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Archive for March 27th, 2009

The best treatment for syphilis is still one of the oldest antibiotics: penicillin. For the treatment of syphilis, penicillin must be given as an injection, not as an oral dose. The dosage and duration of treatment depend on the stage of the infection. For primary, secondary, and early latent syphilis, a single dose of penicillin usually eliminates the infection. Some people develop fever, chills, muscle aches, headache, and a worsening of the chancre or rash about eight hours after the shot; this reaction, called the Jarisch-Herxheimei reaction, is probably due to the rapid killing of the bacteria. It is temporary, usually resolving within twenty-four hours, and it does not lead to permanent problems. It is not an allergic reaction to penicillin.

In a person who has late latent syphilis or syphilis of unknown duration, injections are given weekly for three consecutive weeks. A person who develops neurosyphilis must be hospitalized and receive intravenous penicillin for ten to fourteen days.

To determine if treatment has been successful, follow-up visits for a VDRL or RPR test are essential. If the treatment was successful, then the test result will be lower than it was previously. If treatment has not been successful, it may be because the infection has involved the nervous system; as already indicated, neurosyphilis is treatable but requires a longer course of therapy as well as hospitalization for the administration of intravenous antibiotics.

People who are allergic to penicillin may be treated with other medications, such as doxycycline and tetracycline, if they have primary or secondary syphilis. However, in pregnant women the only recommended regimen is penicillin. The treatment may not be as effective in people infected with HIV as in those not infected, and for this reason close monitoring and follow-up testing are essential in HIV-positive persons.

The treatment for congenital syphilis (the infection of a newborn infant) must be coordinated with a specialist. The antibiotic used to treat children is also penicillin, and the course of treatment depends on the stage at which the child is diagnosed.

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A large body of medical research supports the role of a nutritious diet in keeping the immune system strong. The immune system is a complex network of cells, organs, and tissues that defend the body against infections. Malnourishment weakens it and renders the body more susceptible to viral, bacterial, and parasitic infections.

There has been much discussion about the relationship between diet (and specifically the amino acids L-lysine and arginine) and the frequency and severity of herpes outbreaks. L-lysine is an amino acid found in eggs, meat, and milk as well as other foods. In laboratory settings, it shows potent antiviral properties, but studies of its effectiveness in controlling and treating herpes outbreaks have had mixed results, and L-lysine is at this time not generally thought to be effective for the treatment of herpes simplex infections.

In the late 1970s, studies showed that L-lysine suppressed recurrent infection and hastened recovery from infection when taken in doses of 800-1200 mg per day. However, these studies were not scientifically valid: they were performed with small numbers of subjects, and the results may have been due to a placebo effect. Many earlier studies of L-lysine were similarly flawed, and the question of whether or not the amino acid really works has not yet been satisfactorily answered. Many people believe that taking L-lysine supplements (found in most health food stores) or eating foods rich in L-lysine helps them manage their herpes better. No harmful side effects have been noted with its use, although, once again, there have not been enough scientifically valid long-term studies.

Some researchers believe that the amino acid arginine stimulates the growth of the virus and that the reason lysine works is that it blocks the metabolism of arginine. On the other hand, arginine supplementation has been proven to boost the body’s ability to fight off bacterial infections in burn patients and people who have undergone surgery. In many of the studies of L-lysine, arginine intake was not monitored, and this may be why the various studies have yielded conflicting results.

Some foods, such as nuts and chocolate, that many people associate with herpes outbreaks are high in arginine. For certain people, caffeine, alcohol, and smoking are additional triggers for outbreaks. If you find that a specific food stimulates outbreaks, by all means limit your intake of it.

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of which treatment procedure is used, follow-up treatments are often necessary to get rid of a wart completely, depending on its size when first treated and its location. Talk with your provider about which treatment would be best for you.

If warts do not respond after several attempts at treatment, then the diagnosis should be reconsidered. Warts that are unusual looking should be biopsied to rule out the possibility of cancer.

Finally, two treatments are not recommended. The injection of the medication alpha-interferon into the base of the wart is a painful treatment for warts and usually does not produce better results than the procedures previously described. It is not recommended for the treatment of warts and is unsafe during pregnancy. Similarly, topical treatment with 5-fluorouracil cream is not recommended at this time, although clinical trials are under way that may ultimately prove the usefulness of this treatment.

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Check the expiration date on the package before use. If the expiration date has passed, making the condom more vulnerable to breaking, use a newer condom instead.

Condoms should be completely unrolled onto the erect penis, otherwise they may fall off during the sex act. This is a common cause of condom failure. Men who are not circumcised should pull back the foreskin before putting on the condom. Leave a small space at the tip of the condom as a reservoir for semen. Some condoms have a built-in reservoir.

Make sure there is no air trapped inside the condom, since air inside the condom is another common cause of condom breakage and failure.

Make sure there is enough lubrication, since dryness may increase the risk of the condom breaking. It you are using a latex condom, then make sure you do not use an oil-based lubricant, since, as mentioned earlier, this can cause the condom to break. Liberally apply the lubricant to the outside of the condom and onto your partner’s genital or anal area before insertion; this will help ease penetration and therefore help decrease the chances of breakage. If you use a spermicide as a lubricant, it may offer additional protection against both pregnancy and the spread of STDs if the condom slips or leaks.

Be careful opening the condom package so that you do not accidentally break the condom. Do not use your fingernails or teeth or nail clippers to open the condom package.

If the condom breaks during intercourse, withdraw the penis and apply some spermicide, and continue with a new condom if desired. Consider being tested for STDs if your partner has not been tested.

Use a new condom with every act of intercourse. This may seem like common sense, but it’s worth emphasizing. A used condom has semen on the outside of the condom that could cause infection or pregnancy. Throw used condoms away.

Hold the condom firmly at the base of the penis during withdrawal to prevent it from falling off, and withdraw the penis with the condom while the penis is still erect. It you wait to withdraw the penis until after the erection is gone, there is a higher risk that the condom will fall off.

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Lymph nodes are found in the groin at the juncture of the leg and the body, as well as in other areas of the body, such as the neck and the armpits. They are part of the lymphatic system, through which circulate cells of the immune system that are important in fighting off infection and cancer. Basically any infection in the genital area can result in swelling of the lymph nodes in the groin. Once lymph nodes swell, they usually do not return to their normal size. Swollen lymph nodes are usually rubbery in texture and do not hurt. This list is by no means all inclusive, but it summarizes the most common causes of lymph node swelling. An examination by a health care provider is necessary to make a definitive diagnosis.

Cancer in the genital area. Because the lymph nodes in the groin receive drainage from all the pelvic structures, cancer in any of the genital organs may cause the lymph nodes in that area to swell. Lymph nodes enlarged as the result of a malignancy are usually hard and not moveable. Lymph node swelling in young adults is rarely caused by cancer; more often it is the result of an infection. Lymph node swelling that results from infection usually subsides considerably when the infection is treated. A lymph node biopsy—in which a small piece of tissue is removed and then examined under the microscope—can be performed to rule out cancer if there is a question.

Infection in the genital area. Any genital infection can cause lymph node swelling in the genital area. This includes bacterial infections such as gonorrhea, chlamydia, lymphogranuloma venereum, chancroid, syphilis, and donovanosis, as well as the syndromes PID and MPC in women and NGU in men. The viral infection herpes and the protozoan infection trichomoniasis can also cause lymph node swelling. Even a bladder infection can result in groin node swelling.

Conditions that can cause lymph node swelling throughout the body. Systemic (whole-body) infections such as mononucleosis, HFV, and secondary syphilis, as well as malignancies such as lymphoma (a cancer of the lymph nodes), can cause swelling in lymph nodes throughout the body (neck, armpits, and other areas in addition to the groin). Other symptoms are usually also present.

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