Misplaced Pages

#650349

127-410: Sunglasses or sun glasses (informally called shades or sunnies ; more names below ) are a form of protective eyewear designed primarily to prevent bright sunlight and high-energy visible light from damaging or discomforting the eyes. They can sometimes also function as a visual aid, as variously termed spectacles or glasses exist, featuring lenses that are colored, polarized or darkened. In

254-473: A fashion accessory . The relevance of sunglasses within the fashion industry has included prominent fashion editors' reviews of annual trends in sunglasses as well as runway fashion shows featuring sunglasses as a primary or secondary component of a look. Fashion trends can also draw on the "cool" image of sunglasses and association with a particular lifestyle, especially the close connection between sunglasses and beach life. In some cases, this connection serves as

381-405: A fast heart rate . It is caused by cytokines released by the immune system in response to lipoproteins released from rupturing syphilis bacteria. Penicillin is an effective treatment for syphilis in pregnancy but there is no agreement on which dose or route of delivery is most effective. In 2012, about 0.5% of adults were infected with syphilis, with 6 million new cases. In 1999, it

508-760: A suffumigation . It was also treated by ingestion of mercury compounds. Once the disease had gained a strong foothold, however, the amounts and forms of mercury necessary to control its development exceeded the human body's ability to tolerate it, and the treatment became worse and more lethal than the disease. Nevertheless, medically directed mercury poisoning became widespread through the 17th, 18th, and 19th centuries in Europe, North America, and India. Mercury salts such as mercury (II) chloride were still in prominent medical use as late as 1916, and considered effective and worthwhile treatments. The first-line treatment for uncomplicated syphilis (primary or secondary stages) remains

635-677: A "new fad for wear on city streets ... a favorite affectation of thousands of women all over the U.S." It stated that 20 million sunglasses were sold in the United States in 1937 but estimated that only about 25% of American wearers needed them to protect their eyes. At the same time, sunglasses started to be used as aids for pilots and even produced for the gaining aviation sector, eventually adding to sunglasses as cultural icons and to their popularity. Polarized sunglasses first became available in 1936 when Edwin H. Land began experimenting with making lenses with his patented Polaroid filter. In 1947,

762-491: A $ 6.95 pair of generic glasses offered slightly better protection than expensive Salvatore Ferragamo shades. While non-tinted glasses are very rarely worn without the practical purpose of correcting eyesight or protecting one's eyes, sunglasses have become popular for several further reasons, and are sometimes worn even indoors or at night. Sunglasses can be worn to hide one's eyes. They can make eye contact impossible, which can be intimidating to those not wearing sunglasses;

889-427: A 1 in (2.54 cm) steel ball is dropped on the lens from a height of 50 in (127 cm). In the high velocity test, a 1/4 in (6.35 mm) steel ball is shot at the lens at 150 ft/s (45.72 m/s). To pass both tests, no part of the lens may touch the eye. When driving a vehicle, particularly at high speed, dazzling glare caused by a low Sun, or by lights reflecting off snow, puddles, other vehicles, or even

1016-489: A French invasion ( Italian War of 1494–98 ). Since it was claimed to have been spread by French troops, it was initially called the "French disease" by the people of Naples. The disease reached London in 1497 and was recorded at St Bartholomew's Hospital as infecting 10 out of the 20 patients. In 1530, the pastoral name "syphilis" (the name of a character) was first used by the Italian physician and poet Girolamo Fracastoro as

1143-749: A Moon landing were the original pilot sunglasses produced by American Optical . In 1969 they were used aboard the Eagle , the Lunar Module of Apollo 11 , the first crewed mission to land on the Moon. NASA research primarily by scientists James B. Stephens and Charles G. Miller at the Jet Propulsion Laboratory (JPL) resulted in special lenses that protected against the light in space and during laser and welding work. The lenses used colored dyes and small particles of zinc oxide , which absorbs ultraviolet light and

1270-432: A catch-all term for all types of eye protection, specifically revers to protective equipment that closely resembles common eye wear. To meet most national standards, spectacles must include side shields to reduce the ability of debris to get behind the lenses from the side. Safety glasses can often mount insert frames to mount prescription corrective lenses for users with suboptimal vision. Such insert frames are mounted behind

1397-427: A cause of age-related macular degeneration; before, debates had already existed as to whether "blue blocking" or amber tinted lenses may have a protective effect. Some manufacturers already design glasses to block blue light; the insurance company Suva , which covers most Swiss employees, asked eye experts around Charlotte Remé ( ETH Zürich ) to develop norms for blue blocking, leading to a recommended minimum of 95% of

SECTION 10

#1733093819651

1524-400: A form of chemotherapy , elemental mercury had been used to treat skin diseases in Europe as early as 1363. As syphilis spread, preparations of mercury were among the first medicines used to combat it. Mercury is in fact highly anti-microbial: by the 16th century it was sometimes found to be sufficient to halt development of the disease when applied to ulcers as an inunction or when inhaled as

1651-532: A high level of protection, but not to be worn when driving. The European standard EN 1836:2005 has four transmittance ratings: "0" for insufficient UV protection, "2" for sufficient UHV protection, "6" for good UHV protection and "7" for "full" UHVV protection, meaning that no more than 5% of the 380 nm rays are transmitted. Products which fulfill the standard receive a CE mark . There is no European rating for transmittance protection for radiation of up to 400 nm ("UV400"), as required in other countries (incl.

1778-504: A mortal sin in medieval times. It remains mysterious why the authors of medieval medical treatises so uniformly refrained from describing syphilis or commenting on its existence in the population. Many may have confused it with other diseases such as leprosy ( Hansen's disease ) or elephantiasis . The great variety of symptoms of treponematosis, the different ages at which the various diseases appear, and its widely divergent outcomes depending on climate and culture, would have added greatly to

1905-399: A mortality rate of 8% to 58%, with a greater death rate among males. 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 virulence of the bacteria. With early treatment, few complications result. Syphilis increases the risk of HIV transmission by two to five times, and coinfection

2032-524: A particular (or small range of) wavelength(s), customized to the laser being viewed. Laser protection eye wear is particularly important because of the extremely high intensity of laser light. Welding glass protects against glare and flying sparks. It is a more extreme implementation of the same idea as sunglasses , suited to the more intense light generated during welding . Arc welding goggles must be much darker than blowtorch goggles . Shades 12, 13, and 14 welding glass must be used to stare directly at

2159-407: A road surface when driving into the sun. Sunglasses offer protection against excessive exposure to light, including its visible and invisible components. The most widespread protection is against ultraviolet radiation, which can cause short-term and long-term ocular problems such as photokeratitis (snow blindness), cataracts , pterygium , and various forms of eye cancer . Medical experts advise

2286-449: A single dose of intramuscular benzathine benzylpenicillin . The bacterium is highly vulnerable to penicillin when treated early, and a treated individual is typically rendered non-infective in about 24 hours. Doxycycline and tetracycline are alternative choices for those allergic to penicillin; due to the risk of birth defects , these are not recommended for pregnant women. Resistance to macrolides , rifampicin , and clindamycin

2413-527: A slow doubling time of greater than 30 hours. The bacterium is known for its ability to evade the immune system and its invasiveness. Syphilis is transmitted primarily by sexual contact or during pregnancy from a mother to her baby; the bacterium is able to pass through intact mucous membranes or compromised skin. It is thus transmissible by kissing near a lesion, as well as manual , oral , vaginal , and anal sex . Approximately 30% to 60% of those exposed to primary or secondary syphilis will get

2540-424: A sun visor during his professional football career due to a childhood eye injury and almost always wears dark sunglasses when not wearing a football helmet . Darkened visors now require a doctor's prescription at most levels of the game, mainly because concussion protocol requires officials to look a player in the eye, something made difficult by tinted visors. Special protection is required for space travel because

2667-496: A taboo. The magnitude of its morbidity and mortality in those centuries reflected that, unlike today, there was no adequate understanding of its pathogenesis and no truly effective treatments. Its damage was caused not so much by great sickness or death early in the course of the disease but rather by its gruesome effects decades after infection as it progressed to neurosyphilis with tabes dorsalis . Mercury compounds and isolation were commonly used, with treatments often worse than

SECTION 20

#1733093819651

2794-419: A third of infected people develop tertiary disease. People with tertiary syphilis are not infectious. Gummatous syphilis or late benign syphilis usually occurs 1 to 46 years after the initial infection, with an average of 15 years. This stage is characterized by the formation of chronic gummas , which are soft, tumor-like balls of inflammation which may vary considerably in size. They typically affect

2921-551: A type called glacier glasses or glacier goggles . They typically have very dark round lenses and leather blinders at the sides, which protect the eyes by blocking the Sun's rays around the edges of the lenses. What are Glacier Glasses? Special shaded visors were once allowed in American football ; Jim McMahon , quarterback for the Chicago Bears and San Diego Chargers , famously used

3048-412: Is ANSI Z80.3-2001, which includes three transmittance categories. According to this standard, the lens should have a UVB (280 to 315 nm) transmittance of no more than one per cent and a UVA (315 to 380 nm) transmittance of no more than 0.3 times the visual light transmittance. The ANSI Z87.1-2003 standard includes requirements for basic impact and high impact protection. In the basic impact test,

3175-583: Is benzathine benzylpenicillin injected into a muscle . In those who have a severe penicillin allergy , doxycycline or tetracycline may be used. In those with neurosyphilis , intravenous benzylpenicillin or ceftriaxone is recommended. During treatment people may develop fever, headache, and muscle pains , a reaction known as Jarisch–Herxheimer . In 2015, about 45.4 million people had syphilis infections, of which six million were new cases. During 2015, it caused about 107,000 deaths, down from 202,000 in 1990. After decreasing dramatically with

3302-676: Is ISO 12312. It is divided into three parts, the first of them, about "Sunglasses for general use", was first published in 2013 and then with a new edition in 2022. The second, about "Filters for direct observation of the sun", was published in 2015 and the third "Sunglasses for running, cycling and similar active lifestyles" in 2022. Australia introduced the world's first national standards for sunglasses in 1971. They were updated and expanded in 1990 to AS 1067.1-1990 Sunglasses and fashion spectacles (incl. Part 1 Safety Requirements and Part 2 Performance Requirements), and replaced in 2003 by AS/NZS 1067:2003 Sunglasses and fashion spectacles. This aligned

3429-555: Is a notifiable disease in many countries, including Canada, the European Union , and the United States. This means health care providers are required to notify public health authorities, which will then ideally provide partner notification to the person's partners. Physicians may also encourage patients to send their partners to seek care. Several strategies have been found to improve follow-up for STI testing, including email and text messaging of reminders for appointments. As

3556-801: Is a device used to protect wearer's entire face (or part of it) from hazards such as impact, splash, heat, or glare. With face shields, as with welding helmets and hand shields, the user is continually lifting and lowering the visor. To protect the eyes when the visor is lifted, spectacles should be worn underneath. A respirator is a device designed to protect the wearer from inhaling particulate matter, including airborne microorganisms, fumes, vapours and gases. Insects like flies, bees, and wasps can fly at high speeds and come into contact with your eyes. Their wings or stingers can cause irritation or even scratch your cornea, which can be painful and potentially cause long-term damage. Small projectiles and fragments generated from processes like grinding or machining can have

3683-666: Is a type of headgear used when performing certain types of welding to protect the eyes, face and neck from flash burn, ultraviolet light, sparks, infrared light, and heat. A welding hand shield is a metal plate containing the same protective lens as a welding helmet with a handle on the bottom, intended to be held up in front of the face while working. Hoods (or non-rigid helmets) come with impact-resistant windows usually made of plastic or similar material. An air-supply system may also be incorporated. Hoods are made of non-rigid material for use in confined spaces and of collapsible construction for convenience in carrying and storing. A face shield

3810-599: Is also associated with miscarriage . The main dental defects seen in congenital syphilis are the peg-shaped, notched incisors known as Hutchinson's teeth and so-called mulberry molars (also known as Moon or Fournier molars), defective permanent molars with rounded, deformed crowns resembling a mulberry . Treponema pallidum subspecies pallidum is a spiral-shaped, Gram-negative , highly mobile bacterium. Two other human diseases are caused by related Treponema pallidum subspecies, yaws (subspecies pertenue ) and bejel (subspecies endemicum ), and one further caused by

3937-450: Is also used in sunscreen lotions. The research was later broadened to further terrestrial applications, e.g. , deserts, mountains, and fluorescent-lighted offices, and the technology was commercially marketed by a U.S. company. Since 2002 NASA uses the frame of the designer model Titan Minimal Art of the Austrian company Silhouette , combined with specially dark lenses developed jointly by

Sunglasses - Misplaced Pages Continue

4064-570: Is believed to have infected 12 million additional people, with greater than 90% of cases in the developing world . It affects between 700,000 and 1.6 million pregnancies a year, resulting in spontaneous abortions , stillbirths , and congenital syphilis. During 2015, it caused about 107,000 deaths, down from 202,000 in 1990. In sub-Saharan Africa , syphilis contributes to approximately 20% of perinatal deaths . Rates are proportionally higher among intravenous drug users , those who are infected with HIV , and men who have sex with men. In

4191-518: Is common (30–60% in some urban centers). In 2015, Cuba became the first country to eliminate mother-to-child transmission of syphilis. Paleopathologists have known for decades that syphilis was present in the Americas before European contact. The situation in Europe and Afro-Eurasia has been murkier and caused considerable debate. According to the Columbian theory, syphilis was brought to Spain by

4318-495: Is divided into early latent and late latent stages. Early latent syphilis is defined by the World Health Organization as less than 2 years after original infection. Early latent syphilis is infectious as up to 25% of people can develop a recurrent secondary infection (during which bacteria are actively replicating and are infectious). Two years after the original infection the person will enter late latent syphilis and

4445-589: Is effective at reducing the transmission of syphilis. The CDC states, "The surest way to avoid transmission of sexually transmitted diseases, including syphilis, is to abstain from sexual contact or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected." Congenital syphilis in the newborn can be prevented by screening mothers during early pregnancy and treating those who are infected. The United States Preventive Services Task Force (USPSTF) strongly recommends universal screening of all pregnant women, while

4572-415: Is mandatory immediately after some surgical procedures, such as LASIK , and recommended for a certain time period in dusty areas, when leaving the house and in front of a TV screen or computer monitor after LASEK . Dark glasses that do not block UV radiation can be more damaging to the eyes than not wearing eye protection at all, because they tend to open the pupil and allow more UV rays into the eye. Since

4699-430: Is not as infectious as the early phase. The latent phase of syphilis can last many years after which, without treatment, approximately 15-40% of people can develop tertiary syphilis. Tertiary syphilis may occur approximately 3 to 15 years after the initial infection and may be divided into three different forms: gummatous syphilis (15%), late neurosyphilis (6.5%), and cardiovascular syphilis (10%). Without treatment,

4826-559: Is not generally possible to contract syphilis through toilet seats, daily activities, hot tubs, or sharing eating utensils or clothing. This is mainly because the bacteria die very quickly outside of the body, making transmission by objects extremely difficult. Syphilis is difficult to diagnose clinically during early infection. Confirmation is either via blood tests or direct visual inspection using dark field microscopy . Blood tests are more commonly used, as they are easier to perform. Diagnostic tests are unable to distinguish between

4953-399: Is often present. Ceftriaxone , a third-generation cephalosporin antibiotic , may be as effective as penicillin-based treatment. It is recommended that a treated person avoid sex until the sores are healed. In comparison to azithromycin for treatment in early infection, there is lack of strong evidence for superiority of azithromycin to benzathine penicillin G. For neurosyphilis, due to

5080-476: Is sensitive to intense light because it damages the retina and can even blind the individual. There are many different types of eye protection against light suited for different applications. The most common forms of eye protection against light are sunglasses . These primarily protect against UV light from the sun and help increase visibility in bright conditions. They often tend to be fashionable as well as practical. Laser protection eyewear will filter out

5207-671: Is their fit. The lenses should fit close enough to the face that only very little " stray light " can reach the eye from their sides, or from above or below, but not so close that the eyelashes smear the lenses. To protect against "stray light" from the sides, the lenses should fit close enough to the temples and/or merge into broad temple arms or leather blinders. It is not possible to "see" the protection that sunglasses offer. Dark lenses do not automatically filter out more harmful UV radiation and blue light than light lenses. Inadequate dark lenses are even more harmful than inadequate light lenses (or wearing no sunglasses at all) because they provoke

Sunglasses - Misplaced Pages Continue

5334-470: Is to have the lenses measured, either by the manufacturer or by a properly equipped optician . Several standards for sunglasses (see below ) allow a general classification of the UV protection (but not the blue light protection), and manufacturers often indicate simply that the sunglasses meet the requirements of a specific standard rather than publish the exact figures. The only "visible" quality test for sunglasses

5461-399: Is useful in poker , and many professional poker players wear heavily tinted glasses indoors while playing, so that it is more difficult for opponents to read tells which involve eye movement and thus gain an advantage. Fashion trends can be another reason for wearing sunglasses, particularly designer sunglasses from high-end fashion brands. Sunglasses of particular shapes may be in vogue as

5588-416: Is usually made by using blood tests ; the bacteria can also be detected using dark field microscopy . The Centers for Disease Control and Prevention (U.S.) recommends for all pregnant women to be tested. The risk of sexual transmission of syphilis can be reduced by using a latex or polyurethane condom . Syphilis can be effectively treated with antibiotics . The preferred antibiotic for most cases

5715-415: The 1706 solar eclipse through a telescope with a smoky glass filter attached . By the 18th century, tinted, mirror-like framed Murano glasses had been used as so-called "gondola glasses" ( vetri da gondola and also da dama ) by Venetian women and children, to shield their eyes from the glare from the water in the canals. The Doge and other well-off Venetians, such as possibly Goldoni , sported, in

5842-425: The World Health Organization (WHO) recommends all women be tested at their first antenatal visit and again in the third trimester . If they are positive, it is recommended their partners also be treated. Congenital syphilis is still common in the developing world, as many women do not receive antenatal care at all, and the antenatal care others receive does not include screening. It still occasionally occurs in

5969-596: The cerebrospinal fluid in the setting of a known syphilis infection. Dark field microscopy of serous fluid from a chancre may be used to make an immediate diagnosis. Hospitals do not always have equipment or experienced staff members, and testing must be done within 10 minutes of acquiring the sample. Two other tests can be carried out on a sample from the chancre: direct fluorescent antibody (DFA) and polymerase chain reaction (PCR) tests. DFA uses antibodies tagged with fluorescein , which attach to specific syphilis proteins, while PCR uses techniques to detect

6096-496: The early 1920s , the use of sunglasses started to become more widespread, especially among movie stars. Inexpensive mass-produced sunglasses made from celluloid were first produced by Sam Foster in 1929. Foster found a ready market on the beaches of Atlantic City, New Jersey where he began selling sunglasses under the name Foster Grant from a Woolworth on the Boardwalk . By 1938, Life magazine wrote of how sunglasses were

6223-499: The surf or whitewater . In addition to the features for sports glasses, water sunglasses can have increased buoyancy to stop them from sinking should they come off, and they can have a vent or other method to eliminate fogging. Mountain climbing or traveling across glaciers or snowfields requires above-average eye protection, because sunlight (including ultraviolet radiation) is more intense in higher altitudes, and snow and ice reflect additional light. Popular glasses for this use are

6350-442: The 12th century or possibly earlier. Documents describe the use of such crystal sunglasses by judges in ancient Chinese courts to conceal their facial expressions while questioning witnesses. In 1459, Nuno Fernandes made a request for a pair of spectacles to protect the eyes while horseriding in the snow against the glare coming from the snow, though no description of any actual spectacles is given. King Louis XIV 's court watched

6477-458: The 13th century and until the spread of contemporary UV-shielding spectacles against snowblindness , Inuit made and wore snow goggles of flattened walrus or caribou ivory with narrow slits to look through to block almost all of the harmful reflected rays of the sun. In many different forms and with many different materials, the indigenous peoples of North America and northern Asia crafted highly efficient equipment to protect their eyes against

SECTION 50

#1733093819651

6604-595: The 1960s, examples of probable treponematosis —the parent disease of syphilis, bejel , and yaws —in skeletal remains shifted the opinion of some towards a "pre-Columbian" origin. When living conditions changed with urbanization, elite social groups began to practice basic hygiene and started to separate themselves from other social tiers. Consequently, treponematosis was driven out of the age group in which it had become endemic. It then began to appear in adults as syphilis. Because they had never been exposed as children, they were not able to fend off serious illness. Spreading

6731-586: The Armorlite Company began producing lenses with CR-39 resin. At present, Xiamen , China is the world's largest producer of sunglasses with its port exporting 120 million pairs each year. Sunglasses can improve visual comfort and visual clarity by protecting the eye from glare . The lenses of polarized sunglasses reduce glare reflected at some angles off shiny non-metallic surfaces, such as water. They allow wearers to see into water when only surface glare would otherwise be seen, and eliminate glare from

6858-580: The Australian standard to the European standard opening the European market to Australian-made sunglasses. The Australian Standard AS-NZS 1067 defines standards for sunglasses with respect both to UVA (wavelengths between 315 nm and 400 nm) and UVB transmittance. The five ratings for transmittance (filter) under this standard are based on the amount of absorbed light, 0 to 4, with "0" providing some protection from UV radiation and sunglare, and "4" indicating

6985-827: The British T. Longmore reporting in The Optical Manual (1885) of soldiers in Egypt being equipped with tinted glass "eye protectors." By 1895, sunglasses were mentioned in advertisements, such as in The Sioux City Journal . Jean-Marie-Théodore Fieuzal (1836-1888) was the first to argue for UV protection with (yellow) shaded glasses, and by 1899, Rodenstock GmbH produced possibly the first sunglasses intended for shielding eyes from UV light and not just glare . In 1913, Crookes lenses were introduced, made from glass containing cerium , which completely blocked ultraviolet light. In

7112-463: The UK sunglasses must be labelled and show the filter category number. Lenses with light transmission less than 75% are unsuitable for night driving, and lenses with light transmission less than 8% (category 4) are unsuitable for driving at any time; they should by UK law be labelled 'Not suitable for driving and road use'. Yellow tinted lenses are also not recommended for night use. Due to the light levels within

7239-588: The US, Canada, the UK, Australia and Europe, primarily among men who have sex with men. Rates of syphilis among US women have remained stable during this time, while rates among UK women have increased, but at a rate less than that of men. Increased rates among heterosexuals have occurred in China and Russia since the 1990s. This has been attributed to unsafe sexual practices, such as sexual promiscuity, prostitution, and decreasing use of barrier protection. Left untreated, it has

7366-411: The UV brightness decreases. Car windscreens filter out UV light, slowing and limiting the reaction of the lenses and making them unsuitable for driving as they could become too dark or too light for the conditions. Some manufacturers produce special photochromic lenses that adapt to the varying light conditions when driving. Lenses of fixed tint are graded according to the optical density of the tint; in

7493-498: The United States about 55,400 people are newly infected each year as of 2014 . African Americans accounted for almost half of all cases in 2010. As of 2014, syphilis infections continue to increase in the United States. In the United States as of 2020, rates of syphilis have increased by more than threefold; in 2018 approximately 86% of all cases of syphilis in the United States were in men. In 2021, preliminary CDC data illustrated that 2,677 cases of congenital syphilis were found in

7620-515: The United States) and recommended by experts. The current European standard, EN 1836:2005, was preceded by the older standards EN 166:1995 (Personal eye protection – Specifications), EN167: 1995 (Personal eye protection – Optical test methods), and EN168: 1995 (Personal eye protection – Non-optical test methods), which in 2002 were republished as a revised standard under the name of EN 1836:1997 (which included two amendments). In addition to filtering,

7747-561: The absolute number of cases is not large, new ones are continually discovered, most recently in 2015. At least fifteen cases of acquired treponematosis based on evidence from bones, and six examples of congenital treponematosis based on evidence from teeth, are now widely accepted. In several of the twenty-one cases the evidence may also indicate syphilis. In 2020, a group of leading paleopathologists concluded that enough evidence had been collected to prove that treponemal disease, almost certainly including syphilis, had existed in Europe prior to

SECTION 60

#1733093819651

7874-407: The astronauts' helmets, which also has a thin gold coating for extra protection, functions as strong sunglasses. The frames of sunglasses and corrective glasses used in space must meet special requirements. They must be flexible and durable, and must fit firmly in zero-gravity. Reliable fit is particularly important when wearing corrective glasses underneath tight helmets and in space suits: once inside

8001-480: The availability of penicillin in the 1940s, rates of infection have increased since the turn of the millennium in many countries, often in combination with human immunodeficiency virus (HIV). This is believed to be partly due to unsafe drug use, increased prostitution , and decreased use of condoms . Syphilis can present in one of four different stages: primary, secondary, latent, and tertiary, and may also occur congenitally . There may be no symptoms . It

8128-426: The avoided eye contact can also demonstrate the wearer's detachment, which is considered desirable (or " cool ") in some circles. Eye contact can be avoided even more effectively by using mirrored sunglasses . Sunglasses can also be used to hide emotions; this can range from hiding blinking to hiding weeping and its resulting red eyes. In all cases, hiding one's eyes has implications for nonverbal communication ; this

8255-555: The bacterium responsible for treponematosis is rare in skeletal remains and fragile, making it notoriously difficult to recover and analyze. Precise dating to the medieval period is not yet possible but work by Kettu Majander et al. uncovering the presence of several different kinds of treponematosis at the beginning of the early modern period argues against its recent introduction from elsewhere. Therefore, they argue, treponematosis—possibly including syphilis—almost certainly existed in medieval Europe. Despite significant progress in tracing

8382-413: The blue light. Sunglasses are especially important for children, as their ocular lenses are thought to transmit far more HEV light than adults (lenses "yellow" with age). There has been some speculation that sunglasses actually promote skin cancer . This is due to the eyes being tricked into producing less melanocyte -stimulating hormone in the body. The only way to assess the protection of sunglasses

8509-430: The car, filter category 2 lenses which transmit between 18% and 43% of light are recommended for daytime driving. Polarised lenses normally have a fixed tint, and can reduce reflected glare more than non-polarised lenses of the same density, particularly on wet roads. Graduated lenses, with the bottom part lighter than the top, can make it easier to see the controls within the car. All sunglasses should be marked as meeting

8636-413: The company and "the" NASA optometrist Keith Manuel. The frame is very light at 1.8 grams, and does not have screws or hinges that could detach. The color of the lens can vary depending on style, fashion, and purpose, but for general use, red, grey, green, or brown are recommended to avoid or minimize color distortion , which could affect safety when, for instance, driving a car or a school bus. With

8763-575: The confusion of medical practitioners, as indeed they did right down to the middle of the 20th century. In addition, evidence indicates that some writers on disease feared the political implications of discussing a condition more fatal to elites than to commoners. Historian Jon Arrizabalaga has investigated this question for Castile with startling results revealing an effort to hide its association with elites. The first written records of an outbreak of syphilis in Europe occurred in 1495 in Naples, Italy , during

8890-418: The core concept behind an entire brand. People may also wear sunglasses to hide an abnormal appearance of their eyes. This can be true for people with severe visual impairment, such as the blind , who may wear sunglasses to avoid making others uncomfortable. The assumption is that it may be more comfortable for another person not to see the hidden eyes rather than see abnormal eyes or eyes which seem to look in

9017-578: The damaging effects of strong sunlight in icy circumstances. Pliny the Elder claimed that the Roman emperor Nero liked to watch gladiator fights using cut emeralds . These, however, appear to have worked rather like mirrors. The first sunglasses, made from flat panes of smoky quartz called Ai Tai, meaning "dark clouds," which offered no corrective powers but did protect the eyes from glare , were used in China in

9144-607: The developed world, as those most likely to acquire syphilis are least likely to receive care during pregnancy. Several measures to increase access to testing appear effective at reducing rates of congenital syphilis in low- to middle-income countries. Point-of-care testing to detect syphilis appeared to be reliable, although more research is needed to assess its effectiveness and into improving outcomes in mothers and babies. The CDC recommends that sexually active men who have sex with men be tested at least yearly. The USPSTF also recommends screening among those at high risk. Syphilis

9271-499: The disease and has a limited effect on damage which has already occurred. Serologic cure can be measured when the non-treponemal titers decline by a factor of 4 or more in 6–12 months in early syphilis or 12–24 months in late syphilis. 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, muscle pains, headache, and

9398-399: The disease via sexual contact also led to victims being infected with a massive bacterial load from open sores on the genitalia. Adults in higher socioeconomic groups then became very sick with painful and debilitating symptoms lasting for decades. Often, they died of the disease, as did their children who were infected with congenital syphilis. The difference between rural and urban populations

9525-463: The disease. The causative organism, Treponema pallidum , was first identified by Fritz Schaudinn and Erich Hoffmann , in 1905. The first effective treatment for syphilis was arsphenamine , discovered by Sahachiro Hata in 1909, during a survey of hundreds of newly synthesized organic arsenical compounds led by Paul Ehrlich . It was manufactured and marketed from 1910 under the trade name Salvarsan by Hoechst AG . This organoarsenic compound

9652-505: The disease. Its infectivity is exemplified by the fact that an individual inoculated with only 57 organisms has a 50% chance of being infected. Most new cases in the United States (60%) occur in men who have sex with men; and in this population 20% of syphilis cases were due to oral sex alone. Syphilis can be transmitted by blood products , but the risk is low due to screening of donated blood in many countries. The risk of transmission from sharing needles appears to be limited. It

9779-471: The early 20th century, they were also known as sun cheaters ( cheaters then being an American slang term for glasses). Since the 1930s, sunglasses have been a popular fashion accessory, especially on the beach . The American Optometric Association recommends wearing sunglasses that block ultraviolet radiation (UV) whenever a person is in the sunlight to protect the eyes from UV and blue light, which can cause several serious eye problems . Their usage

9906-601: The eye socket to give all-round protection. They have adjustable or elasticized headbands and often are equipped with ventilation ports to allow air in and prevent fogging. For example, swimming goggles to protect the eyes from salt or chlorine . Cover goggles are designed to be worn over eye wear. Like eyecup goggles, they have adjustable or elasticized headbands and are equipped with direct or indirect ventilation ports to allow air in and prevent fogging. While both models keep out large particles, indirect-vented goggles are better at keeping out liquids and dusts. A welding helmet

10033-470: The eyes in the form of splash, mists, vapors, or fumes. When working with or around chemicals, it is important to know the location of emergency eyewash stations and how to access them with restricted vision. When fitted and worn correctly, goggles protect your eyes from hazardous substances. A face shield may be required in areas where workers are exposed to severe chemical hazards. Personal protective equipment devices for chemical hazards: The human eye

10160-485: The fearsome and sordid status of sexually transmitted infections in those centuries. According to a 2020 study, more than 20% of individuals in the age range 15–34 years in late 18th-century London were treated for syphilis. At the time the causative agent was unknown but it was well known that it was spread sexually and also often from mother to child. Its association with sex, especially sexual promiscuity and prostitution , made it an object of fear and revulsion and

10287-631: The front of the vehicle, can be lethal. Sunglasses can protect against glare when driving. Two criteria must be met: vision must be clear, and the glasses must let sufficient light get to the eyes for the driving conditions. General-purpose sunglasses may be too dark, or otherwise unsuitable for driving. The Automobile Association and the Federation of Manufacturing Opticians have produced guidance for selection of sunglasses for driving. Variable tint or photochromic lenses increase their optical density when exposed to UV light, reverting to their clear state when

10414-456: The genitals (2–7%). The most common location in women is the cervix (44%), the penis in heterosexual men (99%), and anally and rectally in men who have sex with men (34%). Lymph node enlargement frequently (80%) occurs around the area of infection, occurring seven to 10 days after chancre formation. The lesion may persist for three to six weeks if left untreated. Secondary syphilis occurs approximately four to ten weeks after

10541-537: The infection. It may occur early, being either asymptomatic or in the form of syphilitic meningitis ; or late as meningovascular syphilis, manifesting as general paresis or tabes dorsalis . Meningovascular syphilis involves inflammation of the small and medium arteries of the central nervous system. It can present between 1–10 years after the initial infection. Meningovascular syphilis is characterized by stroke, cranial nerve palsies and spinal cord inflammation . Late symptomatic neurosyphilis can develop decades after

10668-546: The introduction of office computing , ergonomists may recommend mildly tinted glasses for use by display operators, in order to increase contrast. Eye protection Eye protection are typically separated into categories based on the style of eye wear and the hazard they are designed to reduce. There categories include: Spectacles with side protection; Goggles ; Welding helmet ; Welding Hand Shields; Non-Rigid Helmets (hoods); Face shield ; and Respirator Face pieces. Safety glasses or spectacles, although often used as

10795-410: The late 18th century, so-called "goldoni glasses," tinted pairs of spectacles with pieces of cloth as sun guards on the sides of the glasses. James Ayscough began experimenting with tinted lenses in spectacles around 1752. These were not "sunglasses" as that term is now used; Ayscough believed that blue- or green-tinted glass could correct for specific vision impairments. Protection from the sun's rays

10922-408: The men who sailed with Christopher Columbus in 1492 and spread from there, with a serious epidemic in Naples beginning as early as 1495. Contemporaries believed the disease sprang from American roots, and in the 16th century physicians wrote extensively about the new disease inflicted on them by the returning explorers. Most evidence supports the Columbian origin hypothesis. However, beginning in

11049-464: The most typical deformities, for example, is a collapsed nasal bridge called saddle nose . Salmon discovered that it appeared often in medieval illuminations , especially among the men tormenting Christ in scenes of the crucifixion. The association of saddle nose with men perceived to be so evil they would kill the son of God indicates the artists were thinking of syphilis, which is typically transmitted through sexual intercourse with promiscuous partners,

11176-761: The mouth or vagina. Latent syphilis has no symptoms and can last years. In tertiary syphilis, there are gummas (soft, non-cancerous growths), neurological problems, or heart symptoms. Syphilis has been known as " the great imitator " because it may cause symptoms similar to many other diseases. Syphilis is most commonly spread through sexual activity . It may also be transmitted from mother to baby during pregnancy or at birth, resulting in congenital syphilis . Other diseases caused by Treponema bacteria include yaws ( T. pallidum subspecies pertenue ), pinta ( T. carateum ), and nonvenereal endemic syphilis ( T. pallidum subspecies endemicum ). These three diseases are not typically sexually transmitted. Diagnosis

11303-709: The necessary blue light protection. However, not every yellow or brown lens blocks sufficient blue light. In rare cases, lenses can filter out too much blue light (i.e., 100%), which affects color vision and can be dangerous in traffic when colored signals are not properly recognized. High prices cannot guarantee sufficient protection as no correlation between high prices and increased UV protection has been demonstrated. A 1995 study reported that "Expensive brands and polarizing sunglasses do not guarantee optimal UVA protection." The Australian Competition & Consumer Commission has also reported that "[c]onsumers cannot rely on price as an indicator of quality". One survey even found that

11430-499: The optic nerve , uveitis , and interstitial keratitis . The acute symptoms usually resolve after three to six weeks; about 25% of people may present with a recurrence of secondary symptoms. Many people who present with secondary syphilis (40–85% of women, 20–65% of men) do not report previously having had the classical chancre of primary syphilis. Latent syphilis is defined as having serologic proof of infection without symptoms of disease. It develops after secondary syphilis and

11557-488: The original infection and includes 2 types; general paresis and tabes dorsalis. General paresis presents with dementia, personality changes, delusions, seizures, psychosis and depression. Tabes dorsalis is characterized by gait instability, sharp pains in the trunk and limbs, impaired positional sensation of the limbs as well as having a positive Romberg's sign . Both tabes dorsalis and general paresis may present with Argyll Robertson pupil which are pupils that constrict when

11684-673: The person focuses on near objects ( accommodation reflex ) but do not constrict when exposed to bright light ( pupillary reflex ). Congenital syphilis is that which is transmitted during pregnancy or during birth. Two-thirds of syphilitic infants are born without symptoms. Common symptoms that develop over the first couple of years of life include enlargement of the liver and spleen (70%), rash (70%), fever (40%), neurosyphilis (20%), and lung inflammation (20%). If untreated, late congenital syphilis may occur in 40%, including saddle nose deformation, Higouménakis' sign , saber shin , or Clutton's joints among others. Infection during pregnancy

11811-456: The poor penetration of benzathine penicillin into the central nervous system , those affected are given large doses of intravenous penicillin G for a minimum of 10 days. If a person is allergic to penicillin, ceftriaxone may be used or penicillin desensitization attempted. Other late presentations may be treated with once-weekly intramuscular benzathine penicillin for three weeks. Treatment at this stage solely limits further progression of

11938-404: The population of 332 million in the United States. Syphilis was very common in Europe during the 18th and 19th centuries. Flaubert found it universal among 19th-century Egyptian prostitutes. In the developed world during the early 20th century, infections declined rapidly with the widespread use of antibiotics , until the 1980s and 1990s. Since 2000, rates of syphilis have been increasing in

12065-499: The possibility of false positives with nontreponemal tests, confirmation is required with a treponemal test, such as Treponema pallidum particle agglutination assay (TPHA) or fluorescent treponemal antibody absorption test (FTA-Abs). Treponemal antibody tests usually become positive two to five weeks after the initial infection and remain positive for many years. Neurosyphilis is diagnosed by finding high numbers of leukocytes (predominately lymphocytes ) and high protein levels in

12192-477: The potential to penetrate some types of protective eye-wear. In the United States the ANSI/ISEA Z87.1-2020 standard is used to certify protective eye-wear which is capable of protecting from these hazards. Debris such as dust, dirt, and small rocks can be picked up by the wind and fly into your eyes. This can cause discomfort and potentially lead to a corneal abrasion or infection. Ultraviolet (UV) radiation from

12319-417: The presence of specific syphilis genes . These tests are not as time-sensitive, as they do not require living bacteria to make the diagnosis. As of 2018 , there is no vaccine effective for prevention. Several vaccines based on treponemal proteins reduce lesion development in an animal model but research continues. Condom use reduces the likelihood of transmission during sex, but does not eliminate

12446-415: The presence of syphilis in past historic periods, definitive findings from paleopathology and aDNA studies are still lacking for the medieval period. Evidence from art is therefore helpful in settling the issue. Research by Marylynn Salmon has demonstrated that deformities in medieval subjects can be identified by comparing them to those of modern victims of syphilis in medical drawings and photographs. One of

12573-747: The primary infection. While secondary disease is known for the many different ways it can manifest, symptoms most commonly involve the skin , mucous membranes , and lymph nodes . There may be a symmetrical, reddish-pink, non-itchy rash on the trunk and extremities, including the palms and soles. The rash may become maculopapular or pustular . It may form flat, broad, whitish, wart-like lesions on mucous membranes, known as condyloma latum . All of these lesions harbor bacteria and are infectious. Other symptoms may include fever , sore throat , malaise , weight loss , hair loss , and headache . Rare manifestations include liver inflammation , kidney disease, joint inflammation , periostitis , inflammation of

12700-494: The protective lens. In some applications, regular eye wear, if manufactured from high-impact materials, can be worn with removable side shields. Oversized spectacles are also manufactured, designed to sit over the users normal eye wear. Goggles are forms of protective eyewear that enclose the eye area in order to prevent particulates, infectious fluids, or chemicals from striking the eyes. Goggles come in two styles, eyecup goggles, and cover goggles. Eyecup goggles completely cover

12827-483: The public on the importance of wearing sunglasses to protect the eyes from UV; for adequate protection, experts recommend sunglasses that reflect or filter out 99% or more of UVA and UVB light, with wavelengths up to 400 nm . Sunglasses that meet this requirement are often labeled as "UV400". This is slightly more protection than the widely used standard of the European Union (see below ), which requires that 95% of

12954-500: The pupil to open wider. As a result, more unfiltered radiation enters the eye. Depending on the manufacturing technology, sufficiently protective lenses can block much or little light, resulting in dark or light lenses. The lens color is not a guarantee either. Lenses of various colors can offer sufficient (or insufficient) UV protection. Regarding blue light, the color gives at least a first indication: Blue blocking lenses are commonly yellow or brown, whereas blue or gray lenses cannot offer

13081-438: The radiation up to only 380 nm must be reflected or filtered out. Sunglasses are not sufficient to protect the eyes against permanent harm from looking directly at the Sun, even during a solar eclipse . Special eyewear known as solar viewers are required for direct viewing of the sun. This type of eyewear can filter out UV radiation harmful to the eyes. More recently, high-energy visible light (HEV) has been implicated as

13208-453: The risk. The Centers for Disease Control and Prevention (CDC) states, "Correct and consistent use of latex condoms can reduce the risk of syphilis only when the infected area or site of potential exposure is protected. However, a syphilis sore outside of the area covered by a latex condom can still allow transmission, so caution should be exercised even when using a condom." Abstinence from intimate physical contact with an infected person

13335-442: The skin, bone, and liver, but can occur anywhere. Cardiovascular syphilis usually occurs 10–30 years after the initial infection. The most common complication is syphilitic aortitis , which may result in aortic aneurysm formation. Neurosyphilis refers to an infection involving the central nervous system . Involvement of the central nervous system in syphilis (either asymptomatic or symptomatic) can occur at any stage of

13462-472: The spacesuit, slipped glasses cannot be touched to push them back into place, sometimes for up to ten hours. Frames and glasses must be designed so that small pieces of the glasses such as screws and glass particles cannot become dislodged, then float and be inhaled. 90% of astronauts wear glasses in space, even if they do not require corrective glasses on Earth, because zero-gravity and pressure changes temporarily affect their vision. The first sunglasses used in

13589-412: The stage it presents: primary, secondary, latent or tertiary. The primary stage classically presents with a single chancre (a firm, painless, non-itchy skin ulceration usually between 1 cm and 2 cm in diameter) though there may be multiple sores. In secondary syphilis, a diffuse rash occurs, which frequently involves the palms of the hands and soles of the feet. There may also be sores in

13716-517: The stages of the disease. Blood tests are divided into nontreponemal and treponemal tests. Nontreponemal tests are used initially and include venereal disease research laboratory (VDRL) and rapid plasma reagin (RPR) tests. False positives on the nontreponemal tests can occur with some viral infections, such as varicella (chickenpox) and measles . False positives can also occur with lymphoma , tuberculosis , malaria , endocarditis , connective tissue disease , and pregnancy . Because of

13843-477: The standard also lists requirements for minimum robustness, labeling, materials (non-toxic for skin contact and not combustible) and lack of protrusions (to avoid harm when wearing them). Categories for the European standard, which are required to be marked on the frame: Sunglasses sold in the United States are regulated by the Food and Drug Administration and are required to conform to safety standards. The U.S. standard

13970-534: The standard for the region where sold. An anti-reflection coating is recommended, and a hard coating to protect the lenses from scratches. Sunglasses with deep side arms can block side, or peripheral, vision and are not recommended for driving. Even though some of these glasses are proven good enough for driving at night, it is strongly recommended not to do so, due to the changes in a wide variety of light intensities, especially while using yellow tinted protection glasses. The main purpose of these glasses are to protect

14097-496: The sun can also harm your eyes. Prolonged exposure to UV rays can cause cataracts, macular degeneration, and other eye conditions that can lead to vision loss. A large percentage of eye injuries are caused by direct contact with chemicals. These injuries often result from an inappropriate choice of personal protective equipment that allows a chemical substance to enter from around or under protective eye equipment. Serious and irreversible damage can occur when chemical substances contact

14224-452: The sun or a solar eclipse. These higher index shades are suitable for arc welding and therefore are suitable for solar viewing. Sunglasses will not provide sufficient protection. Some helmets and visors also protect the eyes: Syphilis Syphilis ( / ˈ s ɪ f ə l ɪ s / ) is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum . The signs and symptoms depend on

14351-400: The sunlight is far more intense and harmful than on Earth, where it is always filtered through the atmosphere . Sun protection is needed against much higher UV radiation and even against harmful infrared radiation, both within and outside the spacecraft. Within the spacecraft, astronauts wear sunglasses with darker lenses and a thin protective gold coating. During space walks , the visor of

14478-485: The time) a single, firm, painless, non-itchy skin ulceration with a clean base and sharp borders approximately 0.3–3.0 cm in size. The lesion may take on almost any form. In the classic form, it evolves from a macule to a papule and finally to an erosion or ulcer . Occasionally, multiple lesions may be present (~40%), with multiple lesions being more common when coinfected with HIV. Lesions may be painful or tender (30%), and they may occur in places other than

14605-488: The title of his Latin poem in dactylic hexameter Syphilis sive morbus gallicus ( Syphilis or The French Disease ) describing the ravages of the disease in Italy. In Great Britain it was also called the "Great Pox". In the 16th through 19th centuries, syphilis was one of the largest public health burdens in prevalence , symptoms, and disability, although records of its true prevalence were generally not kept because of

14732-471: The treponemal diseases is pinta , a skin disease and therefore unrecoverable through paleopathology.) Ancient DNA (aDNA) holds the answer, because just as only aDNA suffices to distinguish between syphilis and other diseases that produce similar symptoms in the body, it alone can differentiate spirochetes that are 99.8 percent identical with absolute accuracy. Progress on uncovering the historical extent of syndromes through aDNA remains slow, however, because

14859-406: The very closely related Treponema carateum , pinta . Unlike subspecies pallidum , they do not cause neurological disease. Humans are the only known natural reservoir for subspecies pallidum . It is unable to survive more than a few days without a host . This is due to its small genome (1.14 Mbp ) failing to encode the metabolic pathways necessary to make most of its macronutrients. It has

14986-504: The voyages of Columbus. There is an outstanding issue, however. Damaged teeth and bones may seem to hold proof of pre-Columbian syphilis, but there is a possibility that they point to an endemic form of treponemal disease instead. As syphilis, bejel, and yaws vary considerably in mortality rates and the level of human disease they elicit, it is important to know which one is under discussion in any given case, but it remains difficult for paleopathologists to distinguish among them. (The fourth of

15113-451: The wearer from dust and smog particles entering into the eyes while driving at high speeds. Many of the criteria for sunglasses worn when piloting an aircraft are similar to those for land vehicles. Protection against UV radiation is more important, as its intensity increases with altitude. Polarised glasses are undesirable as aircraft windscreens are often polarised, intentionally or unintentionally, showing Moiré patterns on looking through

15240-555: The windscreen; and some LCDs used by instruments emit polarised light, and can dim or disappear when the pilot turns to look at them. Like corrective glasses , sunglasses have to meet special requirements when worn for sports. They need shatterproof and impact-resistant lenses; a strap or other fixing is typically used to keep glasses in place during sporting activities, and they have a nose cushion. For water sports, so-called water sunglasses (also: surf goggles or water eyewear) are specially adapted for use in turbulent water, such as

15367-466: The wrong direction. People may also wear sunglasses to hide dilated or contracted pupils, bloodshot eyes due to drug use, chronic dark circles or crow's feet, recent physical abuse (such as a black eye ), exophthalmos (bulging eyes), a cataract , or eyes which jerk uncontrollably ( nystagmus ). Lawbreakers have been known to wear sunglasses during or after committing a crime as an aid to hiding their identities. The international standard for sunglasses

15494-475: Was confirmed in trials in 1943, at which time it became the main treatment. Many famous historical figures, including Franz Schubert , Arthur Schopenhauer , Édouard Manet , Charles Baudelaire , and Guy de Maupassant are believed to have had the disease. Friedrich Nietzsche was long believed to have gone mad as a result of tertiary syphilis , but that diagnosis has recently come into question. The earliest known depiction of an individual with syphilis

15621-503: Was first noted by Ellis Herndon Hudson, a clinician who published extensively about the prevalence of treponematosis, including syphilis, in times past. The importance of bacterial load was first noted by the physician Ernest Grin in 1952 in his study of syphilis in Bosnia. The most compelling evidence for the validity of the pre-Columbian hypothesis is the presence of syphilitic-like damage to bones and teeth in medieval skeletal remains. While

15748-449: Was not a concern for him. One of the earliest surviving depictions of a person wearing sunglasses is one from 1772 of the scientist Antoine Lavoisier , who worked with amplified sunlight. By the 19th century, tinted spectacles were worn by railway travelers. Popularly, it is claimed that yellow/amber and brown-tinted glasses had been used to alleviate symptoms of syphilis in the 19th and early 20th centuries, because sensitivity to light

15875-465: Was one of the symptoms of the disease, although no sources have been found that state prescription of such. From the late 19th century, short references of sunglasses have been found in reports, such as one from 1866 by Walter Alden , who wrote of soldiers using, during the American Civil War (1861-1865), "shell spectacles" ("verres de cocquille") to protect against sunlight on long marches, or by

16002-403: Was referred to as "the great imitator" by Sir William Osler due to its varied presentations. Primary syphilis is typically acquired by direct sexual contact with the infectious lesions of another person. Approximately 2–6 weeks after contact (with a range of 10–90 days) a skin lesion, called a chancre , appears at the site and this contains infectious bacteria. This is classically (40% of

16129-449: Was the first modern chemotherapeutic agent . During the 20th century, as both microbiology and pharmacology advanced greatly, syphilis, like many other infectious diseases, became more of a manageable burden than a scary and disfiguring mystery, at least in developed countries among those people who could afford to pay for timely diagnosis and treatment. Penicillin was discovered in 1928, and effectiveness of treatment with penicillin

#650349