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At least 775 records · Page 43Linked to original sources
PubMed1982

Alterations in T lymphocytes and T-lymphocyte subpopulations in patients with syphilis.

The distribution of T-lymphocyte subpopulations was studied in 34 patients with primary or secondary syphilis before and after treatment. An absolute and relative T lymphopenia was found in all patients. In primary syphilis the concentration of helper cells--T cells with Fc receptors for IgM (T mu)--was low whereas in secondary syphilis the suppressor cell concentration--T cells with Fc receptors for IgG (T gamma)--was reduced. Using lymphocytes from healthy subjects this could be imitated in vitro by the addition of serum from patients with secondary syphilis. In many autoimmune diseases a low concentration of T gamma may be a primary factor in the production of autoantibodies. The occurrence of similar changes in patients with secondary syphilis, however, indicates that such fluctuations in the T-cell subpopulations may take place during a strong immune response.

Adolescent↗
PubMed1983

Serological diagnosis of untreated early syphilis. Importance of the differences in THA, TPHA, and VDRL test titres.

The treponemal haemagglutination (THA) test has been used for 11 years as a routine test for syphilis at a central serology laboratory. Among patients with untreated early syphilis the antibodies detected by the THA test usually appeared later or were of relatively lower titre than those detected by the reagin tests. This finding was confirmed by follow up of patients and by replies to questionnaires and has been incorporated in a computer program. During 1981, using the results obtained on unpaired specimens and minimal other data, 74 of 123 patients who were finally diagnosed as having untreated early syphilis were correctly identified by the computer. Most of those not selected by the computer were patients with early primary syphilis with little or no circulating antibody or with late secondary syphilis with very high titres.

Antibodies, Bacterial↗
PubMed1989

Congenital syphilis in The Netherlands: diagnosis and clinical features.

From 1982 to 1985 the 19S IgM-Fluorescent Treponemal Antibody Absorption (19S-IgM-FTA-ABS) test gave a positive result in 19 children. These 19 children plus one dizygotic twin sister were evaluated. Seventeen children were diagnosed as having congenital syphilis and treated. Clinical evidence was seen in 10 children, CSF abnormalities in seven, radiological abnormalities in eight. Of the 17 children treated, only one did not meet the Center for Disease Control (CDC) criteria of a compatible case of congenital syphilis. Of the children not diagnosed as having congenital syphilis, one child was considered to be a compatible case of congenital syphilis according to the CDC-criteria. The CDC-criteria may be a valuable aid in diagnosing congenital syphilis. Guidelines for adequate therapy are given.

Female↗
PubMed2002

Low incidence of syphilis among factory workers in Ethiopia: effect of an intervention based on education and counselling.

BACKGROUND: The prevalence and incidence of syphilis infection were examined in a cohort study of factory workers in Ethiopia. METHOD: Between February 1997 and March 1999, 409 men and 348 women were enrolled and followed in the cohort study. RESULTS: The prevalence (95% CI) of past/current syphilis (positive TPPA serology) was 28.9% (25.7% to 32.3%), and factors associated with past/current syphilis were markers of risky sexual behaviours including HIV infection. In this cohort of factory workers subject to public information/education meetings, testing for HIV antibodies, and individual counselling, the incidence (97.5% one sided CI) of new syphilis infections was 0/691 = 0 (0 to 0.5) per 100 person years. CONCLUSION: This study has documented a reduction in risky sexual behaviours and a low syphilis incidence among factory workers participating in a cohort study on HIV infection progression in Addis Ababa.

Adolescent↗
PubMed1992

Are long bone radiographs necessary in neonates suspected of having congenital syphilis?

The frequency of appendicular bone abnormalities was prospectively evaluated in 93 newborns suspected of having congenital syphilis. The evaluation of each newborn included prenatal history, physical examination, serologic tests, and long bone radiography, which was performed during the first week after birth. In all patients, results of at least one serologic test for syphilis were positive or proof of syphilis was found at autopsy. In 75 patients (81%), the long bone radiographs were normal. The nonspecific finding of lucent metaphyseal bands was the most common abnormality on long bone radiographs; only five newborns had more specific changes of syphilis in the metaphyses and periosteal reaction. In view of the low frequency of relatively specific radiographic findings in the long bones, the authors recommend that long bone radiography not be a part of the routine evaluation of full-term newborns suspected of having congenital syphilis.

Bone Diseases↗
PubMed2006

[Reemergence of infectious syphilis among homosexual men and HIV coinfection in Barcelona, 2002-2003].

BACKGROUND AND OBJECTIVES: An increase in syphilis infections since the mid 1990s has been documented, especially in homosexual men, in different European and North American cities. We intended to describe the characteristics of newly diagnosed cases of syphilis at the Sexually Transmitted Infections Unit of Barcelona in 2002 and 2003. PATIENTS AND METHOD: Descriptive analysis of cases with infectious syphilis and multivariate analysis of factors associated with HIV coinfection. RESULTS: 102 cases were diagnosed with infectious syphilis, 98 males (88 homosexual men). HIV coinfection was present in 34% of cases. Predictive factors of HIV coinfection were age > 30 years (p = 0.003) and having a HIV positive partner (p = 0.044). Clinically, there were no differences between cases coinfected or not with HIV. CONCLUSIONS: There has been a recent increase of syphilis in Barcelona, especially among some core groups of homosexual men with high rates of HIV coinfection.

Adult↗
PubMed2004

Detection of Treponema pallidum in skin lesions of secondary syphilis and characterization of the inflammatory infiltrate.

BACKGROUND: Syphilis is an ancient sexually transmitted disease. However, the pathogenesis of mucocutaneous lesions of secondary syphilis is not completely understood. METHODS: We analyzed the presence of Treponema pallidum in formalin-fixed, paraffin-embedded biopsy specimens from mucocutaneous lesions of secondary syphilis using highly sensitive nested polymerase chain reaction (PCR). The inflammatory infiltrates from the same specimens are also characterized using immunohistochemical methods. RESULTS AND CONCLUSIONS: Ten out of 24 (41.7%) specimens are T. pallidum positive using nested PCR, whereas none of them is T. pallidum positive using traditional silver staining. The presence of T. pallidum in the mucocutaneous lesions indicates that mucocutaneous lesions of secondary syphilis might be caused by direct T. pallidum invasion rather than by an allergic reaction. Furthermore, the majority of inflammatory infiltrating cells are CD45RO-positive T cells and CD68-positive macrophages, suggesting that cellular immunity plays an important role in the host reaction against T. pallidum infection in secondary syphilis.

Adult↗
PubMed2004

Syphilis as a social disease: experience from the post-communist transition period in Estonia.

Increased incidence of sexually transmitted diseases (STD) and radical social changes have taken place at the same time in Estonia. Our aim was to study the trends in syphilis incidence, selected sociodemographic factors and health status indicators during the economic transition. Associations were estimated by the ordinary least square regression method for change in and actual values of syphilis and tuberculosis incidence rate (IR), percentage of non-ethnic Estonians and urban population, homicides rate, unemployment rate and, birth rate. The analysis was performed by counties at three different time periods. Syphilis IR significantly correlated with the proportion of non-ethnic Estonians, urban population, tuberculosis IR and birth rate. Change of syphilis IR correlated significantly with concurrent changes in unemployment rate and tuberculosis IR. Our findings support the theory that syphilis is a social disease, thus emphasizing the importance of social factors in the occurrence of STDs.

Adult↗
PubMedDate not supplied

[Seroprevalence of syphilis in pregnant women in San Luis Potosí].

OBJECTIVE: To determine the seroprevalence of syphilis in pregnant women. METHODS: A seroepidemiologic survey was conducted in 1857 women giving birth at a general hospital in the city of San Luis Potosi, Mexico. RESULTS: Five women (0.27%) were diagnosed with syphilis at the time of delivery. Maternal factors associated with a greater likelihood of syphilis included older age, a higher number of pregnancies and living out of wedlock. CONCLUSIONS: The number of new bhorns exposed to syphilis during pregnancy in San Luis Potosi is underestimated. The results of this study support the need to identify syphilis in infected mothers at the time of delivery.

Adolescent↗
PubMed2005

Clinical characteristics and evolution of syphilis in 24 HIV+ individuals in Rio de Janeiro, Brazil.

A total of 24 patients with syphilis and HIV infection were treated from January 1997 to March 2003 at the Infectious Dermatology Outpatient Clinic of the Evandro Chagas Clinical Research Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. The caseload consisted of 20 males (83.3%) and four females (16.7%), with a mean age of 38.04 years and mean T CD4+ count of 389.5 cells/mL. Syphilis was diagnosed as secondary in 16 (62.5%) patients, late latent in eight (33.3%), and tertiary in one (4.2%). Manifestations of secondary syphilis were palmar and plantar erythematopapulous cutaneous lesions in nine (37.5%), papulous exanthema in four (16.7%), patchy alopecia in 3 (12.5%) and osteochondritis in one patient (4.2%). Tertiary syphilis was characterized by verrucous lesions. Neurosyphilis was diagnosed in four patients (16.7%), with headache as the only manifestation in two patients. Drugs used in treatment included benzathine penicillin, ceftriaxone, erythromycin, and crystalline penicillin. Cure was achieved in 18 patients (75%). Five patients (20.8%) were retreated, three of whom presented a history of re-exposure. This study confirms the importance of establishing the diagnosis of neurosyphilis in patients with HIV infection, in addition to performing follow-up on treatment for syphilis.

Adult↗
PubMed2006

Effects of sex work on the prevalence of syphilis among injection drug users in 3 Russian cities.

OBJECTIVES: We examined risk factors for syphilis infection among injection drug users in 3 Russian Federation cities, focusing particular attention on the potential roles of gender and sex work. METHODS: We conducted a cross-sectional survey of injection drug users in Moscow, Volgograd, and Barnaul, collecting behavioral data and testing for antibodies to Treponema pallidum. Associations between presence of antibodies to T pallidum and covariates were explored. RESULTS: Overall, the prevalence of antibodies to T pallidum was 11% (95% confidence interval=9.7%, 13.1%). Syphilis was associated with involvement in sex work and with gender in Moscow and Barnaul but not in Volgograd. Female injection drug users not involved in sex work were more likely than men to be younger and to have recently begun to inject; female injection drug users involved in sex work were more likely than those not involved in sex work to inject daily. CONCLUSIONS: Syphilis transmission dynamics varied by region. Sex work can increase syphilis risk among injection drug users, potentially feeding the momentum of sexually transmitted HIV and syphilis among noninjectors. Targeted interventions are needed to reduce both sexual and injection risk behaviors among injection drug users.

Adult↗
PubMed1990

The effects of case definition in maternal screening and reporting criteria on rates of congenital syphilis.

Reports of congenital syphilis in 1987 were reviewed to determine how new national guidelines for defining congenital syphilis would influence reported rates in Los Angeles County. After reviewing all reported reactive serologic tests for syphilis, we found 166 additional cases, resulting in a 426 percent increase in the 1987 reported rate of congenital syphilis. Rates of congenital syphilis are dependent upon surveillance practices, screening policies, and case definition.

Female↗
PubMed1997

Sociodemographic factors and the variation in syphilis rates among US counties, 1984 through 1993: an ecological analysis.

OBJECTIVES: Syphilis in the United States is focally distributed, with high incidence rates in the South and in metropolitan areas nationwide. In this study an ecological analysis, using the county as the unit of analysis, was performed to generate hypotheses about community-level determinants of syphilis rates. METHODS: Bivariate rank correlations and multivariate, backward stepwise elimination linear regressions were performed. Mean annual incidence of primary- and secondary-stage syphilis in a county was the dependent variable, and county sociodemographic characteristics (from census data) were the independent variables. RESULTS: In the multivariate regression model, sociodemographic characteristics accounted for 71% of the variation in syphilis rates among counties. With other factors accounted for, the most highly correlated characteristics were percentage non-Hispanic Black population, county location in the South, percentage of the population that was urban, percentage Hispanic population, and percentage of births to women younger than 20 years. CONCLUSIONS: Most of the variation in syphilis rates among counties is accounted for by sociodemographic characteristics. Identification and remediation of modifiable health determinants for which these factors are markers are needed to improve the health status of these populations.

Adolescent↗
PubMed1999

What's driving an epidemic? The spread of syphilis along an interstate highway in rural North Carolina.

OBJECTIVES: The purpose of this study was to determine whether county syphilis rates were increased along Interstate Highway 95 (I-95) in North Carolina during a recent epidemic. METHODS: Ecological data on syphilis cases demographic data, highway data, and drug activity data were used to conduct a cross-sectional and longitudinal study of North Carolina countries from 1985 to 1994. Crude and adjusted incidence rate ratios (IRRs) were determined by means of standard and longitudinal Poisson regression models adjusted for sociodemographic factors and drug use. RESULTS: Ten-year syphilis rates in I-95 counties greatly exceeded rates in non-I-95 counties (38 vs 16 cases per 100,000 persons) and remained higher after adjustment for race, age, sex, poverty, large cities, and drug activity (adjusted IRR = 2.05, 95% confidence interval [CI] = 1.84, 2.28). Syphilis rates were stable until 1989, when rates increased sharply in I-95 counties but remained stable in non-I-95 counties. Increased drug activity in I-95 counties preceded the rise in syphilis cases. CONCLUSIONS: A better understanding of the relationship between high-ways and the spread of sexually transmitted diseases may guide future prevention interventions.

Adult↗
PubMed2003

HIV infections and associated costs attributable to syphilis coinfection among African Americans.

OBJECTIVES: We estimated the number and cost of syphilis-attributable HIV cases among African Americans. METHODS: A mathematical model of HIV transmission was used to estimate the number of partnerships consisting of HIV-discordant African Americans in which infectious syphilis was present and the number of new HIV cases attributable to syphilis in these partnerships. RESULTS: In 2000, an estimated 545 new cases of HIV infection among African Americans could be attributed to the facilitative effects of infectious syphilis, at a cost of about 113 million dollars. CONCLUSIONS: Syphilis prevention could reduce HIV incidence rates and the disproportionate burden of HIV/AIDS on the African American community, resulting in substantial reductions in future HIV/AIDS medical costs.

Black or African American↗
PubMed2000

Evaluation of rapid diagnostic tests for the detection of human immunodeficiency virus types 1 and 2, hepatitis B surface antigen, and syphilis in Ho Chi Minh City, Vietnam.

An evaluation of three new rapid diagnostic test kits for human immunodeficiency virus types 1 and 2 (HIV-1/2), hepatitis B surface antigen (HBsAg), and syphilis involved a two-phase comparison of rapid diagnostic assays using prospectively collected from hospitals and clinics in Ho Chi Minh City, Vietnam. After specificity and sensitivity testing, three new rapid diagnostic test kits were tested in parallel with six commonly used diagnostic test kits. The Determine HIV-1/2 test had fewer indeterminate or equivocal results than the Capillus HIV-1/HIV-2 or HIV Blot 2.2 tests. However, the Determine HIV-1/2 test yielded one false-positive result when compared with the Serodia HIV, HIV Blot 2.2, and microparticle enzyme immunoassay (IMx) HIV tests. The Serodia HBsAg test yielded more false-negative results when compared with the Determine HBsAg diagnostic test kit. The results of the syphilis diagnostic tests evaluated in this clinical trial consistently agreed with those of the rapid plasma reagin test for syphilis. The Determine Syphilis Treponema pallidum (TP) test had three false-positive results compared with the Serodia TP and the Serodia TP x particle agglutination (PA) tests, which had two false-positive results that were confirmed as negative by an ELISA. Application of these serologic tests within this comparative evaluation framework, using the World Health Organization alternative testing strategies, proved to be an effective way to determine serostatus related to HIV, hepatitis B, and syphilis.

Evaluation Studies as Topic↗
PubMed1998

Periodic syphilis profile in a New Delhi hospital.

The study reports the prevalence of syphilis determined at intervals of ten years amongst attendees of the Sexually Transmitted Diseases Centre (STD), in New Delhi, from 1954, to 1994. It was observed that the number of STD cases increased by about eight times in 1984 as compared to 1954. The prevalence of STDs had risen from 5.5 per cent in 1964 to 14.7 per cent in 1994. However, the syphilis load has been decreasing since 1974. Childhood syphilis has decreased from 12.6 per cent in 1954 to 0.5 per cent in 1994. However in adult males it increased from 62.3 per cent in 1954 to 80.4 per cent in 1984. Cardiovascular syphilis was last reported in 1954. The prevalence of syphilis was approximately three times higher in males than in females.

Adult↗
PubMedDate not supplied

[Congenital syphilis: update and perspectives].

Congenital syphilis is responsible for a variety of clinical symptoms, from subclinical attacks to septicemic forms that may be fatal. The most frequently encountered forms typically involve low birth weight, heptosplenomegaly and jaundice. Premature birth, anemia, cutaneous lesions, coryza, anasarca and pseudoparalysis may also occur. Neonatal X rays generally show characteristic but nonspecific osteochondrocyte lesions and periosteous dystrophy. A clinical form partly associated with growing tissues may be detected late. Diagnosis of fetal syphilis depends on the detection by immunofluorescence of specific IgM immunoglobulins in the newborn. Parenteral antibiotic treatment with 100,000 IU penicillin/kg.day for 15 days is given to newborns with symptoms. The classification and treatment of asymptomatic forms is unclear. A single injection of benzathine-penicillin is a good compromise between simple surveillance and admission to hospital for 10 days of intravenous treatment. In any case, serological surveillance is required to check that IgM disappears from the blood or that the titer of IgG decreases. Reinfection is always possible, even in a newborn treated correctly. In developing countries, pediatricians must be aware of the various clinical forms of congenital syphilis. In addition, national programs to combat sexually transmitted diseases should be supported and developed by international aid agencies. In economically advanced countries, attention is currently focused on the restricted nature of medical treatment. Improvements in the management of congenital syphilis depend above all on dealing with the social and cultural problems of populations affected by syphilis.

Adult↗