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[PMID]:28631307
[Au] Autor:Dalal A; Eskin-Schwartz M; Mimouni D; Ray S; Days W; Hodak E; Leibovici L; Paul M
[Ad] Endereço:Department of Dermatology, Beilinson Hospital, Rabin Medical Center, 39 Jabotinski Street, Petah Tikva, Israel, 49100.
[Ti] Título:Interventions for the prevention of recurrent erysipelas and cellulitis.
[So] Source:Cochrane Database Syst Rev;6:CD009758, 2017 06 20.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Erysipelas and cellulitis (hereafter referred to as 'cellulitis') are common bacterial skin infections usually affecting the lower extremities. Despite their burden of morbidity, the evidence for different prevention strategies is unclear. OBJECTIVES: To assess the beneficial and adverse effects of antibiotic prophylaxis or other prophylactic interventions for the prevention of recurrent episodes of cellulitis in adults aged over 16. SEARCH METHODS: We searched the following databases up to June 2016: the Cochrane Skin Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and LILACS. We also searched five trials registry databases, and checked reference lists of included studies and reviews for further references to relevant randomised controlled trials (RCTs). We searched two sets of dermatology conference proceedings, and BIOSIS Previews. SELECTION CRITERIA: Randomised controlled trials evaluating any therapy for the prevention of recurrent cellulitis. DATA COLLECTION AND ANALYSIS: Two authors independently carried out study selection, data extraction, assessment of risks of bias, and analyses. Our primary prespecified outcome was recurrence of cellulitis when on treatment and after treatment. Our secondary outcomes included incidence rate, time to next episode, hospitalisation, quality of life, development of resistance to antibiotics, adverse reactions and mortality. MAIN RESULTS: We included six trials, with a total of 573 evaluable participants, who were aged on average between 50 and 70. There were few previous episodes of cellulitis in those recruited to the trials, ranging between one and four episodes per study.Five of the six included trials assessed prevention with antibiotics in participants with cellulitis of the legs, and one assessed selenium in participants with cellulitis of the arms. Among the studies assessing antibiotics, one study evaluated oral erythromycin (n = 32) and four studies assessed penicillin (n = 481). Treatment duration varied from six to 18 months, and two studies continued to follow up participants after discontinuation of prophylaxis, with a follow-up period of up to one and a half to two years. Four studies were single-centre, and two were multicentre; they were conducted in five countries: the UK, Sweden, Tunisia, Israel, and Austria.Based on five trials, antibiotic prophylaxis (at the end of the treatment phase ('on prophylaxis')) decreased the risk of cellulitis recurrence by 69%, compared to no treatment or placebo (risk ratio (RR) 0.31, 95% confidence interval (CI) 0.13 to 0.72; n = 513; P = 0.007), number needed to treat for an additional beneficial outcome (NNTB) six, (95% CI 5 to 15), and we rated the certainty of evidence for this outcome as moderate.Under prophylactic treatment and compared to no treatment or placebo, antibiotic prophylaxis reduced the incidence rate of cellulitis by 56% (RR 0.44, 95% CI 0.22 to 0.89; four studies; n = 473; P value = 0.02; moderate-certainty evidence) and significantly decreased the rate until the next episode of cellulitis (hazard ratio (HR) 0.51, 95% CI 0.34 to 0.78; three studies; n = 437; P = 0.002; moderate-certainty evidence).The protective effects of antibiotic did not last after prophylaxis had been stopped ('post-prophylaxis') for risk of cellulitis recurrence (RR 0.88, 95% CI 0.59 to 1.31; two studies; n = 287; P = 0.52), incidence rate of cellulitis (RR 0.94, 95% CI 0.65 to 1.36; two studies; n = 287; P = 0.74), and rate until next episode of cellulitis (HR 0.78, 95% CI 0.39 to 1.56; two studies; n = 287). Evidence was of low certainty.Effects are relevant mainly for people after at least two episodes of leg cellulitis occurring within a period up to three years.We found no significant differences in adverse effects or hospitalisation between antibiotic and no treatment or placebo; for adverse effects: RR 0.87, 95% CI 0.58 to 1.30; four studies; n = 469; P = 0.48; for hospitalisation: RR 0.77, 95% CI 0.37 to 1.57; three studies; n = 429; P = 0.47, with certainty of evidence rated low for these outcomes. The existing data did not allow us to fully explore its impact on length of hospital stay.The common adverse reactions were gastrointestinal symptoms, mainly nausea and diarrhoea; rash (severe cutaneous adverse reactions were not reported); and thrush. Three studies reported adverse effects that led to discontinuation of the assigned therapy. In one study (erythromycin), three participants reported abdominal pain and nausea, so their treatment was changed to penicillin. In another study, two participants treated with penicillin withdrew from treatment due to diarrhoea or nausea. In one study, around 10% of participants stopped treatment due to pain at the injection site (the active treatment group was given intramuscular injections of benzathine penicillin).None of the included studies assessed the development of antimicrobial resistance or quality-of-life measures.With regard to the risks of bias, two included studies were at low risk of bias and we judged three others as being at high risk of bias, mainly due to lack of blinding. AUTHORS' CONCLUSIONS: In terms of recurrence, incidence, and time to next episode, antibiotic is probably an effective preventive treatment for recurrent cellulitis of the lower limbs in those under prophylactic treatment, compared with placebo or no treatment (moderate-certainty evidence). However, these preventive effects of antibiotics appear to diminish after they are discontinued (low-certainty evidence). Treatment with antibiotic does not trigger any serious adverse events, and those associated are minor, such as nausea and rash (low-certainty evidence). The evidence is limited to people with at least two past episodes of leg cellulitis within a time frame of up to three years, and none of the studies investigated other common interventions such as lymphoedema reduction methods or proper skin care. Larger, high-quality studies are warranted, including long-term follow-up and other prophylactic measures.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antibioticoprofilaxia
Celulite (Flegmão)/prevenção & controle
Erisipela/prevenção & controle
Prevenção Secundária/métodos
Selênio/uso terapêutico
[Mh] Termos MeSH secundário: Idoso
Antibacterianos/efeitos adversos
Antibioticoprofilaxia/efeitos adversos
Braço
Eritromicina/efeitos adversos
Eritromicina/uso terapêutico
Hospitalização/estatística & dados numéricos
Seres Humanos
Dermatoses da Perna/prevenção & controle
Meia-Idade
Penicilina G Benzatina/efeitos adversos
Penicilina G Benzatina/uso terapêutico
Penicilina V/efeitos adversos
Penicilina V/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Recidiva
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 63937KV33D (Erythromycin); H6241UJ22B (Selenium); RIT82F58GK (Penicillin G Benzathine); Z61I075U2W (Penicillin V)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170901
[Lr] Data última revisão:
170901
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170621
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD009758.pub2


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[PMID]:28617789
[Au] Autor:Culliford-Semmens N; Tilton E; Webb R; Lennon D; Paku B; Malcolm J; French S; Blair N; Wilson N
[Ad] Endereço:Research Fellow, Green Lane Paediatric and Congenital Cardiac Services, Starship Children's Hospital, Auckland.
[Ti] Título:Adequate adherence to benzathine penicillin secondary prophylaxis following the diagnosis of rheumatic heart disease by echocardiographic screening.
[So] Source:N Z Med J;130(1457):50-57, 2017 Jun 16.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:AIMS: The primary aim of this study was to determine adherence to benzathine penicillin (BPG) for individuals diagnosed with rheumatic heart disease (RHD) by echocardiographic screening between 2007-2012. METHODS: BPG records were obtained for 57 patients, median age 12 at time of diagnosis. A 'days at risk' analysis was undertaken. Annual adherence was calculated for each individual. A comparison with the Wellington region's Rheumatic Fever 2013 adherence data was undertaken. RESULTS: Adherence to BPG was good with a median follow-up time of 5.8 years. Days at risk analysis: median 0% at year one and 2.7% at year five. The median adherence for the entire cohort over the entire follow-up period was 92%, range 0-100%. There was no difference of proportions of late doses compared to the Wellington region. Median adherence was higher for register based (94%, n=48) compared to primary health care penicillin delivery (37%, n=7), p<0.005. During follow-up, 30% of the cohort moved between regions or overseas. CONCLUSIONS: Good adherence rates are achievable for secondary prophylaxis when RHD is diagnosed by echocardiographic screening. This likely reflects the benefit of rheumatic fever registers and community nursing services rather than the pathway of the diagnosis for RHD.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Adesão à Medicação/estatística & dados numéricos
Penicilina G Benzatina/uso terapêutico
Cardiopatia Reumática/diagnóstico por imagem
Prevenção Secundária/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Ecocardiografia
Feminino
Seguimentos
Seres Humanos
Masculino
Programas de Rastreamento
Nova Zelândia
Atenção Primária à Saúde
Sistema de Registros
Cardiopatia Reumática/tratamento farmacológico
Medição de Risco
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170720
[Lr] Data última revisão:
170720
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE


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[PMID]:28554544
[Au] Autor:Joseph J; Kent N; Bowen A; Hart J; Sheel M; Wardrop R; Abbs S; Bazely S; Rybak M
[Ad] Endereço:PathWest Laboratory Medicine, QE2 Medical Centre Redevelopment, Australia. Electronic address: john.joseph@health.wa.gov.au.
[Ti] Título:Immuno-nephelometric determination of group streptococcal anti-streptolysin O titres (ASOT) from dried blood spots: Method for validating a new assay.
[So] Source:J Immunol Methods;448:59-65, 2017 Sep.
[Is] ISSN:1872-7905
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:This study was designed to determine the sensitivity and reproducibility of recovering anti-streptolysin O titres (ASOT) from dried blood spot (DBS) samples, a methodologic subcomponent of the penicillin pharmacokinetic studies in children receiving secondary prophylaxis with intramuscular benzathine penicillin for acute rheumatic fever.
[Mh] Termos MeSH primário: Antiestreptolisina/sangue
Teste em Amostras de Sangue Seco
Testes Imunológicos/métodos
Febre Reumática/diagnóstico
Estreptolisinas/imunologia
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Antibacterianos/farmacocinética
Proteínas de Bactérias/imunologia
Biomarcadores/sangue
Calibragem
Desenho de Equipamento
Estudos de Viabilidade
Seres Humanos
Testes Imunológicos/instrumentação
Testes Imunológicos/normas
Injeções Intramusculares
Nefelometria e Turbidimetria
Penicilina G Benzatina/administração & dosagem
Penicilina G Benzatina/farmacocinética
Valor Preditivo dos Testes
Padrões de Referência
Reprodutibilidade dos Testes
Febre Reumática/sangue
Febre Reumática/tratamento farmacológico
Febre Reumática/microbiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VALIDATION STUDIES
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Bacterial Proteins); 0 (Biomarkers); 0 (Streptolysins); 0 (streptolysin O); 9006-92-2 (Antistreptolysin); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE


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[PMID]:28418316
[Au] Autor:Katanami Y; Hashimoto T; Takaya S; Yamamoto K; Kutsuna S; Takeshita N; Hayakawa K; Kanagawa S; Ohmagari N
[Ti] Título:Amoxicillin and Ceftriaxone as Treatment Alternatives to Penicillin for Maternal Syphilis.
[So] Source:Emerg Infect Dis;23(5):827-829, 2017 05.
[Is] ISSN:1080-6059
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:There is no proven alternative to penicillin for treatment of maternal syphilis. We report 2 case-patients with maternal syphilis who were successfully treated without penicillin. We used amoxicillin and probenecid for the first case-patient and amoxicillin, probenecid, and ceftriaxone for the second case-patient.
[Mh] Termos MeSH primário: Amoxicilina/uso terapêutico
Antibacterianos/uso terapêutico
Ceftriaxona/uso terapêutico
Complicações Infecciosas na Gravidez/tratamento farmacológico
Complicações Infecciosas na Gravidez/microbiologia
Sífilis/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Substituição de Medicamentos
Feminino
Seres Humanos
Recém-Nascido
Penicilina G Benzatina/uso terapêutico
Penicilinas/uso terapêutico
Gravidez
Complicações Infecciosas na Gravidez/diagnóstico
Resultado da Gravidez
Sífilis/diagnóstico
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Penicillins); 75J73V1629 (Ceftriaxone); 804826J2HU (Amoxicillin); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.3201/eid2305.161936


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[PMID]:28200045
[Au] Autor:Andrade R; Rodriguez-Barradas MC; Yasukawa K; Villarreal E; Ross M; Serpa JA
[Ad] Endereço:Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
[Ti] Título:Single Dose Versus 3 Doses of Intramuscular Benzathine Penicillin for Early Syphilis in HIV: A Randomized Clinical Trial.
[So] Source:Clin Infect Dis;64(6):759-764, 2017 03 15.
[Is] ISSN:1537-6591
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Patients coinfected with syphilis and human immunodeficiency virus (HIV) may have a slower decrease in rapid plasma reagin (RPR) titers. Currently a single dose of 2.4 million units of intramuscular benzathine penicillin G (BPG) is recommended for the treatment of early syphilis. Some observational studies have suggested that this regimen may lead to high failure rates in coinfected patients. Methods: We conducted an open-label randomized clinical trial to compare the efficacy of single-dose and 3-dose regimens of BPG for the treatment of early syphilis in HIV-infected individuals. RPR titers were monitored every 3 months. Treatment success was defined as a decrease in RPR titers of ≥2 dilutions (4-fold) during a 12-month follow-up period. Results: Sixty-four patients were included. In the intention-to-treat analysis, treatment success rates were 80% (28 of 35 subjects) and 93% (27 of 29 subjects) in the single-dose and 3-dose regimens, respectively (absolute difference, 13% [95% confidence interval {CI}, -5% to 30%; P = .17). In the per-protocol analysis, success rates were 93% (27 of 29) and 100% in the single-dose and 3-dose regimens, respectively (absolute difference, 7% [95% CI, -7% to 22%]; P = .49). CD4 T-cell count, RPR titer and syphilis stage did not affect treatment results. Conclusions: When compared with a single dose of BPG, a 3-dose regimen did not improve syphilis serological outcomes. Our results support the Centers for Disease Control and Prevention recommendation of a single dose of BPG in HIV-infected patients with early syphilis. Clinical Trials Registration: NCT02611765.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Infecções por HIV/complicações
Penicilina G Benzatina/administração & dosagem
Sífilis/tratamento farmacológico
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Injeções Intramusculares
Estudos Longitudinais
Masculino
Meia-Idade
Estudos Prospectivos
Reaginas/sangue
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Reagins); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170727
[Lr] Data última revisão:
170727
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170216
[St] Status:MEDLINE
[do] DOI:10.1093/cid/ciw862


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[PMID]:28072863
[Au] Autor:Kwakye-Maclean C; Agana N; Gyapong J; Nortey P; Adu-Sarkodie Y; Aryee E; Asiedu K; Ballard R; Binka F
[Ad] Endereço:Ga West Municipal Health Administrations, Ghana Health Service, Amasaman, Ghana.
[Ti] Título:A Single Dose Oral Azithromycin versus Intramuscular Benzathine Penicillin for the Treatment of Yaws-A Randomized Non Inferiority Trial in Ghana.
[So] Source:PLoS Negl Trop Dis;11(1):e0005154, 2017 Jan.
[Is] ISSN:1935-2735
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Yaws is a treponemal infection that was almost eradicated fifty years ago; however, the disease has re-emerged in a number of countries including Ghana. A single-dose of intramuscular benzathine penicillin has been the mainstay of treatment for yaws. However, intramuscular injections are painful and pose safety and logistical constraints in the poor areas where yaws occurs. A single center randomized control trial (RCT) carried out in Papua New Guinea in 2012 demonstrated the efficacy of a single-dose of oral azithromycin for the treatment of yaws. In this study, we also compared the efficacy of a single oral dose of azithromycin as an alternative to intramuscular benzathine penicillin for the treatment of the disease in another geographic setting. METHODOLOGY: We conducted an open-label, randomized non-inferiority trial in three neighboring yaws-endemic districts in Southern Ghana. Children aged 1-15 years with yaws lesions were assigned to receive either 30mg/kg of oral azithromycin or 50,000 units/kg of intramuscular benzathine penicillin. The primary end point was clinical cure rate, defined as a complete or partial resolution of lesions 3 weeks after treatment. The secondary endpoint was serological cure, defined as at least a 4-fold decline in baseline RPR titre 6 months after treatment. Non- inferiority of azithromycin treatment was determined if the upper bound limit of a 2 sided 95% CI was less than 10%. FINDINGS: The mean age of participants was 9.5 years (S.D.3.1, range: 1-15 years), 247(70%) were males. The clinical cure rates were 98.2% (95% CI: 96.2-100) in the azithromycin group and 96.9% (95% CI: 94.1-99.6) in the benzathine penicillin group. The serological cure rates at 6 months were 57.4% (95% CI: 49.9-64.9) in the azithromycin group and 49.1% (95% CI: 41.2-56.9) in the benzathine penicillin group, thus achieving the specified criteria for non-inferiority. CONCLUSIONS: A single oral dose of azithromycin, at a dosage of 30mg/kg, was non-inferior to a single dose of intramuscular benzathine penicillin for the treatment of early yaws among Ghanaian patients, and provides additional support for the WHO policy for use of oral azithromycin for the eradication of yaws in resource-poor settings. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR2013030005181 http://www.pactr.org/.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Azitromicina/administração & dosagem
Penicilina G Benzatina/administração & dosagem
Bouba/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Oral
Adolescente
Antibacterianos/efeitos adversos
Azitromicina/efeitos adversos
Criança
Pré-Escolar
Feminino
Gana
Seres Humanos
Lactente
Injeções Intramusculares
Masculino
Penicilina G Benzatina/efeitos adversos
Resultado do Tratamento
Treponema pallidum
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 83905-01-5 (Azithromycin); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170111
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0005154


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[PMID]:28061759
[Au] Autor:Okello E; Longenecker CT; Beaton A; Kamya MR; Lwabi P
[Ad] Endereço:Uganda Heart Institute, Kampala, Uganda. emmkol@hotmail.com.
[Ti] Título:Rheumatic heart disease in Uganda: predictors of morbidity and mortality one year after presentation.
[So] Source:BMC Cardiovasc Disord;17(1):20, 2017 Jan 07.
[Is] ISSN:1471-2261
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Rheumatic heart disease (RHD), the long-term consequence of rheumatic fever, accounts for most cardiovascular morbidity and mortality among young adults in developing countries. However, data on contemporary outcomes from resource constrained areas are limited. METHODS: A prospective cohort study of participants aged 5-60 years with established RHD was conducted in Kampala, Uganda, in which clinical exam, echocardiography, electrocardiography (ECG), and laboratory evaluation were done every 3 months and every 4-week benzathine penicillin prophylaxis was prescribed. Participants were followed up for 12 months and outcomes and predictors of morbidity and mortality were assessed using Kaplan Meier curves and Cox proportional hazards models. RESULTS: Of 449 subjects, 66.8% (300/449) were females, median age was 30 (interquartile range 20). 73.7% (331/449) had atleast one follow up visit. Among these, 35% (116/331) developed decompensated heart failure and, 63.7% (211/331) developed atrial fibrillation. Heart failure was associated with poor penicillin adherence (OR = 3.3, CI 2-5.4, p = 0.001), and left ventricular end diastolic diameter greater than 55 mm (OR = 3.16, CI 1.73-5.76, p = 0.001). Atrial fibrillation was associated with left atrial diameter >40 mm (OR = 7.5, CI 2.4-9.8, p = 0.001). There were 59 deaths with a 1-year mortality rate of 17.8%. Most deaths occurred within the first three months of presentation. Subjects whose average adherence to benzathine penicillin was <80% had significantly greater mortality (31% vs. 9%, log rank p < 0.001). In multivariate analysis, the risk of death among those with poor penicillin adherence was 3.81 times higher than those with better adherence (HR = 3.81, CI 1.92-7.63, p = 0.001). Other predictors of 1 year mortality included heart failure (HR 8.36, CI 3.28-21.31, p = 0.001) and left ventricular end diastolic diameter greater than 55 mm (HR = 1.93, CI 1.07-3.49, p = 0.02). CONCLUSION: In this study of RHD in Uganda, morbidity and mortality within 1 year of presentation were higher than in recently published from other low and middle income countries. Suboptimal adherence to benzathine penicillin injections was associated with incident heart failure and mortality over 1 year. Future studies should test interventions to improve adherence among patients with advanced disease who are at the highest risk of mortality.
[Mh] Termos MeSH primário: Fibrilação Atrial/mortalidade
Países em Desenvolvimento
Insuficiência Cardíaca/mortalidade
Cardiopatia Reumática/mortalidade
[Mh] Termos MeSH secundário: Adolescente
Adulto
Antibacterianos/administração & dosagem
Fibrilação Atrial/diagnóstico
Fibrilação Atrial/terapia
Distribuição de Qui-Quadrado
Criança
Pré-Escolar
Esquema de Medicação
Feminino
Insuficiência Cardíaca/diagnóstico
Insuficiência Cardíaca/terapia
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Adesão à Medicação
Meia-Idade
Análise Multivariada
Razão de Chances
Penicilina G Benzatina/administração & dosagem
Valor Preditivo dos Testes
Prognóstico
Modelos de Riscos Proporcionais
Estudos Prospectivos
Cardiopatia Reumática/diagnóstico
Cardiopatia Reumática/terapia
Medição de Risco
Fatores de Risco
Fatores de Tempo
Uganda/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170108
[St] Status:MEDLINE
[do] DOI:10.1186/s12872-016-0451-8


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[PMID]:27956203
[Au] Autor:Rac MW; Revell PA; Eppes CS
[Ad] Endereço:Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX. Electronic address: Martha.Rac@bcm.edu.
[Ti] Título:Syphilis during pregnancy: a preventable threat to maternal-fetal health.
[So] Source:Am J Obstet Gynecol;216(4):352-363, 2017 Apr.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Syphilis remains the most common congenital infection worldwide and has tremendous consequences for the mother and her developing fetus if left untreated. Recently, there has been an increase in the number of congenital syphilis cases in the United States. Thus, recognition and appropriate treatment of reproductive-age women must be a priority. Testing should be performed at initiation of prenatal care and twice during the third trimester in high-risk patients. There are 2 diagnostic algorithms available and physicians should be aware of which algorithm is utilized by their testing laboratory. Women testing positive for syphilis should undergo a history and physical exam as well as testing for other sexually transmitted infections, including HIV. Serofast syphilis can occur in patients with previous adequate treatment but persistent low nontreponemal titers (<1:8). Syphilis can infect the fetus in all stages of the disease regardless of trimester and can sometimes be detected with ultrasound >20 weeks. The most common findings include hepatomegaly and placentomegaly, but also elevated peak systolic velocity in the middle cerebral artery (indicative of fetal anemia), ascites, and hydrops fetalis. Pregnancies with ultrasound abnormalities are at higher risk of compromise during syphilotherapy as well as fetal treatment failure. Thus, we recommend a pretreatment ultrasound in viable pregnancies when feasible. The only recommended treatment during pregnancy is benzathine penicillin G and it should be administered according to maternal stage of infection per Centers for Disease Control and Prevention guidelines. Women with a penicillin allergy should be desensitized and then treated with penicillin appropriate for their stage of syphilis. The Jarisch-Herxheimer reaction occurs in up to 44% of gravidas and can cause contractions, fetal heart rate abnormalities, and even stillbirth in the most severely affected pregnancies. We recommend all viable pregnancies receive the first dose of benzathine penicillin G in a labor and delivery department under continuous fetal monitoring for at least 24 hours. Thereafter, the remaining benzathine penicillin G doses can be given in an outpatient setting. The rate of maternal titer decline is not tied to pregnancy outcomes. Therefore, after adequate syphilotherapy, maternal titers should be checked monthly to ensure they are not increasing four-fold, as this may indicate reinfection or treatment failure.
[Mh] Termos MeSH primário: Complicações Infecciosas na Gravidez/diagnóstico
Sífilis Congênita/prevenção & controle
Sífilis/diagnóstico
[Mh] Termos MeSH secundário: Algoritmos
Anemia/etiologia
Antibacterianos/uso terapêutico
Ascite/diagnóstico por imagem
Feminino
Hepatomegalia/diagnóstico por imagem
Seres Humanos
Hidropisia Fetal/diagnóstico por imagem
Penicilina G Benzatina/uso terapêutico
Doenças Placentárias/diagnóstico por imagem
Poli-Hidrâmnios/diagnóstico por imagem
Gravidez
Complicações Infecciosas na Gravidez/tratamento farmacológico
Complicações Infecciosas na Gravidez/epidemiologia
Sífilis/tratamento farmacológico
Sífilis/epidemiologia
Sífilis Congênita/diagnóstico por imagem
Ultrassonografia Pré-Natal
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161214
[St] Status:MEDLINE


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[PMID]:27679405
[Au] Autor:Liu Z; Wang L; Zhang G; Long H
[Ad] Endereço:Department of Stomatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
[Ti] Título:Warty mucosal lesions: Oral condyloma lata of secondary syphilis.
[So] Source:Indian J Dermatol Venereol Leprol;83(2):277, 2017 Mar-Apr.
[Is] ISSN:0973-3922
[Cp] País de publicação:India
[La] Idioma:eng
[Mh] Termos MeSH primário: Mucosa Bucal/patologia
Sífilis/complicações
Sífilis/diagnóstico
Verrugas/diagnóstico
Verrugas/etiologia
[Mh] Termos MeSH secundário: Adulto
Seres Humanos
Masculino
Mucosa Bucal/efeitos dos fármacos
Penicilina G Benzatina/farmacologia
Penicilina G Benzatina/uso terapêutico
Sífilis/tratamento farmacológico
Verrugas/tratamento farmacológico
[Pt] Tipo de publicação:CASE REPORTS; LETTER
[Nm] Nome de substância:
RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170606
[Lr] Data última revisão:
170606
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160929
[St] Status:MEDLINE
[do] DOI:10.4103/0378-6323.191129


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[PMID]:28033297
[Au] Autor:Shao LL; Guo R; Shi WJ; Liu YJ; Feng B; Han L; Liu QZ
[Ad] Endereço:Department of Dermatovenereology, Tianjin Medical University General Hospital, Tianjin, China.
[Ti] Título:Could lengthening minocycline therapy better treat early syphilis?
[So] Source:Medicine (Baltimore);95(52):e5773, 2016 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Syphilis is a sexually transmitted disease caused by Treponema pallidum. Minocycline, a representative tetracycline derivative, has the greatest antimicrobial activity among all tetracyclines. There are few reports about treating syphilis with minocycline because there is a lack of efficacy data from controlled trials. We compared the rates of serological cure in patients with early syphilis who were treated with minocycline or benzathine penicillin G (BPG).During the study period, a total of 40 syphilis patients received the BPG treatment, which was a single intramuscular dose of 2.4 million units of BPG, and 156 patients were treated with minocycline; 77 patients were placed in the 2-week, standard minocycline therapy group and received 100 mg of minocycline orally, twice daily for 14 days, and 79 patients were placed in the 4-week, lengthened minocycline therapy group and received 100 mg of minocycline orally, twice daily for 28 days. The outcome of interest was the rate of serological cure in these patients.At the end of the 2-year follow-up, the serological cure rate of the 4-week, lengthened minocycline therapy group (87.34%) was higher than that of both the 2-week, standard minocycline therapy group (72.73%) and the BPG treatment group (77.50%). In addition, the curative effect of the 4-week, lengthened minocycline therapy was significantly greater than that of the 2-week, standard minocycline therapy in patients who were aged >40 years; exhibited an initial rapid plasma reagin titer ≥1: 32; or exhibited secondary syphilis (P = 0.000, 0.008, 0.000; <0.05).Minocycline appears to be an effective agent for treating early syphilis, especially when applied as a 4-week, lengthened therapy.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Minociclina/administração & dosagem
Sífilis/tratamento farmacológico
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Esquema de Medicação
Feminino
Seres Humanos
Masculino
Meia-Idade
Penicilina G Benzatina/uso terapêutico
Reaginas/sangue
Estudos Retrospectivos
Sífilis/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Reagins); FYY3R43WGO (Minocycline); RIT82F58GK (Penicillin G Benzathine)
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170224
[Lr] Data última revisão:
170224
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161230
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000005773



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