T. endemicum causes endemic syphilis, or bejel [also known as Skrljevo disease, Rijeka (Fiume), or Grobnik disease]. Bejel is characterized by mucous, skin, or osseous lesions, and is found mainly in dry and arid or temperate areas of Africa and the Middle East (Table 1). However, it has been eradicated in many locations. Bejel is transmitted by direct contact or contaminated fomites, and it mainly affects children 5 to 12 years old. Like yaws and pinta, bejel affects rural populations with poor sanitation and hygiene.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.