Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
33,100
result(s) for
"syphilis"
Sort by:
Syphilis and subjectivity : from the Victorians to the present
This book demystifies the cultural work of syphilis from the late nineteenth century to the present. By interrogating the motivations that engender habits of belief, thought, and conduct regarding the disease and notions of the self, this interdisciplinary volume investigates constructions of syphilis that had a significant role in shaping modern subjectivity. Chapters draw from a variety of scholarly methods, such as cultural and literary studies, sociology, and anthropology. Authors unravel the representations and influence of syphilis in various cultural forms: cartography, medical writings, literature, historical periodicals, and contemporary popular discourses such as internet forums and electronic news media. Exploring the ways syphilitic rhetoric responds to, generates, or threatens social systems and cultural capital offers a method by which we can better understand the geographies of blame that are central to the conceptual heritage of the disease. This unique volume will appeal to students and scholars in the medical humanities, medical sociology, the history of medicine, and Victorian and modernist studies.
Book
Factors Associated with Serological Cure and the Serofast State of HIV-Negative Patients with Primary, Secondary, Latent, and Tertiary Syphilis
Some syphilis patients remain in a serologically active state after the recommended therapy. We currently know too little about the characteristics of this serological response.
We conducted a cohort study using the clinical database from Zhongshan Hospital, Medical College of Xiamen. In total, 1,327 HIV-negative patients with primary, secondary, latent, and tertiary syphilis were enrolled. Bivariate and multivariate analyses were utilised to identify factors associated with a serological cure and serofast state in syphilis patients one year after therapy. Chi-square tests were used to determine the differences in the serological cure rate across different therapy time points.
One year after the recommended therapy, 870 patients achieved a serological cure, and 457 patients (34.4%) remained in the serofast state. The serological cure rate increased only within the first 6 months. The bivariate analysis indicated that male or younger patients had a higher likelihood of a serological cure than female or older patients. Having a baseline titre ≤ 1∶2 or ≥ 1∶64 was associated with an increased likelihood of a serological cure. The serological cure rate decreased for the different disease stages in the order of primary, secondary, latent, and tertiary syphilis. A distinction should be drawn between early and late syphilis. The multivariate analysis indicated that a serological cure was significantly associated with the disease phase, gender, age, and baseline rapid plasma reagin (RPR) titre.
The serofast state is common in clinical work. After one year of the recommended therapy, quite a few syphilis patients remained RPR positive. The primary endpoint of the study indicated that disease phase, gender, age and baseline RPR titre were crucial factors associated with a serological cure.
Journal Article
In the land of pain
The nineteenth-century French writer offers an account of his life as he succumbed to the pain of syphilis, detailing the symptoms of his disease, his fellow patients in search of a cure, and the impact of his physical suffering.
BOOK
P100 Multi-speciality and multi-agency working to tackle the epidemic of syphilis in the North East
IntroductionSyphilis rates in the North East have been rising. In 2021 the number of syphilis diagnoses increased by 66% compared to 2016.1,2 This rise has been seen in the heterosexual population, with rates of syphilis in GBMSM falling.1 Anecdotally, there is a high proportion of untraceable contacts and therefore people unaware of their diagnosis, at risk of secondary syphilitic presentations and late complications.Syphilis has versatile presentations and recognition of syphilis can be challenging even for experienced clinicians.3 This article summarises some of the work done in the North East in the last two years to address this.MethodsTo address the rise in syphilis seen in the North East, a working group of local multispecialty clinicians was created. Over the past 2 years, this group has targeted improving awareness, earlier diagnosis of syphilis and management of syphilis in pregnancy.Results• Two regional update events were arranged. One for midwives, obstetrics and neonatology, a second for public health, sexual health, infectious diseases and microbiology.• A North East-specific factsheet was produced which highlighted the rising rates, changing demographics and reminded clinicians of the clinical signs and symptoms of syphilis and how to test. This was distributed to hospital clinicians, general practice and pharmacies.• Speciality specific factsheets are being produced. These provide more detail on specialty specific presentations (e.g. retrosternal pain in cardiology). These will be disseminated through regional speciality networks and educational sessions.• Regional good practice guidelines for the management of pregnant women with syphilis and their babies have been updated following local audits and case reviews. A relaunch event on the back of the ISOSS report on syphilis in pregnancy and updated BASSH guidelines is planned.DiscussionWe hope these targeted interventions will increase awareness of the current epidemic of syphilis in the North East, improve earlier diagnosis, reduce morbidity and onward transmission.
Journal Article
The occasional human sacrifice : medical experimentation and the price of saying no
\"Shocking cases of abusive medical research and the whistleblowers who spoke out against them, sometimes at the expense of their careers. The Occasional Human Sacrifice is an intellectual inquiry into the moral struggle that whistleblowers face, and why it is not the kind of struggle that most people imagine. Carl Elliott is a bioethicist at the University of Minnesota who was trained in medicine as well as philosophy. For many years he fought for an external inquiry into a psychiatric research study at his own university in which an especially vulnerable patient lost his life. Elliott's efforts alienated friends and colleagues. The university stonewalled him and denied wrongdoing until a state investigation finally vindicated his claims. His experience frames the six stories in this book of medical research in which patients were deceived into participating in experimental programs they did not understand, many of which had astonishing and well-concealed mortality rates. Beginning with the public health worker who exposed the Tuskegee Syphilis Study and ending with the four physicians who in 2016 blew the whistle on lethal synthetic trachea transplants at the Karolinska Institute, Elliott tells the extraordinary stories of insiders who spoke out against such abuses, and often paid a terrible price for doing the right thing\"-- Provided by publisher.
Book
P173 An audit of syphilis in pregnancy in a North West sexual health clinic
IntroductionFollowing a case of congenital syphilis, the standard of care given to patients testing positive for syphilis in pregnancy was audited. Our aims were to assess whether the care delivered met BASHH standards and to gather demographic information looking for inequalities which could affect outcomes.MethodsGUMCAD data was collected for all female patients coded A1-A6 from August 2020–2022. A retrospective case note review was undertaken to identify pregnant patients and gather further information about syphilis management and demographics. Standards were BASHH guidelines.Results29 patients were identified with a median age 26. Two thirds were born in the UK and 27/29 were referred from antenatal testing.3 patients were diagnosed with early syphilis and 21 with late latent. 4 had been adequately treated previously, 1 was false positive. All patients requiring treatment were treated before the 3rd trimester.All patients had an RPR prior to treatment, were treated with a recommended regimen and had a contact option documented for partners as per BASHH standards.Only 38% had an RPR repeated at 6 months and 65% had a birth plan completed.Missed testing opportunities were identified; a third of patients had attended the service previously and none had been tested for syphilis or HIV.Where birth outcomes were known there were 11 live births and 3 miscarriages. Three infants were treated for congenital Syphilis.DiscussionAreas of good practice included treatment and partner notification, however, weaknesses in follow up and communication with antenatal colleagues were seen. The high numbers requiring treatment and 3 possible congenital syphilis cases is out of proportion with figures reported by ISOSS which highlights clinical concerns.
Journal Article
Global Estimates of Syphilis in Pregnancy and Associated Adverse Outcomes: Analysis of Multinational Antenatal Surveillance Data
The World Health Organization initiative to eliminate mother-to-child transmission of syphilis aims for ≥ 90% of pregnant women to be tested for syphilis and ≥ 90% to receive treatment by 2015. We calculated global and regional estimates of syphilis in pregnancy and associated adverse outcomes for 2008, as well as antenatal care (ANC) coverage for women with syphilis.
Estimates were based upon a health service delivery model. National syphilis seropositivity data from 97 of 193 countries and ANC coverage from 147 countries were obtained from World Health Organization databases. Proportions of adverse outcomes and effectiveness of screening and treatment were from published literature. Regional estimates of ANC syphilis testing and treatment were examined through sensitivity analysis. In 2008, approximately 1.36 million (range: 1.16 to 1.56 million) pregnant women globally were estimated to have probable active syphilis; of these, 80% had attended ANC. Globally, 520,905 (best case: 425,847; worst case: 615,963) adverse outcomes were estimated to be caused by maternal syphilis, including approximately 212,327 (174,938; 249,716) stillbirths (>28 wk) or early fetal deaths (22 to 28 wk), 91,764 (76,141; 107,397) neonatal deaths, 65,267 (56,929; 73,605) preterm or low birth weight infants, and 151,547 (117,848; 185,245) infected newborns. Approximately 66% of adverse outcomes occurred in ANC attendees who were not tested or were not treated for syphilis. In 2008, based on the middle case scenario, clinical services likely averted 26% of all adverse outcomes. Limitations include missing syphilis seropositivity data for many countries in Europe, the Mediterranean, and North America, and use of estimates for the proportion of syphilis that was \"probable active,\" and for testing and treatment coverage.
Syphilis continues to affect large numbers of pregnant women, causing substantial perinatal morbidity and mortality that could be prevented by early testing and treatment. In this analysis, most adverse outcomes occurred among women who attended ANC but were not tested or treated for syphilis, highlighting the need to improve the quality of ANC as well as ANC coverage. In addition, improved ANC data on syphilis testing coverage, positivity, and treatment are needed. Please see later in the article for the Editors' Summary.
Journal Article
One Dose versus Three Doses of Benzathine Penicillin G in Early Syphilis
In this randomized, controlled trial, persons with early syphilis received a single treatment or three treatments with benzathine penicillin G at a dose of 2.4 million units. No benefit was seen with the additional doses.
Journal Article
P301 Elimination of mother-to-child transmission of HIV and syphilis in the Mercosul countries: a general overview
BackgroundMercosul (Southern Common Market) consists of four countries – Argentina, Brazil, Paraguay and Uruguay – with close economic relations in Latin America. The displacement of people within countries and across borders is frequent observed and needs surveillance and health care implementation for infections that do not recognize borders. The present study aims to presenting the HIV and syphilis overview in Mercosul countries, highlighting the vertical transmission of these diseases.MethodsWe systematically collected data from Mercosul countries in the past two years through Ministry of Health websites, countries national official data and Pan-American Health Organization (PAHO) reports. We compared country data with each other and with the targets set by PAHO elimination of mother-to-child transmission (MTCT) of HIV and syphilis.ResultsThe HIV detection in Uruguay and Paraguay had the highest rates, with 29/100,000 inhabitants and 22.8/100,000 inhabitants, when compared to Brazil (17.8/100,000 inhabitants) and Argentina (10.3/100,000 inhabitants). Regarding the MTCT of HIV, Brazil and Uruguay are within the PAHO elimination target (≤2%), showing rates of 1.6% and 1.5%, respectively. The syphilis rates have increased significantly in recent years, reaching 75.8/100,000 inhabitants in Brazil, 51.1/100,000 inhabitants in Argentina and 46/100,000 inhabitants in Paraguay. In Brazil, the pregnant rates were 20.8 pregnant women per 1,000 live births (LB) in 2019. The goal of eliminating congenital syphilis (≤0.5/1,000 LB) was not achieved by any country, with Paraguay having the highest rate (17.9/1,000 LB), followed by Brazil (8.2/1,000 LB), Argentina (1.55/1,000 LB) and Uruguay (1.4/1,000 LB).ConclusionsOfficial national standardization data is an important tool for planning joint actions. These data indicate the need to maximize strategies, especially related to congenital syphilis prevention. Also they reinforce the importance of political commitment from the Ministries of Health and international cooperation for the elimination of MTCT in Mercosul.
Journal Article