Influente político, autor de diversos livros e industrial de sucesso, o general José Vieira Couto de Magalhães (1837-1898) foi um dos raros homens de seu tempo que deixou registradas preciosas informações cotidianas quanto aos medicamentos e cuidados com seu próprio corpo na busca por reestabelecer a saúde. Suas anotações pessoais corresponderam a dois momentos distintos de sua vida. Primeiro ao início da década de 1880, quando vivia sempre muito incomodado pela frequente dificuldade de digestão. Nessa fase, Couto demonstrou estar mais interessado em se medicar a partir da leitura de compêndios de medicina. Posteriormente, entre os anos 1887-1890, o general escreveu um caderno de anotações onde redigiu breves referências sobre o diagnóstico de sífilis dado a ele por dois médicos que estiveram em sua casa, quando tinha 52 anos e era presidente da Província de São Paulo. Doença incurável e fortemente atrelada à moral, a sífilis era então associada à prostituição e considerada uma das causas da degeneração da prole. Bastante debilitado quando estava no estágio terciário da sífilis, o general se consultou com os melhores médicos do Brasil e também da França, onde esteve por duas vezes a tratamento. Na tentativa de compreender qual teria sido o sentido desse diagnóstico para um homem de alta projeção social, eu me deparo nesse trabalho com algumas questões caras para a época. Uma delas diz respeito à vida nem sempre fácil e muito menos prestigiada dos médicos os mesmos que por muito tempo foram analisados a partir de um enfoque predominantemente foucaultiano como sendo detentores de um poder disciplinar sobre a sociedade. Para trabalhar com a história de vida e as anotações do general Couto de Magalhães e, acima de tudo, com os silêncios contidos em seus escritos, procuro cruzar informações dos diários com alguns periódicos, teses e livros de medicina da época. / As an influential politician and a successful industrialist, and having written a number of books, General José Vieira Couto de Magalhães (1837-1998) was one of the few men of his time leaving a register with precious information about everyday life concerning medicine and body care aiming to the restoring of health. His personal notes correspond to two different moments of his life. Firstly, to the beginning of the 1880s, when he was affected by digestion problems. In this phase, Couto demonstrated more interest in self-medication based on the reading of medical compendiums. Afterwards, between 1887 and 1890, the General kept a notebook in which he wrote brief reference notes on the syphilis diagnosis he was given at home by two doctors. At this time he was 52 and used to be the president of the Province of São Paulo. Incurable and closely related to moral issues, syphilis was then associated with prostitution, being considered one of the causes of degeneration in offspring. At the third stage of the disease, the General was quite impaired and thus had appointments with the best physicians in Brazil as well as in France, where he travelled to twice during the treatment. In an attempt to understand the implications of such diagnosis for a man in a high social position, this study faces crucial issues for that time period. One of them concerns the usually difficult and much less prestigious life of medical doctors who were for a long time analyzed from a predominantly foucaultian perspective as having a disciplinary power over society. In order to work with Magalhãess life story and notes and above all with the silences inside his writings I try to compare the information in his journals with other from periodicals , theses and medical books from that historical period.

FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / Objetivou-se avaliar o conhecimento, a atitude e a prÃtica dos enfermeiros atuantes na EstratÃgia SaÃde da FamÃlia (ESF) acerca do controle da sÃfilis na gestaÃÃo; associar as variÃveis explanatÃrias com o conhecimento, a atitude e a prÃtica dos enfermeiros acerca do controle da sÃfilis na gestaÃÃo e comparar o conhecimento e a atitude com a prÃtica em relaÃÃo à sÃfilis na gestaÃÃo. Trata-se de um estudo avaliativo do tipo Conhecimento, Atitude e PrÃtica (CAP) e abordagem quantitativa, realizado no perÃodo de junho a agosto de 2012, com 171 enfermeiros da ESF, utilizando-se como instrumento um questionÃrio inquÃrito CAP em relaÃÃo à sÃfilis na gestaÃÃo. Os dados foram organizados em tabelas e grÃficos, segundo a estatÃstica descritiva e inferencial utilizando-se os testes Mann-Whitney, Kruskal-Wallis, Qui-quadrado e Fisher. O estudo foi aprovado pelo COMEPE/UFC com o protocolo de n 81/12. Quanto ao perfil dos enfermeiros, verificou-se uma idade mÃdia de 37,5 anos, com 90,1% do sexo feminino, 64,3% com ensino superior em instituiÃÃes pÃblicas e 77,8% sÃo especialistas, formados hà cerca de 12 anos, atuando na ESF hà uma mÃdia de 9 anos e 53,8% tinha alguma capacitaÃÃo sobre a temÃtica. Em relaÃÃo ao conhecimento dos enfermeiros, a maioria (67,3%) foi classificada como adequado, mas ainda 32,7% de enfermeiros teve conhecimento inadequado e regular. Quanto à atitude e prÃtica, observou-se 97,1% dos participantes tinham crenÃas e opiniÃes adequadas e 94,2% as colocavam em prÃtica adequadamente. Houve uma associaÃÃo estatisticamente significativa entre a instituiÃÃo de graduaÃÃo e a atitude dos enfermeiros; a autoclassificaÃÃo positiva em relaÃÃo ao conhecimento acerca da sÃfilis na gestaÃÃo com a prÃtica adequada; o conhecimento e a prÃtica, bem como entre a atitude e a prÃtica. As principais dificuldades percebidas pelos enfermeiros no controle da sÃfilis congÃnita foram: a demora dos resultados dos exames de VDRL (45,6%); a dificuldade de convocar o(s) parceiro(s) e a sua adesÃo ao tratamento (28,1%), assim como o inÃcio tardio do prÃ-natal (19,9%). Frente ao exposto, destaca-se a importÃncia do reconhecimento da sÃfilis congÃnita como um importante problema de saÃde pÃblica pelo enfermeiro, visto que a partir de suas aÃÃes adequadas e baseadas no conhecimento tÃcnico-cientÃfico podem interferir diretamente no controle da sÃfilis congÃnita, ofertando-se uma assistÃncia prÃ-natal de qualidade, integral e humanizada.

Many men who have sex with men (MSM) engage in alcohol and drug use. Drug use, particularly methamphetamines, amyl nitrates (poppers), and drugs used to treat erectile dysfunction among MSM may also contribute to risks such as unprotected sex, which leads to the possibility of contracting syphilis, Human immunodeficiency virus (HIV), and other Sexually Transmitted Infections (STIs). In the Metro Atlanta Area (Fulton and Dekalb Counties), primary and secondary syphilis rates among MSM are still rising and rank highest among the other counties in the area. Guided by the risk and protective factor theory, the purpose of this study was to determine if club drug use was a contributing factor in high-risk sexual behavior among MSM with syphilis. Data were collected from the State Electronic Notifiable Disease Surveillance System with permission from the State of Georgia's Division of Public Health's STD division and was tested by using hierarchical regression analyses. The findings were inconsistent with the reported literature; there was no association between drug use and risky sexual behavior in this sample of MSM infected with syphilis. However, there was an association between prior incarceration being predictive of engaging in sex with anonymous partners and having sex while high. Implications for positive social change include evidence for the need for public health interventions that target incarcerated MSM because they exhibit the highest-risk sexual behavior due to their time served in the correctional system. Further exploration of this topic could be used to develop health information and policies to meet the needs of those affected by high-risk sexual behavior while incarcerated and upon release, ultimately reducing the spread of HIV.

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (leaves 77-93).

EVALUATION AND DETERMINATION OF THE SENSITIVITY AND SPECIFICITY OF A Treponema pallidum DRIED BLOOD SPOT (DBS) METHOD FOR SEROLOGIC DIAGNOSIS OF SYPHILIS Background: Syphilis is a sexually transmitted infection (STI) caused by Treponema pallidum subspecies pallidum. Syphilis is known as the "great imitator" due to the similarity of clinical signs and symptoms to other infectious diseases. The primary diagnosis of syphilis relies on clinical findings, including the examination of treponemal lesions, and/or serologic tests. Serologic tests are divided into nontreponemal and treponemal tests. Nontreponemal tests are useful for screening, while treponemal tests are used as confirmatory tests. Methods: A total of 200 serum and DBS specimens collected from patients at the Los Angeles Municipal Sexually Transmitted Disease Clinics were tested by the DBS and enzyme immunoassay (EIA) methods. These samples were sent to the Syphilis Diagnostics Laboratory, Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia for testing. Samples were blindly evaluated by the TREP-SPOTTM DBS and the TREP- SURETM EIA methods for the detection of anti-treponemal IgG- and IgM-class antibodies. Results: The sensitivity of the DBS method was 83% (95% CI, 73.89 - 89.50) and specificity was 100% (95% CI, 95.39 - 100)). The positive predictive value and negative predictive values were 100% (95% CI, 94.48 - 100) and 85% (95% CI, 77.43 - 91.0), respectively. The efficiency of the DBS method was 91.5%. The kappa value for the agreement between the DBS method and EIA assay was 0.83 (95% CI, 0.754 - 0.906). The correlation coefficient (r2) between the anti-treponemal antibody assay results obtained from DBS and serum samples was 0.94. Conclusion: DBS is an optimal choice to be used as a screening tool for the detection of anti-treponemal antibodies for the diagnosis of syphilis. The detection of anti-treponemal antibodies (TREP-SPOTTM DBS EIA) compared favorably to the results of serum-base assay (TREP-SURETM EIA), with an overall concordance of 91.5%. Dried blood spots are technically easier to obtain and are suitable blood samples for primary health care centers.

Treponema pallidum is the causative agent of the sexually transmitted disease, syphilis. The organism can not be cultured in vitro, which has inhibited the understanding of the pathogenesis of syphilis. There has been no evidence of a treponemal toxin but adherence of large numbers of treponemes is able to destroy cell monolayers of different cell types (Fitzgerald et al, 1982). Non-pathogenic treponemes failed to adhere to cultured cells and this suggests that adherence is associated with virulence of T. pallidum (Fitzgerald et al, 1977). In this study we explored the interaction of T. pallidum with HaCaT cells which are immortalized human keratinocytes with characteristics equivalent to their natural counterpart. The adhesion assay confirmed binding of the organism to HaCaT cell monolayers. Migration assays and electron microscopy revealed that T. pallidum migrates through a confluent keratinocyte layer and western blotting experiments that differentiate between soluble and insoluble occludin confirmed that T. pallidum does not loosen the tight junctions. It is concluded that T. pallidum passes through the keratinocyte layer by trans-cellular rather than inter-cellular migration. / Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2010.

No description available.

Orientador: Adriano Dias / Banca: Maria Rita Carvalho Garbi Novaes / Banca: Leila Bernarda Donato Gottems / Resumo: A sífilis congênita apresenta elevada morbidade e mortalidade. Permanece com altas taxas de transmissão no Brasil e representa um desafio para a saúde pública, apesar do tratamento acessível de baixo custo. O objetivo deste trabalho foi descrever o perfil terapêuticoassistencial da sífilis congênita na SES/DF. Trata-se de um estudo descritivo, com dados secundários, a partir das identificações dos casos em 2008, pelos hospitais selecionados para o estudo e notificados junto a Diretoria de Vigilância Epidemiológica da SES/DF (DIVEP/DST/AIDS/DF), com a identificação dos 81 casos, buscou-se nos hospitais e centros de saúde, as informações relativas à sífilis congênita, dados obstétricos e epidemiológicos da mãe. Foram encontradas, 87,5% gestantes que fizeram o pré-natal, 17,3% gestantes que não realizaram VDRL no pré-natal. O tratamento dos RN foi inadequado quanto ao manejo clínico em 51,7%. Observou-se inconstância na realização dos exames: radiológico, hemograma e líquor cefalorraquidiano, encontrado campos em branco ou ignorados em fichas de notificação compulsória, prontuários da mãe e da criança. Quanto ao acompanhamento das crianças até os 18 meses de vida e o seguimento terapêutico, não foi possível avaliar a aplicação do Protocolo do MS, devido a não localização de registros. Conclui-se que há falhas no controle da transmissão vertical da sífilis, nas intervenções terapêuticas e o seguimento das crianças com SC requer ações ordenadas, capacitação profissional, integração entre os serviços de assistência e vigilância / Abstract: Congenital syphilis has high morbidity and mortality. Remains with high transmission rates in Brazil and as a public health challenge, despite the affordable low cost treatment. The objective of this study was to describe the therapeutic -assistant profile of congenital syphilis in the SES / DF. It is a descriptive study ,using secondary data ,from the identification of cases in 2008, of hospitals selected for the study and reported along with the Directorate of Epidemiological Surveillance SES / DF (DIVEP / STD / AIDS / DF). With the identification of 81 cases, we seek at hospitals and health centers, information on congenital syphilis, obstetric and epidemiological data from the mother ,were surveyed, and then, with this, a profile of children with CS was made. Were found 87.5% pregnant women who received prenatal care, 17.3% women were not performed in this pregnancy VDRL, and treatment of newborns were inadequate and the clinical management in 51.7%. There was inconsistency in the examinations: X-rays, blood counts and cerebrospinal fluid, finding fields in blank or ignored in compulsory notification forms, such as charts of mother and child. The monitoring of children up to 18 months and therapeutic treatment witch the implementation of the Protocol to the MS was not possible to due to not finding records. We conclude that there are flaws in the control of vertical transmission of syphilis, in the therapeutic interventions in children. The class of SC requires actions ordered, professional capacitation, and integration of care services and supervision / Mestre

The aim of the diploma work was the effort to map the problems and occurrence of sexually transmissible diseases, particularly gonorrhea and syphilis, in Southern Bohemia in the time period 2000 {--} 2005. Standardized questionaries ``Report of veneral disease{\crqq} of the Ministry of Health of the Czech Republic were used. The basic set is formed by patients that contracted during the period 2000 {--} 2005 one of the four sexually transmissible diseases subject to obligatory report to the National registry of veneral diseases of the Czech Republic. Four hypotheses were proposed for the subject. The work is divided into two parts: a theoretical and a practical part. The current state of the issue is outlined in the theoretical part. Here are further described the most frequent sexually transmissible diseases, their prevention and also the social impact of prostitution and the effort to provide a legislative treatment to this problem. The practical part covers the results of analyses of data from the given question-forms and their presentation in overview tables and graphs. Case studies of patients with syphilis from the Dermatovenerogical department of the Hospital Ceske Budejovice are presented including an interesting photo documentation showing the clinical and epidemiological importance of this problem.

No description available.