Syphilis: the Facts
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Borrelia Burgdorferi and Treponema Pallidum: a Comparison of Functional Genomics, Environmental Adaptations, and Pathogenic Mechanisms
PERSPECTIVE SERIES Bacterial polymorphisms Martin J. Blaser and James M. Musser, Series Editors Borrelia burgdorferi and Treponema pallidum: a comparison of functional genomics, environmental adaptations, and pathogenic mechanisms Stephen F. Porcella and Tom G. Schwan Laboratory of Human Bacterial Pathogenesis, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, Montana, USA Address correspondence to: Tom G. Schwan, Rocky Mountain Laboratories, 903 South 4th Street, Hamilton, Montana 59840, USA. Phone: (406) 363-9250; Fax: (406) 363-9445; E-mail: [email protected]. Spirochetes are a diverse group of bacteria found in (6–8). Here, we compare the biology and genomes of soil, deep in marine sediments, commensal in the gut these two spirochetal pathogens with reference to their of termites and other arthropods, or obligate parasites different host associations and modes of transmission. of vertebrates. Two pathogenic spirochetes that are the focus of this perspective are Borrelia burgdorferi sensu Genomic structure lato, a causative agent of Lyme disease, and Treponema A striking difference between B. burgdorferi and T. pal- pallidum subspecies pallidum, the agent of venereal lidum is their total genomic structure. Although both syphilis. Although these organisms are bound togeth- pathogens have small genomes, compared with many er by ancient ancestry and similar morphology (Figure well known bacteria such as Escherichia coli and Mycobac- 1), as well as by the protean nature of the infections terium tuberculosis, the genomic structure of B. burgdorferi they cause, many differences exist in their life cycles, environmental adaptations, and impact on human health and behavior. The specific mechanisms con- tributing to multisystem disease and persistent, long- term infections caused by both organisms in spite of significant immune responses are not yet understood. -
Extending the Cure: Policy Responses to the Growing Threat Of
RAMANAN LAXMINARAYAN and ANUP MALANI with David Howard and David L. Smith EXTENDING THE CURE Policy responses to the growing threat of antibiotic resistance EXTENDING THE CURE RAMANAN LAXMINARAYAN and ANUP MALANI with David Howard and David L. Smith EXTENDING THE CURE Policy responses to the growing threat of antibiotic resistance © Resources for the Future 2007. All rights reserved. LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Laxminarayan, Ramanan. Extending the cure : policy responses to the growing threat of antibiotic resistance / by Ramanan Laxminarayan and Anup Malani ; with David Howard and David L. Smith. p. ; cm. Includes bibliographical references. ISBN 978-1-933115-57-3 (pbk. : alk. Paper) 1. Drug resistance in microorganisms—United States. 2. Drug resistance in microorganisms—Government policy—United States. I. Malani, Anup. II. Title. III. Title: Policy responses to the growing threat of antibiotic resistance. [DNLM: 1. Drug Resistance, Bacterial—United States. 2. Anti-Bacterial Agents—United States. 3. Drug Utilization—United States. 4. Health Policy—United States. QW 52 L425e 2007] QR177.L39 2007 616.9`041—dc22 2007008949 RESOURCES FOR THE FUTURE 1616 P Street, NW Washington, DC 20036-1400 USA www.rff.org ABOUT RESOURCES FOR THE FUTURE RFF is a nonprofit and nonpartisan organization that conducts independent research—rooted primarily in economics and other social sciences—on environmental, energy, natural resources, and public health issues. RFF is headquartered in Washington, D.C., but its research scope comprises programs in nations around the world. Founded in 1952, RFF pioneered the application of economics as a tool to develop more effective policy for the use and conservation of natural resources. -
Medications Used for Behavioral and Emotional Disorders: a Guide for Parents, Foster Parents
MEDICATIONS USED FOR BEHAVIORAL & EMOTIONAL DISORDERS A GUIDE FOR PARENTS, FOSTER PARENTS, FAMILIES, YOUTH, CAREGIVERS, GUARDIANS, AND SOCIAL WORKERS Final May 10, 2010 Overview This booklet is a guide for parents and other caregivers to help you understand the medications that are sometimes used to help children with behavioral or emotional problems. Being able to talk openly with your child’s doctor or other health care provider is very important. This guide may make it easier for you to talk with your child's doctors about medications. You will find information about the medications that may be used to help treat these conditions in children. How these medications work and possible side effects are also included. As a parent or caregiver of a child with a behavioral or emotional disorder, you may be feeling overwhelmed as you try to help your child cope with his or her problems. Many parents and caregivers feel that nobody understands the frustration of caring for a child with a behavioral or emotional disorder. But many other families are in the same situation. According to one study, over 4 million children ages 9 to 17 have some kind of emotional or behavioral problem that affects their daily lives. 2 Getting Help Children with behavioral or emotional disorders are a special group and need special care. Many times children have symptoms that are different from adults with the same disorder. Symptoms may also vary from child to child, and it can be difficult to understand a child's signs and symptoms. Children may have trouble understanding their illness and may not be able to describe how they feel. -
Lymphogranuloma Venereum (LGV) Reporting and Case Investigation
Public Health and Primary Health Care Communicable Disease Control 4th Floor, 300 Carlton St, Winnipeg, MB R3B 3M9 T 204 788-6737 F 204 948-2040 www.manitoba.ca November, 2015 Re: Lymphogranuloma Venereum (LGV) Reporting and Case Investigation Reporting of LGV (Chlamydia trachomatis L1, L2 and L3 serovars) is as follows: Laboratory: All positive laboratory results for Chlamydia trachomatis L1, L2 and L3 serovars are reportable to the Public Health Surveillance Unit by secure fax (204-948- 3044). Health Care Professional: For Public Health investigation and to meet the requirement for contact notification under the Reporting of Diseases and Conditions Regulation in the Public Health Act, the Notification of Sexually Transmitted Disease (NSTD) form ( http://www.gov.mb.ca/health/publichealth/cdc/protocol/form3.pdf ) must be completed for all laboratory-confirmed cases of LGV. Please check with the public health office in your region with respect to procedures for return of NSTD forms for case and contact investigation. Cooperation with Public Health investigation is appreciated. Regional Public Health or First Nations Inuit Health Branch: Return completed NSTD forms to the Public Health Surveillance Unit by mail (address on form) or secure fax (204-948-3044). Sincerely, “Original Signed By” “Original Signed By” Richard Baydack, PhD Carla Ens, PhD Director, Communicable Disease Control Director, Epidemiology & Surveillance Public Health and Primary Health Care Public Health and Primary Health Care Manitoba Health, Healthy Living and Seniors Manitoba Health, Healthy Living and Seniors Communicable Disease Management Protocol Lymphogranuloma Venereum (LGV) Communicable Disease Control Unit Etiology distinct stages (2, 9). Primary infection appears three to 30 days after infection (2, 8) and presents LGV is caused by Chlamydia trachomatis (C. -
Definition of Cure for Hodgkin's Disease
[CANCER RESEARCH 31, 1828-1833, November 1971] Definition of Cure for Hodgkin's Disease Emil Frei, III, and Edmund A. Gehan The Department of Developmental Therapeutics [E. M.] and the Department of Biomathematics [E. A. G./, The University of Texas M. D. Anderson Hospital and Tumor Institute at Houston, Houston, Texas 77025 Summary whose progressive death rate from all causes is similar to that of a normal population of the same sex and age constitution." "We can speak of cure for Hodgkin's disease when in I would add that it should also be unassociated with time-probably a decade or so after treatment-there remains a continuing morbidity from the disease or its treatment. While group of disease-free survivors whose progressive death rate this excellent definition is quite acceptable for Hodgkin's from all causes is similar to that of a normal population of the disease (or for most cancers, for that matter), it has the major same age and sex constitution." Analysis of survival curves for limitation that it takes years to determine the cure rate of a patients with Hodgkin's disease indicates that even for patients given form of treatment. The rapid progress in therapeutic with Stage I and II disease there is excessive mortality per unit research has brought focus on the need for determining the time as compared to the control population for at least 10 probability of cure as early as possible. years after treatment. Thus, while the above definition is acceptable, the lag period required for the evaluation of Survival Data for Selected Other Cancers potentially curative treatment is very long. -
Managing Chronic Conditions. Experience in Eight Countries
European on Health Systems and Policies MANAGING CHRonIC CONDITIONS Experience in eight countries Ellen Nolte, Cécile Knai, Martin McKee Observatory Studies Series No 15 Managing chronic conditions The European Observatory on Health Systems and Policies supports and promotes evidence- based health policy-making through comprehensive and rigorous analysis of health systems in Europe. It brings together a wide range of policy-makers, academics and practitioners to analyse trends in health reform, drawing on experience from across Europe to illuminate policy issues. The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Governments of Belgium, Finland, Norway, Slovenia, Spain and Sweden, the Veneto Region of Italy, the European Investment Bank, the Open Society Institute, the World Bank, the London School of Economics and Political Science and the London School of Hygiene & Tropical Medicine. Managing chronic conditions Experience in eight countries Ellen Nolte Cécile Knai Martin McKee Keywords: CHRONIC DISEASE - prevention and control DISEASE MANAGEMENT DELIVERY OF HEALTH CARE - organization and administration DENMARK FRANCE GERMANY THE NETHERLANDS SWEDEN UNITED KINGDOM AUSTRALIA CANADA EUROPE © World Health Organization 2008, on behalf of the European Observatory on Health Systems and Policies All rights reserved. The European Observatory on Health Systems and Policies welcomes requests for permission to reproduce or translate its publications, in part or in full. Address requests about publications to: Publications, WHO Regional Office for Europe, Scherfigsvej 8 DK-2100 Copenhagen Ø, Denmark Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (http://www.euro.who.int/pubrequest). -
CHAPTER 4 Infectious Disease
CHAPTER 4 Infectious Disease 99 | Massachusetts State Health Assessment Infectious Disease This chapter provides information on preventing and controlling infectious diseases, and related trends, disparities, and resources in the Commonwealth of Massachusetts. It addresses the following infectious disease topic areas: • Foodborne Diseases • Healthcare-Associated Infections • Sexually Transmitted Infections • Human Immunodeficiency Virus • Viral Hepatitis • Tuberculosis • Vectorborne Diseases • Immunization • Selected Resources, Services, and Programs Chapter Data Highlights • Over 4,200 confirmed cases of foodborne disease in 2015 • HIV infections decreased by 31% from 2005 to 2014 • In 2015, hepatitis C case rates were 26 and 10 times higher, respectively, among White non-Hispanics compared to Asian non-Hispanics and Black non-Hispanics • In 2016, 190 cases of TB were reported in Massachusetts • Tickborne babesiosis increased 15% from 2015 to 2016 • Influenza and pneumonia ranked in the top ten leading causes of death among Massachusetts residents in 2014 100 | Massachusetts State Health Assessment Overview Infectious diseases have been causing human illness and death since the dawn of human existence. The effective prevention and control of these diseases is one of the major reasons for increases in life expectancy. In 1701, Massachusetts passed legislation requiring the isolation of the sick “for better preventing the spread of infection.”190 Since then, Massachusetts has led the nation in infection prevention and control. For example, Massachusetts was the only state to achieve a score of 10 out of 10 in Health Security Ranking which includes reducing healthcare-associated infections (HAIs), biosafety training in public health laboratories, public health funding commitment, national health security preparedness, public health accreditation, flu vaccination rates, climate change readiness,afety as well as a biosafety professional on staff and emergency health care access. -
Syphilis General Information
Syphilis General Information What is syphilis? Syphilis is a sexually transmitted infection. It is caused by a kind of bacteria called Treponema pallidum. How do people get syphilis? Syphilis is spread by vaginal, anal, or oral sex with someone who has an active syphilis infection. It is passed from person to person through direct contact with a syphilis sore. Most often the sores are found on the genitals, but they can occur on the lips, in the mouth, or anywhere on the body. Babies can get syphilis if their mother is infected because the bacteria can pass through the placenta during pregnancy. What are the symptoms? Many people infected with syphilis do not have any symptoms for years. However, with or without symptoms, the syphilis infection will stay in the body until it is cured. If it is not treated it can cause serious complications. While in the body, syphilis passes through many stages. At each of these stages there are different symptoms. The symptoms are: • a painless sore that is round, flat and raised on the sides, like a large boil (because this sore is painless and can be hidden somewhere that you cannot see, you may not know you have a sore) • rashes anywhere on the body, especially on the palms of the hands and soles of the feet • swollen glands In its later stages syphilis can cause symptoms in the heart, brain or other organs. The first symptoms can start from 10 to 90 days (average 21 days) after contact with someone who has the infection. What is the treatment? Syphilis can be treated with a penicillin injection or with other antibiotics prescribed by a doctor. -
Fads and Epidemics in Infectious Disease: Syphilis, Lyme and Bartonella Laura J
Fads and Epidemics in Infectious Disease: Syphilis, Lyme and Bartonella Laura J. Balcer, M.D. Philadelphia, PA Objectives preantibiotic era estimated that syphilis would infect as At the conclusion of this program, participants will be able many as 10% of Americans during their lifetimes.1 to With the development of antibiotics (particularly 1. Identify the neuro-ophthalmologic and ocular manifes- penicillin) and the institution of public health measures to tations of syphilis, Lyme disease, and Bartonella control the spread of disease, incidence rates of primary henselae infection. and secondary infection reduced dramatically, reaching a 2. Apply current techniques for the diagnosis and treat- nadir in 2000 when only 5979 cases were reported in the ment of syphilis, Lyme disease, and Bartonella U.S.1 Since that time, overall incidence rates have again henselae infection with neurologic or ocular involve- increased, with marked variation with respect to geo- ment. graphic, racial, and other demographic factors. Epidemio- 3. Discuss important aspects of the epidemiology and logic studies have also suggested that syphilis increases pathogenesis of syphilis, Lyme disease, and Bartonella susceptibility to human immunodeficiency virus (HIV) henselae infection. infection, and increases the likelihood that patients with both syphilis and HIV will transmit HIV infection.1 To CME Questions control increases in the incidence of primary and second- 1. Which of the following neuro-ophthalmologic manifes- ary syphilis, the U.S. Centers for Disease Control and tations may occur in patients with syphilis, Lyme Prevention (CDC) have launched a National Plan to disease, or Bartonella henselae infection (i.e., which Eliminate Syphilis, with the goal of reducing the annual are common to all three disorders)? number of cases to 1,000 (incidence rate of 0.4/100,000/ a. -
How the Current System Fails People with Chronic Illnesses
How the Current System Fails People With Chronic Illnesses Reinhard Priester Robert L. Kane Annette M. Totten Copyright 2005 by the Society of Actuaries. All rights reserved by the Society of Actuaries. Permission is granted to make brief excerpts for a published review. Permission is also granted to make limited numbers of copies of items in this monograph for personal, internal, classroom or other instructional use, on condition that the foregoing copyright notice is used so as to give reasonable notice of the Society's copyright. This consent for free limited copying without prior consent of the Society does not extend to making copies for general distribution, for advertising or promotional purposes, for inclusion in new collective works or for resale. 1 Abstract The Institute of Medicine concluded in 2001 that with regard to quality, “between the health care we have and the care we could have lies not just a gap, but a chasm.” In fact, the chasm is not only over quality. The lack of access, financial barriers, high costs and workforce shortages are among the other dimensions of our health care system that further expose the chasm between “what is” and “what should be.” These deficiencies are particularly troubling for people with chronic conditions who, on average, use the health care system more frequently, consume more health care resources and are more likely to see multiple health care professionals and have long- term relationships with them. When the health care system fails, chronically ill patients are often harmed the most. The foremost reason America’s health care system cannot optimally provide the services needed by people with chronic conditions is that the system remains based on an episodic, acute care medical model. -
Folliculitis
Folliculitis Common Cutaneous • Inflammation of hair follicle(s) Bacterial Infections • Symptoms: Often pruritic (itchy) Pseudomonas folliculitis Eosinophilic Folliculitis (HIV) Folliculitis: Causes • Bacteria: – Gram positives (Staph): most common – Gram negatives: Pseudomonas – “hot tub” folliculitis • Fungal: Pityrosporum aka Malassezia • HIV: eosinophilic folliculitis (not bacterial) • Renal Failure: perforating folliculitis (not bacterial) Treatment of Folliculitis 21 year old female with controlled Crohn’s disease and history of • Bacterial hidradenitis suppuritiva presents stating – culture pustule she has recurrent flares of her HS – topical clindamycin or oral cephalexin / doxycycline – shower and change shirt after exercise – keep skin dry; loose clothing • Fungal: topical antifungals (e.g., ketoconazole) • Eosinophilic folliculitis – Phototherapy – Treat the HIV MRSA MRSA Eradication • Swab nares mupirocin ointment bid x 5 days • GI noted Crohn’s was controlled but increased – Swab axillae, perineum, pharynx infliximab intensity, but that was not controlling • Chlorhexidine 4% bodywash qd x 1 week recurrent “flares” • Chlorhexidine mouthwash qd x 1 week; soak toothbrush (or disposable) •I & D MRSA on three occasions • Bleach bath: 1/3 cup to tub, soak x 10 min tiw x 1 week, then prn (perhaps weekly) • THIS WAS INFLIXIMAB-RELATED • Oral antibiotics x 14 days: Bactrim, Doxycycline, depends FURUNCULOSIS FROM MRSA COLONIZATION on sensitivities – D/C infliximab • Swab partners – Anti-MRSA regimen • Hand sanitizer frequently – Patient is better • Bleach wipes to surfaces (doorknobs, faucet handles) • Towels use once then wash; paper towels when possible Pointing abscess (furuncle) --pointing requires I & D-- Acute Paronychia Furuncle Treatment Impetigo • Incise & Drain (I & D) Culture pus • Warm soaks • Antibiotics – e.g., cephalexin orally AND mupirocin topically • If recurrent, suspect nasal carriage of Staph aureus swab culture and mupirocin to nares b.i.d. -
Differential Diagnosis of the Scalp Hair Folliculitis
Acta Clin Croat 2011; 50:395-402 Review DIFFERENTIAL DIAGNOSIS OF THE SCALP HAIR FOLLICULITIS Liborija Lugović-Mihić1, Freja Barišić2, Vedrana Bulat1, Marija Buljan1, Mirna Šitum1, Lada Bradić1 and Josip Mihić3 1University Department of Dermatovenereology, 2University Department of Ophthalmology, Sestre milosrdnice University Hospital Center, Zagreb; 3Department of Neurosurgery, Dr Josip Benčević General Hospital, Slavonski Brod, Croatia SUMMARY – Scalp hair folliculitis is a relatively common condition in dermatological practice and a major diagnostic and therapeutic challenge due to the lack of exact guidelines. Generally, inflammatory diseases of the pilosebaceous follicle of the scalp most often manifest as folliculitis. There are numerous infective agents that may cause folliculitis, including bacteria, viruses and fungi, as well as many noninfective causes. Several noninfectious diseases may present as scalp hair folli- culitis, such as folliculitis decalvans capillitii, perifolliculitis capitis abscendens et suffodiens, erosive pustular dermatitis, lichen planopilaris, eosinophilic pustular folliculitis, etc. The classification of folliculitis is both confusing and controversial. There are many different forms of folliculitis and se- veral classifications. According to the considerable variability of histologic findings, there are three groups of folliculitis: infectious folliculitis, noninfectious folliculitis and perifolliculitis. The diagno- sis of folliculitis occasionally requires histologic confirmation and cannot be based