Management Of Syphilis Research Articles

Interview with Larry H. Taber: Evaluation and management of syphilis in pregnant women and newborn infants. Interview by John D. Nelson.

Interview with Larry H. Taber: Evaluation and management of syphilis in pregnant women and newborn infants. Interview by John D. Nelson.

Syphilis Serology Today

Serologic testing is an important adjunct in the diagnosis and management of syphilis. In this review, the various currently used serologic tests, both non-treponemal and treponemal, are considered. Special emphasis is placed on their relative advantages, applications, and limitations. Conditions under which these tests may be falsely positive are discussed. Additional diagnostic tools cited are the dark-field examination, for use in early-lesion syphilis, and cytological and immunochemical techniques for determining potentially active neurosyphilis. The analysis of every serologic report, and its correlation to the historical, epidemiological, and clinical findings, is highlighted.

Questionnaire survey of reported early congenital syphilis: problems in diagnosis, prevention, and treatment.

A retrospective questionnaire survey of a sample of 173 of the 360 cases of early congenital syphilis reported in 1972 revealed serious problems with diagnostic certainty, prevention, and treatment of congenital syphilis. Only 24 (13.9%) of the reported cases could be categorized as probably or definite cases based on criteria developed from a literature review. Forty percent of the mothers received no prenatal care and an additional 19% received no prenatal care until the third trimester. Initial and followup serologic testing was inadequate in those who received care. Eighty-three different penicillin treatment schedules were used in the treatment of 128 infants. Carefully reasoned diagnostic and therapeutic decision making about the management of congenital syphilis appears to be lacking.

The erythrocyte sedimentation rate in syphilis.

The erythrocyte sedimentation rate was studied in 520 men and 202 women with syphilis. It was raised in 66-6 per cent. of sero-negative primary cases, 80 per cent. of sero-positive cases, 100 per cent. of secondary cases, 80 per cent. of early latent cases, and 73-9 per cent. of late latent cases. It was also raised in sixteen out of seventeen cases of neurosyphilis and in all eleven cases of cardiovascular syphilis. It was concluded that the ESR had little place in the management of syphilis in general, but could be helpful in the post-treatment follow-up of late syphilis.

The management of gonorrhoea and syphilis.

Medical Journal of AustraliaVolume 1, Issue 6 p. 303-304 Brush up Your Medicine THE MANAGEMENT OF GONORRHOEA AND SYPHILIS W. A. Lopez M.C., M.B., D.P.H., D.I.H., F.A.C.M.A., W. A. Lopez M.C., M.B., D.P.H., D.I.H., F.A.C.M.A. Division of Epidemiology, New South Wales Department of Health, SydneyDeputy Director.Address for reprints : Dr W. A. Lopez, Deputy Director, Division of Epidemiology, New South Wales Department of Health, 93 Macquarie Street, Sydney, N.S.W. 2000.Search for more papers by this author W. A. Lopez M.C., M.B., D.P.H., D.I.H., F.A.C.M.A., W. A. Lopez M.C., M.B., D.P.H., D.I.H., F.A.C.M.A. Division of Epidemiology, New South Wales Department of Health, SydneyDeputy Director.Address for reprints : Dr W. A. Lopez, Deputy Director, Division of Epidemiology, New South Wales Department of Health, 93 Macquarie Street, Sydney, N.S.W. 2000.Search for more papers by this author First published: 01 February 1973 https://doi.org/10.5694/j.1326-5377.1973.tb119751.x Deputy Director. Address for reprints : Dr W. A. Lopez, Deputy Director, Division of Epidemiology, New South Wales Department of Health, 93 Macquarie Street, Sydney, N.S.W. 2000. AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume1, Issue6February 1973Pages 303-304 RelatedInformation

Alcohol and the heart.

Editorials1 September 1967Alcohol and the HeartCARL S. ALEXANDER, M.D.CARL S. ALEXANDER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-67-3-670 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEarlier in this century much of clinical medicine in large urban hospitals was concerned with the diagnosis and management of syphilis and tuberculosis. Today, heart disease, cancer, and the complications of acute and chronic alcoholism attract our attention. The toxic effects of alcohol on the liver and brain are, of course, well-known, but less common and less well-known are the effects on skeletal and cardiac muscle.While the relationship of chronic alcoholism to heart disease was described by von Bollinger (1) in 1884, this was largely ignored while beriberi, originally described in the Orient (2), held the stage. It soon...

New Laboratory Methods in the Diagnosis and Management of Syphilis

New Laboratory Methods in the Diagnosis and Management of Syphilis

Recent Advances in Diagnosis and Treatment of Venereal Diseases

T HE VENEREAL DISEASES, particularly syphilis and gonorrhea, and to a lesser degree the minor venereal diseases, chancroid, granuloma inguinale, and lyinphogranuloma venereum, are still major public health problems. From 1957 through 1961 a marked increase occurred in reported cases of early infectious syphilis (primary and secondary) and gonorrhea. As shown in the table on page 612, the minor venereal disea.ses showed a decrease in reported cases from 1957 to 1960, but an increase in 1961 (1). Perhaps if private physicians are alerted to the increasing incidence of early infectious syphilis, they will become more suspicious regarding the possibility of this infection in their patients. The following review of the diagnosis and management of syphilis and gonorrhea, summarizing selections from recent literature, provides a ready reference.

Clinical Emphasis in the Diagnosis and Management of Syphilis

Clinical Emphasis in the Diagnosis and Management of Syphilis

Some remarks on the management of late syphilis

Some remarks on the management of late syphilis

Modern Trends in the Management and Control of Syphilis

T HE progress which modem medicine has made in the control of syphilis stands out as one of mankind's greatest victories in the conquest of communicable disease. In the past, unreliable techniques made diagnosis uncertain; today we have techniques that assure almost complete accuracy in diagnosis. The ineffective, painful, and often dangerous, chemotherapeutic techniques of the past have been replaced by extraordinarily effective methods of treatment. There has, indeed, been a remarkable advance toward the goal of eventual eradication of syphilis. The downward trend in the incidenceof syphilis in the United States in recent years can be best appraised when one considers the drop from 363,647 cases and 12,956 deaths during the peak year of 1946, to 156,099 cases and 5430 deaths in 1953. Many of the gains made during this time can be attributed to an improved health education program coupled with the development of one of modem science's greatest discoveries-penicillin. No longer is there a place in the treatment of syphilis for the toxic arsenicals and heavy metals, with their painful and dangerous side effects which occasionally resulted in serious disease or even death. In addition to the therapeutic advances that have been made, modern case-finding techniques, improved reporting, and better follow-up procedures have all contributed to the decline in the incidence of the disease. The armed forces and numerous health agencies, during and after World War II, helped materially to advance this cause through their research and through their wide dissemination of information about the prophylaxis and treatment of syphilis.

Modern Trends in the Management and Control of Syphilis

T HE progress which modem medicine has made in the control of syphilis stands out as one of mankind's greatest victories in the conquest of communicable disease. In the past, unreliable techniques made diagnosis uncertain; today we have techniques that assure almost complete accuracy in diagnosis. The ineffective, painful, and often dangerous, chemotherapeutic techniques of the past have been replaced by extraordinarily effective methods of treatment. There has, indeed, been a remarkable advance toward the goal of eventual eradication of syphilis. The downward trend in the incidenceof syphilis in the United States in recent years can be best appraised when one considers the drop from 363,647 cases and 12,956 deaths during the peak year of 1946, to 156,099 cases and 5430 deaths in 1953. Many of the gains made during this time can be attributed to an improved health education program coupled with the development of one of modem science's greatest discoveries-penicillin. No longer is there a place in the treatment of syphilis for the toxic arsenicals and heavy metals, with their painful and dangerous side effects which occasionally resulted in serious disease or even death. In addition to the therapeutic advances that have been made, modern case-finding techniques, improved reporting, and better follow-up procedures have all contributed to the decline in the incidence of the disease. The armed forces and numerous health agencies, during and after World War II, helped materially to advance this cause through their research and through their wide dissemination of information about the prophylaxis and treatment of syphilis.

TREATMENT OF EARLY SYPHILIS

THE of penicillin G procaine in oil with 2% aluminum monostearate (PAM) in the treatment of syphilis, and its continued extensive use have justified the early hopes held for it. Although newer preparations such as benzathine penicillin G appear to have certain advantages over the earlier preparation, there is little question of the value of PAM in the management of syphilis. It seems appropriate at this time, therefore, to review the experience of the Venereal Disease Program of the Public Health Service with this preparation. Through the Public Health Service's Venereal Disease Research Laboratory and the patient material made available first at the various rapid treatment centers and later at the prevention and control centers, the Program has had excellent opportunity to study and evaluate PAM. Observation of sufficiently large groups of patients treated by various schedules had enabled it to arrive at valid comparisons of

The Management of Late and Latent Syphilis

The Management of Late and Latent Syphilis

Penicillin treatment of cardiovascular syphilis.

Evaluation of Treatment Among the still unsolved problems in the evaluation of penicillin therapy are: (1) uncertain criteria of diagnosis, clinical and post-mortem, of uncomplicated syphilitic aortitis; (2) influence of race and sex; (3) prophylactic effect; (4) amount of treatment adequate in early syphilis to prevent the development of cardiovascular complications. Furthermore, insufficient time has elapsed to determine the efficiency of penicillin in the management of cardiovascular syphilis. Evaluation of the effect of penicillin therapy on prognosis is also difficult because we do not know whether or not cardiovascular syphilis is changing with the passage of time, so that we are now seeing a different type of this phase of syphilis. The simultaneous occurrence in patients of cardiovascular and other forms of late syphilis, such as neurosyphilis, may alter the picture of therapeutic efficacy, besides increasing the potential reactivity of the patient to a particular treatment system or drug. Other variable factors involved are: the presence of diabetes mellitus; hypertension; degree of arteriosclerosis; renal function.

DERMATOLOGY AND SYPHILOLOGY—PENICILLIN TREATEMENT OF CARDIOVASCULAR SYPHILS

Evaluation of Treatment Among the still unsolved problems in the evaluation of penicillin therapy are: (1) uncertain criteria of diagnosis, clinical and post-mortem, of uncomplicated syphilitic aortitis; (2) influence of race and sex; (3) prophylactic effect; (4) amount of treatment adequate in early syphilis to prevent the development of cardiovascular complications. Furthermore, insufficient time has elapsed to determine the efficiency of penicillin in the management of cardiovascular syphilis. Evaluation of the effect of penicillin therapy on prognosis is also difficult because we do not know whether or not cardiovascular syphilis is changing with the passage of time, so that we are now seeing a different type of this phase of syphilis. The simultaneous occurrence in patients of cardiovascular and other forms of late syphilis, such as neurosyphilis, may alter the picture of therapeutic efficacy, besides increasing the potential reactivity of the patient to a particular treatment system or drug. Other variable factors involved are: the presence of diabetes mellitus; hypertension; degree of arteriosclerosis; renal function.

A study of syphilis in Northern Alberta.

SINCE 1943, when Mahoney, Arnold and Harris first reported on the use of penicillin in the treatment of syphilis, many excellent papers have been presented dealing with the efficacy of various dosage schedules in the different manifestations of the disease. It is not our purpose in this discussion to add to these reports but rather to present information concerning a problem in the management of syphilis in northern Alberta and the manner in which it is being attacked. The syphilis rate amongst the white population in this province has recently been extremely low, varying from 0.7 per 1,000 in 1945 to a present rate of 0.3 per 1,000. Two spot surveys, one in 1921 and one in 1935, had disclosed no evidence of syphilis in the population of northern Alberta in excess of that in the inhabitants of the province as a whole. However, during the early days of World

Clinical Management of Ocular Syphilis

Clinical Management of Ocular Syphilis

NATURE OF ANTIGENS AND ANTIBODIES IN SEROLOGY OF SYPHILIS

SEROLOGIC tests for syphilis have come to be recognized as necessary laboratory aids in the diagnosis, management and prognosis of clinical syphilis. Yet, for many years the actual antigen-antibody mechanisms involved have not been adequately explained. The apparent anomaly of lipidal beef heart antigen's being associated with a high degree of specificity in reacting with syphilitic serum has been a source of much concern, especially to the immunologist. It is not the purpose of this report to solve this vexing problem, but to review the present immunologic and physicochemical concepts of the nature of the antigens and antibodies involved. ANTIGENS The nature of the antigens involved in the serologic tests for syphilis will be considered first. In the original serologic test for syphilis, Wassermann, Neisser and Bruck1discovered that aqueous extracts of syphilitic tissue effected complement fixation when mixed with syphilitic serum. One year later, Laridsteiner and

Prenatal Management of Syphilis with Special Reference to Penicillin Therapy

Prenatal Management of Syphilis with Special Reference to Penicillin Therapy