ABSTRACT
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.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Syphilis/diagnosis , Mouth Diseases/diagnosis , Penicillin G Benzathine/therapeutic use , Syphilis/drug therapy , Retrospective Studies , Mouth Diseases/drug therapyABSTRACT
With the increasing rates of adult syphilis infection,some reports have suggested that the syphilis infection accounted for about 1.45％ of the etiology the infantile cholestasis,syphilis infection often lead to multiple organ and system dysfunction as a cause of infant cholestasis disease,it characterized by infantile cholestasis which performanced with jaundice,itchy skin,dark yellow urine,acholic stools,etc when it involved liver,syphilis infection can also merge with mucosal syphilis,osseous syphilis,neurosyphilis.The treatment of infant cholestasis caused by syphilis infection includes early system of adequate antisyphilitics treatment,meanwhile,we should cholagogue,removing jaundice,hepatic protection,and nutritional therapy for cholestasis.In this article,we are planing to review the etiology,clinical manifestation,diagnosis,treatment and prevention of the infantile cholestasis caused by syphilis infection.
ABSTRACT
Objective To explore the expression level and influencing factors of CD4 +CD25 + regulatory cells(Treg)among male drug -abusers with syphilis.Methods 144 male drug -abusers with syphilis,41 male drug -abusers without syphilis,35 male non -drug abuser with syphilis and 35 male healthy volunteers were enrolled in this study.Expression levels of CD4 +CD25 +Treg of them were detected.A questionnaire interview was conducted among these participants, including drug abuse duration,drug types and abuse ways.Results The levels of Treg expression of drug -abusers with syphilis were significantly higher than that of drug -abusers without syphilis and non -drug abuser with syphilis (P <0.01 ).Despite of the stage of syphilis,types of drugs and abuse way,Treg expression levels with drug abuse duration of"above 1 -year"were significantly higher than those of "1 -year or below"(P <0.01 ).Treg expression levels were positively correlated to drug abuse duration (R2 =0.672,P <0.01)among patients.Among the participants,people both with traditional and new drugs were significantly higher than that with only traditional or new drug (P <0.01).In addition, people both with injecting and non -injecting abuse were significantly higher than that with one way of drug -abuse (P <0.01).Among those with drug abuse duration of "above 1 -year",Treg levels of drug -abusers with traditional drugs and injecting abuse way were remarkably higher than that with new drug and non -injecting abuse respectively (P <0.01). Conclusion Among male drug -abusers with syphilis,suppression of cellular immune function resulting from increased CD4 +CD25 +regulatory T cells is related to drug abuse duration,and is also influenced by drug types and abuse ways.
ABSTRACT
Introdução: As doenças infecciosas durante a gravidez são relativamente frequentes, entre essas doenças encontra-se a sífilis, sendo factível a transmissão materno-fetal, tornou-se uma doença de notificação compulsória desde julho de 2005. Assim sendo é um excelente indicador de uma atenção pré-natal e puerperal de qualidade na saúde materna e neonatal. Objetivo: Determinar o perfil epidemiológico das gestantes com VDRL reagente atendidas no Centro de Saúde (CS) n.° 2 de Samambaia DF de 2005 a 2009.Metodologia: Trata-se de um estudo retrospectivo, transversal, mediante verificação direta nos prontuários de pacientes com notificação de sífilis gestacional na Vigilância Epidemiológica do CS n.º 02. Resultados: O estudo revelou que nas gestantes analisadas, a idade média foi de 28 anos, prevalecendo a escolaridade primária e relacionamento estável. Foram encontrados 63,7% multíparas, 22,7 % de casos de abortamentos anteriores e 45,4% casos de sífilis em outras gestações. O início do pré-natal ocorreu no 1.º trimestre em 40,9%, com o número de consultas igual ou inferior a cinco em 68,3% e 13,6% não realizaram pré-natal. O VDRL foi realizado no 2.° trimestre em 36,4%, no 3.° trimestre em 18,2% e no pós-parto em 18,2%. O tratamento foi considerado adequado em 67,6% das gestantes. Entretanto, 13,6% dos parceiros não receberam qualquer tipo de tratamento. Conclusão: Os autores reafirmam a importância da sífilis gestacional como indicador de assistência pré-natal, visto ser uma doença totalmente passível de prevenção, diagnóstico e tratamento durante a gestação. Entretanto, a dificuldade de acesso ao serviço de pré-natal e exames laboratoriais torna mais difícil o diagnóstico precoce, a adesão ao tratamento da gestante e do parceiro e o estabelecimento do vinculo entre a equipe de saúde e a gestante, o que aumenta a probabilidade de transmissão vertical da sífilis.
Introduction: Syphilis is a sexually transmissible disease which, during pregnancy, may have disastrous effects on the fetus. This disease is still ongoing as a huge public health matter and an indicator the quality of the prenatal care.Objective: To evaluate the epidemiological profile of the pregnant women with positive VDRL test had been attended in Health Center n.° 2 of Samambaia DF, from 2005 to 2009.Methods: Data were collected retrospectively from clinical records of the pregnant women with positive VDRL test had been attended in Health Center n.° 2 of Samambaia DF. Results: This study revealed that in the pregnant women analysed, an average age of 28 years old, prevailing the primary level of education and stable relationship. Also, the study showed the subjects had aborted in 22,7% and 45,4% had a diagnosis of syphilis in others pregnancies. The prenatal began in the first trimester in 40,9% of the pregnant women and 13,6% did not have prenatal care . The VDRL was realized in the second trimester in 36,4%, in the second trimester in 18,2% and post-pregnancy in 18,2%. Treatment was considered adequate in 67,6% of pregnant women. However, 13,6% of the partners did not receive treatment during pregnancy. Conclusions: The authors reaffirm the importance of syphilis infection during pregnancy as na indicator of perinatal health, since it is a disease that may be completely prevented by prenatal care. The results also point out the relevance of surveillance strategy for syphilis in pregnancy, regarding the goal of congenital syphilis elimination. Only a better antenatal care, achieved by means of training health care providers, will allow the reduction of vertical transmission of syphilis. In addition, a high prevalence of syphilis infection during pregnancy allows one to question the quality of the prenatal care, which was available to the studied group.