drug and that will solve all your issues, of course. And there'll be no side effects, just like everything else. Um, so it says, scientists are gearing up for human tricks.  Not tricks, trials. Human trials, which makes way more sense than tricks. Human tricks. For a groundbreaking, truth growing science. A tooth growing drug with hopes to offer those suffering from tooth loss a revolutionary alternative. Molecular biologist and dentist Katsu, uh, Takashi  developed the first of its kind drug by deactivating the uterine sensation associated gene, the UTI. One, protein, which is known to stop tooth growth. He has been working on tooth regeneration for almost 20 years. We want to do something to help those who are suffering from tooth loss or absence.  While there has been no treatment to date providing a permanent cure, we feel that people's expectations for tooth growth are high.  By stopping USAG 1 from interacting with other proteins, the drug prompts bone morphogenetic protein, BMP, signaling and encourages the growth of new bone and teeth. The researchers noted  that mice and ferrets share the same USAG 1 properties as humans. The animals happen to grow new teeth from the drug. So my concern would be that if you're growing new teeth and growing new bones, how does your body know which  to grow when and how long? Right, like if you hope to grow one tooth back, are you going to, you know, make yourself taller?  Like, are you going to make your fingers grow long, too long, and you're going to look like Edward Scissorfingers? Um, the USAG 1 protein has a high amino acid homology of 97 percent between different animal species, including humans, mice, and eagles? Wow, that's very specific.  Beagles.  Um, is that what they're doing the studies on? Oh, that's horrible. If you go back and listen. Remember what Fauci was doing to dogs? That nobody's bringing up again? Like, the horrific trials that Fauci was involved with? And I'm pretty sure it was all specifically beagles. Where they would  essentially put them in a cage where they couldn't escape and then put thousands of bugs in there that would essentially eat them alive?  And meanwhile, I'm sure he's just living it up on a yacht somewhere after getting roasted by the Senate this week.  Anyways, just a side tangent, human trials are set to start in September 2024 at Kyoto University Hospital in Japan, using 30 male participants between the ages of 30 and 64 who are missing at least one molar. The next phase will look at children who suffer from congenital tooth deficiency.  Then, researchers will explore other  Generations who have lost a tooth due to environmental factors have proven successful the drug could become widely available as soon as 2030. The promising development in dentistry has the potential to revolutionize the way the treatment of tooth loss and provide solutions for people across the globe. So, if this lady, this girl, this woman, maybe just waited a few years,  I don't think that was her problem. The problem was vanity and living in Miami around a bunch of vain people.  People, but anyways, interesting, very interesting.  Now, the next thing we're going to talk about here, which I found to be a pretty wild scenario is that there was a dad. Dad went on stage and punched a comedian  over his sexualized joke about his baby son. Now, from what I saw, this wasn't onstage joke. This was like on Twitter,  uh,  prior to this. But let me read 'cause maybe I'm wrong, I didn't read this article yet. It says, footage of a dad punching a comedian's mid, uh, comedian Midat after he allegedly made a sexualized joke about his three-year-old son has gone viral. Spanish comedian Jamie. Caravaca was performing a standup comedy show in Madrid on Monday evening when a man unexpectedly gets on stage. Dad, Alberto Pugalito, punched Caravaca  in the head while shouting in Spanish. This is for the pedophile comment he made about my son. Will you repeat now what you said about my son? Pugalito continued while calling the comedian a piece of shit.  Say it. Say it again to my face, he said, enraged. Here, now, say it to my face. Yeah, I'm pretty sure this happened, like, on Twitter, and then he went to his show and started, and, like, punched him on stage and then smacked him in the face. It says,  Three month old son. The dad hit Caravaca one more time before leaving the stage.  Says comedian makes jokes at art. So here's the video. Let's go ahead and watch it. It's in Spanish. So I'll, I'll translate for you. In which case, don't listen to me translating and listen to the Spanish.  It says, who are you?  What's up? It  says, this is for, this is for my Alright, let's just start the whole thing with this. So loud. He  said, who are you? Huh? Oh shit.  What's up, huh? He smacks him. What have you said?  This is  for the pedophile account. Huh? Huh? Will you repeat now what you said about my son?  Huh? Piece of shit. Now what?  What were you saying about a black cock in my son's second cock at  three months  old? Huh? Piece of shit?  Huh? Now what? Say it. Say it again to my  face. Here. Now. Say it to my face.  He said, I'm sorry. He turns around. I'm sorry. I'm sorry. I'm sorry. I'm sorry. I'm asking you all for forgiveness. I'm sorry, I'm sorry. I'm just a dad that defends his kids. He has made sectionalizing comments about my three month old son. And that has it's consequences. He says, can we talk to you? He says, no, you can go. He calls him a clown. He's a weird  dad. I don't believe in that so much. And this next bit is how I would crack your fucking skull. And then he says, let's leave.  Good.  Finally, justice is served for somebody who's talking shit online, who in no way shape or form would ever back it up or say the same thing in person. So this man, this father gets his, in a Twitter argument with some comedian online.  The comedian then tells him something about his son sucking black cock. Excuse my vulgarity.  And his son's three months old. So this man drives to his comedy show, goes up on stage, punches him, and then smacks him in the face while ridiculing him in front of his entire crowd.  That deserves a standing ovation, and I'm sure it was much more entertaining than whatever bullshit comedy this clown, as he would describe it, was going to actually do during his show.  Alright, so, good. Good. More people getting to get smacked. Hundred percent. More people getting to get smacked for the stuff they say online. Good. For sure. 100%.  If you are willing to say something to somebody online, you should understand that that is a real person, potentially, depending on if they're a bot or not, but majority of the time, they're a real person  who  you could see out there and you would never repeat yourself to them in public. Right, just the same way that when you're driving a car, you would never treat people the same way as you treat them when you're driving. Because it's like removed, you remove yourself from the human aspect. It's not a situation we were supposed to find ourselves in biologically. Is that you're going 85 miles an hour with a metal, you know, 3, 5, 8, 000 pound  vehicle representing you.  Not supposed to be that way. Just the same way. It's not supposed to be you're on a  looking, staring at a piece of glass, somehow  communicating with some person across the globe, or maybe even five minutes down the road, but you don't know it in that part, you would say some crazy stuff to that person, but in this situation,  he got what he deserved.  So  let's see if there was any updates on this. Nope.  Clarified the transcription. Cool. So just wanted to point it out. I think this, that's a real dad right there. That's a real man who shows up there, says, say it to my face, say it to my face, smacks him just like he deserved and then leaves. Respectfully looks at the audience, apologizes and says, but I needed to do this for my son.  And I don't disagree.  All right.  Now onto some more serious matters. Okay. Which is the fact that a remote Amazon tribe was given Starlink and given access to the internet and the very Very first thing that they did the very first thing that they did was got addicted to porn.  I Mean to be fair. I don't blame them, right? If you had never if the only thing you've seen is like the seven Ten twenty hundred women that are around you all the time and in your remote tribe You  And all of a sudden you have access to all of these  supermodels from around the world, shaking their ass in your face on a piece of glass in front of you. And you've never had the opportunity of that before.  I get like, I get it.  It really does show you the power of, of like human human biology,  that the very first thing that they did was get addicted to porn, not gambling, not cryptocurrencies,  not NFTs. They got addicted to porn. Almost immediately. Thank you, Elon Musk.  And I believe there's a video here. Let's watch this video. I'm  not sure if there's audio to it.  Let's see.  Let's refresh.  Here we go.  You're just watching this guy in this forest with his knife next to a tree.  It's like indigenous tribe member.  And they're like behind this leaf with the camera. I'm not sure what this has to do with this article at all.  Maybe he's sneaking off with his new iPhone to go  watch Pornhub. Why is this on this page?  Okay, maybe it was like some random,  maybe we'll have context here.  Rare footage of uncontacted tribe in the Amazon. Okay. So it says what started as a moment of optimism and excitement was swiftly transformed into something worrying and sinister. After a remote tribe in the Amazon rainforest was finally hooked up to the Internet.  The Marubo people had resisted modernity.  Moderninity? Modernity? Moderninity? What the fuck? What? And preserved their indigenous way of life in one of the most isolated stretches of the planet for centuries. But then, in September, they found themselves equipped with high speed internet thanks to Elon Musk. The tribe is one of hundreds across Brazil that have been given access to the web through Starlink, the SpaceX subsidiary which provides satellite internet coverage in almost a hundred countries.  But rather than feel beautifully connected to the world, the installation has left the 2, 000 member Marubos feeling bitterly divided as pornography and social media poison its youngsters. When it arrived, everyone was happy.  SonomamaMarubo73 told the New York Times, whose reporters traveled to the tribe's remote villages.  But now, things have gotten worse.  Says, uh, they explained that the internet has brought a number of undeniable benefits, such as the ability to video chat with faraway loved ones, or call for help in emergencies. However, she said, the youth has grown increasingly disinterested in more traditional activities, such as making dyes and jewelry from berries and shells. Yeah,  young people have gotten lazy because of the Internet.  She lamented, they're learning the ways of the white people.  Hmm.  Pretty sure it's not just white people that have access to the internet. After just nine months with Starlink, the Marubo.  Already found themselves faced with the same issues that plague Western families. That's really interesting though, to like kind of accelerate this technological advancement and see as like a Petri dish, how quickly their lifestyle could be tainted.  Um, it says that.  The same issues that plague Western families, addictive social networks, misinformation, wow I'm sure they're so concerned about misinformation, scams, violent video games, and minors watching adult content. Alfredo Marubo, leader of the Marubo Association of Villages, has become the tribe's most vocal critic of the internet.  He told the New York Times that he worried that his culture's oral history and customs will be lost now.  Because everyone is so connected that sometimes they don't even want to talk to their own family. He admitted that he felt most concerned by the newfound interest in pornography, particularly given that Marubo culture frowns upon mere kissing in public. We're worried young people are going to want to try it, he said.  He said of the graphic sex depicted in videos which young men now send each other in group chats. That's a little gay. Alfredo, Alfredo added that some leaders have already noticed more aggressive sexual behavior among their youngsters.  Meanwhile, a father of three said that while he was happy the internet was helping to educate his children, he also felt concerned about the first person shooter video games.  I'm worried they're suddenly going to want to mimic them. I don't think you guys have, you know, the right equipment out there. Uh, yet many tribe members continue to extol  the internet's positive power and potential.  Uh, he pointed out that a venomous snake bite can require swift rescue by helicopter, but before the internet, the Marubo relied on amateur radio to relay urgent messages through several villages in order to reach the authorities. Now such calls are instantaneous, and it could, it's already saved lives.  Very interesting. This is in the village, you don't hunt, fish, or plant, you don't eat. Well. Now they can just order DoorDash, right? Maybe not, but you get the point. Meanwhile, Thomas A. Marubo, 42, the tribe's first woman leader, stressed that while some young people just want to spend the whole afternoon on their phones.  Yeah, I'm sure that's actually quite difficult. Like I have, you know, I have children. I have children that are the age enough to have technology and deal with the woes of an iPad in your house. And you, it took a long time. Like when I was growing up.  Our parents saw the, the, the advances and still gave like some timelines, but there's a lot of children today that just have absolute free reign of their technology, and it baffles me because you have to set those guidelines. The, the, the iPads, the social media, the whatever it is, pornography, whatever it is, is absolutely 100% designed so that you, it hijacks behaviorally the, the biology inside of you to make you want to stay there and give them your money and your attention. Right, because tension is just a currency.  Uh, he explained that decades ago, the most respected Marubo shaman had visions of a handheld device that could connect the entire world. Oh, did he?  You mean he somehow saw a phone? Um, it would be good for the people, he said, but in the end, it wouldn't be. Wow, they foresaw this. In the end, it would be war. Nevertheless, his son, Inoki,  insisted,  I see, I think the internet will bring us much more benefit than harm, at least for now. And regardless, there's no going back. The leaders have been clear, he said. We can't live without the internet.  So interesting. So many conversations that you could have about that regarding that, that, that, like, incubator, right? That, that Petri dish of just it completely accelerating from hunter gatherer societies immediately being Thrusted into, for lack of a better word. thrusted into our modern society of technology and all of the negative side effects that that would have on the not just the youth but the I guarantee you the adults are watching just as much porn as the kids right or playing the first person shooters or you know there's so many things that that are actual negative effects on society  so speaking of like faraway tribes and I'm not going to touch on this long because I have to get to the bigger deep dive but there was this african tomb  and  The king, the tomb of this king was made of completely human blood. Is that what I'm reading? Right? So scientists have uncovered a grisly secret at the tomb of an infamously bloodthirsty ruler. King Geza ruled the West African kingdom of Dahami from 1818 to 1858 before it fell to the French colonization at the end of the 19th century. And yet he carried his violent tyranny to the literally, as a news study published in the journal of  Prodemic  says, Over the course of his four decade reign, King Geza was known both for his military power and his brutality towards his enemies. Uh, he was so vicious that the ally, uh, leading to his hut was paved with the skulls. The alley leading to his hut was paved with the skulls and jawbones of defeated enemies,  while his throne rested on the skulls of four defeated enemy leaders.  Gangster. Ironically, according to the official records, Gezzo died peacefully in his home, but he couldn't resist bringing a bit of savagery down to the underworld with him. Before his death, he ordered the construction of two adjoined funer Funerary huts to be built in honor of his father,  who wrote from 1797 to 1818. For decades, rumors swirled around his tomb, suggesting that it was built using the blood of 41 human sacrifice victims. Now a team of researchers have confirmed that this is indeed true.  True.  Whoa.  According to the team of medical and archaeological specialists, the victims would likely have been prisoners of war or enslaved people. And because 41 is a sacred number in voodoos, they would likely have been sacrificed in a ceremony conducted to protect the late king's remains. Geez. The study's authors explained the kings of Aberney were god kings,  whose culture and religion centered on voodoo beliefs.  In this chronocultural context, death is only a change of state, not a total disappearance. Importantly, which I completely agree with. Importantly, a barrier between the human world and the place where the body is laid can be magically delineated. The separator is part of a supernatural border, since metaphysical elements are incorporated into the physical world.  Prayer, sacred water, and the blood of enemies were among the elements considered key to consecrating buildings such as these. When combined,  so prayers, water, and blood.  When combined, their mystical force was believed to symbolically protect what remains of the subtle essence of the deceased king. Geez,  uh, to determine the truth behind the legend, the scientists use a technique called high resolution, tandem, uh, tandem mass spectra spectrometry, spectrometry to analyze the mortar, uh, used to build the funeral Hutt's wall. Specifically, they examine the proteins present rather than the genes  as DNA degrades easily over time, depending on the storage conditions and most importantly, for this study, it cannot provide information on the source tissue.  Unlike proteins, which can serve as biological archive, the testing identified hemoglobin and. Uh, immunoglobins.  from both human and chickens present.  Very interesting. This involved a sacrifice of as many as 500 victims. So it's possible the blood in the mortar may have come from one such ceremony.  It's a ceremony called the great customs.  Now the researchers hope that future DNA analysis might help pinpoint the exact number of individuals in the tomb. As far as we're concerned, even one is too many. Yeah. Thank you for your insight. Yeah. Don't kill people and scrub them on the walls. Well, after you die to protect you  don't do that.  All right. Now we have our deep dive, my friends,  which is going to be about Gabriela Rico Jimenez.  But first,  make sure you hit that subscribe button.  Make sure you leave a five star review and make sure you should you support your boy. Go to Ronan basics. com. Check out the new website. Some of the products are a backorder right now, and you can actually pay and order them. And I will ship and deliver them to you as soon as they are here. So it's been months and months and months working on this, finding the right manufacturers, working with them side by side, sample after sample, after sample. I am a meticulous perfectionist  with certain things when it comes to business. And.  Manufacturing suppliers and getting the product to be perfect is one of them.  So go check it out. Ronan basics. com.  Some of the products are up there already with pictures like the wallets. We will have the actual legitimate product pictures very shortly for the hats, beanies, backpacks, all of it. So you can actually see what you're getting, but I promise you you'll love it. All right. So.  That's what I got. Let's go ahead and talk about this right here, which is Gabriela Rico Jimenez, the very, very dark and curiously interesting story about the disappearance of Of a Mexican supermodel.  So let's go ahead and read this together. There's several, several articles about this one from the daily mail. One from, uh, this right here is from the daily mail, which outlines all of this as well. But the most  intricate of these I found from this Reddit post, which has all of it.  So, here we go.  Let's watch this video first. This is the video  of this supermodel, Gabriela Jimenez, where she is freaking out outside of this hotel.  And I will tell you what she's saying again. We have a lot of Spanish translations today, interestingly enough.  Uh, so, let's go ahead and watch this video and I'll tell you what she's saying. Translate for you. Right?  All right. It says, let's hear what the young girl was shouting on the street. This is from a news company  She's saying I wanted my freedom  and you can hear the pain in her voice  Since Monterey freed me, but it cost me a lot of work.  I was in Mexico City for a year and four months She's crying  all of this began in mid 2001  I barely remember. They were young and powerful, and they killed them.  I'd been knocking on doors. What I wanted was my freedom. I want my freedom.  She was claiming to have been abducted or essentially being, kind of, uh, being trafficked in a trafficking situation.  Um, Carlos Slim. Dominique knew about this. I want my freedom. Now that name becomes very, very important. Carlos Slim. You may be familiar with it. One of the richest men in the world, and is the richest man in Mexico today. It hurts my soul, she said, that they took him away. Leave me alone. They have already taken me to the police station, and they have told me that they know nothing.  She's screaming at these police officers right now.  They took me to the general hospital.  You, you were there. Go get the, you killed Murino.  And we'll talk about who that is in a minute, it's a politician. They told me, who did they kill? The  Queen of England? The Queen of Germany? Did they kill the princesses? And Mickey Mouse?  It was also him, she said.  What? Nothing is gonna come here. The people where you come from, they are crazy.  They killed a lot of people, she's screaming at this man, telling him. Death to that kind of human. Go away.  Saying that he was a part of it.  They ate humans. Disgusting, she said.  They ate humans.  I wasn't aware of anything. Of the murders. Yes. But they ate humans. Humans. They smell like human flesh.  Now this female police officer is walking up to her. You are not going to take me until this is clarified. You already took me there. Let me go.  As this female police officer grabs her,  she says, let me go.  It says, this is the sad  reality of the young Gabriela Rico Jimenez that you saw a moment ago tried to attack the police officer who managed to take her, no, the police officer grabbed her and she pushed back. She wasn't attacking the police officer. That's  so silly. There's  the video for you and the translation thereof. Let's go ahead and read this article and talk about it.  So, this says the event took place in August of 2009  in Monterrey, Nuevo León, Mexico, in front of a hotel located on Ocampo Street, in between the avenue of Pino Suarez and not going to try and pronounce that. The news broadcast features a young woman named Gabriela Rico Jimenez screaming in front of a luxury hotel. She repeatedly pleads for her freedom and claims she was held against her will. She makes claims of murder and cannibalism and drops some very big names in her accusations. Most public outbursts such as this could be attributed to mental illness or substance abuse, but Gabriela's claims are consistent and somewhat coherent and she speaks with such horror and conviction. I feel compelled to further consider her credibility.  Then they show the news clip.  There's the transcription, I already read it for you. It said, What happened to Gabriela Rico Jimenez? So, you saw this woman, out in front of this hotel, screaming at this man, screaming at this man, saying, You knew about this. You were a part of it. You were there. They took me to the hospital because of it. And they said, who, who did the, who did they kill? Who did they kill? Did they kill the princesses? Did they kill the Queen of England? Did they kill Mickey Mouse making fun of her?  And she said, no, they killed Marino. And Marino  was a politician.  She even mentions the name Carlos Slim. Now, Carlos Slim, as I was telling you, was one of the most powerful people and the richest man in Mexico.  Carlos Slim is a huge contributor and donor to the Clinton Foundation.  The Clinton family  funds all of these politicians, Democratic politicians. And guess what else he funded?  The movie, The Sound of Freedom.  Hmm. So the same man being accused by this woman who disappeared and was never saw again  funded the Clinton campaign  was,  she claims,  was trafficking people,  cannibalizing them, and set up the murder of a politician.  That same man funded the movie, The Sound of Freedom,  which is just so happens to be about trafficking children.  That's interesting.  Very interesting, especially when you understand the controversy surrounding The Sound of Freedom, and the man who did the documentary, and the accusations against him.  Now it says a witness speaks, and this is, let's see.  Here it is. Here's where it talks about Carlos Slim.  It says what happened to her. Finally, Gabriela Rico Jimenez, the woman who was arrested outside of a hotel in Monterey, was helped by DIF police on Monterey. And after she was detained in jail by the regional police, she was, she was sent to a psychiatric center in Buenos Aires. colony where she will stay indefinitely while she receives help and can be well cared for.  Gabriela mentions the name Carlo Slim, and who was a Mexican business magnet of Lebanese descent. He is the richest man in Mexico and was the richest man in the world from 2010 to 2013.  He has a son Carlos Slim,  who serves as chairman of the board of his father's conglomerate company. The Merino,  Gabriela claims was murdered is Juan Camilo Mourinho Torre Torrezo,  who is a Mexican politician affiliated with the National Action Party, and the Secretary of the Interior of the Cabinet of President Felipe Calderón. He died in November of 2008.  During a Mexican city Learjet crash, the government plane was seen traveling and crashed into rush hour traffic under mysterious circumstances. There were 16 fatalities, all 9 people on board and 7 people on the ground died.  Juan Camilo Mourinho was 37. As President Felipe Calderon's strongman, he had been leading a government campaign against Mexico's powerful and violent drug gangs. Illuminati conspiracy theories frequently mention the British monarch, among others, as well as Disney symbolism. There is also a rumor that the Prince Philip, the Queen's husband, once said that cannibalism is a radical, but realistic solution to the problem of overpopulation?  Whoa, let's see if we can verify that in a minute. Um, there is a testimony of the alleged witness to Gabriella's breakdown on a Spanish language blog called the black Manic  a law student claims to have spoken with Gabriella and gives the following account of their interaction.  Um, it says a witness speaks after a long time. I will not reveal his name for obvious reasons. So what he says is basically that he was in the detention center at the time he was working as a law student and was in this detention center doing some work. And he said that he saw her there. He said, I still remember her face full of despair, fear, anguish. She felt very weary of the environment and a strange feeling. I approached her and asked her some questions.  Um, if I name, if I knew where she lived, she told me that she, they were all, that we were all dead. And that we were all dead, that we were all, we were among them, among other things. That simply left me paralyzed after 20 minutes of being with her some tall well dressed people arrived They practically pulled me out of there I asked them why they did this if this was just a poor girl with a mental disorder  Asked where that where they were taking her. They told me that was not my business to for me to retire When they left me they stopped me and asked me what she told me  I answered them insane and I ran away. The next day I went to the senior officers of the ministry and told them about the issue and wanted information because the girl's family requested it. They just laughed and said, really? If she does not exist, she never existed. And you do not work here.  I got a shiver and left. I left everything and left Monterey. I had a feeling that what had happened those days and what that girl said were true as I could. I left everything and got out of there. She told me that in Monterey there was some kind of underground base where they lived and regularly stole children as food and other things.  By my profession, I dare not reveal my encounter. I have family and children who depend on me. And for logical and reputation reasons, I cannot. I would like to go out and spread it to the four winds, but society would call me crazy. Although I have the marks of the attack,  is a little bad back, there are nights I just cannot sleep.  That's a weird translation. I have the same feeling, the same feeling that when I saw them the first time, it was like a, uh, presentiment is appreciated that they do not judge me as crazy for telling me that. Only me and for those who were with me at the time know what happened. Those are monsters. At least the one who attacked me was a monster. If he found me, he would only have died since a drawing came into my hands.  What?   Interesting.  Hmm.  So  that's what happened to this woman. She's never been seen since nobody knows where she's at and the internet was essentially scrubbed of her modeling history. Like she was a pretty prominent supermodel. She had brushed arms with all of these oligarch types like Carlos Slim and she Essentially after this happened, you look up her name now and you can't find anything about her as a person or her modeling career besides just these articles about this situation calling her crazy. But she's never been seen again. And she was 21 at the time. So she would be what this was 15 years ago, she'd be 3536 right now. And some people believe she's just still in that same mental institution. And she may very well have been a part of some like MK ultra type mind programming. And so  crazy shit. Transcribed  And there's video of it and the only reason that they showed this video on the news was because she was a prominent model.  And so when you look at who is Carlos Slim, who is the person that she is claiming was a part of this, who is at the head of this, and actually if you understand that the most powerful people in Mexico, who have the most money,  I mean, this is conjecture,  um, but,  Very likely have ties like you don't you don't get to flaunt your money or be in a position of very high power in Mexico I assume without having some way shape or form brushed arms with the cartels.  So who is Carlos Slim?  Well, let's watch this video of Trump  First and see what he has to say about Carlos Slim   Times is Carlos Slim now Carlos Slim as you know comes from Mexico He's given many millions of dollars to the Clintons and their initiatives. So Carlos Slim, largest owner of the paper from Mexico, reporters at the New York times, they're not journalists, they're corporate   lobbyists for Carlos Slim and Hillary Clinton. He is the majority holder of the New York times.  So why did Hunter Biden and Hillary Clinton's Mexican cartel partner, Carlos Slim fund the sound of freedom?  That's interesting. And here's a picture with Joe Biden, Carlos Slim, and Hunter Biden all together, says the sound of freedom brings to light the horror of human trafficking. However, there's one major question about the film. Why did Carlos Slim, a man with connections to Mexican cartels, Hillary Clinton and Hunter Biden fund the film?  In 2016, Donald Trump warned America about Carlos Slim and his connections with the New York times. And Hillary Clinton saying now Carlos Slim, as you know, is a Comes from Mexico. He has given many millions of dollars to the Clintons in those organizations.  WikiLeaks emails revealed that Slim had connections to with drug, Mexican drug cartels. Even the Guardian published the article titled, who is more dangerous? El Chapo or Carlos Slim?  Hunter Biden's laptop revealed that Slim was also a top customer of the Bidens.  There are even pictures of Hunter and Joe doing business with Mr. Slim. Now here comes the tricky question. Why did Mr. Slim fund the Sound of Freedom when he has direct ties to cartels that are guilty of smuggling?  The Deep State's most effective tool against Trump was the QAnon conspiracy theory. Q is effective because the Deep State  used the theory and its associated accounts to leak just enough information to be credible, but at the same time, nothing being leaked could ever  tie anyone directly, hence why dark to light never happened. Hmm.  What is this company? National  The national file. com. Okay. So maybe take this with a grain of salt because I don't know, but I mean, it's legit. Everything he's saying is legit. Or she, um, Q also gave the false pretense that to MAGA supporters that they did not need to be involved with their local GOP through the trust plan line. Okay.  Um,  Hmm.  Interesting. Uh, re energizing the Q PSY op may have been Slim's reason for funding the sound of freedom.  The solution to the human trafficking problem is the same as election integrity. America's first patriots get involved with their local GOP to ensure MAGA, congressional and presidential candidates,  are on the ballot and win free and fair elections. Hmm. Okay.  Uh, so take that all with a grain of salt, but nothing he said that was factually incorrect. Carlos Slim is tied to  drug cartels. Carlos Slim is tied to the Bi

Le malattie sessualmente trasmesse sono fortemente sottostimate. Molti addirittura pensano che malattie infettive come la sifilide siano oggi retaggio del passato. In questo episodio raccontiamo la storia di come la sifilide sia arrivata e si sia diffusa in Europa partendo proprio dal nostro Paese. La sifilide incarna un ottimo modello di malattia sessualmente trasmessa con quello che comporta in termini di stigma sociale, ignoranza del rischio e sottovalutazione della gravità dei sintomi.

Las infecciones de transmisión sexual no han dejado de crecer en los últimos años. En concreto, la sífilis se ha multiplicado por 10 entre 2016 y 2022. Esta enfermedad ha sido denominada "mal francés" por los españoles y "mal napolitano" por los franceses, lo que revela su origen incierto.La primera epidemia se registró en 1493 tras el asedio de las tropas francesas a la ciudad de Nápoles pero no está claro si la trajo Colón de América o si ya estaba en Europa y no había sido identificada. La enfermedad está causada por la bacteria Treponema pallidum y un grupo de internacional de investigadores ha descrito el genoma más antiguo conocido de una subespecie de este microorganismo, hallado en restos humanos de hace 2.000 años en Brasil. En “Más cerca” (Radio 5) hemos entrevistado a Fernando González Candelas, catedrático de Genética de la Universidad de Valencia y uno de los autores de este estudio que ha sido publicado en la revista Nature.Escuchar audio

Las infecciones de transmisión sexual no han dejado de crecer en los últimos años. En concreto, la sífilis se ha multiplicado por 10 entre 2016 y 2022. Esta enfermedad ha sido denominada "mal francés" por los españoles y "mal napolitano" por los franceses, lo que revela su origen incierto.La primera epidemia se registró en 1493 tras el asedio de las tropas francesas a la ciudad de Nápoles pero no está claro si la trajo Colón de América o si ya estaba en Europa y no había sido identificada. La enfermedad está causada por la bacteria Treponema pallidum y un grupo de internacional de investigadores ha descrito el genoma más antiguo conocido de una subespecie de este microorganismo, hallado en restos humanos de hace 2.000 años en Brasil. En “Más cerca” (Radio 5) hemos entrevistado a Fernando González Candelas, catedrático de Genética de la Universidad de Valencia y uno de los autores de este estudio que ha sido publicado en la revista Nature.Escuchar audio

AABP Executive Director Dr. Fred Gingrich is joined by Dr. Anne Murphy and Dr. Karin Orsel in this episode to discuss a common cause of lameness, digital dermatitis. Our guests start by describing this disease that was first identified in 1972 and has spread around the world. The disease is seen in most dairy farms in the U.S. as well as in feedlots and cow-calf operations. Even though the disease has been identified on many farms for many years, we do not know the exact mechanism of the disease or if the Treponema bacteria is the sole implicating factor in its development. There are several factors that lead to the development of the disease, such as creating the “right” environment for the bacteria to grow. Orsel discusses some of the challenges with vaccine development for preventing the disease as well as some genetic parameters within breeds that can influence the disease. Murphy discusses the importance of performing a full lameness exam to ensure veterinarians, hoof trimmers, and farm employees can correctly diagnose the cause of the lameness. Treatment for digital dermatitis typically involves a topical antibiotic such as tetracycline. Since this is extralabel use of an antibiotic, the veterinarian must prescribe the medication to the farm. Murphy also discusses the importance of foot baths and biosecurity measures to control and prevent the disease on farms.  Our guests also discuss the resources available to AABP members on the Lameness Committee resource page. This includes a review of treatments available to treat digital dermatitis and the available scientific evidence to support their claims found here. Other resources can be found at this link,  then click on the Lameness Committee tab or Resources from another AABP committee.  If you are interested in joining the Lameness Committee, or another AABP committee, please send an email to fred@aabp.org.  Genetic parameters for hoof lesions and their relationship with feet and leg traits in Canadian Holstein cows. N. Chapinal, A. Koeck, A. Sewalem, D.F. Kelton, S. Mason, G. Cramer, F. MigliorJournal of Dairy Science, Volume 96, Issue 4, 2013.https://doi.org/10.3168/jds.2012-6071 

Treponema pallidum - “bleik snurra tråd” - er en mystisk mikrobe. Jørgen og Ingrid snakker seg gjennom absolutt hele syfilishistorien - fra tidenes morgen via Ibsen frem til vår tid.Referanser: 1. Sandvik A, Kveim Lie A. Ubehandlet syfilis - fra Oslo til Tuskegee. Tidsskr Nor Legeforen 2016 136: 2010-62. Tampa M, Sarbu I, Matei C, Benea V, Georgescu SR. Brief history of syphilis. J Med Life. 2014;7(1):4-10.3. Vesterhus P. Hvordan ble Osvald syk? Tidsskr Nor Lægeforen 2007 127: 1814-65. Gordon AG. Diagnosis of Oscar Wilde. Lancet. 2001;357(9263):1209.6. Tobin MJ. Fiftieth Anniversary of Uncovering the Tuskegee Syphilis Study: The Story and Timeless Lessons. Am J Respir Crit Care Med. 2022;205(10):1145-58.7. Ropper AH. Neurosyphilis. N Engl J Med. 2019;381(14):1358-63.8. Gjestland T. The Oslo study of untreated syphilis; an epidemiologic investigation of the natural course of the syphilitic infection based upon a re-study of the Boeck-Bruusgaard material. Acta Derm Venereol Suppl (Stockh).1955;35(Suppl 34):3-3689. Dhakal A, Sbar E. Jarisch Herxheimer Reaction. [Updated 2022 Apr 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. 10. CDC. Sexually Transmitted Infections Treatment Guidelines. July 202111. FHI. Syfilis - veileder for helsepersonell. Smittevernveilederen. Oppdatert 07.04.2019.12. OUS metodebok, HUS metodebok. 13. Intervju avdelingsoverlege Turid Thune (muntlig meddelelse). Hosted on Acast. See acast.com/privacy for more information.

3.30 Spirochetes Microbiology review for the USMLE Step 1 Exam Spirochetes are spiral or corkscrew-shaped bacteria that stain gram negative. They have a unique endoflagella that distinguishes them from other species of bacteria. The endoflagella rotates within the periplasmic space and causes the bacteria to move, acting as its own propeller. Borrelia burgdorferi, Treponema pallidum, and Leptospira interrogans are the three important species of spirochetes to know. Borrelia burgdorferi causes Lyme disease, which is spread from wildlife to ticks and then to humans. The deer tick, also known as ixodes scapularis, is associated with Borrelia burgdorferi, but deer are not the reservoir for the bacteria. Lyme disease presents in three stages: erythema migrans (bulls-eye rash), flu-like symptoms, Bell's palsy, myocarditis, transient myalgias, arthritis, and neurological symptoms like encephalopathy and peripheral neuropathy. Treponema pallidum causes syphilis, which presents in stages: primary (chancre), secondary (rash), latent, and tertiary (gummas, neurological symptoms). Leptospira interrogans causes leptospirosis (Weil's disease), which is spread from infected animal urine to humans through broken skin, mucous membranes, or ingestion. Leptospirosis presents with flu-like symptoms, jaundice, renal failure, and meningitis.

3.04 Gram Negative Bacteria   Microbiology review for the USMLE Step 1 Exam.   Gram negative bacteria are characterized by a thin cell wall surrounded by a lipid outer membrane They do not retain the violet gram stain and appear pink after staining Gram negative bacteria can be classified by shape: cocci, coccobacilli, bacilli, and spirals Gram negative cocci include Neisseria species, which can be further categorized as maltose fermenters or non maltose fermenters Gram negative coccobacilli include: Bordetella pertussis, Haemophilus influenzae, Pasteurella, Francisella tularensis, Brucella, and Acinetobacter Gram negative bacilli can be divided into lactose fermenting and non lactose fermenting categories Lactose fermenting gram negative bacilli include: Escherichia coli, Klebsiella, Enterobacter, Citrobacter, and Serratia Non lactose fermenting gram negative bacilli can be further divided into oxidase positive and oxidase negative Oxidase positive non lactose fermenting gram negative bacilli include Pseudomonas Oxidase negative non lactose fermenting gram negative bacilli include Shigella, Yersinia, and Salmonella Gram negative spirals can be divided into oxidase positive and oxidase negative categories Oxidase positive gram negative spirals include Vibrio species, Helicobacter pylori, and Campylobacter jejuni Oxidase negative gram negative spirals include Borrelia burgdorferi (cause of lyme disease) and Treponema pallidum (cause of syphilis)

On episode #13 of the Infectious Disease Puscast, Daniel and Sara review the infectious disease literature for the previous two weeks, 9/29/22 – 10/12/22. Hosts: Daniel Griffin and Sara Dong Subscribe (free): Apple Podcasts, Google Podcasts, RSS, email Become a patron of Puscast! Links for this episode Efficacy and safety of switching to Dolutegravir/Lamivudine versus continuing Tenofovir Alafenamide (CID) Antibiotic combinations reduce Staphylococcus aureus clearance (Nature) Cholera Vaccine: Recommendations of the advisory committee on immunization practices (CDC) Detection of Treponema pallidum DNA during early syphilis stages (CID) Association between toxoplasmosis and bipolar disorder (Journal of Psychiatry) The efficacy of soap against schistosome cercariae (PLOS NTD) Recurrent ESBL Escherichia coli urosepsis in a pediatric renal transplant patient (NIH) After action review of the response to an outbreak of Lassa fever in Sierra Leone (PLOS NTD) Music is by Ronald Jenkees

Introduction: False positive RPR. By Hector Arreaza, MD. Read by Alinor Mezinord, MS III, Ross University School of Medicine.  Today we will talk about syphilis. Significant research has been done to determine the origin of this ancient infection. Some experts support that syphilis originated in the New World (the Americas) because the first cases in Europe were reported after the Christopher Columbus crew returned from their expeditions. On the other hand, some people defend the idea of the origin of syphilis in the Old World. Whatever its origin, syphilis is still affecting thousands of people worldwide. According to the World Health Organization, “syphilis in pregnancy is the second leading cause of stillbirth globally and also results in prematurity, low birth weight, neonatal death, and infections in newborns.”[1] The cases in the US are not as high as in other countries, but certain areas have cases higher than the national or state average. Such is the case in Kern County. Our incidence of syphilis is higher than the national average.That's why it is important to screen for this disease. RPR is the most common test to screen for syphilis; however, it may not be completely accurate. RPR is a non-treponemal test that can cause false positive results. On December 20, 2021, the CDC released a letter announcing an FDA alert regarding a high RPR false positive rate when done with Bio-Rad Laboratories BioPlex 2200 Syphilis Total & RPR kit. You may not know which kit was used for the test, but you need to know what to do with a positive RPR. Some conditions associated with false positive RPR include COVID-19 vaccines, tuberculosis, endocarditis, rickettsial disease, recent immunizations (smallpox), and pregnancy. In case of RPR positive, you need to confirm syphilis with a treponemal test, which will be more reliable regardless of the possibility of a false positive RPR. We still need to screen because syphilis continues to increase in our nation. I hope you enjoy this episode.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.___________________________Latent Syphilis. By Carol Avila, MD. Comments by Hector Arreaza, MD. Dr. Avila: I had the amazing opportunity to do inpatient pediatrics during my first rotation at a local hospital, and I often treated patients with neonatal syphilis. I was curious to know what is happening in this area (Bakersfield) that made syphilis (seems to me) a very frequent diagnosis of admission in peds, especially because newborns are impacted by a preventable disease.Epidemiology:The latest update available on the CDC website is the 2020 Surveillance Report of Nationally Notifiable STDs which showed:-In 2020, the national rate of syphilis was about 40 per 100,000 population (all stages).-The rate of national congenital syphilis was about 57 cases per 100,000 live births.-During that year, California was ranked #7 for primary and secondary syphilis (P&S), with a 19.5 per 100,000 population. Nevada was the number #1 state.Local data:In 2018 data, the Kern County Public Health Services Department reported:-A total of 1,520 cases of syphilis (all stages) were diagnosed during that year, about 4 cases/day. It is important to mention that there was a spike in the number of cases of syphilis by 86% compared to the prior year, 2017.-In 2020, 250 cases of congenital syphilis per 100,000 live births were reported in Kern County. Significantly higher than the national average (mentioned above, 40 cases per 100,000 residents). -For primary and secondary syphilis, Kern County was 62% higher than the state average, with almost 35 per 100,000 population, and was ranked #6 in the state of California. -San Francisco was ranked #1.-Bottomline: The rate of syphilis and congenital syphilis in Kern County is higher than the state and national average.Definition:Syphilis is a systemic bacterial infection caused by the gram-negative spirochete Treponema pallidum. Transmission:Syphilis is well known as a sexually transmitted disease; however, while many cases happen due to sexual activity, there are a few other ways that syphilis can also be spread.-It can be transmitted during pregnancy, resulting in congenital syphilis.-Also, passing on syphilis via blood transfusions was very common but is now rare thanks to blood supply screening.-Syphilis transmission is also possible through an organ donor, which nowadays is very rare.-Before healthcare providers were wearing gloves as a standard precaution, it was common for syphilis lesions to appear on their fingers and noses.-It can also be transmitted through close and repetitive contact with mucosal or skin lesions of people with active syphilis.Classification:-Syphilis is divided into stages based on clinical findings. Primary, secondary, and tertiary.-The latent phase occurs between secondary and tertiary. -Patients pass through secondary syphilis and may not realize it.-The most contagious stages are primary and secondary, and syphilis could still be contagious in the early latent phase.-Easy classification: Early (primary, secondary, early latent); Late (tertiary and late latent); Neurosyphilis (which occurs any time).Primary syphilis:-It usually happens 3 weeks after the initial contact with the spirochete, but it can also be seen after 90 days. The bacteria will destroy the local tissue when we see the syphilitic chancre, a painless, well-demarcated lesion with firm, indurated margins. It might go unnoticed; without treatment, the bacteria will spread to the bloodstream, and the infection will progress to the secondary stage.Secondary syphilis:-In the secondary stage, the patient can have a wide variety of signs and symptoms. General constitutional symptoms are common; however, it is characterized by a body-wide rash, prominent in palms and soles. This rash can be macular, papular, or pustular; patients can also develop patches in oral mucosa and tongue, as well as wart-like sores called condylomata lata. Tertiary syphilis:-In the pre-antibiotic era, 15 to 30 years after the initial infection, patients could develop any of the three forms of tertiary syphilis. -Cardiovascular syphilis involves the ascending thoracic aorta. Patients may present with aorticaneurysm or left heart failure. -Gummatous syphilis is uncommon, but it is especially important in patients coinfected with HIV. Gummas can appear in the skin, bones, or internal organs. -Central Nervous System syphilis presents with general paresis, tabes dorsalis, meningitis, hearing and vision loss, and dementia.Latent syphilis:-It occurs when the patient has positive serology for T. pallidum, but the patient is asymptomatic. -Latent syphilis can also be divided into early latent (when the primary infection occurred within the previous 12 months); and late latent syphilis (when the primary stage happened more than 12 months ago.)-Differentiating early and late latent syphilis is vital because the treatment will differ.Congenital syphilis:-The infection occurs during pregnancy.-It can cause miscarriage, stillbirth, or birth defects like nasal cartilage destruction, and frontalbossing, among others. Screening and Diagnostic Testing:-The USPSTF recommends screening asymptomatic, nonpregnant adults and adolescents at increased risk for syphilis infection (Grade A).-The USPSTF recommends early screening for syphilis infection in all pregnant women. as early as possible when they first present to care. -Repeat screening: The CDC and joint guidelines from the American Academy of Pediatrics (AAP) and the ACOG endorse repeat screening, especially for women at risk, early in the third trimester (at about 28 weeks of gestation) and again at delivery.-High-risk patients include men who have sex with men (MSM) and men and women living with HIV. -Also, people with a history of incarceration, a history of commercial sex work, certain racial/ethnic groups (African Americans and Hispanics), and being a male younger than 29 years.How to screen: -Initial screening should be done with a nontreponemal test (RPR or VDRL); if positive, a treponemal test (TP-PA or FTA-ABS) would be the next step. -Nontreponemal tests can be positive in patients with preexisting conditions, e.g., collagen vascular diseases, pregnancy, malignancy, tuberculosis, etc.-The USPSTF also refers to the reverse sequence screening algorithm, where we perform a treponemal test first in those patients that could be missed after a nontreponemal test, for example, people who are homeless, also in nontraditional and nonclinical settings. -A treponemal test will be followed by a nontreponemal test, however, there is no evidence of the accuracy of this screening algorithm, so it is an open field for researchers.-Remember that most patients will have positive antibodies for life, irrespective of treatment or disease stage.Treatment:-One word: Penicillin is the treatment of choice.-Additionally, every patient diagnosed with primary and secondary syphilis should be tested for HIV and other sexually transmitted diseases at the time of diagnosis. Primary, secondary, and early latent syphilis: Benzathine penicillin G, 2.4-million-unit IM, in a single dose.-Children/Infant age > 1 month of age: Benzathine PCN G, 50,000 units/kg body weight IM up to 2.4 million-unit in a single dose. -Children > 1 month with P&S syphilis should be evaluated for sexual abuse.Arreaza:-Pregnancy: Treatment is still penicillin G, if there is a penicillin allergy, desensitization should be done in a controlled setting.-In non-pregnant with PCN allergy- alternatives are doxycycline 100 mg BID x14 days or Ceftriaxone 1 G daily IM or IV for 10-14 days.-For P&S syphilis: clinical and serological evaluation should be done at 6 to 12 months after treatment. Late latent syphilis and tertiary: Benzathine penicillin G, 7.2-million-unit total, administered as 2.4 million units IM each week x3 doses. (2.4 x3 = 7.2). A good strategy is to assume all latent syphilis are late latent. -Follow up with a quantitative nontreponemal serologic test at 6, 12, and 24 months, and compare thistiter with the initial titer at the time of diagnosis.-Special recommendation: Check RPR titer the same day you give the first dose of penicillin.Neurosyphilis: -CSF examination is recommended if neurologic findings are present.-If neurosyphilis is confirmed, it will require aqueous penicillin G, 3-4 million units IV every 4 hours for 10-14 days. Alternative ceftriaxone 2 G IV daily x14 days. Get guidance from an ID specialist. We will continue talking about syphilis in another episode, which was an excellent introduction.____________________________Conclusion: Now we conclude episode number 112, “Syphilis Basics.” Dr. Avila raised our awareness of syphilis in our community and the importance of screening all adolescents and adults at risk of infection, and especially ALL pregnant persons, during their first prenatal visit or as early as possible. Timely treatment with penicillin is important to prevent late complications of syphilis and especially to prevent the devastating consequences of congenital syphilis. This week we thank Hector Arreaza, Carol Avila, and Alinor Mezinord. Audio edition by Adrianne Silva.Even without trying, every night, you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you; send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week!References:1. Data on syphilis, The Global Health Observatory, World Health Organization, who.int, https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/data-on-syphilis,  accessed September 14, 2022. 2. Center for Disease Control and Prevention. (2022, April 11). National Overview of STD.  https://www.cdc.gov/std/statistics/2020/overview.htm#CongenitalSyphilis. 3. STDs in Kern County, Kern County Public Health Services Department, STDS in Kern County 2018, https://kernpublichealth.com/wp-content/uploads/STDs-in-Kern-County-2018-slide-set-comparison.pdf, downloaded on Sep 12, 2022. 4. Center for Disease Control and Prevention. (2022, April 4). Reported Cases and Rates of Reported Cases by State, Ranked by Rates, United States, 2020. https://www.cdc.gov/std/statistics/2020/tables/13.htm 5. Morgen, Sam, Reported cases of STDs in Kern County dropped in 2020, but decrease could be misleading, The Bakersfield Californian, Apr 17, 2022, bakersfield.com, https://www.bakersfield.com/news/reported-cases-of-stds-in-kern-county-dropped-in-2020-but-decrease-could-be-misleading/article_6e7d8d36-bd18-11ec-a98f-7f247bc2517e.html. 6. U.S. Preventive Services Task Force. (2016, June 7). Syphilis Infection in Nonpregnant Adults and Adolescents: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-in-nonpregnant-adults-and-adolescents. 7. Center For Disease Control And Prevention. (2022, July 21). Sexually Transmitted Infections Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/syphilis.htm. 8. Calonge N; U.S. Preventive Services Task Force. Screening for syphilis infection: recommendation statement. Ann Fam Med. 2004 Jul-Aug;2(4):362-5. doi: 10.1370/afm.215. Erratum in: Ann Fam Med. 2004 Sep-Oct;2(5):517. PMID: 15335137; PMCID: PMC1466700. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1466700/. 9. Royalty-free music used for this episode: Good Vibes Alt Mix by Videvo, downloaded on May 06, 2022 from https://www.videvo.net/royalty-free-music-track/good-vibes-alt-mix/1017292/ 

Lots of practical clinical pearls in this episode! “Reverse sequence testing” for syphilis has largely taken over the traditional testing algorithm. Traditionally, non-Treponemal tests (RPR, VDRL) were done first with a reflex to a Treponema specific test if that was positive (MHATP). But this is now considered the antiquated technique. Reverse sequence testing has the advantage of potentially identifying infected patients very early on. In this session, we will give easy to use/practical tools for reverse sequence test interpretation, and how to best manage “discordant“ results.

Welcome to the 12th episode of 5 Minute Medicine! In this episode, we will be exploring Syphilis, an infection caused by the gram-negative spirochete (meaning spiral shaped) bacteria called Treponema pallidum. We will discuss a clinical case, pathophysiology, the various stages, symptoms, clinical features, diagnosis and treatment! All of the highest yield information is covered, with many easy ways to remember the important features of this pathology, including the “PANT” pneumonic of Neurosyphilis! We hope you are enjoying the content so far! Follow us on Spotify to be notified of our releases. We would really appreciate if you rate us 5 stars and give us a review on Apple Podcasts if you have the time too, as this really helps our discoverability follow our Ig @5.min.medicine for quizzes and notes on the topics!

Dr. Michael Gelfand, Chief of Infectious Diseases at the University of Tennessee Health Sciences Center, discusses the spectrum of Syphilis disease, one of the great mimickers and historical scourges of human kind. Syphilis cases are also seeing a resurgence in recent years, especially in high U.S. prevalence areas such as the midwest, northeast, and south. Syphilis rates are also increasing across the globe in places such as Europe, Russia, and China. Dr. Gelfand begins his talk by discussing the historical origins of Syphilis, including that Treponema pallidum may have been brought back to Europe from the new world by returning explorers. He then provides more information on the epidemiology of Syphilis. Next, Dr. Gelfand talks about the natural progression of Syphilis, from primary disease to its secondary and tertiary forms. The clinical manifestations of syphilis disease are then described. Dr. Gelfand then describes the conundrum of Syphilis testing. Lastly, Dr. Gelfand focuses on tertiary forms of Syphilis, including neurosyphilis. The treatment of various forms of Syphilis is also discussed. From a grand rounds lecture originally recorded on April 14, 2022.

In this episode, we review the high-yield topic of Treponema pallidum / Syphilis from the Microbiology section. Follow Medbullets on social media: Facebook: www.facebook.com/medbullets Instagram: www.instagram.com/medbulletsofficial Twitter: www.twitter.com/medbulletsIn this episode --- Send in a voice message: https://anchor.fm/medbulletsstep1/message

The emergence of syphilis in 15th century Europe caused widespread panic and finger-pointing as to the cause and origin of this disease. Unfortunately, the treatment at the time was as dangerous as it was ineffectual. Many historical figures have been associated with syphilis; some will have certainly had it but others will be to cast aspersions against one’s character. This is because it is a disease of rare distinction that sits at the historical nexus of a sex, disease, moral depravity, and mental illness. It would take centuries before the cause of syphilis (Treponema pallidum) would be known. However, despite all of our knowledge and available treatment of syphilis, we see the prevalence of this on the rise. This is the story of syphilis.Support the show: https://theadelaideshow.com.au/listen-or-download-the-podcast/adelaide-in-crowd/See omnystudio.com/listener for privacy information.

Brief History of Syphilis Evaluation of the fluorescent treponemal antibody-absorption (FTA-Abs) test specificity Anticardiolipin antibodies in Lyme disease A Brief History of Laboratory Diagnostics for Syphilis Relapsing Fever Syphilis Lyme How the LYMErix Lyme Disease Vaccine was Pulled from the Market Chronic syphilis facts | General center | SteadyHealth.com Distinction between Borrelia and Borreliella is more robustly supported by molecular and phenotypic characteristics than all other neighbouring prokaryotic genera: Response to Margos' et al. "The genus Borrelia reloaded" (PLoS ONE 13(12): e0208432) The History and Evolution of Molecular Diagnostics Ceftriaxone treatment of penicillin resistant neurosyphilis in alcoholic patients Plasmid DNA in Treponema pallidum (Nichols): Potential for Antibiotic Resistance by Syphilis Bacteria Preparation of atypical forms of Treponema pallidum and detection of antibodies to them in the experiment Lupus or syphilis? That is the question! Sexual Transmission of Lyme Borreliosis? The Question That Calls for an Answer A tale of two spirochetes: lyme disease and syphilis Syphilis & Lyme: a comparison Remembering the Tuskegee Syphilis Experiment 45 Years Later: Racism and Medical Denial LYME DISEASE: THE NEW TUSKEGEE EXPERIMENT The Tuskegee Experiment Never Ended: "Why You Can't Get Treated for Lyme Disease" Talky Beat by Twin Musicom is licensed under a Creative Commons Attribution 4.0 license. https://creativecommons.org/licenses/by/4.0/ Source: http://www.twinmusicom.org/song/265/talky-beat Artist: http://www.twinmusicom.org Stream Keep It Easy, All Day by Jeremy T Murphree | Listen online for free on SoundCloud --- Send in a voice message: https://anchor.fm/morgellons/message Support this podcast: https://anchor.fm/morgellons/support

In this episode, we look at the new research which demonstrates Lyme disease in a Morgellons patient, and question if molecular testing for syphilis wouldn't also be appropriate. Morgellons Petition to the CDC Ofshane - Road Tripzzz Study Cements Link Between Protean Morgellons Lesions and Lyme Disease. New Morgellons Research History of Morgellons disease: from delusion to definition Clinical evaluation of Morgellons disease in a cohort of North American patients Dermatological and Genital Manifestations of Lyme Disease Including Morgellons Disease An Update on the Global Epidemiology of Syphilis How Syphilis Came Roaring Back New CDC statistics: nearly half a million people diagnosed with Lyme disease annually False positive lyme serology due to syphilis: Report of 6 cases and review of the literature Cross-reactivity between Lyme and syphilis screening assays: Lyme disease does not cause false-positive syphilis screens Treponema denticola infection is not a cause of false positive Treponema pallidum serology Rapid Plasma Reagin Breanna Lum; Shane R. Sergent. Removal of bovine digital dermatitis-associated treponemes from hoof knives after foot-trimming: a disinfection field study Fluorescence in situ hybridization for the identification of Treponema pallidum in tissue sections Morgellons Fireside By Justice JHR Insomnia by Jeremy T Murphree --- Send in a voice message: https://anchor.fm/morgellons/message Support this podcast: https://anchor.fm/morgellons/support

On this week's episode of Fast Facts - Perio Edition your host, Katrina Sanders, RDH talks to us about bacteria outlier, Aggregatibacter actinomycetemcomitans!    Quotes:    “Although there were some pieces of evidence that did point to the fact that there was some plausibility that AA could be present in rapid rate episodic cases, we also saw that P. gingivalis showed up to the party and along with her, she brought her buddies Tannerella forsythia and Treponema denticola.”   “Currently this bacteria, we believe, is linked to other systemic diseases when it is able to create a systemic burden by entering the bloodstream and circulating through the body.”   Resources:   DentistRX: https://www.dentistrx.com  More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/    Katrina Sanders Website: https://www.katrinasanders.com  Katrina Sanders Instagram: https://www.instagram.com/thedentalwinegenist/

On this week’s episode of Fast Facts - Perio Edition your host, Katrina Sanders, RDH talks to us about bacteria outlier, Aggregatibacter actinomycetemcomitans!    Quotes:    “Although there were some pieces of evidence that did point to the fact that there was some plausibility that AA could be present in rapid rate episodic cases, we also saw that P. gingivalis showed up to the party and along with her, she brought her buddies Tannerella forsythia and Treponema denticola.”   “Currently this bacteria, we believe, is linked to other systemic diseases when it is able to create a systemic burden by entering the bloodstream and circulating through the body.”   Resources:   DentistRX: https://www.dentistrx.com  More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/    Katrina Sanders Website: https://www.katrinasanders.com  Katrina Sanders Instagram: https://www.instagram.com/thedentalwinegenist/

On this week's episode of Fast Facts - Perio Edition your host, Katrina Sanders, RDH takes us through red complex bacteria!   Quotes:    “These red complex bacteria are Tannerella forsythia, Treponema denticola, and the Regina George of red complex bacteria Porphyromonas gingivalis.”   “It is believed that once these bacteria are present, that the body is in a complete state of oral inflammatory conditions and this is where we begin to see periodontal disease truly manifest.”   Resources:   DentistRX: https://www.dentistrx.com  More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/    Katrina Sanders Website: https://www.katrinasanders.com  Katrina Sanders Instagram: https://www.instagram.com/thedentalwinegenist/

On this week’s episode of Fast Facts - Perio Edition your host, Katrina Sanders, RDH takes us through red complex bacteria!   Quotes:    “These red complex bacteria are Tannerella forsythia, Treponema denticola, and the Regina George of red complex bacteria Porphyromonas gingivalis.”   “It is believed that once these bacteria are present, that the body is in a complete state of oral inflammatory conditions and this is where we begin to see periodontal disease truly manifest.”   Resources:   DentistRX: https://www.dentistrx.com  More Fast Facts: https://www.ataleoftwohygienists.com/fast-facts/    Katrina Sanders Website: https://www.katrinasanders.com  Katrina Sanders Instagram: https://www.instagram.com/thedentalwinegenist/

“The Tuskegee Study Of Untreated Syphilis in the Negro Male” went on for 40 years. It caused generations of Black Americans to mistrust medicine, making it one of the bleakest points in the history of microbiology. Join Jon and Tess as they dive deeper into this study, the history of syphilis, and Treponema pallidum's hold on humanity. 

Multiple enzymes can make hydrogen sulfide from cysteine in Treponema denticola https://www.sciencedirect.com/science/article/abs/pii/S1075996420300871 Linda Phillips, Lianrui Chu, David Kolodrubetz, Multiple enzymes can make hydrogen sulfide from cysteine in Treponema denticola, Anaerobe, Volume 64, 2020, 102231, ISSN 1075-9964, https://doi.org/10.1016/j.anaerobe.2020.102231. (http://www.sciencedirect.com/science/article/pii/S1075996420300871) Advanced Dental Biofilm https://www.youtube.com/watch?v=mPyL0-nlJ_4 Coursera Bacteria and Chronic Infections https://www.coursera.org/learn/bacterial-infections Distinction between Borrelia and Borreliella is more robustly supported by molecular and phenotypic characteristics than all other neighbouring prokaryotic genera: Response to Margos' et al. "The genus Borrelia reloaded" (PLoS ONE 13(12): e0208432) https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0221397 USC researchers think THC in marijuana may be able to treat deadly COVID complication https://www.thestate.com/news/coronavirus/article245321785.html The bacterium that causes syphilis, Treponema pallidum, likely uses a single gene to escape the immune system, new research from UW Medicine in Seattle suggests. The finding may help explain how syphilis can hide in the body for decades, thereby frustrating the immune system's attempts to eradicate it. Apr 16, 2020 https://newsroom.uw.edu/news/syphilis-eludes-immune-attack-altering-single-gene "Re-infected with syphilis 10 times" A physician from St James' revealed that she's coming across students who have been reinfected with syphilis up to ten times as a result of consistent unprotected sex. https://www.facebook.com/ucdsu/photos/a.313511135602/10158236236350603/ --- Send in a voice message: https://anchor.fm/morgellons/message Support this podcast: https://anchor.fm/morgellons/support

Spirochetes - Treponema pallidum

Today we'll talk about two spirochete bacteria, Treponema pallidum and Borrelia burgdorferi.  High-yield, board-relevant information with two board-style practice questions.  --- Send in a voice message: https://anchor.fm/bradleysmicroboardreview/message Support this podcast: https://anchor.fm/bradleysmicroboardreview/support

Treponema pallidum, kleine korkenzieherförmige Bakterien, lösen die Syphilis (syn. Lues) aus, die 1493 plötzlich in Europa auftauchte. Kaum eine andere Erkrankung ist historisch so stigmatisiert und hat eine so vielfältiges klinisches Erscheinungsbild. Wie schon William Osler wusste: “He who knows syphilis knows medicine”. Till Koch und Thomas Meyer sprechen über die Syphilis. PD Dr. Thomas … „Infektiopod#06 – Syphilis“ weiterlesen

In 1495, a mysterious and deadly plague struck the city of Naples. Over the next 500 years, the medical attempts to understand and treat this new disease -- syphilis -- would mold and shape medicine in surprising ways. In this episode, Tony Breu and I will perform an historical and physiological biography of syphilis, covering the development of germ theory, epic poetry, mercury saunas, intentionally infecting patients with malaria, magic bullets, and lots and lots of experiments on poor rabbits. This presentation was performed live at the American College of Physicians’ national meeting in Philadelphia on April 11, 2019.   Sources (WARNING -- LONG LIST):   Swain, K. ‘Extraordinarily arduous and fraught with danger’: syphilis, Salvarsan, and general paresis of the insane. Lancet Psychiatry 5, (2018).   Kępa, M. et al. Analysis of mercury levels in historical bone material from syphilitic subjects – pilot studies (short report). Kępa Małgorzata 69, 367-377(11) (2012).   Forrai, J. Syphilis - Recognition, Description and Diagnosis. (2011). doi:10.5772/24205   Parascandola, J. From mercury to miracle drugs: syphilis therapy over the centuries. Pharm Hist 51, 14–23 (2009).   Eisler, C. Who Is Dürer’s ‘Syphilitic Man’? Perspect Biol Med 52, 48–60 (2009).   Rothschild, B. M. History of Syphilis. Clin Infect Dis 40, 1454–1463 (2005).   Schwartz, R. S. Paul Ehrlich’s Magic Bullets. New Engl J Medicine 350, 1079–1080 (2004).   Fee, E. The wages of sin. Lancet 354, SIV61 (1999).   O’Shea, J. ‘Two Minutes with Venus, Two Years with Mercury’-Mercury as an Antisyphilitic Chemotherapeutic Agent. J Roy Soc Med 83, 392–395 (1989).   Mahoney, J., Arnold, R., Sterner, B. L., Harris, A. & Zwally, M. Penicillin Treatment of Early Syphilis: II. Jama 251, 2005–2010 (1984).   Waugh, M. Role played by Italy in the history of syphilis. Sex Transm Infect 58, 92–95 (1982).   Thorburn, A. Fritz Richard Schaudinn, 1871-1906: protozoologist of syphilis. Sex Transm Infect 47, 459–461 (1971).   CROSBY, A. W. The Early History of Syphilis: A Reappraisal. Am Anthropol 71, 218–227 (1969).   Clark, E. G. & Danbolt, N. The Oslo study of the natural history of untreated syphilis An epidemiologic investigation based on a restudy of the Boeck-Bruusgaard material a review and appraisal. J Chron Dis 2, 311–344 (1955).   MUNGER, R. S. Guaiacum, the Holy Wood from the New World. J Hist Med All Sci IV, 196–229 (1949).   Thomas, E. & r, W. Rapid Treatment of Early Syphilis with Multiple Injections of Mapharsen. J Nerv Ment Dis 99, 88 (1944).   WIEDER, L., FOERSTER, O. & FOERSTER, H. MAPHARSEN IN THE TREATMENT OF SYPHILIS: FURTHER EXPERIENCES. Arch Dermatol Syph 35, 402–413 (1937).   THON, L. SHOULD THE INTERNIST KNOW SYPHILIS? J Amer Med Assoc 97, 994–996 (1931).   Sarton, G. The Earliest Printed Literature on Syphilis, being Ten Tractates from the Years 1495-1498. Karl Sudhoff , Charles Singer , Henry E. Sigerist. Isis 8, 351–354 (1926).   COLE, H., GERICKE, A. & SOLLMANN, T. THE TREATMENT OF SYPHILIS BY MERCURY INHALATIONS: HISTORY, METHOD AND RESULTS. Arch Dermatol Syph 5, 18–33 (1922).   Mason, U. Observation: Use and Abuse of Salvarsan. J Natl Med Assoc 3, 340–3 (1911).   Fleming, A. & Colebrook, L. ON THE USE OF SALVARSAN IN THE TREATMENT OF SYPHILIS. Lancet 177, 1631–1634 (1911).   Evans, A. The Treatment of Syphilis by Salvarsan (Dioxy-diamido-arseno-benzol). Brit Med J 1, 617 (1911).   Boeck, W. History, Theory and Practice of Syphilisation. New Engl J Medicine 73, 20–25 (1865).   Veale, H. Remarks on Syphilis and Its Treatment. Edinb Medical J 10, 10–26 (1864).   LaFond RE and Lukehart SA, Biological Basis for Syphilis. Clinical Microbiology Reviews 2006.   Secher L et al, Treponema pallidum in peripheral nerve tissue of syphilitic chancres. Acta dermato-venereologica 1982.  Hollander DH, Turner TB, The role of temperature in experimental treponemal infection. American journal of syphilis, gonorrhea, and venereal diseases, 1954   Eagle H, et al. The effect of hyperpyrexia on the therapeutic efficacy of penicillin in experimental syphilis. American journal of syphilis, gonorrhea, and venereal diseases, 1947.   Kampmeier RH, Syphilis therapy: an historical perspective. Journal of the American Venereal Disease Association 1976.   Pachner AR, Spirochetal Diseases of the CNS. Neurologic clinics, 1986.   Sell S et al, Experimental syphilitic orchitis in rabbits: ultrastructural appearance of Treponema pallidum during phagocytosis and dissolution by macrophages in vivo. Laboratory investigation; a journal of technical methods and pathology, 1982.   Taylor SH, Diuretics in cardiovascular therapy. Perusing the past, practising in the present, preparing for the future. Zeitschrift für Kardiologie, 1985.   Ovchinnikov NM, [Treponema pallidum in peripheral nerves of rabbit syphiloma]. 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The American journal of physiology, 1972   Sell S and Salman J, Demonstration of Treponema pallidum in Axons of Cutaneous Nerves in Experimental Chancres of Rabbits, Sexually Transmitted Diseases, 1992   Penn CW, Avoidance of Host Defences by Treponema pallidum in Situ and on Extraction from Infected Rabbit Testes, Microbiology 1981.   Beutler B and Munford RS, Tumor Necrosis Factor and the Jarisch–Herxheimer Reaction, The New England Journal of Medicine 1996.   Radolf JD et al, Treponema pallidum: doing a remarkable job with what it's got. Trends in Microbiology, 1999   Tight RR, Perkins RL, Treponema pallidum infection in subcutaneous polyethylene chambers in rabbits. Infection and immunity, 1976   Salazar JC et al, Treponema pallidum Elicits Innate and Adaptive Cellular Immune Responses in Skin and Blood during Secondary Syphilis: A Flow-Cytometric Analysis. The Journal of Infectious Diseases, 2007   Azevedo BF et al, Toxic Effects of Mercury on the Cardiovascular and Central Nervous Systems. Journal of Biomedicine and Biotechnology 2012,   Clarkson TW and Magos L, The Toxicology of Mercury and Its Chemical Compounds, Critical Reviews in Toxicology 2008.   Fitzgerald TJ, The Th1/Th2-like switch in syphilitic infection: is it detrimental? Infection and immunity, 1992   Batterman RC et al, THE SUBCUTANEOUS ADMINISTRATION OF MERCAPTOMERIN (THIOMERIN®): Effective Mercurial Diuretic for the Treatment of Congestive Heart Failure. Journal of the American Medical Association, 1949   Batterman RC, The status of mercurial diuretics for the treatment of congestive heart failure. American Heart Journal, 1951   Bleich HL et al, The Role of Regional Body Temperature in the Pathogenesis of Disease, The New England Journal of Medicine, 1981   Vander Veer JB et al, The Prolonged Use of an Oral Mercurial Diuretic in Ambulatory Patients with Congestive Heart Failure. Circulation 1950   Cox DL et al, The outer membrane, not a coat of host proteins, limits antigenicity of virulent Treponema pallidum. Infection and immunity, 1992.   Fildes P, The Mechanism of the Anti-bacterial Action of Mercury. Br J Exp Pathol, 1940   Clarkson TW, THE MECHANISM OF ACTION OF MERCURIAL DIURETICS IN RATS; THE METABOLISM OF 203Hg‐LABELLED CHLORMERODRIN. British Journal of Pharmacology and Chemotherapy, 1965   Engelkens HJ et al, The localisation of treponemes and characterisation of the inflammatory infiltrate in skin biopsies from patients with primary or secondary syphilis, or early infectious yaws. Genitourinary Medicine, 1993   Belum GR et al, The Jarisch–Herxheimer reaction: Revisited. Travel Medicine and Infectious Disease, 2013   Arando M et al, The Jarisch–Herxheimer reaction in syphilis: could molecular typing help to understand it better? Journal of the European Academy of Dermatology and Venereology, 2018.   Butler T, The Jarisch–Herxheimer Reaction After Antibiotic Treatment of Spirochetal Infections: A Review of Recent Cases and Our Understanding of Pathogenesis. The American Journal of Tropical Medicine and Hygiene, 2016   Carlson JA et al, The Immunopathobiology of Syphilis: The Manifestations and Course of Syphilis Are Determined by the Level of Delayed-Type Hypersensitivity. The American Journal of Dermatopathology 2011.   Aronson IK and Soltani K, The enigma of the pathogenesis of the Jarisch-Herxheimer reaction. The British Journal of Venereal Diseases, 1976   Sellato TJ et al, The Cutaneous Response in Humans to Treponema pallidum Lipoprotein Analogues Involves Cellular Elements of Both Innate and Adaptive Immunity, The Journal of Immunology 2001   Spiller HA, Rethinking mercury: the role of selenium in the pathophysiology of mercury toxicity. Clinical Toxicology 2017   Sell S et al, Reinfection of chancre-immune rabbits with Treponema pallidum. I. Light and immunofluorescence studies. The American journal of pathology 1985.    Grant SS and Hung DT, Persistent bacterial infections, antibiotic tolerance, and the oxidative stress response, Virulence 2013   Lant AF, Modern diuretics and the kidney. Journal of Clinical Pathology, 1981   Kamath SU et al, Mercury-based traditional herbo-metallic preparations: a toxicological perspective, Archives of Toxicology 2012.   Yeter et al, Mercury Promotes Catecholamines Which Potentiate Mercurial Autoimmunity and Vasodilation: Implications for Inositol 1,4,5-Triphosphate 3-Kinase C Susceptibility in Kawasaki Syndrome. Korean Circulation Journal 2013   Wöβmann W et al, Mercury intoxication presenting with hypertension and tachycardia. Archives of Disease in Childhood, 1999   Giacani L et al, Identification of the Treponema pallidum subsp. pallidum TP0092 (RpoE) Regulon and Its Implications for Pathogen Persistence in the Host and Syphilis Pathogenesis. Journal of Bacteriology 2013.   Edwards AM, From tooth to hoof: treponemes in tissue‐destructive diseases. Journal of Applied Microbiology, 2003   Wolgemuth CW, Flagellar motility of the pathogenic spirochetes. Seminars in Cell & Developmental Biology 2015.   Solomon HC and Kopp I, Fever Therapy. The New England Journal of Medicine 1937.   Rice KM et al, Environmental Mercury and Its Toxic Effects. Journal of Preventive Medicine and Public Health 2014.   Drusin LM, Electron microscopy of Treponema pallidum occurring in a human primary lesion. Journal of bacteriology 1969.   McNeely MC et al, Cutaneous secondary syphilis: Preliminary immunohistopathologic support for a role for immune complexes in lesion pathogenesis. Journal of the American Academy of Dermatology 1986.   Borenstein LA et al, Contribution of rabbit leukocyte defensins to the host response in experimental syphilis. Infection and immunity 1991.   Cabot RC et al, Case 51-1976 — Bicentennial CPC — Syphilis, Diarrhea and Death in the 1820's. The New England Journal of Medicine 1976.   Hobman JL and Crossman LC, Bacterial antimicrobial metal ion resistance. 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Show Notes Jeff: Welcome back to EMplify, the podcast corollary to EB Medicine’s Emergency Medicine Practice. I’m Jeff Nusbaum, and I’m back with my co-host, Nachi Gupta. This month, we’re moving from the trauma bay back to a more private setting, to discuss Emergency Department Diagnosis and Treatment of Sexually Transmitted Diseases. Nachi: And for those of you who follow along with the print issue and might be reading in a public place, this issue has a few images that might not be ideal for wandering eyes. Jeff: I’d say we need a “not safe for work” label on this episode, though I think we are one of the unique workplaces where this is actually quite safe. Nachi: And we’re obviously pushing for “safe” practices this month. The article was authored by Dr. Pfenning-Bass and Dr. Bridges from the University of South Carolina School of medicine. It was edited by Dr. Borhart of Georgetown University and Dr. Castellone of Eastern Connecticut Health Network. Jeff: Thanks, team for this deep dive. Nachi: STDs or STIs are incredibly common and often under recognized by both the public and health care providers. Jeff: In addition, the rates of STDs in the US continue to rise, partly due to the fact that many patients have minimal to no symptoms, leading to unknowing rapid spread and an estimated 20 million new STDs diagnosed each year. Treating these 20 million cases amounts to a whopping $16 billion dollars worth of care annually. Nachi: 20 million! Kinda scary if you step back and think about it. Jeff: Definitely, perhaps even more scary, undiagnosed and untreated STDs can lead to infertility, ectopic pregnancies, spontaneous abortions, chronic pelvic pain and chronic infections. On top of this, there is also growing antibiotic resistance, making treatment more difficult. Nachi: All the more reason we need evidence based guidelines, which our team from South Carolina has nicely laid out after reviewing 107 references dating back to 1990, as well as guidelines from the CDC and the national guideline clearinghouse. Jeff: Alright, so let’s start with some basics: pathophysiology, prehospital care, and the H&P. STDs are caused by bacteria, viruses, or parasites that are transmitted vaginally, anally, or orally during sexual contact, or passed from a mother to her baby during delivery and breastfeeding. Nachi: In terms of prehospital care, first, make sure you are practicing proper precautions and don appropriate personal protective equipment to eliminate or reduce the chance of bloodborne and infectious disease exposure. In those with concern for possible sexual assault, consider transport to facilities capable of performing these sensitive exams. Jeff: As in many of the prehospital sections we have covered -- a destination consult could be very appropriate here if you’re unsure of the assault capabilities at your closest ER. Nachi: And in such circumstances, though patient care comes first, make sure to balance medical stabilization with the need to protect evidence. Jeff: Exactly. Moving on to the ED… The history and physical should be conducted in a private setting. For the exam, have a chaperone present, whose name you can document. The “5 Ps” are a helpful starting point for your history: partners, practices, prevention of pregnancy, protection from STDs, and past STDs. Nachi: 5 p’s, I actually haven’t heard this mnemonic before, but I like it and will certainly incorporate it into my practice. Again, the 5 p’s stand for: partners, practices, prevention of pregnancy, protection from STDs, and past STDs. After you have gathered all of your information, make sure to end with an open ended question like “Is there anything else about your sexual practices that I need to know?” Jeff: Though some of the information and even the history gathering may make you or the patient somewhat uncomfortable, it’s essential. Multiple partners, anonymous partners, and no condom use all increase the risk of multiple infections. Try to create a rapport that is comfortable and open for your patient to provide as much detail as they can. Nachi: And as with any infectious work up, tachycardia, hypotension, and fever should all raise the concern for possible sepsis. In your sepsis source differential, definitely consider PID in addition to the usual sources. As a mini plug for a prior issue, PID was actually covered in the December 2016 issue of Emergency Medicine Practice, in detail. Jeff: Getting back to the physical exam: though some question the utility of the pelvic exam as our diagnostics get better, the literature suggests the pelvic definitely still has a big role both in diagnosing and differentiating STDs and other pathology. Don’t skip this step when indicated. Nachi: Now that we have a broad overview, let’s talk about specific STDs, covering diagnosis, testing, and treatment. Jeff: If following along in the article, appendices 1, 2 and 3, list detailed physical exam findings for the STDs were going to discuss, while table 3 lists treatment options. A great resource to use while following along or as a reference during a clinical shift! Nachi: First up, let’s talk chlamydia, the most common bacterial cause of STDs, with 1.7 million reported infections in 2017. Most are asymptomatic, which increases spread, especially in young women. Jeff: Chlamydia trachomatis has a 2-3 day life cycle in which elementary bodies enter endocervical and urethral cells and replicate, eventually causing host cell wall rupture and further spread. Nachi: Though patients with chlamydia are often asymptomatic, cervicitis in women and urethritis in men are the most common presenting symptoms. Vaginal discharge is the most common exam finding followed by cervical ectropion, endocervical mucus, and easily induced bleeding. Other presenting symptoms include urinary frequency, dysuria, PID, or even Fitz-Hugh-Curtis syndrome, which is a PID induced perihepatitis. In men, epididymitis, prostatitis, and proctitis are all possible presenting symptoms also. Jeff: And of note, chlamydia can also cause both conjunctivitis and pharyngitis. Nachi: This article has a ton of helpful images. Check out figures 1 and 2 for some classic findings with chlamydial infections. Jeff: When testing for chlamydia, nucleic acid amplification is the test of choice as it has the highest sensitivity, 92% when tested from a first-catch urine sample vs. 97% from a vaginal sample. While these numbers are similar, and you’re gut may be to forego the pelvic exam, consider the pelvic exam to aid in the diagnosis of PID and to evaluate for cervicovaginal lesions or other concomitant stds. Nachi: Similarly, in men, the test of choice is also a nucleic acid amplification test, with a first catch urine preferred over a urethral swab. Jeff: And lastly, nucleic acid amplification is also the test of choice from rectal and oropharyngeal samples, though you need to check with your lab first as nucleic acid amplification is not technically cleared by the FDA for this indication. Nachi: Treatment for chlamydia is simple, 1g of azithromycin, or doxycycline 100 mg BID x 7 days. Fluoroquinolones are a second line treatment modality. Jeff: In pregnant women, chlamydia can lead to ectopic pregnancy, premature rupture of membranes, and premature delivery. The single 1g azithromycin dose is also safe and effective with amox 500 mg TID x 7 days as a second line. Pregnant women undergoing treatment should have a documented test-of cure 3-4 weeks after treatment. Nachi: Next up, we have gonorrhoeae, the gram-negative diplococci. Gonorrhea is the second most commonly reported STD, affecting 0.8% of women and 0.6% of men, with over 500,000 reported cases in 2017. Jeff: Gonorrhea attaches to epithelial cells, altering the surface structures leading to penetration, proliferation and eventual systemic dissemination. Nachi: Though some may be asymptomatic, women often present with cervicitis, vaginal pruritis, mucopurulent discharge, and a friable cervical mucosa, along with dysuria, frequency, pelvic pain and abnormal vaginal bleeding. Jeff: Men often present with epididymitis, urethritis, along with dysuria and mucopurulent discharge. Proctitis, pharyngitis, and conjunctivitis are all possible complications. Nachi: In it’s disseminated form, gonorrhea can lead to purulent arthritis, tenosynovitis, dermatitis, polyarthralgias, endocarditis, meningitis, and osteomyelitis. Jeff: In both men and women the test of choice for gonorrhea again is NAAT, with endocervical samples being preferred to urine samples due to higher sensitivity. In men, urethral and first catch urine samples have a sensitivity and specificity of greater than 97%. Nachi: And as with chlamydial samples, the FDA has not approved gonorrhea NAAT for rectal and oropharyngeal samples, but most labs are able to process these samples. Jeff: Yeah, definitely check before you go swabbing samples that cannot be run. Lastly, in regards to testing, though it won’t likely change your management in the moment, the CDC does recommend a gonococcal culture in cases of confirmed or suspected treatment failure Nachi: It’s also worth noting that although NAAT can be used in children, but culture is additionally preferred in all settings due to legal ramifications of sexual abuse. Jeff: It pains me just to think about how awful that is. Ugh. Moving on to treatment: when treating gonorrhea, the current recommendation is to treat both with cefitriaxone and azithro. 250 mg IM is the preferred dose, up from just 125 mg IM which was preferred dose two decades ago along with 1g of azithro. Nachi: And if ceftriaxone IM cannot be administered easily, 400 mg PO cefixime is the second line treatment of choice. If there is a documented cephalosporin allergy, PO gemifloxacin or gentamycin may be used. And for those with an azithomycin intolerance, a 7 day course of doxycycline may be substituted instead. Jeff: In pregnant women, gonococcal infections are associated with chorioamnionitis, premature rupture of membranes, preterm birth, low birth weight, and spontaneous abortions. Pregnant woman therefore should be treated with both ceftriaxone and azithro in the same manner as their non pregnant counterparts. Nachi: There is also one quick controversy to discuss here. Jeff: oh yeah, go on… Nachi: The CDC currently recommends the IM dose of ceftriaxone, not IV. And this is because of the depot effect. However, it’s unclear if this effect is in fact true, as IM and IV ceftriaxone levels measured in blood 24 hours later are similar. So if the patient has an IV already, should we just give the ceftriaxone IV instead of IM? Jeff: I think it is probably okay, but I’ll wait for a bit more research. For now, I would continue to stick with the CDC recommendation of IM as the correct route. Nachi: And with the continuing rise of STD’s and the public health and economic burden we are describing here, I think the IM route, which is known to be effective, should still be used -- until the CDC changes their recommendations. Next up we have the great imitator/masquerader, syphilis, caused by the spirochete Treponema pallidum. LIke the other STDs we’ve discussed so far, cases of syphilis are also on the rise with over 30k cases in 2017, a 10% increase from 2016. Jeff: Syphilis is spread via direct contact between open lesions and microscopic abrasions in the mucous membranes of vagina, anus, or oropharynx. The organism then disseminates via the lymphatics and blood stream. Nachi: Infection with syphilis comes in three stages. Primary syphilis is characterized by a single, painless lesion, or chancre, which occurs about 3 weeks after inoculation. 6-8 weeks later, secondary syphilis develops. This often presents with a rash, typically on the palms and soles of the feet, or with condyloma lata, or lymphadenopathy. Jeff: Tertiary syphilis doesn’t appear until about 20 years post infection and it includes gummatous lesions and cardiac involvement including aortic disease. Nachi: Patients at any stage may go long periods without any symptoms, which is known as latent syphilis. In addition, at any stage a patient may develop neurosyphilis, which can present with strokes, altered mental status, cranial nerve dysfunction, and tabes dorsalis. Jeff: In early syphilis, dark-field examination is the definitive method of detection, though this is impractical in the ED setting. There are, instead, 2 different algorithms to follow. The CDC traditional algorithm recommends a nontreponemal test like rapid plasma reagin or RPR or the venereal disease research lab test also called VDRL, followed by confirmational treponemal test (fluoresent treponemal antibody absorption or FTA-ABS or T pallidum passive agglutination also called TP-PA). More recently there has been a shift to the reverse sequence, with screening with a treponemal assay followed by a confirmatory nontreponemal assay. Nachi: The reason for the change is that there is an increased availability of rapid treponemal assays. And where available, the reverse sequence offers increased throughput and the ability to detect early primary syphilis better. The CDC, however, still recommends the traditional testing pathway -- that is nontreponemal tests first like RPR or VDRL, followed by treponemal tests like FTA-ABS or TP-PA. The article also notes that emergency clinicians should rely on clinical manifestations in addition to serologic testing, when determining whether to treat for syphilis. Jeff: For neurosyphilis, the CSF-VDRL test is highly specific but poorly sensitive. In cases of a negative CSF-VDRL but still with high clinical suspicion, consider a CSF FTA-ABS test, which has lower sensitivity, but is also highly specific and may catch the diagnosis. Nachi: Treatment for primary, secondary, and early latent syphilis is with 2.4 million units of Penicillin G IM. For ocular and neurosyphilis, treatment is with 18-24 million units of pen G IV every 4 hours or continuously for 10-14 days. In patients who have a penicillin allergy, skin testing and desensitization should be attempted rather than azithromycin due to concerns for resistance. Jeff: For pregnant women, PCN is the only proven therapy. Interestingly, there is some evidence to suggest that a second IM dose may be beneficial in treating primary and secondary syphilis in pregnancy though data are limited. Nachi: We also have to mention the Jarisch-Herxheimer reaction before moving on. This is a syndrome of fevers, chills, headache, myalgias, tachycardia, flushing and hypotension following high dose PCN treatment due to a massive release of endotoxins when the bacteria die. This typically occurs in the first 12 hours but can occur up to 24 hours after treatment. Treatment is supportive. Concern of this reaction should never delay PCN treatment!! Jeff: The next condition to discuss is Bacterial vaginosis, or BV, which, interestingly, is not always an STD. It is therefore critically important to choose your words wisely when speaking with a patient who has BV. Nachi: That is an important point that is worth repeating. BV is not always an STD. So what is BV? BV occurs when there is a decrease or absence of lactobacilli that help maintain the acidic pH of the vagina leading to an overgrowth of Gardnerella, bacteroides, ureaplasma and mycoplasma. BV does not occur in those who have never had intercourse and it may increase the risk of other STDs and HIV. Jeff: 50% of women with BV are asymptomatic, while the others will have a thin, grayish-white, homogeneous vaginal discharge with a fishy smell, along with pruritis. Nachi: To diagnose BV, most use the amsel criteria, which requires 3 of following 4: 1) a thin, milky, homogeneous vaginal discharge, 2) the release of a fishy odor before or after the addition of potassium hydroxide, 3) a vaginal pH > 4.5, and 4) the presence of clue cells in the vaginal fluid. These criteria are 90% sensitive and 77% specific, with clue cells being the most reliable predictor. Jeff: And for those of us without immediately available microscopy, you can make the diagnosis based on characteristic vaginal discharge alone. Treat with metronidazole, 500 mg BID for 7 days, metronidazole gel, or an intravaginal applicator for 5 days, with the intravagainal applicator being better tolerated than the oral equivalent Nachi: BV in pregnancy increases risk of preterm birth, chorioamnionitis, postpartum endometriitis and postcesarean wound infections. Pregnant patients are treated the same as nonpregnant or with 400 mg of clindamycin BID x 7 days. Jeff: Always nice when there is really only one treatment regimen across the board. And that will be a general theme for treatment options in pregnancy with a few exceptions. Nachi: Next up we have Granuloma inguinale, or donovanosis, which is caused by Klebsiella granulomatis. Jeff: Granuloma inguinale is endemic to India, the Caribbean, central australia, and southern africa. It is rarely diagnosed in the US. Nachi: Granuloma inguinale presents with highly vascular, ulcerative lesions on the genitals or perineum. They are typically painless and bleed easily. If disseminated, Granuloma inguinale can lead to intra-abdominal organ and bone lesions and elephantiasis-like swelling of the external genitalia. Jeff: Granuloma inguinale can can be diagnosed by microscopy from the surface debris of purulent ulcers. Nachi: Once you have the diagnosis, the CDC recommends treatment with azithromycin for at least 3 weeks and until all lesions have resolved. Jeff: Next we have lymphogramuloma venereum or LGV. Nachi: LGV is a C. Trachomatis infection of the lymphatics and lymph nodes. This is predominantly a disease of the tropics and subtropical areas of the world. Jeff: On exam, in the primary stage, you would expect a small, painless papule, pustule, nodule or ulcer on the coronal sulcus of the penis or on the posterior forchette, vulva, or cervix of women. The primary stage eventually progresses to the secondary stage, which is characterized by unilateral lymphadenopathy with fluctuant, painful lymph nodes known as buboes. Nachi: Check out figure 11 for a great classic image of the “groove sign” which is involvement of both the inguinal and femoral lymph nodes, and is seen in 15-20% of cases. And actually even more common than the groove sign is a presentation with proctitis. Jeff: Testing for LGV should be based on high clinical suspicion, and NAAT should be performed on a sample from the primary ulcer base or from aspirate from a bubo. Nachi: Treatment for LGV is with doxycycline 100 mg BID x 21 days. Jeff: So, to summarize, for LGV, remember painful lymphadenopathy, especially in those with proctitis. Treat with doxy. Nachi: Next we have Mycoplasma genitalium, which causes nongonococcal urethritis in men and mucopurulent cervicitis and PID in women. Jeff: Unfortunately, there is no diagnostic test for M. genitalium, and it should be considered clinically, especially in the setting of recurrent urethritis. Nachi: Treat with azithro, but not 1g x 1. Instead, M. Genitalium should be treated with a course of azithro, with 500 mg on day 1 followed by 250 mg daily for 4 days. Moxifloxacin is an alternative. Jeff: Simple enough. Moving on to everybody’s favorite, genital herpes. Nachi: umm, I’m not sure sure anybody would call herpes their favorite. Why would you even say that? Jeff: i don’t know, seemed natural at the time… Regardless, primary genital herpes is caused by either HSV1 or HSV2. Though only an estimate, and likely an underestimate at that, it is estimated that at least 1 in 6 people in the US between 14 and 49 have genital herpes. Nachi: That’s much higher than I would have thought. Jeff: Patients usually contract oral herpes from HSV-1 due to nonsexual contact with saliva and genital herpes due to sexual contact with an infected person. Nachi: Keep in mind, however, that HSV1 can and will also cause genital infections if spread via oral sex. Jeff: Localized symptoms include pain, itching, dysuria, and lymphadenopathy and systemic symptoms include fever, headache, and malaise. In women, look for herpetic vesicles on the external genitalia along with tender ulcers in areas of rupture, see figure 12 for a characteristic image. Nachi: Though symptoms tend to be more severe in woman, men may present with vesicles on the glans penis, penile shaft, scrotum, perianal area, and rectum or even with dysuria and penile discharge. Jeff: HSV1 and 2 infections also have the ability to recur, though recurrences tend to become less frequent and severe over time. Nachi: It’s noteworthy that there is also a direct correlation between stress levels and the severity of an HSV outbreak. Jeff: Herpes can be diagnosed by viral culture of an unroofed vesicle or by NAAT. PCR based assays can also differentiate between HSV1 and HSV2 Nachi: While there is no cure, antivirals may help prevent and shorten outbreaks. Ideally you should begin treatment within 72 hours of lesion appearance. Treat with acyclovir, valacyclovir, or famciclovir. In addition, don't forget about adjuncts like analgesia, sitz bathes, and urinary catheter placement for severe dysuria. Jeff: HSV can also be vertically transmitted from mother to child so in pregnancy, treat with acyclovir 400 mg 3x/day for 7 days or valacyclovir Nachi: And because transmission is so easy, babies born to mothers with active lesions should be delivered by cesarean section. Jeff: Let’s move on to human papillomavirus, or HPV. There are over 100 types of HPV with 40 being transmitted through skin to skin contact, typically via vaginal and anal intercourse. Nachi: Most infections are asymptomatic and clear within 2 years. Jeff: Right, but one of the main reasons this is such a big deal is that HPV types 16 and 18 are oncogenic strains and can lead to cervical, penile, vulvar, vaginal, anal, and oropharyngeal cancers. Amazingly, HPV is responsible for more than 95% of the cervical cancers in women. Nachi: Hence the importance of the new vaccine series that most young adults and children are now opting for. Vaccination should occur in women through age 26 or men through age 21 if not previously vaccinated. Jeff: Critically important to take advantage of a vaccine that can prevent cancer! Nachi: And though not as important in terms of health consequences, just be aware that HPV 6 and 11 may lead to anogenital warts, known as condyloma acuminata. Jeff: In terms of exam findings, as you just mentioned, most infections are asymptomatic and self-limited. If symptoms do develop, HPV typically causes those cauliflower like or white plaque like growths lesions on the external genitalia, perineum, and perianal skin. Nachi: For testing, there is a limited role in the ED. Diagnosis should be made by visual inspection, followed eventually by a biopsy. Jeff: And just like the biopsy, which is unlikely to be done in the emergency department, most treatment is also not ED based. Treatment options include cryotherapy, immune-based therapy, and surgical excision, which has both the highest success rates and lowest recurrence. Nachi: Next up, we have trichomoniasis. Jeff:Trichomoniasis is a single-celled, flagellated, anaerobic protozoa, that directly damages the epithelium, causing microulcerations in the vagina, urethra, and paraurethral glands. Nachi: With an estimated 3.7 million infected people in the US, this is something you’re also bound to see. Jeff: Risk factors include recent or current incarceration, IV drug use, and co-infection with BV. Nachi: Note the common theme here - co infection. It’s very common for patients to have more than one STD, so make sure not to anchor when you think you’ve nailed the diagnosis. Jeff: On exam the majority of both women and men are asymptomatic. In women, you may find a purulent, frothy vaginal discharge, vaginal odor, vulvovaginal irritation, itching, dyspareunia, and dysuria Nachi: And don’t forget about the classic colpitis macularis, or the strawberry cervix. Though this is frequently taught and stressed, it’s actually only seen in 2-5% of infected women. Jeff: But to be fair, a strawberry cervix and frothy vagianl discharge together have a specificity of 99% for trich, which is really not bad. Nachi: While many EDs sadly aren’t blessed with a wet mount, the wet mount has the advantage of being simple, convenient, and generally low cost. Jeff: While all of that is true regarding the wet mount, it’s no longer first line, again with NAAT being preferred, as it’s highly sensitive, approaching 100%. Nachi: And for those of us who don’t have access to NAAT, there are also antigen-detecting tests which don’t perform quite as well, but they are much more sensitive than the traditional wet mount. Jeff: Treatment for trichomoniasis is with oral metronidazole, 2g in a single oral dose a or 500 mg twice a day for 7 days. Alternatively, the more expensive tinidazole, 2g for 1 dose, is actually superior according to the most recent evidence. Nachi: For pregnant patients, trichomoniasis is unfortunately associated with premature delivery and premature rupture of membranes, with no improvement following treatment. Still, patients should be tested and treated, preferentially with metronidazole, to relieve symptoms and prevent partner spread. Jeff: We have two more special populations to discuss in this month’s issue - those in correctional facilities and sexual partner treatment. If you are lucky enough to be involved in treating those in correctional facilities, keep in mind that rates of gonorrhea, chlamydia, syphilis, and trichomoniasis are higher in persons in both juvenile and adult detention facilities than the general public. Nachi: In general for patients in correctional facilities, maintain a lower threshold for just about everything. This is just an at-risk population. Jeff: Let’s move on to sexual partners, and expedited partner therapy or EPT. Nachi: Once you’ve diagnosed a patient with an STD, you can also provide a prescription or medication to the patient to give to their partner or partners. Jeff: This practice is critically important to stop partners from unknowingly spreading the STD further which is a real problem. Unless prohibited by law, emergency clinicians should routinely offer EPT to patients with chlamydia, gonorrhea, or trichomoniasis. To see your states’ current status, the CDC maintains a list of the status in all 50 states. Nachi: In terms of specific partner therapies, for chlamydia, EPT can be accomplished with a single 1g dose of azithromycin or doxycyclin 100 mg bid for 7 days. Consider concurrent treatment for gonococcal infection also. Jeff: For Gonorrhea, EPT includes a single oral dose of 400 mg of cefixime and a 1g oral dose of azithromycin. Nachi: For EPT for syphilis, unfortunately the partner has to present to the ED for a single IM injection of penicillin G. While this does place a burden on the partner, it opens up an opportunity for additional serologic testing and possibly treatment of his or her partners as well. Jeff: Routine EPT for those with BV is not recommend as the data shows that partner treatment does not affect rates of relapse or recurrence. Nachi: For genital herpes, you should counsel patients and their partners that they should abstain from sexual activities when there are lesions or prodromal symptoms. Make sure to refer partners for evaluation as well. Jeff: Since there isn’t much data on HPV partner notification, for now, encourage patients to be open with their partners so they may seek treatment as well. Nachi: And lastly, for Trichomoniasis, EPT includes 2 g of metronidazole or 500 mg BID for 7 days or that single 2g dose of tinidazole. Jeff: In general, it is always better to have the partner present to a physician for diagnosis and treatment, but EPT is an option when that seems unlikely or impossible. Nachi: Also, when possible be sure to inquire about drug allergies and provide some guidelines on ER presentation for allergic reactions. Jeff: So that wraps up EPT. Let’s discuss disposition. Though most will end up going home, a few may require IV medications, such as those with severe HSV, disseminated gonococcus, and neurosyphilis. Nachi: Admission should also be strongly considered in those who are pregnant or with concern for complications. Those with severe nausea, vomiting, high fever, the inability to tolerate oral antibiotics, and those failing oral antibiotics should also be considered for admission. Jeff: But if your patient doesn’t meet those criteria, as most will not, and they are headed home, stress the importance of follow up. Especially for those with gonorrhea and chlamydia, for whom a test of cure after completion of their medication is recommended. This is even more important for pregnant women. Nachi: Chlamydia, gonorrhea, HIV, and syphilis are among the many infectious diseases that require mandatory reporting. Definitely familiarize yourself with your states’ reporting laws, as most of these patients will be headed home and you’ll want to make sure you don’t miss your chance to prevent further spread. Jeff: Perfect, so that’s it for this month’s issue. Let’s close out with some high yield points and clinical pearls. Nachi: STDs are under recognized by patients and healthcare professionals. They can often present with minimal or no symptoms and are passed unknowingly to partners. Jeff: STD’s can have devastating effects during pregnancy on the fetus. Treat these patients aggressively in the ER. Nachi: The rising rate of STD’s continues to be an economic burden on the U.S. healthcare system. Jeff: Patients can present with multiple STD’s concurrently. Avoid premature diagnostic closure and consider multiple simultaneous processes. Nachi: Urinary tract infections and STD’s can present similarly. Be sure to do a pelvic exam to avoid misdiagnosis. For the exam, always have a chaperone present. Jeff: Acute unilateral epididymitis is most commonly a result of chlamydia in men under the age of 35. Nachi: Chlamydia is the most common bacterial STD. The diagnostic test of choice is nucleic acid amplification testing (NAAT). Treat with azithromycin or doxycycline. Jeff: Gonorrhea is the second most common STD. The diagnostic test of choice here is again NAAT. Treat with ceftriaxone and azithromycin. Nachi: Gonorrhea can lead to disseminated infection such as purulent arthritis, tenosynovitis, dermatitis, polyarthralgias, endocarditis, meningitis, and osteomyelitis. Jeff: Syphilis has a wide variety of presentations over three stages. For concern of early syphilis, send RPR or VDRL for nontreponemal testing as well as an FTA-ABS or TP-PA for treponemal testing. Nachi: Tertiary syphilis can present with gummatous lesions or aortic disease many years after the primary syphilis infection. Jeff: At any stage of syphilis, the central nervous system can become infected, leading to neurosyphilis. Nachi: Bacterial vaginosis presents with a white, frothy, malodorous vaginal discharge. Treat with metronidazole. Jeff: Genital herpes is caused by HSV-1 or HSV-2. Diagnosis can often be made clinically. If sending a sample for testing, be aware that viral shedding is intermittent, so you may have a falsely negative result. Antivirals can help prevent or shorten outbreaks and decrease transmission. Nachi: Lymphogranuloma Venereum presents with small, painless papules, nodules, or ulcers. Groove sign is present in only 15%-20% of cases. Jeff: Consider Fitz-Hugh-Curtis syndrome in your differential for a sexually active patient with right upper quadrant pain. Nachi: Offer expedited partner therapy to all patients with STD’s to prevent further spread Jeff: So that wraps up Episode 27 - STDs in the ED! Incredibly high yield topic with lots of pearls. Nachi: As always, additional materials are available on our website for Emergency Medicine Practice subscribers. If you’re not a subscriber, consider joining today. You can find out more at ebmedicine.net/subscribe. Subscribers get in-depth articles on hundreds of emergency medicine topics, concise summaries of the articles, calculators and risk scores, and CME credit. You’ll also get enhanced access to the podcast, including any images and tables mentioned. PA’s and NP’s - make sure to use the code APP4 at checkout to save 50%. Jeff: I’ll repeat that, since saving money is important. APPs, use the promotion code APP4 at checkout to receive 50% off on your subscription. Speaking of PAs - for those of you attending the SEMPA conference in just a few weeks, make sure to check out the EB Medicine Booth, #302 for lots of good stuff. For those of you not attending the conference, just be jealous that your colleagues are hanging out in New Orleans. Nachi: And the address for this month’s credit is ebmedicine.net/E0419, so head over there to get your CME credit. As always, the you heard throughout the episode corresponds to the answers to the CME questions. Lastly, be sure to find us on iTunes and rate us or leave comments there. You can also email us directly at EMplify@ebmedicine.net with any comments or suggestions. Talk to you next month! Most Important References 3. Workowski KA, Bolan GA. Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep. 2015;64(Rr- 03):1-137. (Expert guidelines/systematic review) 5. Torrone E, Papp J, Weinstock H. Prevalence of Chlamydia trachomatis genital infection among persons aged 14-39 years- -United States, 2007-2012. MMWR Morb Mortal Wkly Rep. 2014;63(38):834-838. (Expert guideline/systematic review) 98. Schillinger JA, Gorwitz R, Rietmeijer C, et al. The expedited partner therapy continuum: a conceptual framework to guide programmatic efforts to increase partner treatment. Sex Transm Dis. 2016;43(2 Suppl 1):S63-S75. (Systematic review; 42 articles) 103. Centers for Disease Control and Prevention. 2018 National Notifiable Conditions (Historical). National Notifiable Diseases Surveillance System (NNDSS). Accessed March 10, 2019. (CDC website) 105. Carter MW, Wu H, Cohen S, et al. Linkage and referral to HIV and other medical and social services: a focused literature review for sexually transmitted disease prevention and control programs. Sex Transm Dis. 2016;43(2 Suppl 1):S76-S82. (Systematic review; 33 studies)

In this episode from a survey of genomes, Daijah Sek from the 2019 Hiram College Genetics course walks us through the genome of the syphilis pathogen Treponema pallidum.

On this episode, we want you to meet the bacterium named Treponema pallidum! He's got a cool name! He's got a cool bod! Will it be enough to make up for how much of a doofus he is?**CORRECTION NOTE**: Alex said "darkfield microscopy" in place of what should have been "fluorescent microscopy". They go hand-in-hand, but are a little different. Please don't yell at her.Theme music is "Lovesick" written and performed by Mors Ontologica.

On this episode, we want you to meet the bacterium named Treponema pallidum! He's got a cool name! He's got a cool bod! Will it be enough to make up for how much of a doofus he is?**CORRECTION NOTE**: Alex said "darkfield microscopy" in place of what should have been "fluorescent microscopy". They go hand-in-hand, but are a little different. Please don't yell at her.Theme music is "Lovesick" written and performed by Mors Ontologica.

Hello Listener! Thank you for listening.  If you would like to support the podcast, and keep the lights on, you can support us whenever you use Amazon through the link below: It will not cost you anything extra, and I can not see who purchased what. Or you can become a Fluffle Supporter by donating through Patreon.com at the link below: Patreon/Hare of the Rabbit What's this Patreon? Patreon is an established online platform that allows fans to provide regular financial support to creators. Patreon was created by a musician who needed a easy way for fans to support his band. What do you need? Please support Hare of the Rabbit Podcast financially by becoming a Patron. Patrons agree to a regular contribution, starting at $1 per episode. Patreon.com takes a token amount as a small processing fee, but most of your money will go directly towards supporting the Hare of the Rabbit Podcast. You can change or stop your payments at any time. You can also support by donating through PayPal.com at the link below: Hare of the Rabbit PayPal Thank you for your support, Jeff Hittinger.   Breeding Rabbits Definitions A female rabbit is called a doe. A male rabbit is called a buck. When referring to the parents of a rabbit, the mother is called the dam, and the father is called the sire. When you mate two rabbits together, this is called breeding. When you check to see if the doe is pregnant or when you breed her again before she is due to give birth, this is called testing. When you put a box in the hutch that is lined with hay, this is called nesting. When the doe gives birth, this is called kindling. The period of time between breeding and kindling is called the gestation period. She gives birth to a bunch of bunnies called kits. This bunch of bunnies is called a litter. When you take the young rabbits away from the mother, this is called weaning. Breeding Plan - Discuss This With Your Parents! Before we begin to discuss breeding rabbits, it is important to understand that there are several reasons NOT to breed your rabbits. Some of these are very good reasons. If you are a beginning rabbit owner, or have rabbits as pets only, there are a lot more justifications for NOT breeding your rabbit than to go ahead with it! One major consideration when deciding to breed any animals is the overpopulation of pets in general. Some others include the extra expense, health considerations of your animals, and having to find homes for young rabbits you cannot keep. However, if you are an experienced rabbit raiser (or you are a beginner with help), have sound knowledge of rabbit care and health, and want to produce rabbits for showing, meat, or fiber, then it could be an excellent decision to start a breeding program, or at least try it out! Determine the best time to start your breeding program! Be sure your rabbits are healthy. Choose the rabbits you wish to breed. Another wise thing to do when just starting out is to contact a breeder that raises your chosen breed, and offer to purchase a pregnant doe from him or her. Ask to have her bred to one of the breeder’s best bucks, although with an increase in quality comes an increase in price. It can be a great investment though, and get you started with young rabbits you know were bred well. When To Breed There is a reason for the expression, “breeds like a rabbit!” Rabbits are notoriously fertile from a young age, and easy to breed. Their young grow quickly, and the mothers and young do not require a lot of human intervention, for the most part. However, in order to ensure the health of your animals, it is prudent to wait until they reach full body and reproductive maturity before breeding. There are four main weight classes of rabbits: small, medium, large, and giant breeds. The age at which the rabbit is ready to reproduce depends highly on the maximum weight they are expected to achieve as an adult. Smaller breeds tend to sexually mature faster than the larger breeds. The general rule for the proper age to begin breeding at is as follows: Small breeds (under 6 pounds max) – 4 ½ months Medium to Large Breeds (6-11 pounds max) – 6 months Giant Breeds (Over 11 pounds max) – 9 months Also in general, bucks tend to be about a month behind does in maturing. So, if you want to mate a purebred Polish buck and doe, she might be ready at 4 ½ months of age to reproduce, but it would be advisable to wait until he is closer to 6 months of age. Waiting is worth it – your animals will be much more productive, or perhaps “reproductive,” if you are patient and wait until they’re really ready! Health Check And Signs That A Doe Is Ready For Breeding It is important to check each rabbit before breeding to be sure that the rabbit is healthy and in good physical condition. The weight should be appropriate for the sex and breed of your rabbit. Never breed your rabbit if it shows signs of a sickness or illness. If a doe is ready to breed, they will begin to rub their chin on their food dish to mark their territory. Before breeding, check the bottom of the cage of both the doe and buck for evidence of diarrhea or loose stools. Do not breed the rabbit having this condition until it has been adequately treated. Also check the genitals of both rabbits for any signs of disease or infection (for example, extreme redness, discharge, sores or scabbiness). A good reference is the ARBA Official Guidebook section on diseases. Selecting Breed Pairs You should know as much as possible about the rabbit you are choosing to breed. It is more likely to pass on good traits with two healthy and qualified rabbits. Check the pedigree background for the rabbit’s strong points; such as strong shoulder, good body, and excellent type. It's usually a good idea to select rabbits to breed whose ancestry has evidence of good productivity and good genetics. That is where productivity records and pedigrees listing show winnings come in handy. Keep productivity and show records of your herd just for this purpose. Only mate rabbits of the same breed. Exceptions to this include breeding for meat, pets or genetic experimentation. You cannot sell a pedigree rabbit that has mixed blood in its background going back 4 generations. It is advisable to breed only purebred, pedigreed rabbits. The main reason for this is because pedigreed rabbits have documented bloodlines, characteristics, and a general history you can look back on that will help you better predict the outcome of the breeding you have planned. When breeding two rabbits of unknown heritage, there is a much bigger potential for birthing problems and genetic defects. It is also easier to find homes and interested buyers for well-bred stock. Be advised though, that even having two purebred, pedigreed rabbits does not ensure a good cross – the goal should always be for the animals to out-produce themselves. The hope is that the offspring will be of better quality and meet the ideal of the breed standard more closely than their parents. Therefore, you must carefully evaluate your pairing to make sure the rabbits complement one another in confirmation (body type) and if it matters to the breed, color and markings as well. Choose the rabbits based on their strengths and weaknesses. A buck with strong shoulders would be matched with a doe with weak shoulders but good size. Try to offset any weaknesses with strengths. Try not to put two weak features together since that will only fix the weak feature in the blood line. Who Can Be Bred To Whom? Never breed brothers to sisters. Other combinations are fine: father-to-daughter, mother-to-son, cousins, etc. Until you gain some knowledge as to how genetics works with inbreeding, I would recommend your not breeding closely related pairs. As mentioned before, mate the same breeds together unless you are trying to get meat rabbits with certain characteristics or you are doing genetic experiments or you don't care about the fate of the offspring. You cannot sell the offspring as pedigree if their ancestry is not of the same breed going back four generations. You may mate rabbits of the same breed having different colors. Keep in mind, though, that there are many combinations of possibilities when mixing colors. Some of the offspring may have colors that are not recognized by ARBA. It is usually best to mate rabbits having the same color to start off with until you know more about how the colors interact. You can also, join the national specialty group for the breed you are interested in raising. They usually have literature on how to develop the best color, size, and shape of your rabbit. Avoid breeding rabbits that have genetic defects such as tooth malocclusion (wolf teeth) or moon eye (cloudy cornea), or produces offspring whose skull does not come together (except in dwarfs, where approximately 25% are born too small with deformed head or legs - the offspring are called peanuts). Determine whether the sire or dam is responsible for passing the genetic defect and eliminate it for breeding purposes. Strive to meet the perfect standard for the breed you are mating. You can order the ARBA Standard of Perfection Booklet to know exactly what is expected of the breed. Gauging Interest Rabbits have a reputation for being ready to breed all the time. This is not necessarily the case! Bucks are typically a bit more consistently ready. You can tell that your buck is interested in mating when he starts vigorously sniffing around a table you’ve just placed a doe on moments ago, or if through cages, the buck begins acting more excited and slightly aggressive when he smells a neighboring doe. He may also begin acting amorous toward other objects when he is out and about! Does, however, are not quite as obvious about expressing their desires. A doe rabbit is atypical from most mammals, as she is polyestrous, meaning she has no regular heat cycles. The eggs of a female rabbit are not shed at regular intervals – instead, ovulation is stimulated by mating. This offers the breeder a lot of flexibility in terms of what time of year and how frequently they will breed members of their herd. Some signs that a doe may be more willing to breed are restlessness, and “chinning,” which is the act of her rubbing her chin on the cage or piece of equipment inside the cage. Mating Process Because does are not as willing to breed and they are very territorial, you always bring the doe to the male’s cage. If the doe does not show interest in mating after ten minutes, you should take her out of the cage and try again in a couple days. When ready to breed the doe, take it to the buck's cage. Never bring the buck to the doe's cage. The reason for this is that the buck has less tendency to breed in the doe's cage. He's too busy sniffing around the cage. Most often, rabbit mating is a quick and painless process, requiring little to no assistance on the part of their human handlers. When you are ready to have the doe bred, the most important thing to remember is to bring the doe to the buck’s cage – NOT the other way around. Sexually mature does are incredibly territorial, and can do severe damage to a buck that suddenly enters her territory. It only helps to have good equipment. A wire cage, that open from the front and are all wire allow for easy access and easy monitoring. Most often, once the doe is placed in the cage housing the buck, he will circle her briefly, and then mount her. If she is receptive, she will lift her tail for him. Keep a close eye on both rabbits, to ensure that the doe remains on good behavior. Be ready to remove her immediately if she starts growling or even attacking the buck. Try to breed at least two does on the same day, hopefully from different breeds or colors. This way you can move babies from litters around if we need to foster any kits. Having different breeds or different colors in the nest box makes it easier to see who came from which litter. If the doe runs around in a circle, this is not so bad. I’ll let her run a few laps then I’ll put my hand in the cage and stop her for the buck to breed her. Most of the time the doe will accept the buck. If the doe sits down or tries to climb the sides of the cage, I’ll wait for 5 minutes . If she won’t stand still and accept the buck, I’ll take the doe out and try her again in a few hours or the next day. And the next day if necessary. If she doesn’t accept the buck, I will wait for the next week to try her again. A really good sign is when the buck gives a grunt when he’s done doing his thing, and falls off of the doe onto his side. Once this has occurred, it is wise to get the doe out of there. Although some bucks are more aggressive than others, they will rarely hurt the doe. If you do not see the ritual just described take place within a minute or so of placing them together, and it looks like they are getting along, you can leave the doe in there for a few minutes to see what will happen. If you’re not sure if the mating was successful, it is a good idea to try again anywhere from 6 to 10 hours later, and simply repeat what you did the first time. If you are unsure about whether or not a successful breeding took place, you can carefully introduce the doe to the buck again in about 7-10 days. If she is uninterested in him, or acts grouchy, she is probably pregnant. The buck will breed with the doe, usually immediately. After a few sniffs which apprise him of the situation, the buck promptly circles around to the hind end of the doe, mounts the doe, accomplishes the rabbit mating, and then falls off the doe with a grunt. Signs of success: the grunt and fall-off. The buck might also get all macho, and thump the cage floor a couple times. A second rabbit mating before removing the doe seems to increase the success rate and litter size. Just leave the doe in the cage. The buck will catch his breath, lose interest in thumping the floor, and regain interest in the doe. He’ll remount her, she’ll lift her hind end, and a second mating will occur. Some breeders like to see a third breeding. And frequently a third breeding might take place during the half-hour we leave the buck and doe together. But we are usually satisfied with two matings. Remove the doe to her cage. Toss hay into her cage, and a little bit of black oil sunflower seeds (BOSS) or whole oats into the feeder as a reward. There’s another reason too: to keep her mind off the condition of her bladder. She’ll go straight to the feeder or to the hay, instead of heading to the back of her cage where her toilet area is. It's just one more trick to give the doe the best chance at a big litter. Some leave the doe with the buck overnight. Others put the doe in, watch it, and when they have mated, remove the doe. If you do the latter, put the doe back in with the buck 1 to 12 hours after the initial breeding. This will increase the likelihood of pregnancy and may increase the number of offspring. Although in most temperate climates, most rabbits will willingly mate year-round, cold weather does tend to put a damper on their libido. Some rabbits aren’t affected, but females especially seem to be less receptive to the males during the winter months. Providing a heat lamp on the doe a day or two before mating, extending the daylight hours in your rabbitry with artificial light, or keeping her cage located next to a window with lots of light can help with this. Keep in mind also, that the better overall condition your animals are in, the better breeders they will be. Try to avoid mating bucks and does that are molting their coats, or are experiencing weak or thin flesh condition. Rabbit Mating: What do you do when the doe doesn't cooperate with the buck? In my area, late autumn is when does want to just hunker into the corner of the buck's cage, and no amount of sweet-talking or complaining on the buck's part can coax cooperation out of the doe. Here are a few tricks that might help convince the doe: Retry the rabbit mating in a day or two. The doe may be ready then. Check the weather forecast. If the doe spurned an attempt at rabbit mating, you could plan to re-try the breeding when the barometer is rising or the temperature is warming. This works some of the time. You could try swapping cages. Put the buck in the doe's cage, and the doe in the buck's cage for an overnight stay. In the morning, or when you return to the animals, put the doe back into her own cage where the buck is waiting. She may be willing this time, since she is now familiar with the buck's scent. If the doe's tail begins to twitch, or if the doe begins circling to mount the buck, the doe is 'in the mood,' even if she circles the buck's cage at first. After Mating The doe may become very cranky over the next few days. This is okay! Do give her space. Leave her in her cage. Leave her alone, if this is what she wants. Always be sure to put the doe back to her cage where she is going to kindle. After 14 days into the pregnancy, you can use a stethoscope to listen for the heartbeats. If your doe is pregnant, you can expect the babies to be born in 28 to 32 days. Palpating can be done 10 days after mating in her cage to make it less stressful. At 3 weeks or more you may see an increase in the size of your doe’s belly. You may keep a ratio of one buck to 10 does if you wish. The buck may be bred up to 7 times a week effectively. Sometimes, you can use the buck twice in one day. The most I use a buck is twice a week. Palpating It can be frustrating to find that you waited nearly an entire month, and your female rabbit was never pregnant! You can avoid some of this wait time by palpating your doe 10-14 days after mating to see if you can feel any babies. Learning to palpate takes a little practice. Older does are easier to practice on than first litter does, as their muscles are a bit more relaxed, and they are generally more patient. Take the doe out of her cage and place her on a carpeted table. With one hand, grasp the doe over the shoulders and take the other hand with the thumb and fingers opposing each other push up into the abdomen just in front of the pelvis. This can feel awkward at first, and most people don’t want to push hard enough to actually feel anything. Enough pressure can be used to raise the doe's hindquarters nearly off the table. People who fail at palpation usually do so out of fear of hurting the doe her babies. The chances of that happening are very slim. Each embryo is cushioned in its own amniotic sac, so what you are actually feeling is the fluid filled amnion-not the embryo itself. Once you are secure in your position, move your hand back and forth along each side of the abdomen and slightly towards the middle. At 10 days, the embryo feels like a firm blueberry. At 12 days, they feel more like marbles, and at 14 days, they should feel more like large grapes or olives. Once you feel an embryo or two, it is wise to stop and pet the doe, and let her go back to her home. The entire procedure takes only seconds to perform once you know how. A common palpation mistake occurs when people confuse the round fecal pellets for embryos. Confusion can be avoided by remembering that the fecal pellets are small, very hard, and are found closer to the backbone, while embryos are found about midway into the abdominal cavity. If you squeeze these pellets instead of embryos, they will feel very hard, almost like rocks. Developing babies have more of a firm-fruit feel. Care Of Pregnant Doe Make sure the doe has plenty of fresh water and food in a clean house. Do not over feed your doe during the early stages of pregnancy. Keep a calendar and accurate records of the day you breed the doe. You should test her for pregnancy between the 10th and 14th day after the initial breeding. There are two ways to do this. The overall preferred method is to palpate the lower abdomen of the doe with your thumb and forefinger checking for nodules about the size of a marble. The other method is not only more risky but also more inaccurate, and not recommended. This method is to mate the doe with the buck again. This can cause problems because the doe has two uterine horns, each of which can carry babies. It is possible for one horn to be fertilized on the first mating and the second to be fertilized on the second mating. This will create a hormonal imbalance and cause the babies in both uteri to not form right, causing her to pass blobs instead of babies at the date of kindling. There is also a chance these "mummified" blobs could cause complications leading to the death of the doe. Nest Box Nest boxes can be made in a variety of sizes and types. Nest boxes can be made of wood, wire, or metal. Suggested sizes of the nest boxes are: Small breeds – 14” long, 8” wide, 7” high Med. breeds – 18” long, 10” wide, 8”high Lg. breeds – 20” long, 12” wide, 10” high Hay and straw is most often used for the nesting in the nest box. You can use less bedding in the summer. You need to use more hay and shavings during the cold winter months. Gestation in rabbits is typically 28-34 days. However, many breeders will tell you that their rabbits nearly always kindle (give birth) on the 31st day! Around day 26, you should place a nest box in the doe’s cage so that she can begin to prepare a nest. Pre Kindling Behavior Before kindling, the doe will prepare a nest. Some does will carry a mouthful of hay around to prepare for her new litter. She may also pull fur form her chest and belly for nesting materials and to prepare for nursing. You should place a nest box in her cage on the 29th day after breeding. I have placed it even earlier if the Doe is showing any signs of kindling. Thirty-one days after breeding, she should kindle her litter. Every rabbit is different in the way she prepares to kindle her kits. You can provide a wooden nest box, or a metal one that is easy to clean and sanitize. They come in a variety of sizes, and it is important to get the right size for the breed of rabbit you have. The rule of thumb is that it only needs to be large enough for the doe to comfortably turn her body around in. The idea is that it is a cozy den for the babies to stay warm and dry. If the nest box is too large, it may also lead the female to start using it as a toilet, which is not healthy for her litter. The nest box should be filled with wood shavings, and plenty of fresh grass hay. The doe will instinctively begin to pull fur from her chest and back to line the nest she is preparing for her babies. Some does pull hair a bit gradually, and some wait until right before they kindle. It is important, during these last few days, that the doe have ample access to fresh hay and water, along with her regular pellet feed. It is also important to keep her environment free from unusual or sudden loud noises, as this can spook the doe, and cause her to stomp on or even eat her kits (babies) at birth. Checking The New Litter It is important to check the young when they are born. It’s important to keep the area where the kits are quiet. A nervous doe may protect her young by jumping in the nest box. Kits are born without fur and with their eyes closed. Eyes should open within 10-14 days. At least once a day, look carefully at the nest box. There is no need to disturb it, or pull it out to look at it. You are looking for movement. Most rabbits kindle late at night, or in the early hours of the morning. You will know that the babies have arrived, when you see the fluff in the nest box moving, seemingly on its own! There are varying opinions around when the nest box should be pulled out and looked at. Ideally, this should be done in the first 24 hours, to check on the health and well being of the newborns. Any dead kits, or remaining placenta should be removed immediately and disposed of. A sign of a successful, healthy delivery is little to no trace of blood, and kits that appear to be clean, dry, and have big round bellies. The young are very vulnerable, as they are born naked, blind, and deaf. It is okay to handle each kit gently, as the mother rabbit is likely used to your scent. Also, rabbits only nurse their young twice a day, for 5-10 minutes at a time, so don’t interrupt if you see that happening! Fostering Kits When you have larger litters some of the kits are unable to get the amount of food they need. To prepare for this, breeders breed more than one doe to kindle at the same time. If a doe has an unusually large litter, they can move some kits to the smaller litter, and this is called fostering. Fostering should be done in the morning. Newborn Care And Checking The Litter Most doe’s only feed once every 24 hours. You will want to continue to check your newborn’s daily. Be sure that all kits stay with the warmth of the other kits. As the kits begin to grow, you need to check to be sure that their belly’s are round. Baby rabbits begin to grow their fur within a few days, and by 2 weeks they are completely furred. Hand Feeding A Rabbit Sometimes a doe dies after her kits are born. If this happens you may wish to try to feed and care for the babies until they can care for themselves. There are mixes available at many pet stores. The formula for hand fed babies is: 1 pint skim milk 2 egg yolks 2 tablespoons Karo syrup 1 tablespoon bonemeal (available in garden supply centers) Use an eyedropper to feed the kits twice a day. You must also be sure that the kits urinate regularly. To do this, gently rub their genitals with a cotton ball after they’re fed. Continue this procedure until they’re 14 days old. Eye Problems Rabbits eyes open between 10 and 14 days Sometimes help is needed to open a rabbits eyes To do this, take your fingers and gently separate the eyelids, and then wash away any crusty materials. Handling Kits At three weeks of age, kits begin to come out of the nest box. No need to worry! They can now maneuver in and out of the box. Kits begin to eats pellets and drink water at three weeks of age, even though they are still nursing from their mother. More food and water should now be available to the kits. This is an excellent time to begin to handle the young. They may be jumpy at first, but the more you hold them the calmer they will be. Sexing The Litter Kits need to be separated by sex around 6-8 weeks. Making this distinction is called sexing and may call for an experienced 4H member or a breeder’s assistance Sexing the litter Procedure: 1.) One hand restrains the rabbits head. 2.) Place your finger and second fingers of the other hand around the base of the tail. Use your thumb to press down gently in front of the sexual organ. 3.) If a rabbit is a doe, you will see a slit like opening. This opening will begin near your thumb and slope down towards the rabbit’s tail. 4.) If the rabbit is a buck, the opening will look rounded and protrude slightly. Good Bye Nest Box When rabbits are self sufficient, eating pellets, and drinking water, it is time to remove the nest box. Leaving it in longer will allow them to use it as a litter box. Weaning Bucks And Does Weaning is changing the way a kit is nourished form nursing to eating other food. Young are separated from their mother, and no longer nurse from her. This is done in 6 to 8 weeks from birth. A doe’s body needs to rest because producing milk is work for a rabbit’s body. The doe needs a break before she can raise another litter. Littermates will mature as they approach 8 weeks of age. Rabbits have mature instincts about their territory and breeding. Rabbits can mate and produce litters before they are full grown. (This would be very stressful on a doe if she is young.) Do not keep more than one rabbit in each cage when the rabbit is 3 months or older. Rabbits mature faster when alone, do not fight, and do not breed, thus eliminating unexpected results. Tattooing Tattooing is done at weaning. It is done for identification purposes, and purebreds should be tattooed. Pedigrees All purebred rabbits should have pedigree papers showing that they are pure bred. Try to complete your pedigrees as part of the overall weaning process. Evaluating A Rabbit's Reproductive Life After the doe has kindled, some breeders normally re-breed her at 6 weeks and wean the litter at 5-7 weeks. This cycle continues until she is about 4 years old or until her production is unsatisfactory. Review the herd records every quarter to determine which rabbits are not producing up to par and eliminate them. In October through December, some rabbits go into what is called moulting. At this period, many do not conceive. If you have lights on all the time in your rabbitry, this will help. Rabbits are like chickens that lay eggs only if there is enough light. Raising most of my rabbits outside, I would take this problem into consideration when evaluating them. Also, if it gets too hot in the summer, especially for those who live in the Southern U.S., the buck produces less viable sperm and the conception rate goes down. Some people keep their bucks air conditioned to keep the conception rate high. Some breederd standards for a doe is that she produce at least the following number of rabbits per year all the way to weaning: Dwarfs: 8 Small Breeds: 14 Medium Breeds: 16 Meat Type: 20 Giants: 16 Good luck in your endeavors to produce fine rabbits! http://sussex4h.org/Clubs/sc4h_allstar_rabbits_breeding.html http://www.debmark.com/rabbits/breeding.htm https://qualitycage.com/blogs/quality-rabbit-care/the-basics-of-breeding-rabbits-part-one https://www.raising-rabbits.com/rabbit-mating.html http://www.rabbitgeek.com/breedingtips.html https://thehomesteadinghippy.com/breed-rabbits/ Sexually Transmitted Bacterial Infections in Rabbit Treponematosis in Rabbits Treponematosis is a sexually transmitted infection in rabbits that is caused by a bacterial organism called Treponema paraluis cuniculi. This bacterium is spread by sexual contact between rabbits, from direct contact with lesions from another animal, and from mother to newborn during development or birth. This bacterial organism is closely related in form and character to the human species Treponema pallidum (syphilis), but is confined to rabbits; it is not transmissible between species. If this infection is caught early, before systemic damage can occur, it can usually be treated successfully with antibiotics. Symptoms and Types The signs and symptoms of treponematosis are varied and may include the following: History of swelling and redness around the vulva or anus, lips and nose History of possible abortion or loss of pregnancy, long and difficult deliveries, or appearance of stress during pregnancy Swelling early on of the area near and around the genital regions, the eyes, and around the grooming regions Lesions are often on the face only Raised bumps and crusting on the skin surface Causes Treponematosis comes from the bacterial species Treponema cuniculi and is spread through direct contact with the organism. It is possible for the disease to be in a latent stage, and for the infected rabbit to pass the disease on to other rabbits, even though the infected rabbit is not showing any apparent symptoms. Therefore, it is not always possible to determine with a normal inspection whether a potential breeding partner is infected before allowing sexual contact between the two rabbits. If you have recently bred your rabbit, or your rabbit has been paired with a different sexual partner, there is a possibility that your rabbit has come into contact with an infected partner. Conversely, infection can also be seen in younger animals that may not have had sexual contact and thus may have caught the infection congenitally/in utero, or through direct contact with the lesions in the passage of the birth canal. Diagnosis To formally diagnose your rabbit's condition, your veterinarian will need to rule out other conditions that might cause similar symptoms, such as ear mites. Some of the common outer symptoms, such as dry crusts that form with excessive saliva in and around the face, matting of hair around the face, and lesions around the face, will need to be closely inspected, with fluid and tissue samples taken for biopsy. Along with the thorough physical exam, your veterinarian will need you to give a thorough history of your rabbit's health and onset of symptoms. Your doctor's initial diagnosis will take into account the background history of symptoms and possible incidents that might have led to this condition. If the final diagnosis is treponematosis, all of the rabbits that have come into contact with the infected rabbits will need to receive medical treatment. Treatment Treatment in the form of a topical treatment is necessary. It is also necessary to keep the lesions clean and dry to help them heal quickly. While this is not always necessary, it can help speed the recovery. A simple topical (external) antibiotic can also be used to speed healing. Only medications that can be applied topically may be used, as oral applications can be fatal, unless your veterinarian advises otherwise. Your rabbit will require follow-up monitoring and care to ensure complete resolution of the symptoms. Living and Management It is important to follow-up with your health provider to ensure the rabbit avoids exposure to other rabbits that may still carry this infection, which can result in recontamination, and to avoid infecting other animals until your veterinarian is confident that your rabbit is clear of the Treponema cuniculi bacteria. If you have other rabbits, there is a good possibility that they are also infected and should also receive treatment. Even if they are not showing symptoms, your veterinarian may choose to err on the side of prophylactic treatment to avoid further complications. The prognosis for rabbits with treponematosis is excellent provided treatment commences immediately and that all rabbits with the T. cuniculi infection receive treatment promptly. https://www.petmd.com/rabbit/conditions/reproductive/c_rb_treponematosis Rabbit Dance an Oneida legend retold by Desiree Barber Long ago, two hunters went hunting deer for their village. They hunted for a very long time without seeing any signs of deer, but they didn't return to the village for they knew they had to provide food for the winter. Suddenly, they heard a very loud thump! They stopped and listened to see if there would be another thump, and sure enough, they heard it again! This time the thump was louder, "THUMP!" One hunter said to the other, "What is that?" The other hunter said, "I don't know, but IT sounds very close!" So, both hunters got on their bellies and crawled to a nearby clearing surrounded by bushes. In the center of the clearing they saw the biggest rabbit they had ever seen! The first hunter started to aim his bow and arrow at the huge rabbit, but the second hunter stopped him and said, "Let's wait to see what he is going to do." Both hunters waited and watched the huge rabbit as he lifted one of his big back legs and thumped it three times on the ground. Then, out from every direction hopped regular sized rabbits. The hunters watched very closely not wanting to miss anything. The little rabbits gathered around the big rabbit, and the big rabbit began to thump his back leg in a pattern as the little rabbits danced. The hunters watched in awe as the rabbits danced. Then the big rabbit thumped his leg in the directions in which the hunters lay. The huge rabbit looked in that direction and leaped into the sky. Then all the rabbits quickly hopped away. The hunters watched still in awe. They realized they had to go back to the village and tell the people what they had seen and heard. They ran all the way to the village and asked if they could speak to the elders. After they told their story, one of the elders said, "Show us how the beat and the dance went." The hunters showed them exactly what the rabbits did. Another elder said, "The rabbits gave this dance to tell us to show them respect and appreciation for what they give to us. We will name the dance after them, and we will dance it at our socials to show them our gratitude." So this is the way it was then and is now. That is how the rabbit dance came to be. http://www.uwosh.edu/coehs/cmagproject/ethnomath/legend/legend16.htm https://en.wikipedia.org/wiki/Oneida_people   © Copyrighted

The Swan Rabbit Breed This is a now extinct rabbit breed, and may heave been a mixed or mongrel derived from Giant Breeds, and in particular the Patagonian. They have been extinct since about 1885, and there has been very little documented about this very unusual breed. It seems to have been indigenous to the Isle of Man, or at least that is where several breeders located stock to take to the British mainland. It was a very large rabbit that was not particularly handsome. It weighed in at 16-20lbs, with a brown-grey fur color, on a large frame. The ears were only 2 inches long, with the hollow insides pointed towards the front, and not towards the sides of the head. It is written that when you cross the Swan Rabbit with the Patagonian, the progeny's ears would be of a much shorter length. It was like the Patagonian, a useful meat and fur rabbit. https://books.google.com/books?id=O069kBAETeIC&pg=PA148&lpg=PA148&dq=%22swan+rabbit%22+breed&source=bl&ots=B6LFvVnBhB&sig=9cJ0mvEvCic5iGcqyL24hRQRQ04&hl=en&sa=X&ved=2ahUKEwifjKWttbPdAhWmTt8KHTUDC2AQ6AEwCXoECAQQAQ#v=onepage&q=%22swan%20rabbit%22%20breed&f=false Hyperemia and Red Eye in Rabbits Red eye is a relatively common condition which causes swelling or irritation in the rabbit's eye or eyelid. This appearance of blood vessels in the eyeball can develop because of various reasons, including many systemic or body diseases. If your rabbit has red eye, seek veterinary advice immediately, as it is generally a secondary symptom to a more serious condition. Symptoms and Types The signs and symptoms of red eye and related conditions often depend on the underlying cause. For example, if the red eye is due to a dental disorder, there may be signs of tooth decay or dental disease in the animal. Other common signs and symptoms may include: Impaired vision Swollen eyelids Eye discharge Extra tissue around the eyes Nasal discharge and upper respiratory infection or cold Hair loss and crusting in the mucous membrane, especially around the eyes, nasal area and cheeks Lethargy Depression Abnormal posture Facial masses Causes Because there are many causes to rabbit red eye, it is often difficult to identify the exact cause. However, some factors may include: Bacterial infections, including Treponema cuniculi (or rabbit syphilis), which can cause swollen eyelids Conjunctivitis, a common disorder causing red eye that can result from allergies, bacterial or viral irritants; sometimes occurring as a side-effect of a respiratory tract infection Keratitis, which is usually a fungal infection of the eye, and which can follow an injury to the eye Glaucoma, which if left untreated, can cause blindness Dental diseases, which can bring debris in the eye, causing inflammation or blocking a tear duct Diagnosis The veterinarian will run a variety of laboratory tests to diagnose the cause for the rabbit's red eye. This includes skin and other type of cultures, as well as exams testing for cataracts and other ocular diseases that can impair vision and health. If the veterinarian is still unable to diagnose the condition, they may run special tests including: Tonometry – measures the eye pressure in order to diagnose glaucoma and other related disorders Schirmer tear test – detects dry eye , a condition which can lead to red eye Cytologic examinations – identifies infections within the tear ducts and surrounding tissues Fluorescein stains – helps rule out ulcerative keratitis, a condition which can lead to red eye. Treatment is almost always dependent on the underlying cause of the condition. For example, if the rabbit's red eye is due to a dental disease, a tooth extraction may be necessary; whereas a case of bacterial-caused red eye may require an antibiotic prescription. To alleviate the rabbit's pain, the veterinarian will prescribe topical anti-inflammatory medication. In some cases, animals will require a short-course of topical steroid agents, especially rabbits with ulcers, delayed wound healing, and those with certain infections. Living and Management Some animals may require long-term pain management. Still others may require repeat eye exams to help ensure the rabbit's eye inflammation is managed properly, and that eye pressure remains stable to help prevent blindness. https://www.petmd.com/rabbit/conditions/eyes/c_rb_red_eye The Swan There was once a young Norwegian girl who lived in the village of Ranrike in the time of the Vikings. She was a pretty little girl, with curly golden blonde hair that shined as bright as the Goddess Sunna herself. Her name was Bekkhild, and she loved to play outdoors in the fresh air, and bright sunshine. That is until one day when a spider crawled up her arm and bit her ! The bite from the horribly ugly spider hurt, and made the little girl feel sick. A few days later she felt better, but from that time on she was afraid of all of nature's creatures whether they were big or small. Little Bekkhild was terrified by the birds in the air, the furry animals that scurried about, and of course by the bugs that crawled upon the ground, or flew with tiny wings. Little Bekkhild did, however, love flowers. She loved big flowers, little flowers, and especially the ones that bloomed into pretty colors like red, blue, orange, or yellow. Often she would venture out to look at these beautiful blossoms that surrounded her home, but as soon as she saw a bee, or an animal, she would run home to the safety of her house. Her parents took her down to the meadow often to see the flowers in bloom there, but unless they held her hand to protect her from the insects and animals, she would cry, and want to go home. One day her mother and father brought her to the pond at the edge of the meadow, and laid out a large blanket for them to sit upon. After a while her mother and father fell asleep in the warm sunshine. Bekkhild had been told to stay away from the water, but she had seen beautiful white flowers floating in the pond among the green leaves, and she hoped to get a closer look at them . Her mother had told her that they were called pond lilies, and they were so pretty that she wanted to pick one. Bekkhild cautiously walked down to the edge of the pond, keeping her eyes wide open for any creatures that might attack her. She turned around from time to time to make sure that her mother and father were still there to protect her. With her parents safely in sight, and the lovely flower within reach, she leaned over to snatch up the beautiful bloom. Just as she was about to get hold of the flower a large pure white swan swam around the corner right in front of her ! Bekkhild was so scared she did not even scream as she fell backwards onto the ground . As tears welled up in the little girls eyes the swan stopped and turned its neck as if it were examining her. Bekkhild was about to get up, and run back to her parents, when the swan began to sparkle. To Bekkhild's astonishment the swan turned into a beautiful woman, who was wearing a dress as white as the feathers on the swan. Her hair was as golden blonde as hers, and the woman had a pleasant ,friendly smile. The swan - woman reached out with her hand, and wiped away the little girls tears, before asking : " Why are you afraid of me princess ? " Bekkhild stuttered as she replied : " I..I...I am scared of aminals! " The swan - woman laughed, and corrected her. " You mean a-n-i-m-a-l-s, don' t you little princess ? " Bekkhild stood up, and put her hands on her hips. " That is what I said ! Aminals ! " she said with a frown. " What are you ? " asked Bekkhild . " I am a Valkyrie, little princess. My name is Swanhild, and I ride with Odin ! " The Valkyrie said boldly. " My name is Bekkhild ! " The little girl blurted out. The Valkyrie laughed a little when she replied : " Well, that is a pretty name for a little princess. " The Valkyrie reached down, and held the little girl's hand. " You should not be afraid of the animals that walk or fly. Nor should you fear insects that crawl, or take to the sky on tiny wings. They are all a part of nature's beauty, and are a gift from the Gods. " Swanhild said in a soothing tone. " Come with me, and I will show you, little princess." she added. They walked holding hands for only a moment before they spotted a rabbit feeding in the grass. Bekkhild quickly retreated behind Swanhild's leg for protection ! The Valkyrie, however, gently pulled her to her side, and then knelt down to pick up some fresh green grass. She handed it to Bekkhild, and motioned for her to give it to the rabbit. Bekkhild trembled as the rabbit slowly crept over to the leafy meal she held out to the furry little creature. The Valkyrie held her hand even tighter, to give the little girl strength, as the rabbit began to feed on the grass. As the rabbit chewed the munching motion made its little nose wriggle back and forth. Bekkhild giggled, and without even realizing it she had stopped shaking, and was no longer afraid. When the rabbit finished its meal it slowly hopped away back into the grass. Bekkhild jumped up and down, and laughed as it went to feed in another part of the meadow. Next the Valkyrie held out her finger up into the air, and a beautiful yellow bird flew over and landed on it. The bird was so pretty that Bekkhild just stood there staring up at the tiny bird for a moment. It had a pretty yellow head, a yellow breast, and the feathers on its back were black and yellow. As the bird sat nervously on her finger the Valkyrie told Bekkhild in a whisper : " This little bird is known as the Yellow Hammer. It comes here from the Germanic lands in the summer, and then it returns south to warmer lands in the winter." Bekkhild was flushed with joy ! She had never seen anything so beautiful ! " It is so pretty : " she said in a low whisper so as not to scare away the little bird. The Valkyrie placed her finger over her lips and said : " Shhh . Listen little princess ! " The Yellow Hammer suddenly started to chirp a lovely little song. A moment later, from off in the distance, another Yellow Hammer sang the same tune. The tiny bird then took to its wings, and flew off in the direction of the other bird. " You see little princess you do not have to fear nature' s creatures. They will not harm you if you do not try to harm them. " Swanhild said with a smile. " Yes, they are pretty, but it was a nasty bug that bit me ! " Bekkhild replied in a whining tone. " Not all insects are harmful little princess. " The Valkyrie said in response. The woman in white held out her hand and a beautiful butterfly fluttered onto her palm. It had a black body, and beautiful orange wings, with black spots on them. It flapped its wings a few times, and then held them upright as if it were showing Bekkhild exactly how beautiful it was. " I know that butterflies are pretty, but most bugs are ugly. " Bekkhild complained. The Valkyrie allowed the butterfly to fly away, and then took Bekkhild over to an old oak tree. On one of the lower limb's leaves there was a small multi - legged creature that was chewing on the edge of the leaf. " This is what a butterfly looks like before it becomes a butterfly princess. " Swanhild said as she showed the insect to her. Bekkhild looked at the bug in disbelief. " But... but...., that is ugly ! " replied the little girl. " How can that turn into a pretty butterfly? " she asked. The Valkyrie broke off the branch, with the insect on it, and told Bekkhild : " Well princess, this little insect is called a caterpillar, and it eats a lot to give itself enough energy to turn itself into a butterfly. When it is ready it builds itself a little house, called a cocoon, and it lives in there while it changes. When it is ready, it comes out, dries its wings, and then flies away. " Bekkhild put her hands to her mouth, and smiled from ear to ear as she said in amazement : " Oh my ! " The Valkyrie then walked Bekkhild back over to the edge of the pond. As they reached the water's edge Swanhild reached down, and picked a beautiful large white lily from among the pads growing there, and handed it to Bekkhild. " I have to go now princess my sisters are waiting for me. " Swanhild pointed to three swans swimming a short way off in the pond as she spoke. Bekkhild looked sad as she said : " Can I ask you a question ? " Swanhild nodded her approval. " Why do you call me princess ? My name is Bekkhild . " As the Valkyrie began to sparkle, and turn back into a swan, she told Bekkhild : " Because one day you will be Princess Bekkhild ! " - Glenn Bergen http://www.anindependentasatru.com/-blog/short-children-s-story-the-swan © Copyrighted

Hello Listener! Thank you for listening.  If you would like to support the podcast, and keep the lights on, you can support us whenever you use Amazon through the link below: It will not cost you anything extra, and I can not see who purchased what. Or you can become a Fluffle Supporter by donating through Patreon.com at the link below: Patreon/Hare of the Rabbit What's this Patreon? Patreon is an established online platform that allows fans to provide regular financial support to creators. Patreon was created by a musician who needed a easy way for fans to support his band. What do you need? Please support Hare of the Rabbit Podcast financially by becoming a Patron. Patrons agree to a regular contribution, starting at $1 per episode. Patreon.com takes a token amount as a small processing fee, but most of your money will go directly towards supporting the Hare of the Rabbit Podcast. You can change or stop your payments at any time. You can also support by donating through PayPal.com at the link below: Hare of the Rabbit PayPal Thank you for your support, Jeff Hittinger.   English Spots are a very old breed of rabbit. There are 7 recognized varieties (colors): Black, Blue, Chocolate, Gold, Grey, Lilac, and Tortoise. Adult English Spots weigh 5 to 8 pounds, between 2.3 and 3.6 kg. They are a fully arched breed and are allowed to run up and down the table to show off their type and markings while being judged. This week we traveled to a few family events including a second year birthday party and a graduation party. We traveled through 5 states and the District of Columbia all in one day! We were not sure if we were able to get out of our development. We have experienced some extreme rain, and the bridge to get into our development was washed out, as well as the road was washed away in another place. The counties to the North and South were looking for people that were washed away in the flooding. The main road to get to town is still closed, and we need to take side roads. Now enough about our adventures this week, and on with the English Spot. English Spot Rabbit Breed History/Origin English Spots are believed to have been developed in the late 1800s, of course, in England. Though spotted (broken pattern) rabbits had roamed England for well over 200 years, they were nothing special until the beginning of the 1800s. They generally weighed 7-10 pounds, and were the average spotted meat rabbit, several in every barn. In the early 1820’s, as the general interest in rabbits began to increase, extensive descriptions of the “perfect” spotting patterns was made. It was difficult to get all the various markings aggregated correctly in the same rabbit, which was fine, because farmers rose to the challenge for the next 100 years. In 1893, a drawing of “the perfect English Spot” was published in Britain’s Fur & Feather. The same standard is in use today, and describes the herringbone, butterfly, eye circle, cheek spot, ears and ear base, leg marking, and the chain and hip spots that together make up the side pattern. Ten years after the drawing was published, the winning rabbits in English shows more and more closely approximated that ideal. Photos in 1905 showed rabbits that were clearly Eng. Spot rabbits, though their hip markings were still blotchy and congested. Saddle markings had given way to the desired herringbone stripe. The breed was imported to Germany in 1889, and from there to other countries in Europe. According to the AESRC (American English Spot Rabbit Club) 1947 guidebook, 1890 was the first time English were on the table across the pond. In 1891 the National English Rabbit Club was formed and the markings we all know and love were standardized. The English Spot Rabbit is one of the oldest rabbit breeds, dating back to the mid-19th century. The main purpose for developing this particular breed of rabbit was for show purposes, which back in those days, was uncommon since rabbits were mainly used for meat and fur purposes. It is suggested that they may have come from the Great Lorrainese which is now known as the Giant Papillon, although it is also said that they may have descended from the English Butterfly and/or the Checkered Giant. According to the 1975 guidebook English Spots were in America by 1910. In 1910, the English Spot Rabbit was imported to North America and 12 years later in 1924, the American Rabbit Breeders Association (ARBA) accepted it as a recognized breed, and subsequently, the American English Spot Rabbit Club was established. The AESRC was founded in 1924. The first group of members organized the club at the Trenton Inter-State Fair in Trenton, NJ. The first National All English show was held in 1952 in Louisville, KY. In the UK, the breed is known simply as the "English" rabbit. The French named the breed "Lapin Papillon Anglais", or the English Butterfly Rabbit from the butterfly marking on the nose. Previous generations of the breed entailed a white rabbit with patches of color and through the years has acquired clearly defined markings. English Spots have a specific marking pattern and must meet certain marking requirements to be showable in ARBA sanctioned shows. The Eng. Spot is a medium-sized breed with an arched body type. Its weight has been set at 6 - 8 pounds (2.72 - 3.62 kg) in the UK, and 6 - 8 pounds in the USA. The standard for the markings remains the same since 1893. Their markings consist of a butterfly marking on the muzzle; eye circles; cheek spot which is a small spot on the cheek wisker; colored ears; a spine marking which is a stripe from the nape of the neck to the tip of the tail that widends above the hips with a herring bone effect meaning jagged marks on each side; and a sweep of side spot markings consisting of a chain, body markings, and hip markings. The side marking spots should start out small in the chain and gradually get larger with the largest spot in the center of the hip markings. The spots should start out with two chain spots at the nape and sweep down, increasing in number, along the belly then swirl up around the hip. All spots should be round and separated from other spots or markings. The rabbits should be free of stray spots on the head and stray spots near the spine. The markings should also be balanced - meaning the two sides of the body and head should be mirror image in size, shape, and placement of the markings. Two other breeds have similar markings (Rhinelander and Checkered Giant), but the English Spot is the only one of the three to have spots on the shoulder. Some of the English Spot marking disqualifications include: more than one break in the spine marking or a break that exceeds 1/4 inch; a missing cheek spot; more than one stray spot on the head; any head markings that touch each other; and white spots in the upper half of the ears. It is permissible for Spots to have colored/mismatched toenails. English Spots that do the best in competition have good type and like to show off and have clean sharp markings with round spots and are free of stray spots. Character English Spots are a very active breed. They are very friendly and love attention. They make a good pet or 4-H project for older children and are a challenging breed for rabbit raisers to breed and show. The English Spot rabbit is an active and hardy breed. They are noted for being very friendly, inquisitive rabbit breed with an engaging personality. They are very lively and energetic and as an active breed they require plenty of exercise with enough space to run and jump. They are very playful and display some entertaining acrobatics most of the time. They are usually sweet in nature and are very good with children, and also excellent as pets. As a playful breed, the English Spot rabbit needs some toys for playing and exercising. The average lifespan of an English Spot rabbit is about 5 to 8 years. Like the majority of rabbits, the most important component of the diet of an English Spot rabbit is hay, a roughage that reduces the chance of blockages and malocclusion whilst providing indigestible fiber necessary to keep the gut moving. Grass hays such as timothy are generally preferred over legume hays like clover and alfalfa. Legume hays are higher in protein, calories, and calcium, which in excess can cause kidney stones and loose stool. This type of hay should be reserved for young kits or lactating does. Some of the vegetables that rabbits enjoy are parsley, thyme, cilantro, dandelion, and basil. The green, leafy tops of radishes and carrots also are excellent sources of nutrients—more than the vegetable itself. New vegetables should be introduced slowly due to the delicate digestive systems of rabbits. It is recommended that cauliflower, broccoli, lettuce and cabbage be avoided, as they cause gas and can lead to gastrointestinal stasis, which can be fatal. Vegetables such as potatoes and corn should also avoided due to their high starch content. All breeds of rabbits also require an unlimited amount of fresh water, usually provided for in a water crock, tip-proof ceramic pet dish, or hanging water bottle. It is challenging to breed a well marked English Spot because not all babies in a litter will be marked, not to mention showable, or marked well. When a pair of marked English Spots are bred together the litter will consist of 1/2 marked, 1/4 Solid (solid colored with no white), and 1/4 Charlie (mostly white with colored ears, partial butterfly, and some other partial markings). Although they can not be shown, the Solids and Charlies can be used in breeding programs. If a Solid is bred to a Charlie, the entire litter will be marked; and when a Self or a Charlie is bred to a marked English Spot, 1/2 the litter will be marked. Breeding English Spots English Spots are a challenging breed to raise because not all English Spots are marked and it is very difficult to get an English Spot that is marked very well. Marked Spots may have marking disqualifications. Markings (as well as type, fur, and color) can be improved by careful selection at breeding and thoughtful selection of breeding stock. Because there are 7 recognized varieties of English Spots, breeding can become more complicated when unrecognized colors or Spots with poor color are part of the litter. Even though they can be difficult, the challenge of deciding which rabbits to breed together and the excitement of looking in the nest box to see what the doe has makes them a lot of fun. Their playful and active temperament also makes them fun. English Spot does are supposed to be very good mothers - they produce a lot of milk for the babies, make good nests and take good care of the babies. Most of the time they have large litters with 6-9 babies and the does are very good about taking on foster babies. Markings English Spots are either Solid, Charlies, or Marked. A Solid is a colored rabbit with no white. A Charlie is a mostly white rabbit with colored ears, a partial butterfly sort of like a mustache, and some other partial marking like a thin spine marking, cheek spots, and sometimes a few side spots. The partially marked babies "typically have a mustache similar to Charlie Chaplin" and therefore are called 'charlies'. A Marked Spot usually has a full butterfly marking and a spine marking that extends all the way to the tail. A Marked Spot is not necessarily showable. Spots are only showable based on their markings when they meet all the requirements in the Standard. Although Solid and Charlies are not showable, they can be useful in a breeding program. A very plainly marked Spot is not a true Charlie - Charlies has very little color. A true Charlie in a breeding program will never have a Solid baby. The butterfly should be faulted for irregularly shaped wings, drags of color, runs of white, nose fork out of proportion, or blunt/crooked/off centered nose fork. Disqualify for split butterfly or white spots in the butterfly. The English Spot pattern is caused by the broken gene. In fact, the symbol for the broken gene is “En” referring to “English Spotting.” When you breed broken to broken – or spot to spot – about 50% of the offspring will be broken colored, 25% will be solid, and 25% will be very lightly marked rabbits known as “charlies.” You can predict the percentages of Solids, Charlies, and Marked Spots in a litter of English Spots - at least theoretically. Marked X Marked = 50% Marked, 25% Solid, and 25% Charlie. Marked X Charlie = 50% Marked & 50% Charlie Marked X Solid = 50% Marked & 50% Solid Solid X Charlie = 100% Marked Charlie X Charlie = 100% Charlie Solid X Solid = 100% Solid Even though you can predict the percentage of marked babies (genetically), individual litters vary. When 2 Marked rabbits are bred together it is certainly possible to have an all marked litter or a litter with no marked babies at all. Color Because English Spots are most known for their markings and the markings are worth the most points when showing, it is tempting to breed rabbits based on their markings regardless of color. Pairing rabbits with incompatible color can cause problems in later generations - it could increase the chances of getting unrecognized colors and could ruin the quality of the color. Even though color is not worth a lot of points, poor color can detract from the general appearance of the rabbit or make markings look less defined. Even worse - you may have to cull some very well marked Spots from your breeding program because they are an unrecognized color or they have a color disqualification. In the USA, the accepted colors are black, blue chocolate, gold, gray, lilac, and tortoise. In the UK, English rabbits are recognized in black, blue, tortoiseshell, chocolate, and gray only. All other colors are specifically rejected as "inadmissible." When choosing breeding stock and making decisions about mating, it is important to look at the colors in the rabbits' pedigree and not just the color of the rabbits you want to breed. Although the colors in the pedigree give you an idea what colors rabbits likely carry, it does not tell you what colors the ancestors' siblings were. For instance there may be no dilutes (ie. Blue, Lilac) in the pedigree, but the rabbits could carry the gene and there are probably siblings of the rabbits in the pedigree that have been dilutes. Be wary of Chocolate in the pedigrees of Greys - if a Grey carries Chocolate, even when bred to Black it can produce Ambers (chocolate greys/chocolate agouti). Blue and Lilac appear to be similar colors, but if you compare good Blues and Lilacs, they are a very different color - they are just both dilutes (Blues are the dilute of Black and Lilacs are the dilute of Chocolate). Crossing Blues and Lilacs will lead to poor blue color and lilacs that are bluish. A pregnant English Spot will require adequate food to support her and her young. Three weeks into the pregnancy, it is common for breeders to provide the doe with a nest box filled with straw. The doe will burrow in the straw and begin lining the nest with hair she pulls from her stomach, in order to insulate her litter and keep them warm, and when ready, she will have her young in the nest. When the kits are 8 weeks of age, it is advised for the young to be separated from their mother. Type Type is very important in Spots and should always be considered when deciding which Spots to breed together. Avoid breeding Spots with the same type flaws together, especially the common type problems in English Spots like chopped hindquarters, short legs, and compact body types. Improving a marking problem through culling is easier than improving a type problem through culling. It can also be difficult to make the decision to cull a very well marked rabbit that does not have good type. Is there any rabbit so remarkable to look at and yet so difficult to produce as the English Spot? Sports, Charlies, and mis-marks all frustrate the English Spot breeder, but he or she keeps at it for the satisfaction of a seeing a well-marked “Spotted Beauty” running home to win. That’s right – English Spots, as well as other full-arch type breeds, do not pose on the show table but run the length of it, end to end and back again. This is the best way to show off their markings, and they are quite fun to watch and to judge. The ideal body type is long and lean, with the belly carried well off the table. Body type and marking are of nearly equal importance in the English Spot standard. Organizations National English Rabbit Club The American English Spot Rabbit Club (AESRC) The American Rabbit Breeders Association (ARBA) http://americanenglishspot.weebly.com/breed-history.html http://www.petguide.com/breeds/rabbit/english-spot-rabbit/ https://sites.google.com/site/watchmerunspots/englis-spots The US national club: www.AmericanEnglishSpot.weebly.com https://www.raising-rabbits.com/english-spot.html http://rabbitbreeders.us/english-spot-rabbits http://www.roysfarm.com/english-spot-rabbit/ http://americanenglishspot.weebly.com/standard.html Red Eye in Rabbits Hyperemia and Red Eye in Rabbits Red eye is a relatively common condition which causes swelling or irritation in the rabbit's eye or eyelid. This appearance of blood vessels in the eyeball can develop because of various reasons, including many systemic or body diseases. If your rabbit has red eye, seek veterinary advice immediately, as it is generally a secondary symptom to a more serious condition. Symptoms and Types The signs and symptoms of red eye and related conditions often depend on the underlying cause. For example, if the red eye is due to a dental disorder, there may be signs of tooth decay or dental disease in the animal. Other common signs and symptoms may include: Impaired vision Swollen eyelids Eye discharge Extra tissue around the eyes Nasal discharge and upper respiratory infection or cold Hair loss and crusting in the mucous membrane, especially around the eyes, nasal area and cheeks Lethargy Depression Abnormal posture Facial masses Causes: Because there are many causes to rabbit red eye, it is often difficult to identify the exact cause. However, some factors may include: Bacterial infections, including Treponema cuniculi (or rabbit syphilis), which can cause swollen eyelids Conjunctivitis, a common disorder causing red eye that can result from allergies, bacterial or viral irritants; sometimes occurring as a side-effect of a respiratory tract infection Keratitis, which is usually a fungal infection of the eye, and which can follow an injury to the eye Glaucoma, which if left untreated, can cause blindness Dental diseases, which can bring debris in the eye, causing inflammation or blocking a tear duct Diagnosis The veterinarian will run a variety of laboratory tests to diagnose the cause for the rabbit's red eye. This includes skin and other type of cultures, as well as exams testing for cataracts and other ocular diseases that can impair vision and health. If the veterinarian is still unable to diagnose the condition, they may run special tests including: Tonometry – measures the eye pressure in order to diagnose glaucoma and other related disorders Schirmer tear test – detects dry eye , a condition which can lead to red eye Cytologic examinations – identifies infections within the tear ducts and surrounding tissues Fluorescein stains – helps rule out ulcerative keratitis, a condition which can lead to red eye Treatment Treatment is almost always dependent on the underlying cause of the condition. For example, if the rabbit's red eye is due to a dental disease, a tooth extraction may be necessary; whereas a case of bacterial-caused red eye may require an antibiotic prescription. To alleviate the rabbit's pain, the veterinarian will prescribe topical anti-inflammatory medication. In some cases, animals will require a short-course of topical steroid agents, especially rabbits with ulcers, delayed wound healing, and those with certain infections. Living and Management Some animals may require long-term pain management. Still others may require repeat eye exams to help ensure the rabbit's eye inflammation is managed properly, and that eye pressure remains stable to help prevent blindness. https://www.petmd.com/rabbit/conditions/eyes/c_rb_red_eye The Story of the Perverted Message Hottentot Like many other [First Nation peoples], the Namaquas or Hottentots story of the associate the phases of the moon with the idea of immortality, the apparent waning and waxing of the luminary Moon and being understood by them as a real process of alternate disintegration and reintegration, of decay and growth repeated perpetually. Even the rising and setting of the moon is interpreted by them as its birth and death. They say that once on a time the Moon wished to send to mankind a message of immortality, and the hare undertook to act as messenger. So the Moon charged him to go to men and say, ” As I die and rise to life again, so shall you die and rise to life again.” Accordingly the hare went to men, but either out of forgetfulness or malice he reversed the message and said, ” As I die and do not rise to life again, so you shall also die and not rise to life again.” Then he went back to the Moon, and she asked him what he had said. He told her, and when she heard how he had given the wrong message, she was so angry that he threw a stick at him which split his lip. That is why the hare’s lip is still cloven. So the hare ran away and is still running to this day. Some people, however, say that before he fled he clawed the Moon’s face, which still bears the marks of the scratching, as anybody may see for himself on a clear moonlight night. But the Namaquas are still angry with the hare for robbing them of immortality. The old men of the tribe used to say, ” We are still enraged with the hare, because he brought such a bad message, and we will not eat him.” Hence from the day when a youth comes of age and takes his place among the men, he is forbidden to eat hare’s flesh, or even to come into contact with a fire on which a hare has been cooked. If a man breaks the rule, he is not infrequently banished the village. However, on the payment of a fine he may be readmitted to the community. A similar tale, with some minor differences, is told by Bushman the Bushmen). According to them, the Moon formerly said originally of death # to men, ” As I die and come to life again, so shall ye do ; [death# ] then when ye die, ye shall not die altogether but shall rise again.” the hare [relayed the message s-i-c]. But one man would not believe the glad tidings of immortality, and he would not consent to hold his tongue. For his mother had died, he loudly lamented her, and nothing, could persuade him that she would come to life again. A heated altercation ensued between him and the Moon on this painful subject. “Your mother’s asleep,” says, the Moon. # She’s dead,” says the man, and at it they went again, hammer and tongs, till at last the Moon lost patience and struck the man on the face with her fist, cleaving his mouth with the blow. And as she did so, she cursed him saying, ” His mouth shall be always like this, even when he is a hare. For a hare he shall be. He shall spring away, he shall come doubling back. The dogs shall chase him, and when they have caught him they shall tear him in pieces. He shall altogether die. And all men, when they die, shall die outright. For he would not agree with me, when I bid him not to weep for his mother, for she would live again. * No,’ says he to mc, * my mother will not live again.’ Therefore he shall altogether become a hare. And the people, they shall altogether die, because he contradicted me flat when I told him that the people would do as I do, returning to life after they were dead.” So a righteous retribution overtook the skeptic for his skepticism, for he was turned into a hare, and a hare he has been ever since. But still he has human flesh in his thigh, and that is why, when the Bushmen kill a hare, they will not eat that portion 6f the thigh, but cut it out, because it is human flesh. And still the Bushmen say, ” It was on account of the hare that the Moon cursed us, so that we die altogether. If it had not been for him, we should have come to life again when we died. But he would not believe what the Moon told him, he contradicted her flat.” In this Bushman version of the story the hare is not the animal messenger of God to men, but a human skeptic who, for doubting the gospel of eternal life, is turned into a hare and involves the whole human race in the doom of mortality. This may be an older form of the story than the Hottentot version, in which the hare is a hare and nothing more. https://japanesemythology.wordpress.com/moon-viewing-tradition/african-tales-of-how-the-hare-got-to-the-moon-and-how-mankind-lost-immortality/ In a pan–African story, the Moon sends Hare, her divine messenger, down to earth to give mankind the gift of immortality. “Tell them,” she says, “that just as the Moon dies and rises again, so shall you.” But Hare, in the role of trickster buffoon, manages to get the message wrong, bestowing mortality instead and bringing death to the human world. The Moon is so angry, she beats Hare with a stick, splitting his nose (as it remains today). It is Hare’s role to lead the dead to the Afterlife in penance for what he’s done. https://ronelthemythmaker.wordpress.com/2017/02/23/rabbits-and-hares-of-folklore-folklorethursday/ Word of the week: Latitude © Copyrighted

Vincent, Rich, and Alan discuss a method for identifying viruses of individual environmental bacteria, and the using a picornavirus for oncotherapy.

Syphilis is one of the longest recognized sexually transmitted diseases of the world. After the discovery of Treponema pallidum (1905), the causative agent of syphilis, and the effective use of the antibiotic penicillin to treat the disease (1943), the diagnosis and elimination of syphilis appeared to be easy. The intervening years have shown that the syphilis remains a widespread infectious disease, which may occur in epidemics. Despite progress in the immunologic and serologic diagnosis, syphilis can still be difficult to diagnose of, especially in its latent stage. Routine diagnosis of syphilis may also in patients with co-infection by human immunodeficiency virus (HIV) or with concomitant autoimmune disorders. Because of its sensitive biological structure, T. pallidum cannot be cultured. Once the polymerase chain reaction (PCR) became available (1985), it became possible to identify T. pallidum with certainty on the basis of it specific DNA. Since 1990 PCR was used for diagnosis of syphilis in patients with genital ulcers, in congenital syphilis, and neurosyphilis. The PCR diagnosis of syphilis is not yet available for routine use. The goal in this work was to establish and evaluate PCR for the molecular diagnosis of syphilis on patient samples. The sensitive and specific nested PCR method was used for detection of the 47 kDa treponema pallidum protein (tpp47) gene. No gene polymorphisms were identified for tpp47 gene. After Southern blotting of the amplicon, an internal DNA probe should be used as an additional control. The tpp47 PCR was tested in various samples from patients. For the first time, PCR was used for samples of isolated peripheral blood mononuclear cells (PBMC), granulocytes, lymph nodes aspiration biopsy, and ejaculates. The PCR investigation of PBMC blood fraction had a highest sensitivity of 87.5 %, even in latent infection, if the PBMC was isolated by Ficoll following by high speed centrifugation. The previously published studies of PCR with serum and whole blood samples had a sensitivity of 61 – 66 %. The lymph nodes biopsy after Schaudinn and Hoffmann (1905) combined with PCR allowed the detection of T. pallidum DNA in patients without clinical symptoms of syphilis (latent stage). This approach is very important for the differential diagnosis of widespread lymphadenopathy which may also be caused by HIV infection. This work also showed for the first time by molecular biological methods that the ejaculate in syphilis is infectious, being positive for T. pallidum. In addition, this work showed that skin biopsy specimens from syphilitic lesions should not be embedded into paraffin before the DNA is extracted, but instead should be shock frozen for more sensitive detection of T. pallidum DNA. In addition, swab PCR was used to demonstrate that the pharyngeal mucosa in angina syphilitica of secondary syphilis does not contain T. pallidum. In patients without signs of syphilis and with unclear serological test results, sometimes because of HIV co-infection, latent syphilis was diagnosed by PCR analysis of PBMC, allowing institution of therapy rather than waiting for traditional tests to become positive again. This doctor thesis shows that syphilis diagnosis based on PCR is a sensitive and clinically important method, which can be especially important, if the syphilis serology is inconclusive.

Objectives: To determine trends in the prevalence and aetiological distribution of genital ulcer syndrome (GUS) in a cohort of female bar workers and to assess factors associated with these trends.Methods: An open cohort of 600 women at high risk of HIV and sexually transmitted infection (STI) was offered screening and treatment for STI at 3-month intervals. The prevalence of GUS and associated aetiological agents (Herpes simplex virus (HSV), Treponema pallidum and Haemophilus ducreyi) were monitored over 27 months through clinical examination, dry lesion swabbing and multiplex polymerase chain reaction. The effects of HIV status and other factors on the prevalence trends of STI were assessed.Results: A total of 753 women were recruited into the cohort over 10 examination rounds. At recruitment, the seroprevalence was 67% for HIV and 89% for HSV type 2 (HSV-2). During follow-up, 57% of ulcers had unknown aetiology, 37% were due to genital herpes and 6% to bacterial aetiologies, which disappeared completely in later rounds. The absolute prevalence of genital herpes remained stable at around 2%. The proportion of GUS caused by HSV increased from 22% to 58%, whereas bacterial causes declined. These trends were observed in both HIV-negative and HIV-positive women.Conclusions: The changes observed in the frequency and proportional distribution of GUS aetiologies suggest that regular STI screening and treatment over an extended period can effectively reduce bacterial STI and should therefore be sustained. However, in populations with a high prevalence of HSV-2, there remains a considerable burden of genital herpes, which soon becomes the predominant cause of GUS. Given the observed associations between genital herpes and HIV transmission, high priority should be given to the evaluation of potential interventions to control HSV-2 either through a vaccine or through episodic or suppressive antiviral therapy and primary prevention.

Diese Doktorarbeit entstand im Rahmen eines HIV-Projekt des Tropeninstitutes München in Tansania. Dabei wurden die serologischen Daten bei einer Infektion mit Syphilis innerhalb einer Gruppe von 600 Prostituierten ausgewertet. Das Problem des serologischen Nachweises von Syphilis ist, dass die verschiedenen Testverfahren nur jeweilig begrenzte Aussagekraft bezüglich Stadium und Aktivität der Krankheit haben. Das Ziel meiner Arbeit war daher, herauszufinden, ob mit den Informationen von IgM-AK-Testverfahren zusätzliche Rückschlüsse über die Aktivität und den Verlauf der Infektion mit Treponema pallidum gezogen werden können. Im Mittelpunkt standen dabei Fragestellungen wie Neuinfektion, fragliche Neuinfektion mit dem Verdacht auf biologisch falsch positive Reaktionen, Reinfektion, Heilung und Therapieversagen. Hierzu wurden aus 105 der mit Syphilis infizierten Frauen 56 ausgewählt. Zusätzlich zu den Standardtestverfahren RPR und TPPA – der Rapid Plasma Reagin Test ist ein unspezifischer Kardiolipintest, während der Treponema pallidum Agglutinationstest spezifische AK nachweist – wurden deren Blutproben mit zwei IgM-AK-Tests (dem Fluoreszenz Treponema Absorptionstest und einem neuen Banden-Immuno-Assay, das im Tropeninstitut Antwerpen evaluiert wird) untersucht. Dabei zeigte sich, dass die IgM-Tests die Neuinfektion nur in knapp der Hälfte der Fälle zeitlich früher nachweisen und nur in einem einzigen Fall eine Reinfektion diagnostizieren konnten. Ihre Stärke lag vor allem im Ausschluss von falsch positiven RPR-Ergebnissen bei fraglichen Neuinfektionen. Bei der Beurteilung ob und wann eine Heilung eintrat, konnten sie keinen Vorteil erlangen. Therapieversagen wurde durch die Tests als stabile seropositive Heilung (IgM negativ) gewertet. Insgesamt kann gesagt werden, dass die IgM-AK-Verfahren mit einer Sensitivität von 75% (FTA-ABS) respektive 85% (INNO-LIA) keinen entscheidenden Vorteil über die Standardtests erlangen konnten. Die Hoffnung mit Hilfe von neuen IgM-Tests einen Goldstandard in der Serodiagnostik der Syphilis zu etablieren, konnte anhand dieser Arbeit nicht erfüllt werden.

Überprüfung der Wirksamkeit stallspezifischer Vakzinen zur Bekämpfung der Dermatitis digitalis bei Milchkühen Die Studie wurde als kontrollierter Doppelblindversuch durchgeführt. Die Untersuchungen fanden in einem Milchviehbetrieb in Norddeutschland statt (429 Tiere bei der ersten Untersuchung). Aus den Hautbioptaten typischer DD-Läsionen wurden folgende Erreger im anaeroben Bereich isoliert: Porphyromonas ssp., Porphyromonas levii, Porphyromonas endodonatales, Fusobacterium necrophorum, Bac. stercoris, Prevotella bivis, Peptostreptococcus indolicus, Treponema sp.. Daraus wurden zwei formalininaktivierte Adsorbatvakzinen hergestellt. Die eine enthielt alle Keimarten außer Treponema sp. (Impfgruppe A), die andere alle Keimarten und Treponema sp. (Keimanteil 20 %) aus einer Schüttelkulturvermehrung (Impfgruppe B). Als Placebo wurde die Impflösung ohne Antigen verwendet (Kontrollgruppe). Verabreicht wurden je 5 ml Impfstoff oder Placebo subkutan. Der Klauengesundheitsstatus wurde im Oktober 1998, März 1999, Oktober 1999 und im Januar 2000 im Rahmen der halbjährlich durchgeführten funktionellen Klauenpflege erfasst und die Befunde der Hintergliedmaßen dokumentiert. Die erste Impfung erfolgte im Dezember 1998, die zweite drei Wochen später, die weiteren Impfungen fanden im März 1999 und im November 1999 statt. Zwischen der ersten und vierten Untersuchung durchgeführte Klauen- und Antibiotikabehandlungen wurden vom Betriebsleiter protokolliert. Die Auswertung erbrachte folgende Ergebnisse: 1. Zu keinem der vier Untersuchungszeitpunkte bestanden signifikante Unterschiede bezüglich der Prävalenzen der DD in den zwei Impfgruppen und der Kontrollgruppe. Die Prävalenzen der DD bewegten sich zum Zeitpunkt der vier Untersuchungen um 36 %, 42 %, 51 % und 38 %. 2. An Hintergliedmaßen, die bei der Erstuntersuchung DD-Läsionen aufwiesen, konnten auch bei den Folgeuntersuchungen in den zwei Impfgruppen und der Kontrollgruppe jeweils etwa gleichhäufig derartige Veränderungen diagnostiziert werden. 3. An Hintergliedmaßen, die bei der Erstuntersuchung frei von DD waren, konnten bei den Folgeuntersuchungen in den zwei Impfgruppen und der Kontrollgruppe jeweils etwa gleichhäufig DD-Läsionen diagnostiziert werden. 4. Die Scorewerte (nach DÖPFER, 1994) DD positiver Tiere - als Maßzahl für den Schweregrad der DD-Veränderung - waren zu den vier Untersuchungszeitpunkten in den zwei Impfgruppen und der Kontrollgruppe statistisch nicht signifikant verschieden. 5. Der „maximale gewichtete Flächenindex (max. GFI)“ - als weitere Bewertungsgrundlage für den Schweregrad der DD - war bei den Untersuchungen U2 und U3 in den Impfgruppen und der Kontrollgruppe nicht statistisch signifikant verschieden. Bei U1 war in der Impfgruppe B ein statistisch signifikant höherer Mittelwert (x) festzustellen als in der Kontrollgruppe (x = 82; p = 0,006). Bei U4 war in der Kontrollgruppe ein statistisch signifikant niedrigerer Mittelwert (x) festzustellen als in den Impfgruppen (x = 22,5; p = 0,033). 6. Die Häufigkeit von Klauen- und Antibiotikabehandlungen sowie der Einfluss von DD-Läsionen auf die Abgangsursache waren in den zwei Impfgruppen und der Kontrollgruppe statistisch nicht signifikant verschieden. In der vorliegenden Impfstudie konnte weder eine prophylaktische noch eine therapeutische Wirkung durch die verwendeten stallspezifischen Vakzinen bei der Bekämpfung der Dermatitis digitalis festgestellt werden. Auch das Hinzufügen von Treponema sp. erbrachte keinen Effekt auf die Wirksamkeit des Impfstoffs.