navinnseab/khmer-wikipedia-article huggingface dataset:
រោគ​ស្វាយ: Cause

Cause

Bacteriology

Histopathology of Treponema pallidum spirochetes using a modified Steiner silver stain
Main article: Treponema pallidum
Treponema pallidum subspecies pallidum is a spiral-shaped, Gram-negative, highly mobile bacterium.[8][13] Three other human diseases are caused by related Treponema pallidum, including yaws (subspecies pertenue), pinta (subspecies carateum) and bejel (subspecies endemicum).[4] Unlike subtype pallidum, they do not cause neurological disease.[12] Humans are the only known natural reservoir for subspecies pallidum.[5] It is unable to survive without a host for more than a few days. This is due to its small genome (1.14 MDa) failing to encode the metabolic pathways necessary to make most of its macronutrients. It has a slow doubling time of greater than 30 hours.[8]

Transmission

Syphilis is transmitted primarily by sexual contact or during pregnancy from a mother to her fetus; the spirochaete is able to pass through intact mucous membranes or compromised skin.[4][5] It is thus transmissible by kissing near a lesion, as well as oral, vaginal, and anal sex.[4] Approximately 30 to 60% of those exposed to primary or secondary syphilis will get the disease.[11] Its infectivity is exemplified by the fact that an individual inoculated with only 57 organisms has a 50% chance of being infected.[8] Most (60%) of new cases in the United States occur in men who have sex with men. It can be transmitted via blood products. However, it is tested for in many countries and thus the risk is low. The risk of transmission from sharing needles appears limited.[4] Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.[14]
រោគ​ស្វាយ: Bacteriology

Bacteriology

Histopathology of Treponema pallidum spirochetes using a modified Steiner silver stain
Main article: Treponema pallidum
Treponema pallidum subspecies pallidum is a spiral-shaped, Gram-negative, highly mobile bacterium.[8][13] Three other human diseases are caused by related Treponema pallidum, including yaws (subspecies pertenue), pinta (subspecies carateum) and bejel (subspecies endemicum).[4] Unlike subtype pallidum, they do not cause neurological disease.[12] Humans are the only known natural reservoir for subspecies pallidum.[5] It is unable to survive without a host for more than a few days. This is due to its small genome (1.14 MDa) failing to encode the metabolic pathways necessary to make most of its macronutrients. It has a slow doubling time of greater than 30 hours.[8]
រោគ​ស្វាយ: Transmission

Transmission

Syphilis is transmitted primarily by sexual contact or during pregnancy from a mother to her fetus; the spirochaete is able to pass through intact mucous membranes or compromised skin.[4][5] It is thus transmissible by kissing near a lesion, as well as oral, vaginal, and anal sex.[4] Approximately 30 to 60% of those exposed to primary or secondary syphilis will get the disease.[11] Its infectivity is exemplified by the fact that an individual inoculated with only 57 organisms has a 50% chance of being infected.[8] Most (60%) of new cases in the United States occur in men who have sex with men. It can be transmitted via blood products. However, it is tested for in many countries and thus the risk is low. The risk of transmission from sharing needles appears limited.[4] Syphilis cannot be contracted through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing.[14]
រោគ​ស្វាយ: Diagnosis

Diagnosis

Poster for testing of syphilis, showing a man and a woman bowing their heads in shame

This posters acknowledges the social stigma of syphilis, while urging those who possibly have the disease to be tested. (circa 1936)

Syphilis is difficult to diagnose clinically early in its presentation.[8] Confirmation is either via blood tests or direct visual inspection using microscopy. Blood tests are more commonly used, as they are easier to perform.[4] Diagnostic tests are, however, unable to distinguish between the stages of the disease.[15]

Blood tests

Blood tests are divided into nontreponemal and treponemal tests.[8] Nontreponemal tests are used initially, and include venereal disease research laboratory (VDRL) and rapid plasma reagin tests. However, as these tests are occasionally false positives, confirmation is required with a treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs).[4] False positives on the nontreponemal tests can occur with some viral infections such as varicella and measles, as well as with lymphoma, tuberculosis, malaria, endocarditis, connective tissue disease, and pregnancy.[7] Treponemal antibody tests usually become positive two to five weeks after the initial infection.[8] Neurosyphilis is diagnosed by finding high numbers of leukocytes (predominately lymphocytes) and high protein levels in the cerebrospinal fluid in the setting of a known syphilis infection.[4][7]

Direct testing

Dark ground microscopy of serous fluid from a chancre may be used to make an immediate diagnosis. However, hospitals do not always have equipment or experienced staff members, whereas testing must be done within 10 minutes of acquiring the sample. Sensitivity has been reported to be nearly 80%, thus can only be used to confirm a diagnosis but not rule one out. Two other tests can be carried out on a sample from the chancre: direct fluorescent antibody testing and nucleic acid amplification tests. Direct fluorescent testing uses antibodies tagged with fluorescein, which attach to specific syphilis proteins, while nucleic acid amplification uses techniques, such as the polymerase chain reaction, to detect the presence of specific syphilis genes. These tests are not as time-sensitive, as they do not require living bacteria to make the diagnosis.[8]
រោគ​ស្វាយ: Blood tests

Blood tests

Blood tests are divided into nontreponemal and treponemal tests.[8] Nontreponemal tests are used initially, and include venereal disease research laboratory (VDRL) and rapid plasma reagin tests. However, as these tests are occasionally false positives, confirmation is required with a treponemal test, such as treponemal pallidum particle agglutination (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs).[4] False positives on the nontreponemal tests can occur with some viral infections such as varicella and measles, as well as with lymphoma, tuberculosis, malaria, endocarditis, connective tissue disease, and pregnancy.[7] Treponemal antibody tests usually become positive two to five weeks after the initial infection.[8] Neurosyphilis is diagnosed by finding high numbers of leukocytes (predominately lymphocytes) and high protein levels in the cerebrospinal fluid in the setting of a known syphilis infection.[4][7]
រោគ​ស្វាយ: Direct testing

Direct testing

Dark ground microscopy of serous fluid from a chancre may be used to make an immediate diagnosis. However, hospitals do not always have equipment or experienced staff members, whereas testing must be done within 10 minutes of acquiring the sample. Sensitivity has been reported to be nearly 80%, thus can only be used to confirm a diagnosis but not rule one out. Two other tests can be carried out on a sample from the chancre: direct fluorescent antibody testing and nucleic acid amplification tests. Direct fluorescent testing uses antibodies tagged with fluorescein, which attach to specific syphilis proteins, while nucleic acid amplification uses techniques, such as the polymerase chain reaction, to detect the presence of specific syphilis genes. These tests are not as time-sensitive, as they do not require living bacteria to make the diagnosis.[8]
រោគ​ស្វាយ: Prevention

Prevention

As of 2010, there is no vaccine effective for prevention.[5] Abstinence from intimate physical contact with an infected person is effective at reducing the transmission of syphilis, as is the proper use of a latex condom. Condom use, however, does not completely eliminate the risk.[14][16] Thus, the Centers for Disease Control and Prevention recommends a long-term, mutually monogamous relationship with an uninfected partner and the avoidance of substances such as alcohol and other drugs that increase risky sexual behavior.[14]

Congenital syphilis in the newborn can be prevented by screening mothers during early pregnancy and treating those who are infected.[17] The United States Preventive Services Task Force (USPSTF) strongly recommends universal screening of all pregnant women,[18] while the World Health Organization recommends all women be tested at their first antenatal visit and again in the third trimester.[19] If they are positive, they recommend their partners also be treated.[19] Congenital syphilis is, however, still common in the developing world, as many women do not receive antenatal care at all, and the antenatal care others do receive does not include screening,[17] and it still occasionally occurs in the developed world, as those most likely to acquire syphilis (through drug use, etc.) are least likely to receive care during pregnancy.[17] A number of measures to increase access to testing appear effective at reducing rates of congenital syphilis in low- to middle-income countries.[19]

Syphilis is a notifiable disease in many countries, including Canada[20] the European Union,[21] and the United States.[22] This means health care providers are required to notify public health authorities, which will then ideally provide partner notification to the person's partners.[23] Physicians may also encourage patients to send their partners to seek care.[24] The CDC recommends sexually active men who have sex with men are tested at least yearly.[25]
រោគ​ស្វាយ: Treatment

Treatment

Early infections

The first-choice treatment for uncomplicated syphilis remains a single dose of intramuscular penicillin G or a single dose of oral azithromycin.[26] Doxycycline and tetracycline are alternative choices; however, due to the risk of birth defects these are not recommended for pregnant women. Antibiotic resistance has developed to a number of agents, including macrolides, clindamycin, and rifampin.[5] Ceftriaxone, a third-generation cephalosporin antibiotic, may be as effective as penicillin-based treatment.[4]

Late infections

For neurosyphilis, due to the poor penetration of penicillin G into the central nervous system, those affected are recommended to be given large doses of intravenous penicillin for a minimum of 10 days.[4][5] If a person is allergic, ceftriaxone may be used or penicillin desensitization attempted. Other late presentations may be treated with once-weekly intramuscular penicillin G for three weeks. If allergic, as in the case of early disease, doxycycline or tetracycline may be used, albeit for a longer duration. Treatment at this stage limits further progression, but has only slight effect on damage which has already occurred.[4]

Jarisch-Herxheimer reaction

One of the potential side effects of treatment is the Jarisch-Herxheimer reaction. It frequently starts within one hour and lasts for 24 hours, with symptoms of fever, muscles pains, headache, and tachycardia.[4] It is caused by cytokines released by the immune system in response to lipoproteins released from rupturing syphilis bacteria.[27]
រោគ​ស្វាយ: Early infections

Early infections

The first-choice treatment for uncomplicated syphilis remains a single dose of intramuscular penicillin G or a single dose of oral azithromycin.[26] Doxycycline and tetracycline are alternative choices; however, due to the risk of birth defects these are not recommended for pregnant women. Antibiotic resistance has developed to a number of agents, including macrolides, clindamycin, and rifampin.[5] Ceftriaxone, a third-generation cephalosporin antibiotic, may be as effective as penicillin-based treatment.[4]
រោគ​ស្វាយ: Late infections

Late infections

For neurosyphilis, due to the poor penetration of penicillin G into the central nervous system, those affected are recommended to be given large doses of intravenous penicillin for a minimum of 10 days.[4][5] If a person is allergic, ceftriaxone may be used or penicillin desensitization attempted. Other late presentations may be treated with once-weekly intramuscular penicillin G for three weeks. If allergic, as in the case of early disease, doxycycline or tetracycline may be used, albeit for a longer duration. Treatment at this stage limits further progression, but has only slight effect on damage which has already occurred.[4]
រោគ​ស្វាយ: Jarisch-Herxheimer reaction

Jarisch-Herxheimer reaction

One of the potential side effects of treatment is the Jarisch-Herxheimer reaction. It frequently starts within one hour and lasts for 24 hours, with symptoms of fever, muscles pains, headache, and tachycardia.[4] It is caused by cytokines released by the immune system in response to lipoproteins released from rupturing syphilis bacteria.[27]
រោគ​ស្វាយ: Epidemiology

Epidemiology

Main article: Epidemiology of syphilis

Age-standardized death from syphilis per 100,000 inhabitants in 2004[28]

  no data

  <35
  35-70
  70-105
  105-140
  140-175
  175-210
  210-245
  245-280
  280-315
  315-350
  350-500
  >500

Syphilis is believed to have infected 12 million additional people in 1999, with greater than 90% of cases in the developing world.[5] It affects between 700,000 and 1.6 million pregnancies a year, resulting in spontaneous abortions, stillbirths, and congenital syphilis.[12] During 2010 it caused about 113,000 deaths down from 202,000 in 1990.[29] In sub-Saharan Africa, syphilis contributes to approximately 20% of perinatal deaths.[12] Rates are proportionally higher among intravenous drug users, those who are infected with HIV, and men who have sex with men.[1][2][3] In the United States, rates of syphilis as of 2007 were six times greater in men than women, while they were nearly equal in 1997.[30] African Americans accounted for almost half of all cases in 2010.[31]
Syphilis was very common in Europe during the 18th and 19th centuries. In the developed world during the early 20th century, infections declined rapidly with the widespread use of antibiotics, until the 1980s and 1990s.[13] Since the year 2000, rates of syphilis have been increasing in the USA, Canada, the UK, Australia and Europe, primarily among men who have sex with men.[5] Rates of syphilis among American women have, however, remained stable during this time, and rates among UK women have increased, but at a rate less than that of men.[32] Increased rates among heterosexuals have occurred in China and Russia since the 1990s.[5] This has been attributed to unsafe sexual practices, such as sexual promiscuity, prostitution, and decreasing use of barrier protection.[5][32][33]

Untreated, it has a mortality of 8% to 58%, with a greater death rate in males.[4] The symptoms of syphilis have become less severe over the 19th and 20th centuries, in part due to widespread availability of effective treatment and partly due to decreasing virulence of the spirochaete.[9] With early treatment, few complications result.[8] Syphilis increases the risk of HIV transmission by two to five times, and coinfection is common (30–60% in a number of urban centers).[4][5]
រោគ​ស្វាយ: History

History

Main article: History of syphilis

Portrait of Gerard de Lairesse by Rembrandt van Rijn, circa 1665–67, oil on canvas - De Lairesse, himself a painter and art theorist, had congenital syphilis that deformed his face and eventually blinded him.[34]

The exact origin of syphilis is disputed.[4] Syphilis was indisputably present in the Americas before European contact. The dispute is over whether or not syphilis was also present elsewhere in the world at that time. One of the two primary hypotheses proposes that syphilis was carried from the Americas to Europe by the returning crewmen from Christopher Columbus's voyage to the Americas. The other hypothesis says that syphilis existed in Europe previously, but went unrecognized until shortly after Columbus' return. These are referred to as the Columbian and pre-Columbian hypotheses, respectively.[15] The Columbian hypothesis is best supported by the available evidence.[35][36] The first written records of an outbreak of syphilis in Europe occurred in 1494 or 1495 in Naples, Italy, during a French invasion (Italian War of 1494–98).[13][15] Due to its being spread by returning French troops, it was initially known as the "French disease."[citation needed] In 1530, the name "syphilis" was first used by the Italian physician and poet Girolamo Fracastoro as the title of his Latin poem in dactylic hexameter describing the ravages of the disease in Italy.[37] It was also known historically as the "Great Pox".[38][39]

The causative organism, Treponema pallidum, was first identified by Fritz Schaudinn and Erich Hoffmann in 1905.[13] The first effective treatment (Salvarsan) was developed in 1910 by Paul Ehrlich, which was followed by trials of penicillin and confirmation of its effectiveness in 1943.[13][38] Before the advent of effective treatment, mercury and isolation were commonly used, with treatments often worse than the disease.[38]
Many famous historical figures, including Franz Schubert, Arthur Schopenhauer, and Édouard Manet,[13] are believed to have had the disease.
រោគ​ស្វាយ: Society and culture

Society and culture

Arts and literature

See also: Notable cases of syphilis

The earliest known medical illustration of people with syphilis, Vienna, 1498
The earliest known depiction of an individual with syphilis is Albrecht Dürer's Syphilitic Man, a woodcut believed to represent a Landsknecht, a Northern European mercenary.[40] The myth of the femme fatale or "poison women" of the 19th century is believed to be partly derived from the devastation of syphilis, with classic examples in literature including John Keats' La Belle Dame sans Merci.[41][42]

The artist Jan van der Straet painted a scene of a wealthy man receiving treatment for syphilis with the tropical wood guaiacum sometime around 1580.[43] The title of the work is "Preparation and Use of Guayaco for Treating Syphilis". That the artist chose to include this image in a series of works celebrating the New World indicates how important a treatment, however ineffective, for syphilis was to the European elite at that time. The richly colored and detailed work depicts four servants preparing the concoction while a physician looks on, hiding something behind his back while the hapless patient drinks.[44]

Tuskegee and Guatemala studies

See also: Tuskegee syphilis experiment and Syphilis experiments in Guatemala
One of the most infamous United States cases of questionable medical ethics in the 20th century was the Tuskegee syphilis study.[45] The study took place in Tuskegee, Alabama, and was supported by the U.S. Public Health Service (PHS) in partnership with the Tuskegee Institute.[46] The study began in 1932, when syphilis was a widespread problem and there was no safe and effective treatment.[6] The study was designed to measure the progression of untreated syphilis. By 1947, penicillin had been validated as an effective cure for syphilis and was becoming widely used to treat the disease. Study directors, however, continued the study and did not offer the participants treatment with penicillin.[46] This is debated, and some have found that penicillin was given to many of the subjects.[6] The study did not end until 1972.[46]

Syphilis experiments were also carried out in Guatemala from 1946 to 1948. They were United States-sponsored human experiments, conducted during the government of Juan José Arévalo with the cooperation of some Guatemalan health ministries and officials. Doctors infected soldiers, prisoners, and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects, and then treated them with antibiotics. In October 2010, the U.S. formally apologized to Guatemala for conducting these experiments.[47]
រោគ​ស្វាយ: Arts and literature

Arts and literature

See also: Notable cases of syphilis

The earliest known medical illustration of people with syphilis, Vienna, 1498
The earliest known depiction of an individual with syphilis is Albrecht Dürer's Syphilitic Man, a woodcut believed to represent a Landsknecht, a Northern European mercenary.[40] The myth of the femme fatale or "poison women" of the 19th century is believed to be partly derived from the devastation of syphilis, with classic examples in literature including John Keats' La Belle Dame sans Merci.[41][42]

The artist Jan van der Straet painted a scene of a wealthy man receiving treatment for syphilis with the tropical wood guaiacum sometime around 1580.[43] The title of the work is "Preparation and Use of Guayaco for Treating Syphilis". That the artist chose to include this image in a series of works celebrating the New World indicates how important a treatment, however ineffective, for syphilis was to the European elite at that time. The richly colored and detailed work depicts four servants preparing the concoction while a physician looks on, hiding something behind his back while the hapless patient drinks.[44]
រោគ​ស្វាយ: Tuskegee and Guatemala studies

Tuskegee and Guatemala studies

See also: Tuskegee syphilis experiment and Syphilis experiments in Guatemala
One of the most infamous United States cases of questionable medical ethics in the 20th century was the Tuskegee syphilis study.[45] The study took place in Tuskegee, Alabama, and was supported by the U.S. Public Health Service (PHS) in partnership with the Tuskegee Institute.[46] The study began in 1932, when syphilis was a widespread problem and there was no safe and effective treatment.[6] The study was designed to measure the progression of untreated syphilis. By 1947, penicillin had been validated as an effective cure for syphilis and was becoming widely used to treat the disease. Study directors, however, continued the study and did not offer the participants treatment with penicillin.[46] This is debated, and some have found that penicillin was given to many of the subjects.[6] The study did not end until 1972.[46]

Syphilis experiments were also carried out in Guatemala from 1946 to 1948. They were United States-sponsored human experiments, conducted during the government of Juan José Arévalo with the cooperation of some Guatemalan health ministries and officials. Doctors infected soldiers, prisoners, and mental patients with syphilis and other sexually transmitted diseases, without the informed consent of the subjects, and then treated them with antibiotics. In October 2010, the U.S. formally apologized to Guatemala for conducting these experiments.[47]
រោគ​ស្វាយ: Further reading

Further reading

 Parascandola, John. Sex, Sin, and Science: A History of Syphilis in America (Praeger, 2008) 195 pp. ISBN 978-0-275-99430-3 excerpt and text search
 Shmaefsky, Brian, Hilary Babcock and David L. Heymann. Syphilis (Deadly Diseases & Epidemics) (2009)
 Stein, Claudia. Negotiating the French Pox in Early Modern Germany (2009)
រោងជួង

រោងជួងមានទីតាំងស្ថិតនៅក្នុងព្រះបរមរាជវាំង ដែលនៅខាងជើងពីសំណាកអង្គរវត្ត គេឃើញមានរោងជួងមួយ ដែលគេពុំបានដឹងកាលបរិច្ឆេទច្បាស់លាស់សាងសងឡើងសម្រាប់វាយជាសញ្ញាបើក និងបិទទ្វារព្រះវិហារព្រះកែវមរកតក្នុងពេលមានព្រះរាជពិធីបុណ្យធំៗ និងសម្រាប់ពេលដែលព្រះសង្ឃចូលសិក្សាភាសាបាលី នៅពេលមានសាលាបាលីនៅតាមថែវមុនឆ្នាំ១៩១៤។ ពីព្រោះនៅថ្ងៃទី២០ ខែវិច្ឆិកា ឆ្នាំ១៩១៤មានការបង្កើតសាលាបាលីជាន់ខ្ពស់នៅភ្នំពេញLes clés du Cambodge។
រោងស្គរ (អាស៊ី)

រូបភាពតូច|រោងស្គរវត្តភ្នំ
រូបភាពតូច| ស្គរ​នៅ​វត្ត​ស៊ីសាកេត ជា​ប្រាសាទ​ពុទ្ធសាសនា​ក្នុង ​ក្រុង​វៀងចន្ទន៍ ប្រទេស​ឡាវ
រោងស្គរ  ឬ gulou គឺជារោងឬប៉មមួយនៅចំកណ្តាលទីក្រុងឬភូមិអាស៊ីចាស់ ភាគច្រើនជាប្រទេសចិន ស្គរសញ្ញា ផ្ទះ។  ជាធម្មតាក៏មាន ប៉មជួង នៅក្បែរនោះដែរ។[ ត្រូវការដកស្រង់ ]
ចំណាត់ថ្នាក់ក្រុម:អត្ថបទដែលមានពាក្យជាភាសាចិន