Biomedical subjects
Publications and source records attributed to N J Fiumara.
This article discusses genital ulcers caused by sexually transmitted diseases in female patients, and the etiology, morphology of the ulcerations, diagnostic work-up, and current treatment. The article also discusses patients with a vaginal discharge, laboratory work-up, diagnoses, and treatment.
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This article reviews gonorrhea and discusses various misconceptions that have appeared in the dental literature and in verbal presentations about gonorrhea and dentistry. Facts are presented and some conclusions are offered for the dental profession.
Eighty-eight patients with their first attack of primary syphilis and 101 patients with secondary syphilis were treated with penicillin G benzathine, 2.4 million units intramuscularly each week for 2 consecutive weeks, for a total of 4.8 million units. The serum of all patients with primary syphilis became negative within 1 year and of those in the secondary stage, within 2 years. This report confirms three previously published articles on the serologic response to treatment in a grand total of 588 patients with primary syphilis and 623 patients in the secondary stage.
Chancroid, a disappearing disease in the United States, was reintroduced into the country in 1980 by immigrants from the Caribbean, Mexico, and Southeast Asia. Point epidemics resulted, each of them associated with prostitution. During the 4-month period between March 1 to June 30, 1985, forty-five patients were diagnosed and treated in Massachusetts, thirty-seven from Boston alone. By means of these case records, the morphologic characteristics, laboratory diagnosis, and treatment regimens are described.
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In 1982, 1,871 (79%) of 2,368 eligible 6th, 10th and 12th grade students in Massachusetts participated in a statewide serosurvey for rubella antibodies. Sera were screened at the Centers for Disease Control (CDC) by a reference hemagglutination inhibition assay at 1:8, equivalent to approximately 15 International Units (IU)/ml. Sera negative by the CDC hemagglutination inhibition assay were retested using an enzyme immunoassay, a passive hemagglutination assay, and a commercial hemagglutination inhibition test. The approximate screening levels were 10 IU/ml, 7.5 IU/ml, and 5 IU/ml, respectively. Overall seroprevalence levels varied from 76.4% screening at 15 IU to 93.1% including seropositives from any of the tests. Persons with a school record of vaccination had significantly higher seroprevalence levels than persons without records. However, only 78.3% of persons with a record had antibody greater than or equal to 15 IU compared with 60.0% without records; considering any detectable antibody, the comparison is 95.6% versus 71.4%. The low titers in vaccinees appeared to be due to a falloff of antibody with time since vaccination. Of students with a single vaccination noted in the record with exact dates, 92.3% who were vaccinated 0-4 years prior to the study had antibody at 15 IU compared with less than 78% of students with antibody who were vaccinated five or more years prior to the study. In contrast, using more sensitive assays, there was no significant decline in seroprevalence with time since vaccination. Revaccination studies and epidemiologic data suggest that almost all persons with detectable antibody whether above or below 15 IU/ml are immune to rubella. Thus, immunity levels in Massachusetts schoolchildren in the 6th, 10th, and 12th grades are probably in excess of 90%.
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Explore the source record for details and available documents.
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A total of 4.8 million u of benzathine penicillin G was used to treat 500 patients with their first attack of primary syphilis and 522 with secondary syphilis. All patients with primary syphilis became seronegative within one year, and those with secondary syphilis within two years. The physician now has an objective norm in evaluating the effect of treatment in patients with their first attack of primary or secondary syphilis.
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A 42-year-old patient with an ulcerative left tonsil that was not particularly painful was examined. The routine blood test for syphilis was reactive. The patient was found to have a chancre of the left tonsil. Painless ulcers of the left tonsil in a sexually active individual should be considered as possibly syphilitic.