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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.
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
3.
Rev Saude Publica ; 54: 109, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146299

RESUMEN

OBJECTIVE: To analyze the shortage of benzathine penicillin G (BPG), characterizing its temporal evolution and spatial distribution in the city of Rio de Janeiro from 2013 to 2017. METHODS: This ecological study used gestational and congenital syphilis notifications, BPG distribution records, and sociodemographic data from the population of Rio de Janeiro. To quantify the shortage, a BPG supply indicator was estimated per quarter for each neighborhood between 2013 and 2017. Thematic maps were created to identify areas and periods with greater BPG shortage, described according to sociodemographic factors, health services network, and epidemiological features in the incidence of syphilis. RESULTS: BPG shortage in Rio de Janeiro from 2013 to 2017 was not homogeneous in space nor in time. The temporal evolution and spatial distribution of BPG scarcity shows that the shortage affected the inhabitants of the municipality in different ways. Shortage was lower in 2013 and 2016 and more severe in 2014, 2015, and 2017, particularly in neighborhoods within the programmatic areas PA3 and PA5, poorer and with higher prevalence rates of gestational and congenital syphilis. CONCLUSIONS: Analyzing BPG shortage and its temporal evolution and spatial distribution in Rio de Janeiro allowed us to realize that the inhabitants are affected in different ways. Understanding this process contributes to the planning of actions to face shortage crises, minimizing possible impacts on the management of syphilis and reducing inequality in access to treatment.


Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Penicilina G Benzatina/provisión & distribución , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Brasil/epidemiología , Femenino , Humanos , Masculino , Penicilina G Benzatina/uso terapéutico , Embarazo , Análisis Espacio-Temporal , Sífilis/tratamiento farmacológico , Sífilis Congénita/tratamiento farmacológico
5.
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
6.
BMC Infect Dis ; 20(1): 405, 2020 Jun 10.
Artículo en Inglés | MEDLINE | ID: mdl-32522244

RESUMEN

BACKGROUND: Syphilis is a sexually and vertically transmitted infection caused by the bacteria Treponema pallidum for which there are few proven alternatives to penicillin for treatment. For pregnant women infected with syphilis, penicillin is the only WHO-recommended treatment that will treat the mother and cross the placenta to treat the unborn infant and prevent congenital syphilis. Recent shortages, national level stockouts as well as other barriers to penicillin use call for the urgent identification of alternative therapies to treat pregnant women infected with syphilis. METHODS: This prospective, randomized, non-comparative trial will enroll non-pregnant women aged 18 years and older with active syphilis, defined as a positive rapid treponemal and a positive non-treponemal RPR test with titer ≥1:16. Women will be a, domized in a 2:1 ratio to receive the oral third generation cephalosporin cefixime at a dose of 400 mg two times per day for 10 days (n = 140) or benzathine penicillin G 2.4 million units intramuscularly based on the stage of syphilis infection (n = 70). RPR titers will be collected at enrolment, and at three, six, and nine months following treatment. Participants experiencing a 4-fold (2 titer) decline by 6 months will be considered as having an adequate or curative treatment response. DISCUSSION: Demonstration of efficacy of cefixime in the treatment of active syphilis in this Phase 2 trial among non-pregnant women will inform a proposed randomized controlled trial to evaluate cefixime as an alternative treatment for pregnant women with active syphilis to evaluate prevention of congenital syphilis. TRIAL REGISTRATION: Trial identifier: www.Clinicaltrials.gov, NCT03752112. Registration Date: November 22, 2018.


Asunto(s)
Antibacterianos/uso terapéutico , Cefixima/uso terapéutico , Sífilis/tratamiento farmacológico , Brasil/epidemiología , Protocolos de Ensayos Clínicos como Asunto , Ensayos Clínicos Fase II como Asunto , Femenino , Humanos , Penicilina G Benzatina/uso terapéutico , Distribución Aleatoria , Sífilis/microbiología , Sífilis/prevención & control , Resultado del Tratamiento , Treponema pallidum/efectos de los fármacos , Treponema pallidum/aislamiento & purificación
7.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 358-363, May-June 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1132604

RESUMEN

Abstract Introduction: A resurgence of syphilis in Brazil has been reported in recent years. Objective: With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital. Methods: A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected. Results: A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%). Conclusion: The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.


Resumo Introdução: Um ressurgimento da sífilis no Brasil tem sido relatado nos últimos anos. Objetivo: Investigar a frequência, as características demográficas e clínicas dos pacientes com sífilis adquirida com envolvimento oral que receberam atendimento médico em um centro de referência em medicina oral em um hospital público brasileiro. Método: Estudo retrospectivo, abrangeu 12 anos, feito para identificar tendências de mudança na sífilis. Registros médicos de todos os pacientes diagnosticados com sífilis adquirida que receberam atendimento médico na clínica de medicina oral do hospital de 2005 a 2016 foram revisados e os dados demográficos e clínicos foram coletados. Resultados: Foram diagnosticas 85 pacientes com sífilis adquirida, com um aumento significativo no número de casos nos últimos 5 anos. A idade dos pacientes variou de 16 a 76 anos, com pico na terceira e quarta décadas; 48 casos eram do sexo masculino (56,5%) e 37 do sexo feminino (43,5%). A maioria das lesões orais apareceu como úlceras ou placas únicas, os lábios e a língua representaram os locais mais afetados. Todos os casos foram positivos para Venereal Disease Research Laboratory e Fluorescent Treponemal Antibody Absorption Test e o tratamento foi feito com penicilina G benzatina na maioria dos casos (84,7%). Conclusão: A frequência da sífilis oral tem aumentado com o tempo e as lesões orais podem representar uma pista diagnóstica; portanto, os profissionais de saúde bucal devem ser conscientizados e devidamente treinados na tentativa de desenvolver um alto grau de suspeição clínica no diagnóstico da sífilis.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Sífilis/diagnóstico , Enfermedades de la Boca/diagnóstico , Penicilina G Benzatina/uso terapéutico , Sífilis/tratamiento farmacológico , Estudios Retrospectivos , Enfermedades de la Boca/tratamiento farmacológico
8.
Int J STD AIDS ; 31(7): 699-701, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32362198

RESUMEN

Annular syphilis may range from mildly raised lesions with scaly borders to verrucous plaques. Localized annular syphilis on the genitalia has been rarely reported in HIV-negative cases. This paper reports a case of annular secondary syphilis on the penis. Dermoscopy showed peripheral dotted and short linear vessels and white scaling with a relatively clear central area in an erythematous annular plaque. Histopathology revealed mild hyperkeratosis, parakeratosis, psoriasiform acanthosis, and focal basal vacuolar degeneration with lichenoid, perivascular, and periadnexal infiltrate of lymphohistiocytes and plasma cells in the superficial dermis. Silver stain showed several spirochetes in the lower epidermis and superficial dermis. Electron microscopy revealed a few intercellular and intracytoplasmic spirochetes in the basal epidermis and free spirochetes in the papillary dermis. Rapid plasma reagin and Treponema pallidum particle agglutination assays were positive. The lesions disappeared after intramuscular benzathine penicillin, with no relapse at six-month follow-up.


Asunto(s)
Pene/patología , Sífilis Cutánea/patología , Sífilis/diagnóstico , Treponema pallidum/aislamiento & purificación , Adulto , Humanos , Masculino , Microscopía Electrónica , Penicilina G Benzatina/uso terapéutico , Sífilis/tratamiento farmacológico , Serodiagnóstico de la Sífilis , Resultado del Tratamiento
9.
Klin Monbl Augenheilkd ; 237(5): 605-613, 2020 May.
Artículo en Alemán | MEDLINE | ID: mdl-32434244

RESUMEN

Syphilis is a bacterial infectious disease transmitted by the spirochaete Treponema pallidum. The rate of infection has increased during the last decade. Ocular syphilis is an underestimated presentation of the disease, and it is increased in HIV-positive patients. Even though every part of the eye may be affected, syphilis most commonly occurs with posterior or panuveitis. A distinctive pattern is acute syphilitic placoid chorioretinitis, with typical features in multimodal imaging. If syphilis is suspected, specific and nonspecific Treponema pallidum serological diagnostic tests are mandatory. Clinical outcome, or morphology and vision are commonly improved if antibiotic therapy (penicillin is the drug of choice) is instituted early. Additional corticosteroids are carefully applied according to individual need, and should be initiated after the start of antibiotics.


Asunto(s)
Coriorretinitis/tratamiento farmacológico , Endoftalmitis/tratamiento farmacológico , Infecciones Bacterianas del Ojo , Panuveítis , Sífilis/tratamiento farmacológico , Antibacterianos/uso terapéutico , Humanos
11.
Doc Ophthalmol ; 141(2): 187-193, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32248327

RESUMEN

PURPOSE: We present our findings in two cases of retinal dysfunction caused by syphilitic outer retinopathy. CASE 1: A 59-year-old man visited our clinic complaining of blurred vision in his left eye. Optical coherence tomography (OCT) demonstrated an absence of the ellipsoid zone (EZ) in the left eye. A round yellowish-white lesion was observed in the posterior pole of the left fundus. Fundus autofluorescence (FAF) showed hyperfluorescent areas in the posterior pole of both fundi although no specific ophthalmoscopic findings were seen in the right eye. The amplitudes of the LA 3.0 1 Hz and LA 3.0 30 Hz ERG responses were reduced with better preservation of the rod responses. Based on a strong positivity to the rapid plasma reagin (RPR) assay and the Treponema pallidum hemagglutination (TPHA) test, he was diagnosed with syphilitic outer retinopathy and treated with systemic antibiotics. The treatment resulted in a restoration of the retinal structures and cone function. CASE 2: A 47-year-old man was referred to our clinic complaining of reduced vision in both eyes. Although the ocular fundus appeared normal, FAF showed a diffuse hyperfluorescent area in the posterior pole and multiple hyperfluorescent spots. Indocyanine green angiography showed multiple confluent areas of hypofluorescence. OCT demonstrated irregular EZs in both eyes. The amplitudes of the LA 3.0 1 Hz and LA 3.0 30 Hz ERG responses were slightly reduced with prolonged implicit times. These findings are comparable to the findings in patients with multiple evanescent white dot syndrome. However, the strong positivity to the RPR and TPHA tests led us to diagnose the patient with outer retinopathy caused by syphilis. Systemic administration of antibiotics resulted in the restoration of the retinal structures and retinal function. CONCLUSIONS: Syphilitic outer retinopathy affected the retinal structures and function that can be restored by antibiotic treatments.


Asunto(s)
Infecciones Bacterianas del Ojo/diagnóstico , Retina/fisiopatología , Enfermedades de la Retina/diagnóstico , Sífilis/diagnóstico , Ampicilina/uso terapéutico , Antibacterianos/uso terapéutico , Electrorretinografía , Infecciones Bacterianas del Ojo/tratamiento farmacológico , Infecciones Bacterianas del Ojo/microbiología , Infecciones Bacterianas del Ojo/fisiopatología , Angiografía con Fluoresceína , Pruebas de Hemaglutinación , Humanos , Masculino , Persona de Mediana Edad , Oftalmoscopía , Enfermedades de la Retina/tratamiento farmacológico , Enfermedades de la Retina/microbiología , Enfermedades de la Retina/fisiopatología , Sífilis/tratamiento farmacológico , Sífilis/microbiología , Sífilis/fisiopatología , Tomografía de Coherencia Óptica/métodos
12.
Sex Transm Infect ; 96(5): 342-347, 2020 08.
Artículo en Inglés | MEDLINE | ID: mdl-32241905

RESUMEN

OBJECTIVES: In 2016, WHO estimated 376 million new cases of the four main curable STIs: gonorrhoea, chlamydia, trichomoniasis and syphilis. Further, an estimated 290 million women are infected with human papillomavirus. STIs may lead to severe reproductive health sequelae. Low-income and middle-income countries carry the highest global burden of STIs. A large proportion of urogenital and the vast majority of extragenital non-viral STI cases are asymptomatic. Screening key populations and early and accurate diagnosis are important to provide correct treatment and to control the spread of STIs. This article paints a picture of the state of technology of STI point-of-care testing (POCT) and its implications for health system integration. METHODS: The material for the STI POCT landscape was gathered from publicly available information, published and unpublished reports and prospectuses, and interviews with developers and manufacturers. RESULTS: The development of STI POCT is moving rapidly, and there are much more tests in the pipeline than in 2014, when the first STI POCT landscape analysis was published on the website of WHO. Several of the available tests need to be evaluated independently both in the laboratory and, of particular importance, in different points of care. CONCLUSION: This article reiterates the importance of accurate, rapid and affordable POCT to reach universal health coverage. While highlighting the rapid technical advances in this area, we argue that insufficient attention is being paid to health systems capacity and conditions to ensure the swift and rapid integration of current and future STI POCT. Unless the complexity of health systems, including context, institutions, adoption systems and problem perception, are recognised and mapped, simplistic approaches to policy design and programme implementation will result in poor realisation of intended outcomes and impact.


Asunto(s)
Prestación de Atención de Salud/organización & administración , Pruebas en el Punto de Atención/organización & administración , Enfermedades de Transmisión Sexual/diagnóstico , Infecciones por Chlamydia/diagnóstico , Infecciones por Chlamydia/tratamiento farmacológico , Infecciones por Chlamydia/prevención & control , Infecciones por Chlamydia/transmisión , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/prevención & control , Gonorrea/transmisión , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/prevención & control , Infecciones por VIH/transmisión , Humanos , Ciencia de la Implementación , Masculino , Infecciones por Mycoplasma/diagnóstico , Infecciones por Mycoplasma/tratamiento farmacológico , Infecciones por Mycoplasma/prevención & control , Infecciones por Mycoplasma/transmisión , Mycoplasma genitalium , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/transmisión , Enfermedades de Transmisión Sexual/tratamiento farmacológico , Enfermedades de Transmisión Sexual/prevención & control , Enfermedades de Transmisión Sexual/transmisión , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Sífilis/prevención & control , Sífilis/transmisión , Vaginitis por Trichomonas/diagnóstico , Vaginitis por Trichomonas/tratamiento farmacológico , Vaginitis por Trichomonas/prevención & control , Vaginitis por Trichomonas/transmisión
16.
Ann Dermatol Venereol ; 147(2): 127-130, 2020 Feb.
Artículo en Francés | MEDLINE | ID: mdl-31955971

RESUMEN

INTRODUCTION: Syphilis mainly affects men who have sex with men (MSM) between the ages of 20 and 49. Herein we report a case in a teenager illustrating extension of the epidemic to other populations. PATIENTS AND METHODS: A 15-year-old boy consulted in May 2018 for an anal fissure and painful oral erosions. He reported having had unprotected anal sex with another male teenager of the same age three months earlier. Syphilis serology was positive, with a positive treponemal test (TT) and non-treponemal test (VDRL) at 1/128. A treponemal bacterial DNA PCR assay was also positive for swabs obtained from the oral erosions and anal fissure. Due to a history of allergy to penicillin the patient was treated with doxycycline 200mg daily for 14 days. One month later, the mucosal lesions had subsided, and 3 months later the VDRL titer had decreased by 2 dilutions. CONCLUSION: This case of "early" syphilis illustrates a change in the French epidemiology of sexually transmitted diseases (STIs). STIs currently affect very young and previously unexposed metropolitan French populations. These infections are increasing in teenagers due to an increase in high-risk sexual behavior associated with a lack of knowledge of STIs. This case is a reminder of the current decline in the level of knowledge about STIs among teenagers as compared to young people of the same age in the 1990s.


Asunto(s)
Minorías Sexuales y de Género , Sífilis/transmisión , Adolescente , Factores de Edad , Antibacterianos/uso terapéutico , Doxiciclina/uso terapéutico , Fisura Anal/diagnóstico , Fisura Anal/tratamiento farmacológico , Humanos , Masculino , Enfermedades de la Boca/diagnóstico , Enfermedades de la Boca/tratamiento farmacológico , Conducta Sexual , Sífilis/diagnóstico , Sífilis/tratamiento farmacológico , Serodiagnóstico de la Sífilis
17.
Hist Psychiatry ; 31(2): 163-177, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31965866

RESUMEN

The history of modern psychiatry in China began at the end of the nineteenth century, as a result of the work of missionaries. Soochow was one of the first cities to establish a hospital for the treatment of mental patients, but historians knew little about it. It provided a valuable service from 1898 to 1937. In the 1930s, there were 200 beds in the psychiatry and neurology section, making it the most influential psychiatric hospital in East China. After Soochow was occupied by the Japanese army in 1937, the hospital was destroyed and shut down.


Asunto(s)
Hospitales Psiquiátricos/historia , Misioneros/historia , Psiquiatría/historia , China , Femenino , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Masculino , Servicio de Psiquiatría en Hospital/historia , Sífilis/tratamiento farmacológico , Sífilis/historia , Estados Unidos
18.
Urologe A ; 59(6): 713-717, 2020 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-31494684

RESUMEN

Syphilis is not a deadly disease anymore, thanks to antibiotics. But before their discovery, Paul Ehrlich presented the drug Salvarsan. Its efficacy was doubted and there were many disputes about it. The Berlin physician Heinrich Dreuw had been the most influential opponent-contemporaries and historians described him as being an antisemitic quack, but maybe they were wrong.


Asunto(s)
Antitreponémicos/historia , Arsfenamina/historia , Sífilis/tratamiento farmacológico , Antitreponémicos/uso terapéutico , Arsfenamina/uso terapéutico , Alemania , Historia del Siglo XIX , Historia del Siglo XX , Humanos , Masculino , Médicos , Sífilis/historia
19.
Braz J Otorhinolaryngol ; 86(3): 358-363, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-30956150

RESUMEN

INTRODUCTION: A resurgence of syphilis in Brazil has been reported in recent years. OBJECTIVE: With this in mind, the present study sought to investigate the frequency, demographics, and clinical characteristics of patients with acquired syphilis with oral involvement who received medical care at an Oral Medicine Reference Center in a Brazilian Public Hospital. METHODS: A retrospective study, spanning a period of 12 years, was performed to identify changing trends in syphilis over time. Medical records from all patients diagnosed with acquired syphilis who received medical care at the Hospital's Oral Medicine Clinic from 2005 to 2016 were reviewed, and the demographic and clinical data were collected. RESULTS: A total of 85 patients had been diagnosed with acquired syphilis, with a significant increase in the number of cases over the past 5 years. Patients ranged from 16 to 76 years of age, with a peak in the third and fourth decades. Forty-eight cases affected males (56.5%), while 37 cases affected females (43.5%). Most of the oral lesions appeared as unique ulcers or plaques, with the lips and tongue representing the most affected sites. All cases were positive for Venereal Disease Research Laboratory or Fluorescent Treponemal Antibody Absorption, and treatment was performed with Penicillin G benzathine in most cases (84.7%). CONCLUSION: The frequency of oral syphilis has been rising over time and oral lesions may well represent a diagnostic clue; therefore, oral health professionals must be made aware and properly trained in an attempt to develop a high degree of clinical suspicion in the diagnosis of syphilis.


Asunto(s)
Enfermedades de la Boca/diagnóstico , Sífilis/diagnóstico , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de la Boca/tratamiento farmacológico , Penicilina G Benzatina/uso terapéutico , Estudios Retrospectivos , Sífilis/tratamiento farmacológico , Adulto Joven
20.
Clin Microbiol Infect ; 26(2): 240-246, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31212076

RESUMEN

OBJECTIVES: We aimed to characterize kinetics of non-treponamal antibody titres during the natural course of syphilis and explore their roles in monitoring syphilis treatment efficacy. METHODS: Sixty New Zealand white male rabbits were challenged with Nichols or Amoy Treponema pallidum strains, and the rapid plasma reagin (RPR) test was performed to quantify non-treponemal antibody titres during the infection course. Viable T. pallidum in the challenged rabbits was assessed with rabbit infectivity tests. RESULTS: The RPR titres of the Nichols or Amoy strain between no benzathine penicillin G (BPG) and BPG treatment subgroups displayed a similar trend: first ascending and then descending. Compared with baseline, the proportions of fourfold decline in RPR titres in the Nichols or Amoy group presented a similar result on days 30, 60 and 180 between the no BPG and BPG treatment subgroups (0%, 0/5; 80%, 4/5; 100%, 5/5; vs. 0%, 0/5; 80%, 4/5; 100%, 5/5; p 0.999; 0%, 0/5; 80%, 4/5; 80%, 4/5; vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.098, respectively). Compared with the maximum baseline titre, the proportion of fourfold decline in PRR titre also showed a similar result in the two groups on days 30, 60 and 180 between the no BPG and the BPG treatment subgroups (0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 40%, 2/5; 100%, 5/5; 100%, 5/5; p 0.129; 0%, 0/5; 100%, 5/5; 100%, 5/5, vs. 80%, 4/5; 100%, 5/5; 100%, 5/5; p 0.091, respectively. Moreover, regardless of whether the RPR titres presented a fourfold decline, viable T. pallidum could be detected in untreated rabbits' lymph nodes at 30, 60 and 180 days post infection, while viable T. pallidum was not detected in any of the treated rabbits' lymph nodes. CONCLUSIONS: The RPR titre increased and then decreased (even became negative) during the natural course of syphilis, similar to that seen after BPG treatment. The RPR tetre is thus a questionable indicator of syphilis treatment efficacy.


Asunto(s)
Antiinfecciosos/uso terapéutico , Anticuerpos Antibacterianos/sangre , Sífilis/tratamiento farmacológico , Treponema pallidum/efectos de los fármacos , Animales , Modelos Animales de Enfermedad , Masculino , Plasma , Conejos , Sífilis/sangre , Sífilis/inmunología , Resultado del Tratamiento
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