Syphilis, treatment

Syphilis treatment German physician Paul Ehrhch and Japanese physician Hata Sahachiro discover the effective treatment of arsphenamine (named Salvarsan by Ehrlich) for syphilis. 

In the late fifteenth century AD mercury was successfully used as a treatment for syphilis. In the late sixteenth century the development of the Patio process for the recovery of silver by amalgamation (see Silverand silveralloys) greatiy increased the consumption of mercury. Usage of mercury increased in 1643 when Torricelli invented the barometer, and again in 1720 when Fahrenheit invented the mercury thermometer. Other scientific and medical appHcations foUowed. Industrial usage after 1900, particularly in electrical appHcations, expanded rapidly, offsetting the sharp decline in its use in amalgamation. 

Bismuth compounds were once employed for the treatment of amoebic dysentery, certain skin diseases, and several spirochetal diseases besides syphilis, but these substances are now seldom considered the dmgs of choice. Various insoluble preparations of bismuth, especially the subcarbonate, subnitrate, subgaHate, subcitrate, and subsahcylate, are stiU employed for the treatment of ulcers and other gastrointestinal disorders, even though use for these purposes is often supported largely by tradition. With a few possible exceptions, it is now difficult to justify the presence of bismuth compounds in a modem therapeutic armamentarium. A review of the biological activity of organobismuth compounds has been pubHshed (179). 

Paracelsus, a Swiss physician of the sixteenth century, stated that everything is toxic, it is just the dose that matters. This statement still holds true 500 years after Paracelsus developed it to defend the use of toxic compounds such as lead and mercury in the treatment of serious diseases such as syphilis. Chemical compounds cause their toxic effects by inducing changes in cell physiology and biochemistry, and an understanding of cellular biology is a prerequisite if one wishes to understand the nature of toxic reactions. 

The natural and semi ynthetic penicillins are used in tire treatment of bacterial infections due to susceptible microorganisms. Fbnicillins may be used to treat infections such as urinary tract infections, septicemia, meningitis, intra-abdominal infection, gonorrhea, syphilis, pneumonia, and other respiratory infections. Examples of infectious microorganisms (bacteria) that may respond to penicillin therapy include gonococci, staphylococci,... 

The well-known adverse reaction formerly often observed after intramuscular injection of clemizol penicilUn in the treatment of syphilis with anaphylaxis-like symptoms plus CNS involvement in the absence of immimological sensitization to penicillin was called the Hoigne syndrome or embolic-toxic reaction, and might be explained by intravasal appUcation of LA with subsequent toxic effects [8]. 

Jarisch-Herxheimer reaction following treatment of syphilis, brucellosis, schistosomiasis, or trypanosomiasis... 

Penicillin desensitization is the most common drug desensitization protocol and is required for penicillin-allergic patients when penicillin is clearly the best treatment option, e.g., when syphilis is present in pregnancy. Protocols have been adapted to most antibiotics. Tables 51-5 and 51-6 describe procedures for oral and intravenous penicillin desensitization.25... 

Syphilis, caused by the spirochete Treponema pallidum, can have numerous and complex manifestations. Clinician familiarity, stage-specific diagnosis, and effective treatment are vital. Missed or inappropriately treated syphilis may result in cardiovascular complications, neurologic disease, or congenital syphilis. 

Secondary syphilis Without appropriate treatment, primary syphilis will advance to secondary syphilis, a stage usually apparent from its clinical symptomatology. Symptoms include fatigue, diffuse rash, fever, lymphadenopathy, and genital or perineal condyloma latum. Also, the skin is most often affected and a rash may present as macular, macropapular, or pustular lesions, or involve skin surfaces including the palms of the hands and soles of the feet. 

After confirming the diagnosis of syphilis, the desired outcome is a four-fold decrease in quantitative non-treponemal titers over a 6-month period and within 12 to 24 months after treatment of latent or late syphilis. An algorithm for the treatment of syphilis is shown in Fig. 77-1. 

Treatment modalities administered in primary syphilis are also effective in secondary syphilis and latent syphilis (less than 1 year duration). 

Maternal Syphilis After screening the mother, guidelines recommend that treatment decisions be based on ... 

In treatment of maternal syphilis, recommend the following regimens ... 

Order non-treponemal titers 6, 12, and 24 months after instituting treatment for early or late latent syphilis. 

Although the element is a metalloid, the long, brittle, crystals have a metallic shine. The white, tasteless oxide (arsenic trioxide As203) has been famous and notorious ("inheritance powder") even after centuries traces can be found in bodies. The arsenic compound "Salvarsan" was first used by Paul Ehrlich for the treatment of syphilis — the start of chemotherapy. Popular today as a semiconducting material. Component of LEDs (light-emitting diodes) and lasers. Arsenic hardens lead, used earlier in letter-press printing, today only for lead shot. 

Arsenic compounds have been used in medicine since the time of Hippocrates, ca. 400 BCE (Woolson 1975). Inorganic arsenicals have been used for centuries, and organoarsenicals for at least a century in the treatment of syphilis, yaws, amoebic dysentery, and trypanosomiasis (NAS... 

Treatment recommendations from the CDC for syphilis are presented in Table 46-6. Parenteral penicillin G is the treatment of choice for all stages of syphilis. Benzathine penicillin G is the only penicillin effective for single-dose therapy. 

For pregnant patients, penicillin is the treatment of choice at the dosage recommended for that particular stage of syphilis. To ensure treatment success and prevent transmission to the fetus, some experts advocate an additional intramuscular dose of benzathine penicillin G, 2.4 million units, 1 week after completion of the recommended regimen. 

The majority of patients treated for primary and secondary syphilis experience the Jarisch-Herxheimer reaction after treatment, characterized by flu-like symptoms such as transient headache, fever, chills, malaise, arthralgia, myalgia, tachypnea, peripheral vasodilation, and aggravation of syphilitic lesions. 

Study participation, treatment development based on, 8 Study populations, describing, 149 Subscriber agreements, 122 Succinylcholine, 60, 165, 168 Survey Questionnaire, General Population, 337-348 Susceptibility alleles, 52 Susceptibility genes, 44, 86 Susceptibility testing, 181, 306-307 Suter, Sonia, 17 Suxamethonium, 89, 139-140 Syphilis study, 68... 

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