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Objectives: Syphilis is a resurging disease which can present itself in many ways, including lesions within the head and neck mucosa. Some of these lesions may clinically mimic oral malignancies. This literature review aims to better characterize the mucosal presentations of syphilis. Methods: PubMed, EMBASE, and clinicaltrials.gov were searched for full-text, English articles published from 1950 to 2022 that reported patients with head and neck mucosal manifestations of syphilis. Articles were screened according to PRISMA guidelines. Results: One hundred forty-three manuscripts documenting 236 individual patients were included in the review. Patients with secondary syphilis accounted for 62% of patients presenting with head and neck mucosal lesions. The most common lesions found in primary and secondary syphilis were ulcerations, primarily found on the tongue, lips, and palate. While serologic studies are the gold standard for diagnosing syphilis, biopsy of these lesions have characteristic syphilitic changes. Conclusions: Syphilis' nickname of "The great imitator" remains to be true, and the head and neck mucosal manifestations of this disease can resemble commonly seen malignancies. Awareness of this disease and its lesions is prudent given the rising incidence of syphilis within the United States.
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OBJECTIVES: Early detection of depression in at-risk populations is critical for ensuring better maternal and child health outcomes. This study assessed whether Healthy Start Prenatal Risk Screening (HSPRS) could predict depressive symptoms in women enrolled in a Healthy Start (HS) program in under-resourced, high-risk communities of Hillsborough County. METHODS: Data from HS participants were included for those who were evaluated using the HSPRS and the Edinburgh Postnatal Depression Scale (EPDS). A correlation analysis determined if the HSPRS score was associated with a positive EPDS screen, and HSPRS questions related to the participants psychosocial environment were assessed individually to determine their predictive potential. The crude odds ratio (OR) and adjusted OR (controlling for sociodemographic covariates) were calculated for each question of interest. RESULTS: A total of 736 women were included, with 122 (16.5%) scoring 14 or greater on the EPDS, indicating probable depression risk. There were significant differences between women at risk for depression compared to those not at risk regarding maternal age (p-value = 0.03) and marital status (p-value = 0.01). There were no significant differences in education, ethnicity, or race. The total HSPRS score had a weak yet significant correlation with the EPDS score (r = 0.14, p-value = 0.0001), and seven individual HSPRS questions were significantly associated with risk for perinatal depression. Conclusions for Practice: By focusing on responses to key HSPRS questions rather than the overall score, women may receive access to much needed services more quickly, thereby reducing the risk for poorer maternal and developmental outcomes. SIGNIFICANCE: A young maternal age and single marital status have been identified as risk factors for perinatal depression. Additionally, women from racial/ethnic minority groups or low-income populations are more likely to experience depression. Thus, in communities where women exhibit many pre-identified risk factors for perinatal depression, the ability to quickly identify those at the highest risk is imperative. This work indicates that among medically and socially high-risk mothers enrolled in a HS program, the overall HSPRS score was not as predictive of perinatal depression as individual responses to key questions. Attention to these responses could result in women receiving much needed services quicker.