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1.
Nihon Shokakibyo Gakkai Zasshi ; 118(2): 161-167, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-33563856

RESUMEN

A 44-year-old man was admitted because of general malaise, jaundice, and epigastric pain. The patient had no significant medical history. However, the patient visited a brothel 3 months ago and noticed initial induration on his penis 2 months ago. Physical examination revealed swelling surface lymph nodes in the inguinals. Laboratory examination showed moderate hepatic disorder and jaundice. Hepatitis virus markers and various types of autoantibodies were negative, but serological test for syphilis was positive. The symptoms and abnormal data improved immediately after the patient was treated with amoxicillin (3000mg/day) and probenecid (750mg/day). Thus, a diagnosis of early syphilitic hepatitis was established. In addition, syphilis is not just a genital disease. This disease should be thought of in a patient with liver dysfunction, especially among people of high sexual activity.


Asunto(s)
Hepatitis , Ictericia , Sífilis , Adulto , Amoxicilina , Hepatitis/complicaciones , Hepatitis/tratamiento farmacológico , Humanos , Masculino , Probenecid , Sífilis/complicaciones , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico
2.
Artículo en Inglés | MEDLINE | ID: mdl-33533807

RESUMEN

Syphilis, an infectious disease considered a global public health concern, can cause stillbirths and neonatal deaths. This highlights the importance of continuous surveillance studies among women of reproductive age. A cross-sectional study was carried out to analyze the prevalence and risk factors associated with Treponema pallidum infection in women assisted by primary health care units in Dourados, a city located in Mato Grosso do Sul State, Brazil, which borders Paraguay. A questionnaire was applied to a population-based sample, blood samples were collected for syphilis testing and multivariable analyses were performed to screen associations with T. pallidum infection. The prevalence of T. pallidum infection was 6.04%. Bivariate analysis showed that women referring multiple sexual partners (c2: 6.97 [p=0.014]), income less 2 minimal wages (c2: 15.93 [p=0.003]), who did not have high school (c2: 12.64 [p=0.005]), and reporting history of STIs (c2: 7.30 [p=0.018]) are more likely to have syphilis. In the multivariate analysis, a highest prevalence ratio was observed in women with income less than 2 minimal wages (PR: 0.96 [95% CI: 0.85 - 0.97]), and who did not have high school (PR: 0.94 [95% CI: 0.90 - 0.98]). In addition, 80% of the women reported irregular use of condoms and 63.89% declared having sexual intercourses with multiple partners, which creates more opportunities for the transmission of the infection. These results highlight the need for healthcare systems to implement initiatives to monitor syphilis screening and the commitment of patients and their sexual partners to the treatment in order to achieve a decrease of new cases.


Asunto(s)
Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Adulto , Anciano , Brasil/epidemiología , Ciudades , Condones , Estudios Transversales , Femenino , Humanos , Persona de Mediana Edad , Prevalencia , Salud Pública , Estudios Seroepidemiológicos , Sífilis/diagnóstico , Sexo Inseguro
3.
Matern Child Health J ; 25(2): 198-206, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33394275

RESUMEN

INTRODUCTION: Public health responses often lack the infrastructure to capture the impact of public health emergencies on pregnant women and infants, with limited mechanisms for linking pregnant women with their infants nationally to monitor long-term effects. In 2019, the Centers for Disease Control and Prevention (CDC), in close collaboration with state, local, and territorial health departments, began a 5-year initiative to establish population-based mother-baby linked longitudinal surveillance, the Surveillance for Emerging Threats to Mothers and Babies Network (SET-NET). OBJECTIVES: The objective of this report is to describe an expanded surveillance approach that leverages and modernizes existing surveillance systems to address the impact of emerging health threats during pregnancy on pregnant women and their infants. METHODS: Mother-baby pairs are identified through prospective identification during pregnancy and/or identification of an infant with retrospective linking to maternal information. All data are obtained from existing data sources (e.g., electronic medical records, vital statistics, laboratory reports, and health department investigations and case reporting). RESULTS: Variables were selected for inclusion to address key surveillance questions proposed by CDC and health department subject matter experts. General variables include maternal demographics and health history, pregnancy and infant outcomes, maternal and infant laboratory results, and child health outcomes up to the second birthday. Exposure-specific modular variables are included for hepatitis C, syphilis, and Coronavirus Disease 2019 (COVID-19). The system is structured into four relational datasets (maternal, pregnancy outcomes and birth, infant/child follow-up, and laboratory testing). DISCUSSION: SET-NET provides a population-based mother-baby linked longitudinal surveillance approach and has already demonstrated rapid adaptation to COVID-19. This innovative approach leverages existing data sources and rapidly collects data and informs clinical guidance and practice. These data can help to reduce exposure risk and adverse outcomes among pregnant women and their infants, direct public health action, and strengthen public health systems.


Asunto(s)
Defensa Civil/métodos , Relaciones Madre-Hijo , Vigilancia de la Población/métodos , Adulto , /diagnóstico , Defensa Civil/instrumentación , Femenino , Hepatitis C/complicaciones , Hepatitis C/diagnóstico , Humanos , Recién Nacido , Tamizaje Masivo/métodos , Embarazo , Sífilis/complicaciones , Sífilis/diagnóstico
4.
Public Health ; 190: 62-66, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33360028

RESUMEN

OBJECTIVES: This study aimed to investigate the epidemiological characteristics of syphilis between 2013 and 2018 in the Haidian District of Beijing in China. In addition, this study suggests potential strategies to control the spread of syphilis infection. STUDY DESIGN: Observational study. METHODS: Data were collected from the Infectious Disease Reporting System at medical institutions within the Haidian District of Beijing between 2013 and 2018. Epidemiological methods, combined with Chi-squared test, were used to analyse the distribution of syphilis in terms of time, region, population and development stage. RESULTS: In total, 3048 patients with syphilis were reported in the Haidian District between 2013 and 2018, with an average annual prevalence of 14.26 per 100,000 population. The prevalence of syphilis was higher in rural than urban regions, and the sex ratio of male-to-female was 1.52:1. Patients aged 20-29 years accounted for 22.60% (689/3048) of the total cases. In terms of occupational distributions, the highest proportion (30.61%; 933/3048) was seen in individuals who were homemakers or unemployed. Latent syphilis was present in 66.83% (2037/3048) of patients and accounted for an increased proportion of syphilis cases each year. CONCLUSIONS: Syphilis was epidemic in the Haidian District of Beijing between 2013 and 2018. High prevalence was seen in young and middle-aged males living in urban areas. The prevalence of syphilis has been increasing since 2016; thus, public health policies and intervention strategies need to be strengthened to curb the spread of infection.


Asunto(s)
Población Rural/estadística & datos numéricos , Sífilis/diagnóstico , Sífilis/epidemiología , Treponema pallidum/aislamiento & purificación , Población Urbana/estadística & datos numéricos , Adolescente , Adulto , Distribución por Edad , Anciano , China/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Distribución por Sexo , Serodiagnóstico de la Sífilis , Adulto Joven
5.
Av. odontoestomatol ; 36(3): 161-173, sept.-dic. 2020. graf
Artículo en Español | IBECS | ID: ibc-197415

RESUMEN

INTRODUCCIÓN: la sífilis es una infección bacteriana, que se puede transmitir por contacto sexual o de forma congénita. Esta enfermedad consta de tres estadios, en los cuales se pueden dar diferentes manifestaciones orales. MATERIAL Y MÉTODO: se realizó una búsqueda en la base de datos PubMed, utilizándose como palabras clave: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "oral manifestations", "oral lesions". Como criterios de inclusión se emplearon: series de casos, estudios en los que el tema principal fueran las manifestaciones orales de la sífilis y trabajos en inglés y español. No hubo restricción por fecha. RESULTADOS: se seleccionaron un total de 18 artículos, la N total de pacientes fue de 201. El 10,05% padecía sífilis primaria, el 52,76% sífilis secundaria y el 36, 68% sífilis terciaria. Las lesiones orales predominantes de la sífilis primaria fueron úlceras, inflamación, chancro sifilítico; en la sífilis secundaria se apreciaban placas mucosas, lesiones eritematosas, inflamación, lesiones papulares, lesiones maculares, lesiones erosivas; en la sífilis terciaria aparecen gomas sifilíticos, lesiones leucoplásicas y atrofia lingual. DISCUSIÓN: la sífilis es una infección bacteriana que puede simular diversas enfermedades, es muy importante tenerla en cuenta a la hora de realizar el diagnóstico diferencial de diversas lesiones orales, sobre todo aquellas que se presentan de forma ulcerosa, indurada y asintomática


INTRODUCTION: syphilis is a bacterial infection, which is transmitted by sexual contact or congenitally. This disease develops in three stages, in which different oral manifestations can occur. MATERIAL AND METHOD: a search was made in the PubMed database, using as keywords: "sexually transmitted diseases", "venereal diseases", "syphilis", "primary syphilis", "secondary syphilis", "tertiary syphilis", "Oral manifestations", "oral lesions". The inclusion criteria were: case series, studies in which the main theme was the oral manifestations of syphilis and works in English and Spanish. There was no restriction by date. RESULTS: a total of 18 articles were selected, the total sample of patients was 201. 10.05% had primary syphilis, 52.76% secondary syphilis and 36, 68% tertiary syphilis. The predominant oral lesions of primary syphilis were ulcers, inflammation, syphilitic chancre; in secondary syphilis there were mucous patches, erythematous lesions, inflammation, papular lesions, macular lesions, erosive lesions; in tertiary syphilis, syphilitic gums, leukoplastic lesions and lingual atrophy. DISCUSSION: Syphilis is a bacterial infection that can simulate various diseases, it is very important to take it into account when making the differential diagnosis of various oral lesions, especially those that occur in an ulcerative, indurated and asymptomatic form


Asunto(s)
Humanos , Sífilis/patología , Sífilis/epidemiología , Enfermedades de la Boca/patología , Sífilis/diagnóstico , Boca/lesiones , Diagnóstico Diferencial , Penicilinas/administración & dosificación , Penicilina G Benzatina/administración & dosificación , Doxiciclina/administración & dosificación , Amoxicilina/administración & dosificación , Probenecid/administración & dosificación
6.
BMJ Case Rep ; 13(12)2020 Dec 18.
Artículo en Inglés | MEDLINE | ID: mdl-33370929

RESUMEN

Syphilitic proctitis is a rare presentation of sexually transmitted infection that poses a diagnostic challenge as it mimics rectal cancer clinically, radiologically and endoscopically. We report a case of a 66-year-old male patient with a background of HIV infection presenting with obstructive bowel symptoms and initial diagnosis of rectal cancer on CT. Sigmoidoscopy and histopathology were non-diagnostic. A diagnosis of secondary syphilis was suspected after obtaining sexual history and diagnostic serology, avoiding planned surgical intervention.


Asunto(s)
Infecciones por VIH , Obstrucción Intestinal , Penicilinas/administración & dosificación , Proctitis/diagnóstico , Neoplasias del Recto/diagnóstico , Recto , Treponema pallidum , Anciano , Antibacterianos/administración & dosificación , Diagnóstico Diferencial , Infecciones por VIH/complicaciones , Infecciones por VIH/terapia , Humanos , Obstrucción Intestinal/diagnóstico , Obstrucción Intestinal/etiología , Masculino , Proctitis/etiología , Proctitis/fisiopatología , Proctitis/terapia , Recto/diagnóstico por imagen , Recto/microbiología , Recto/patología , Enfermedades de Transmisión Sexual/diagnóstico , Enfermedades de Transmisión Sexual/terapia , Sigmoidoscopía/métodos , Sífilis/complicaciones , Sífilis/diagnóstico , Sífilis/terapia , Tomografía Computarizada por Rayos X/métodos , Treponema pallidum/inmunología , Treponema pallidum/aislamiento & purificación
7.
Orv Hetil ; 161(45): 1927-1935, 2020 11 08.
Artículo en Húngaro | MEDLINE | ID: mdl-33161392

RESUMEN

Összefoglaló. Bevezetés és célkituzés: A syphiliseredetu uveitis szemészeti és általános tüneteinek ismertetése, a prognózis elemzése olyan esetek kapcsán, amelyekben az uveitis kivizsgálása során derült fény a syphilisre. Módszer: 2011 és 2019 között 14 uveitises beteg vizsgálata során derült fény syphilisre (13 férfi, 1 no), a tünetek 25 szemen jelentkeztek. A betegek adatait retrospektíven elemeztük. Eredmények: A betegek átlagéletkora 46 év volt (23-72 év). A szemészeti diagnózis felállítását követoen 2 beteg nem jelent meg a további borgyógyászati és szemészeti vizsgálaton, 1 beteget más intézetben kezeltek. A gondozott 11 betegnél a gyulladásban érintett szemeken az elso alkalommal észlelt átlagolt látóélesség a jobb szemen 0,71 (0,001-1,0), a bal szemen 0,53 (0,04-1,0) volt. A követési ido átlagosan 22 hónap (1-72) volt. A követési ido végén az átlagolt látóélesség a jobb szemen 0,9 (0,15-1,0), a bal szemen 0,82 (0,08-1,0) volt. A leggyakoribb szemészeti manifesztáció a hátsó uveitis volt, amely papillitis, chorioretinitis vagy kombinált formákban volt megfigyelheto, összesen 20 szemen. A neurosyphilis-protokoll alapján alkalmazott penicillinkezelés után a gyulladásos tünetek minden betegnél megszuntek, a követési ido végén a betegek többségénél a látóélesség teljes volt. A gyengébb látóélesség hátterében látóideg-atrophia, illetve a macula károsodása állt. Következtetés: Eseteinkben a betegek foként középkorú férfiak voltak. Bár jellemzo volt a hátsószegmentum-érintettség, megfelelo kezelés mellett a prognózis jónak volt mondható. Orv Hetil. 2020; 161(45): 1927-1935. INTRODUCTION AND OBJECTIVE: To describe the ocular and general characteristics and to assess prognosis of patients with uveitis, whose syphilis infection was revealed during uveitis workup. METHOD: Between 2011 and 2019, 14 uveitis patients were diagnosed with syphilis (13 males, 1 female) with symptoms in 25 eyes. Patients' clinical records were analyzed retrospectively. RESULTS: The mean age of patients was 46 years (range 23-72 years). 2 patients did not show up for further dermatological and ophthalmic examinations, and 1 patient was treated at another institute. In the 11 patients we treated, the mean visual acuity observed for the first time in the eyes affected by inflammation was 0.71 (0.001-1.0) in the right eye and 0.53 (0.04-1.0) in the left eye. The mean follow-up was 22 months (1-72). At the end of the follow-up period, the mean visual acuity was 0.9 (0.15-1.0) in the right eye and 0.82 (0.08-1.0) in the left eye. The most common ocular manifestation was posterior uveitis (papillitis, chorioretinitis, or in combined forms) in a total of 20 eyes. After receiving penicillin therapy according the neurosyphilis protocol, inflammatory symptoms resolved in all patients, and at the end of the follow-up, the majority of patients had complete visual recovery. Lower visual acuity was due to optic nerve atrophy and macular damage. CONCLUSION: In our case series, the patients were predominantly middle-aged men. Although most patients showed posterior segment involvement, with appropriate treatment the visual outcome was good. Orv Hetil. 2020; 161(45): 1927-1935.


Asunto(s)
Coriorretinitis , Infecciones Bacterianas del Ojo , Neurosífilis , Sífilis , Uveítis , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Adulto Joven
9.
S Afr Med J ; 110(7): 642-645, 2020 Jul 07.
Artículo en Inglés | MEDLINE | ID: mdl-32880340

RESUMEN

We present an unusual case of syphilitic pancreatitis and ascending aortitis in a 41-year-old HIV-negative male patient presenting to a tertiary institution with obstructive jaundice. After a battery of investigations that included computed tomography (CT) and 18F-labelled fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT) imaging, syphilis serology and histology, a diagnosis of tertiary syphilis was made. The patient responded favourably to antibiotics, with resolution of all lesions on FDG PET/CT 13 weeks after initiation of therapy. Even though tertiary syphilis is a rare entity, it should be earmarked as a mimicker of other pathological conditions, including, in this case, primary pancreatic malignancy.


Asunto(s)
Pancreatitis/diagnóstico , Pancreatitis/microbiología , Sífilis/diagnóstico , Adulto , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Biopsia , Angiografía por Tomografía Computarizada , Medios de Contraste , Diagnóstico Diferencial , Humanos , Ictericia Obstructiva/microbiología , Masculino , Páncreas/patología , Neoplasias Pancreáticas/diagnóstico , Sífilis Cardiovascular/diagnóstico , Tomografía Computarizada por Rayos X
11.
BMC Infect Dis ; 20(1): 692, 2020 Sep 21.
Artículo en Inglés | MEDLINE | ID: mdl-32957955

RESUMEN

BACKGROUND: Syphilis has seen an increased incidence in recent years and can have serious and irreversible consequences if left un-diagnosed and untreated. This case report describes a presentation of syphilis and acute kidney injury - a scenario sparsely described in existing literature. CASE PRESENTATION: This 43-year old Man who has Sex with Men (MSM) presented to the emergency department with a 3-week history of vomiting and headaches, progressing to include pyrexia. These symptoms started following his return from a 2-week cruise in Central America throughout which he had been well. He had a background of well-controlled human immunodeficiency virus (HIV). On admission he had an Acute Kidney Injury (AKI) stage 3, without hydronephrosis, presumed to be pre-renal. Leptospirosis, the main differential, was negative serologically. 'Pyrexia of unknown origin' testing was performed, and cefuroxime commenced. Later in the admission, syphilis testing indicated an acute infection and he completed a full treatment course of benzylpenicillin. This, alongside intravenous fluids, resulted in symptom and renal resolution in 9 days and restoration of renal function. CONCLUSIONS: Renal complications in syphilis are rare, furthermore the majority of those documented occur in latent syphilis and are irreversible. There are limited numbers of other documented cases of AKI in acute syphilis, which like the gentleman in this case were reversible and did not lead to permanent kidney damage. This case adds to the knowledge base of AKI in initial presentation of syphilis. It also demonstrates not only the importance of taking a sexual history in patients with new infective symptoms but that testing for syphilis in at-risk groups regardless of history should be performed given its rising incidence. These considerations by physicians can lead to prompt diagnosis and management of syphilis and improve patient care and long-term outcomes.


Asunto(s)
Lesión Renal Aguda/etiología , Sífilis/complicaciones , Lesión Renal Aguda/microbiología , Adulto , Antibacterianos/uso terapéutico , Fiebre/etiología , Infecciones por VIH/tratamiento farmacológico , Homosexualidad Masculina , Humanos , Masculino , Penicilina G/uso terapéutico , Conducta Sexual , Minorías Sexuales y de Género , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Serodiagnóstico de la Sífilis , Viaje
13.
Public Health Rep ; 135(1_suppl): 75S-81S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735184

RESUMEN

Policies facilitating integration of public health programs can improve the public health response, but the literature on approaches to integration across multiple system levels is limited. We describe the efforts of the Massachusetts Department of Public Health to integrate its HIV, viral hepatitis, sexually transmitted infection (STI), and tuberculosis response through policies that mandated contracted organizations to submit specimens for testing to the Massachusetts State Public Health Laboratory; co-test blood specimens for HIV, hepatitis C virus (HCV), and syphilis; integrate HIV, viral hepatitis, and STI disease surveillance and case management in a single data system; and implement an integrated infectious disease drug assistance program. From 2014 through 2018, the number of tests performed by the Massachusetts State Public Health Laboratory increased from 16 321 to 33 674 for HIV, from 11 054 to 33 670 for HCV, and from 19 169 to 30 830 for syphilis. Service contracts enabled rapid response to outbreaks of HIV, hepatitis A, and hepatitis B. Key challenges included lack of a billing infrastructure at the Massachusetts State Public Health Laboratory; the need to complete negotiations with insurers and to establish a retained revenue account to receive health insurance reimbursements for testing services; and time to train testing providers in phlebotomy for required testing. Investing in laboratory infrastructure; creating billing mechanisms to maximize health insurance reimbursement; proactively engaging providers, community members, and other stakeholders; and building capacity to transform practices are needed. Using multilevel policy approaches to integrate the public health response to HIV, STI, viral hepatitis, and tuberculosis is feasible and adaptable to other public health programs.


Asunto(s)
Servicios Contratados/organización & administración , Seguro de Salud/organización & administración , Administración en Salud Pública/métodos , Vigilancia en Salud Pública/métodos , Enfermedades de Transmisión Sexual/diagnóstico , Servicios Contratados/economía , Servicios Contratados/normas , Política de Salud , Accesibilidad a los Servicios de Salud , Hepatitis/diagnóstico , Humanos , Seguro de Salud/economía , Seguro de Salud/legislación & jurisprudencia , Seguro de Salud/normas , Reembolso de Seguro de Salud/economía , Reembolso de Seguro de Salud/legislación & jurisprudencia , Reembolso de Seguro de Salud/normas , Relaciones Interinstitucionales , Massachusetts , Estudios de Casos Organizacionales , Evaluación de Programas y Proyectos de Salud , Administración en Salud Pública/economía , Administración en Salud Pública/legislación & jurisprudencia , Administración en Salud Pública/normas , Sífilis/diagnóstico
14.
Public Health Rep ; 135(1_suppl): 57S-64S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735188

RESUMEN

OBJECTIVES: California is experiencing a syphilis and congenital syphilis epidemic, and many persons diagnosed with syphilis report a history of recent incarceration or sexual contact with a person who has recently been incarcerated. Fresno County's local health department and jail collaborated to implement a routine syphilis screening policy for male adults aged 18-30 and female adults aged 18-35 booked into the facility. We evaluated syphilis screening, case finding, and treatment rates after implementation of the new policy. METHODS: We linked jail census and laboratory data to syphilis surveillance data to assess screening coverage, positivity, and treatment rates for age-eligible persons who were booked into Fresno County Jail from April 1, 2016, through December 31, 2017. RESULTS: Of 24 045 age-eligible persons who were booked into the jail during the study period, 5897 (24.5%) were female and 18 148 (75.5%) were male. Of 7144 (29.7%) persons who were screened for syphilis, 611 (8.6%) had a reactive rapid plasma reagin blood test result (16.4% [253 of 1546] of female adults; 6.4% [358 of 5598] of male adults) and 238 (3.3%) were newly diagnosed with syphilis, as confirmed by matching to the surveillance system (6.9% [106 of 1546] of female adults; 2.4% [132 of 5598] of male adults). Of persons identified with syphilis, 51.7% (n = 123 of 238) received adequate recommended treatment (59.4% [63 of 106] of female adults; 45.5% [60 of 132] of male adults). CONCLUSIONS: The age-based syphilis screening policy adopted in this jail yielded high positivity, including newly identified syphilis infections among female adults of childbearing age. The targeted screening policy was formalized in the county-negotiated contract with the jail's private correctional health care company in 2018-a strategy that can be replicated.


Asunto(s)
Tamizaje Masivo/organización & administración , Prisiones/organización & administración , Sífilis/diagnóstico , Sífilis/epidemiología , Adolescente , Adulto , California/epidemiología , Femenino , Humanos , Incidencia , Masculino , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Adulto Joven
15.
Public Health Rep ; 135(1_suppl): 182S-188S, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32735204

RESUMEN

OBJECTIVES: We evaluated the impact of a 2014 New York City health code change requiring laboratories to indicate if a patient is pregnant or probably pregnant in the electronic laboratory report (ELR) when reporting syphilis and hepatitis B virus (HBV) cases to the New York City Department of Health and Mental Hygiene (DOHMH). METHODS: We calculated the number of pregnant persons with syphilis or HBV infection reported to DOHMH from January 1, 2013, through June 30, 2018. We compared the proportion in which the first report to DOHMH was an ELR with pregnancy indicated before and after the policy change. We calculated time between first ELR with pregnancy indicated and subsequent reporting by a method other than ELR and the proportion of cases in which ELR with pregnancy indicated was the only report source. RESULTS: A total of 552 new syphilis and 8414 HBV-infected cases were reported to DOHMH. From January 2013-June 2014 (pre-change) to January 2017-June 2018 (post-change), the proportion of cases in which ELR with pregnancy indicated was the first report to DOHMH increased significantly (14.7% [23/156] to 46.2% [80/173] for syphilis; 8.0% [200/2498] to 45.3% [851/1879] for HBV infection [P < .001]). Median time between first ELR with pregnancy indicated and subsequent reporting by a method other than ELR was 9.0 days for syphilis and 51.0 days for HBV infection. ELR with pregnancy indicated was the only report for 43.1% (238/552) of syphilis cases and 23.4% (1452/6200) of HBV cases during the study period. CONCLUSION: Including pregnancy status with ELR can increase the ability of public health departments to conduct timely interventions to prevent mother-to-child transmission.


Asunto(s)
Hepatitis B/diagnóstico , Complicaciones Infecciosas del Embarazo/diagnóstico , Vigilancia en Salud Pública/métodos , Sífilis/diagnóstico , Adolescente , Adulto , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Ciudad de Nueva York , Embarazo , Complicaciones Infecciosas del Embarazo/prevención & control , Adulto Joven
16.
Klin Lab Diagn ; 65(8): 521-528, 2020 Jul 20.
Artículo en Ruso | MEDLINE | ID: mdl-32762197

RESUMEN

In medical organizations special forms (approved by orders of the Ministry of health and the Central statistical office) are used to present the results of laboratory examination of the population for syphilis. Currently, these forms include laboratory technologies that do not meet modern standards. In 2018-2019 the normative documents, regulating the use of accounting forms of medical documentation in the public health system, and the practice of using forms with the results of laboratory examination for syphilis were studied in 35 branches of 3 medical organizations of the Lyubertsy district of the Moscow region and in 18 branches of Moscow city was conducted. It is established that in the medical organizations of Moscow and the Moscow region are used the different forms of the registration forms approved by orders of the Ministry of health of the USSR which have now become invalid. The structure of the forms with the results of the population survey for syphilis does not correspond to the applied modern technologies and standards of the survey. On the basis of requirements of modern regulatory documents two new forms of registration forms for the presentation of results of laboratory researches have been developed, within 1,5 years tested and offered for application: one form at screening of the population for syphilis and another - for performing verification examinations for diagnostics and the subsequent clinical and serological supervision.


Asunto(s)
Sífilis , Humanos , Laboratorios , Tamizaje Masivo , Moscú , Encuestas y Cuestionarios , Sífilis/diagnóstico , Sífilis/epidemiología , Serodiagnóstico de la Sífilis
17.
Nurs Clin North Am ; 55(3): 361-377, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32762856

RESUMEN

Despite the near-eradication of syphilis in the United States in the late 1990s, new infections have surged over the past 20 years. Dubbed, "the great imitator," syphilis infections often can be misdiagnosed and resultantly untreated. This leads to people inadvertently infecting others. This article reviews the history of syphilis, including the unethical studies undertaken in the past; current epidemiology; treatment guidelines; and strategies to reduce new infections.


Asunto(s)
Guías como Asunto/normas , Disparidades en Atención de Salud/estadística & datos numéricos , Sífilis/epidemiología , Sífilis/historia , Grupos Étnicos/estadística & datos numéricos , Disparidades en Atención de Salud/historia , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Homosexualidad Masculina/psicología , Humanos , Masculino , Enfermeras Practicantes , Reacción en Cadena de la Polimerasa , Prevalencia , Sífilis/diagnóstico , Personas Transgénero/psicología , Estados Unidos/epidemiología
18.
PLoS One ; 15(8): e0237949, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32817658

RESUMEN

Syphilis, caused by Treponema pallidum ssp. pallidum (TPA), is a persisting global health problem. Although syphilis diagnostics relies mainly on serology, serological tests have some limitations, and it is recommended that the final diagnosis be supported by additional tests. The purpose of this study was to analyze the relationship between serology and PCR in syphilis diagnostics. From the year 2004 to May 2019, a total of 941 samples were taken from 833 patients suspected of having syphilis, in Czech Republic. In all these samples, both nested PCR detection of TPA and serology testing were performed. Of the 941 samples, 126 were seronegative, 651 were seropositive, and 164 were serodiscrepant. Among seronegative samples (n = 126), 11 were PCR-positive (8.7%). Among seropositive samples (n = 651; i.e., samples positive for both non-treponemal and treponemal serology tests), 368 samples were PCR-positive (56.5%). The remaining 164 serodiscrepant samples included RPR negative and treponemal serological test-positive samples (n = 154) and a set of 10 RPR-positive samples negative in treponemal serological tests. While the first group revealed 73 PCR-positive samples (47.4%), the second revealed 5 PCR positive samples (50.0%). PCR detection rates were highest in primary syphilis, with lower rates in the secondary and undetermined syphilis stages. As shown here, the nested PCR can improve diagnostics of syphilis, especially in seronegative patients and in patients with discrepant serology.


Asunto(s)
Reacción en Cadena de la Polimerasa , Serodiagnóstico de la Sífilis/métodos , Sífilis/diagnóstico , Treponema/aislamiento & purificación , Humanos , Estudios Retrospectivos , Sífilis/sangre , Treponema/genética , Treponema/inmunología , Treponema/fisiología
20.
An Bras Dermatol ; 95(5): 589-593, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32727677

RESUMEN

BACKGROUND: Syphilis is one of the most common diseases that start with genital ulcers. Aside from the initial, classic ulcerative lesion of syphilis, called hard chancre, atypical presentations are common, with erosions, erythema, edema, balanitis, and other dermatological manifestations. Associated with initial genital lesions, the presence of inguinal adenopathies is frequent, and the presence of hardened and painless lymphangitis on the dorsum of the penis is rare. OBJECTIVES: To describe atypical penile manifestations in patients with early syphilis. METHODS: The present study reports patients who developed cord-like lesions on the penis. RESULTS: The study included 25 patients with cord-like lesions on the penis; in 19 of those, the diagnosis of syphilis was confirmed. STUDY LIMITATIONS: Small number of patients included. CONCLUSIONS: In view of the findings of the present investigation, it is important to emphasize that all patients who present with cord-like lesions on the penis must undergo a rapid test for syphilis, VDRL, serologies for HIV viral hepatitis B and C and, whenever possible, histopathological and Doppler exams.


Asunto(s)
Balanitis , Hepatitis B , Sífilis , Edema , Humanos , Masculino , Pene , Sífilis/diagnóstico
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