Congenital syphilis: the University of Miami/Jackson Memorial Medical Center experience, 1986-1988

Article Abstract:

The sexually transmitted disease syphilis can cause severe complications when the disease is passed from the mother to her fetus (congenital syphilis). The introduction of antibiotic therapy in the 1950s decreased the incidence of syphilis. Recently, the Centers for Disease Control (CDC) reported a steady increase in congenital syphilis since 1986. About 80 percent of the cases of congenital syphilis are reported from California, Texas, New York, and Florida, with Florida having the highest rate of early syphilis. The incidence of congenital syphilis was studied in one Miami hospital servicing a primarily indigent population. Congenital syphilis was reported in 18.4 cases out of 10,000 births, three times higher than the rate from 1986 to 1988. The mothers of the 56 infants born with congenital syphilis were predominantly black (76 percent), substance abusers (71 percent), and generally did not seek prenatal care (67 percent). Of these, three cases were identified during blood tests performed during pregnancy and four patients were either not tested or were given the wrong treatment. Of the seven women diagnosed and treated for syphilis late in the pregnancy, five received penicillin G (for three weeks) and two were given erythromycin. Thirty-seven infants were born live (66 percent). It was more common for infected infants to be born following early rupture of the membranes surrounding the fetus, which is a known risk factor for infection. Infected infants had lower birth weights, with growth retardation diagnosed in 21 percent. Of the infected infants, 85 percent were born prematurely. A total number of 27 infants died from syphilis, 19 were stillborn and seven died during the newborn period. The mortality from congenital syphilis in this study was 464 deaths for every 1,000 pregnancies, which can be considered a high mortality rate. (Consumer Summary produced by Reliance Medical Information, Inc.)

Florida, Statistics, Disease transmission, Syphilis, Miami, Florida, Syphilis, Congenital, hereditary, and infantile, Congenital syphilis, Miami

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A 25-year experience with 519 anterior colporrhaphy procedures

Article Abstract:

Stress urinary incontinence is the involuntary leakage of urine following coughing, straining, or a sudden voluntary movement. For women, anterior colporrhaphy, the suturing of the of the vagina in the area of the bladder base, has been used to treat this problem. Studies have reported conflicting findings of the effectiveness of anterior colporrhaphy in treating stress urinary incontinence. This study examined the 25-year experiences of one group using two surgical techniques to treat stress urinary incontinence. During the 25-year period, 519 patients underwent anterior colporrhaphy. Of these, 194 patients suffered from genuine stress incontinence and the other patients suffered from mixed urinary stress incontinence. The technique was modified in 1977 to include vaginal retropubic urethropexy. For the 194 women with genuine stress incontinence, the original colporrhaphy technique resulted in cure in 75 percent of cases. This increased to 91 percent when the revised technique was initiated. Cure rate decreased significantly for those who had undergone previous incontinent surgical treatment. The technique was less successful in treating patients suffering from mixed incontinence. Overall, only 64 percent of these patients were cured by surgery. Significant complications resulting from this surgery were seen in only one percent of the patients. These findings suggest that anterior colporrhaphy with vaginal retropubic urethropexy is highly effective for treating genuine stress urinary incontinence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Urinary stress incontinence, Urethra, Urologic surgery

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Physical health status of World Trade Center rescue and recovery worker and volunteers

Article Abstract:

Few months after the attack on World Trade Center in 2001, September 11, health consequences of persons involved in the rescue and recovery team were exposed. Ten thousand personnelEs of Fire Department of New York (FDNY), and 30000 other workers and volunteers were found to suffer from numerous psychological stressors, environmental toxins and other physical hazards.

Risk factors, Stress (Psychology), Fire fighters, Firefighters, 2001 AD, World Trade Center and Pentagon Attacks, 2001

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