Download the Free Unbound MEDLINE PubMed App to your smartphone or tablet.
Available for iPhone, iPad, iPod touch, and Android.
- The Manchester Uveitis Clinic: The First 3000 Patients-Epidemiology and Casemix. [JOURNAL ARTICLE]
- Ocul Immunol Inflamm 2013 Dec 2.
Abstract Purpose: To demonstrate the demography, anatomical, and diagnostic classification of patients with uveitis attending the Manchester Uveitis Clinic (MUC), a specialist uveitis clinic in the northwest of England, UK. Methods: Retrospective retrieval of data on a computerized database incorporating all new referrals to MUC from 1991 to 2013. Results: A total of 3000 new patients with uveitis were seen during a 22-year period. The anatomical types seen were anterior 46%; intermediate 11.1%; posterior 21.8%; and panuveitis 21.1%. The most common diagnoses were Fuchs heterochromic uveitis (11.5% of total), sarcoidosis-related uveitis (9.7%), idiopathic intermediate uveitis (7.9%), idiopathic acute anterior uveitis (7.0%), and toxoplasmosis (6.9%). Syphilis and tuberculosis-associated uveitis increased markedly in frequency during the study period. Conclusions: The uveitis casemix in this region reflects a predominantly white Caucasian population in a temperate country, but with changing characteristics owing to increasing immigration, enhanced diagnostic techniques, changes in referral pattern, and some real changes in disease incidence.
- Trend in prevalence of syphilis among voluntary blood donors in Xi'an, China from 2006 to 2010. [JOURNAL ARTICLE]
- Int J Infect Dis 2013 Nov 27.
This study was conducted to examine the prevalence of syphilis among blood donors in the Xi'an region of China. All blood donors were unremunerated volunteers recruited from 2006 to 2010. Anti-Treponema pallidum and anti-HIV serology responses were determined using ELISA kits. Among 159 902 voluntary blood donors tested, a total of 575 syphilis (0.36%) and 55 HIV (0.03%) infections were identified. While an increasing trend was shown for the prevalence of both syphilis and HIV over the 5-year period, there was no statistical correlation between the two infections. Our results indicate that syphilis and HIV infections are increasing risk factors for the spread of blood-borne infections. Further investigations and improvements in blood collection and testing procedures are needed to help ensure the safety of donated blood in China.
- Prevalence of syphilis infection and associations with sexual risk behaviors among HIV-positive men who have sex with men in Shanghai, China. [JOURNAL ARTICLE]
- Int J STD AIDS 2013 Nov 27.
ObjectiveThe aims of this study were to understand the prevalence and correlates of syphilis infection among HIV-positive men who have sex with men (MSM) in Shanghai, China.MethodsA total of 200 HIV-positive MSM participants were recruited using "snowball" sampling. Participants were tested for syphilis and completed a one-time questionnaire which included demographic characteristics, sexual behaviors with male and female sexual partners, substance use, and use of antiretroviral medications.ResultsPrevalence of syphilis infection was 16.5%. Among HIV/syphilis co-infected participants, 63.6% reported having anal sex with male partners and 24.2% did not use condoms consistently during the past six months, and 66.7% reported having oral sex with male partners and 51.5% reported unprotected oral sex during the past six months. Factors associated with testing seropositive for syphilis infection included receptive anal sex with a male partner in the past six months (AOR = 12.61, 90% CI = 2.38-66.89), illicit drug use in the past six months (AOR = 11.47, 90% CI = 2.47-53.45), and use of antiretroviral medication (AOR = 4.48, 90% CI = 1.43-14.05).ConclusionThese data indicate a need for "positive prevention" interventions targeting HIV-positive MSM in China.
- Preventing congenital syphilis - a regional audit of syphilis in pregnant women seen in Genitourinary Medicine services. [JOURNAL ARTICLE]
- Int J STD AIDS 2013 Nov 27.
Genitourinary case records of 42 pregnant women with syphilis were reviewed as part of a regional audit following the re-emergence of congenital syphilis in the north east of England. National standards, from the British Association of Sexual Health and HIV guidelines on managing syphilis in pregnancy, were met in the majority of cases with 69% being treated according to national guidance and all cases completing treatment. Locally developed standards on multidisciplinary working and communication were less well met, with particular issues regarding the documentation of pregnancy outcomes in GUM records and communication between specialities being highlighted. A regional good practice guide has been developed and implemented to address standards not met, reduce adverse outcomes and prevent future cases of congenital syphilis.
- A rare case of syphilis associated with renal and hepatic involvement. [JOURNAL ARTICLE]
- Dermatol Pract Concept 2013; 3(4):53-54.
We present an unusual case of syphilis that despite starting treatment with penicillin has evolved with renal complications. Due to glomerulonephritis with nephrotic syndrome the case required shared care between the renal physician and dermatologist. Doctors of different specialties need to keep in mind that early syphilis can have visceral involvement and patients might need prompt, specific therapeutic intervention.
- Reaching the Unreachable: Providing STI Control Services to Female Sex Workers via Mobile Team Outreach. [Journal Article]
- PLoS One 2013; 8(11):e81041.
As part of a community-randomized trial of a multicomponent intervention to prevent sexually transmitted infections, we created Mobile Teams (MTs) in ten intervention cities across Peru to improve outreach to female sex workers (FSW) for strengthened STI prevention services.Throughout 20 two-month cycles, MTs provided counseling; condoms; screening and specific treatment for Neisseria gonorrhoeae (NG), Chlamydia trachomatis (CT), and vaginal Trichomonas vaginalis (TV) infections; and periodic presumptive metronidazole treatment for vaginal infections.MTs had 48,207 separate encounters with 24,814 FSW; numbers of sex work venues and of FSW reached increased steadily over several cycles. Approximately 50% of FSW reached per cycle were new. Reported condom use with last client increased from 73% to 93%. Presumptive metronidazole treatment was accepted 83% of times offered. Over 38 months, CT prevalence declined from 15·4% to 8·2%, and TV prevalence from 7·3% to 2·6%. Among participants in ≥9 cycles, CT prevalence decreased from 12·9% to 6·0% (p <0·001); TV from 4·6% to 1·5% (p <0·001); and NG from 0·8% to 0·4% (p =0·07).Mobile outreach to FSW reached many FSW not utilizing government clinics. Self-reported condom use substantially increased; CT and TV prevalences declined significantly. The community-randomized trial, reported separately, demonstrated significantly greater reductions in composite prevalence of CT, NG, TV, or high-titer syphilis serology in FSW in these ten intervention cities than in ten matched control cities.
- HIV and syphilis infection in pregnant women in Ecuador: prevalence and characteristics of antenatal care. [JOURNAL ARTICLE]
- Sex Transm Infect 2013 Nov 26.
This study aimed to obtain nationally representative estimates of HIV and syphilis prevalence and coverage of preventive antenatal services in pregnant women in Ecuador, in order to develop a national strategy for the elimination of mother-to-child transmission of HIV and syphilis.A national probability sample of 5988 women presenting for delivery or miscarriage services was selected from 15 healthcare facilities during 2011-2012, using a two-stage cluster sample technique. Biological specimens were collected and an interview and review of medical records were performed. Agreement between these last two sources was measured. Estimates were adjusted for the sampling design.Estimated national HIV prevalence (0.60%) was higher than confirmed syphilis infection prevalence (0.25%). In the coastal region, HIV prevalence (1.13%) exceeded the threshold that defines a generalised epidemic and syphilis prevalence reached 0.37%. An estimated 5.9% of women did not use antenatal care services while 73.0% completed at least four consultations. HIV testing coverage (89.9%) was higher than for syphilis (71.6%). Agreement between medical records and interviews was mostly moderate (0.40-0.75). Important variables were frequently not recorded, such as timing of syphilis testing, which was not recorded in 49.6%.The concentration of HIV and syphilis infections in the coastal region of Ecuador highlights the need for intensified prevention and a response tailored to local epidemic conditions. Major challenges for the elimination initiative include achieving universal, early access to antenatal care, improving coverage of HIV and syphilis testing, and improving the quality of medical records to support progress monitoring.
- Disease-induced level of shame in patients with acne, psoriasis and syphilis. [JOURNAL ARTICLE]
- Postepy Dermatol Alergol 2013 Aug; 30(4):233-236.
A prolonged feeling of shame leads to particularly negative consequences and it accompanies, as well as triggers, any kind of stigma.AS EMPIRICAL WORKS ON SHAME DUE TO STIGMATIZING DISEASES ARE SCARCE, THE AUTHORS AIMED TO INVESTIGATE THE FOLLOWING: 1) which diseases are perceived as the most embarrassing, and 2) what level of shame is attributed to the embarrassing diseases by affected patients. Additionally, the authors assumed that the differentiation variable for the second aim would be the level of infectiousness (or non-infectiousness) of a given disease.A two-stage study was carried out in 2011-2013. Three groups of patients affected by various diseases were included into the actual study: 1) people suffering from non-infectious (42 psoriasis and 42 acne subjects) and 2) infectious (25 syphilis cases) diseases. The patients filled in an original questionnaire, designed especially for the purpose of the study.As the most shameful acne patients consider syphilis, but patients with syphilis - AIDS. Patients with syphilis assigned to their disease the greatest shame (average 75%), and the lowest - acne patients (average 30%). Patients with psoriasis assessed on 52% shame experienced because of the disease.The conducted study confirmed the accuracy of the empirical assumptions which may be applicable in prevention as well as therapy of negative consequences of shame.
- Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines. [JOURNAL ARTICLE]
- Postepy Dermatol Alergol 2013 Aug; 30(4):203-210.
Syphilis continues to be an important epidemiologic problem. For a few years a steady increase in the incidence of this sexually transmitted disease has been observed. Advances in medical science obligate the doctor to use only such diagnostic and therapeutic approaches that are scientifically proven. Based on the European (IUSTI) and U.S. (CDC) guidelines, in this manuscript, we present some selected practical issues concerning diagnosis and treatment of syphilis. We truly hope that the present review will help all doctors taking care of syphilitic patients to systematize the current knowledge.
- Pityriasis lichenoides-like secondary syphilis and neurosyphilis in a HIV-infected patient. [JOURNAL ARTICLE]
- Postepy Dermatol Alergol 2013 Apr; 30(2):127-130.
Papulo- and vesiculo-necrotic lesions are rare manifestations of secondary syphilis. Until now it has been described only in HIV-infected patients with advanced stages of immunosuppression. This case report describes an unusual case of PLEVA-like syphilis in a 33-year-old man with newly diagnosed HIV infection. Despite that the CD4 cells level and viral load did not indicate the advance stage of immunosuppression, the unusual manifestation of syphilis and neurosyphilis occurred. The presented case indicates the need for HIV screening in every patient with syphilis especially when the clinical manifestation is unusual. Importance of syphilis testing in every case with atypical rashes should be also highlighted.