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Straight, No Chaser: Syphilis Prevention, Treatment and the Tuskegee Experience

Introduction

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Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.

Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.

The Tuskegee Experiments

tuskegee

In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.

The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

  • None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
  • Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
  • Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

Aftermath

The aftermath of the study includes the following:

  • Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
  • Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.

Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.

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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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From the Health Library of SterlingMedicalAdvice.com: "Can I use antibiotics if I forgot to refrigerate them?"

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I left my son’s liquid antibiotic sitting on the kitchen counter all day instead of putting it back in the refrigerator. Is the medicine still OK?
Depending on the medication, including liquid antibiotics, it may no longer be effective due to improper storage. Certain medications will break down and lose their potency if not stored in the refrigerator. If you are unsure if the medication is still effective, consult your doctor or pharmacist.
Always be sure to read all the labels on the medication container for directions for use and storage.
 
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About SterlingMedicalAdvice.com: "Is SterlingMedicalAdvice.com right for me?"

Everyone, whether insured or not, can register for SterlingMedicalAdvice.com.

  • If you enjoy being empowered with more knowledge and control over your healthcare, SterlingMedicalAdvice.com is for you.
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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About SterlingMedicalAdvice.com: "How will my health information be protected?"

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www.SterlingMedicalAdvice.com’s website is completely compliant with HIPPA guidelines and regulations, meaning the highest level of security is protecting our site and your information! No information will ever be released without your explicit direction to do so, even if your physician or insurance company requests it without your permission.  Remember, if you keep your health information updated on SterlingMedicalAdvice.com, you will have a readily retrievable folder of your information at your disposal.  Try us and enjoy the difference personal healthcare consulting makes.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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When you sign up at www.SterlingMedicalAdvice.com, you provide a medical history that becomes a permanent part of your record. The information you give us during each chat will also be filed in your record. Your SMA consultant will access your updated information every time you log in for a new chat. Your information is personalized, and your service is immediate. Try us, and experience personal healthcare consulting!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About SterlingMedicalAdvice.com: Are there limits to how often I can use the site?

You can reach your SMA consultants 24 hours a day, seven days a week. The following interactions are included in your subscription.

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Unlimited

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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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Yes! SMA offers individual and family plans for both STERLING ADVICE® and STERLING ADVICE PLUS®.
The STERLING ADVICE® plan offers you information and advice on all medical disclipines, and the STERLING ADVICE PLUS® plan adds on ancillary care considerations, including mental health, dentistry, pharmacy, nutrition and personal training. Subscribe to either plan, and cover your whole family, including children up to age 26.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: What if I'm not satisfied with the advice I receive?

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www.SterlingMedicalAdvice offers a 100% satisfaction guarantee! If your SMA consultant is unclear in addressing your health concern or does not answer your questions adequately, you can talk with another consultant free of charge. We love your feedback. Try us and experience the difference!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: What If I Need Prescriptions?

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SterlingMedicalAdvice.com consultants may advise you on medications you have and are likely to receive based on your condition. They may advise you of important drug side effects, interactions and dosing considerations. However, you will need to obtain prescriptions from your physician when needed. The expert consultants of SterlingMedicalAdvice.com do not prescribe medications, because SMA is a medical information and advice service, not a medical practice.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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When is SterlingMedicalAdvice.com Available?

SMA will be available to subscribers 24 hours a day, seven days a week, starting on November 1, 2013.  If you have an immediate need or possible emergency, you can receive instant information and advice.  If you have a need for general information, you can review our vast Question Bank 24/7.  If you have a need for general information from a specialist, we will get you information within minutes!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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From the Health Library of SterlingMedicalAdvice.com: “Does eating yogurt with probiotics help weight loss?”

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According to the available medical literature, if you eat yogurt with probiotics before or after you eat, it will break down all the fat you have ingested. This does retard weight gain!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: How is this different than online libraries?

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When you join SMA, you gain a live personal healthcare consulting team!
Whenever your SMA consultants chat with you, they have your personal health information in front of them. This is the information you give us in our initial questionnaire and which we update during every chat. Every interaction with SMA is customized and personal, which makes all the difference in getting you the best answer to your questions.
With SMA you are not just looking through an encyclopedia, though you do have an extensive resource of health information at your fingertips.
Try us, and experience the difference!
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: When Can and Should I Use It?

SMA is available 24 hours a day, seven days a week. Any time you have a health question or concern is a good time to chat or review the information contained within. For example, log in and chat with your SMA consultant …
• when you need medical advice regarding an immediate concern
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Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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About www.SterlingMedicalAdvice.com: How Do I Use It?

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Starting November 1st, www.SterlingMedicalAdvice.com will offer three separate options for your use.

  • When you have a healthcare question or concern, log into www.SterlingMedicalAdvice.com and chat with your SMA expert consultant. Your dynamic and experienced online SMA team, representing over 15 different medical and healthcare specialties, is at your service around the clock.
  • If you have a specific question on a general topic, log into www.SterlingMedicalAdvice.com and view the thousands of questions in our database, compiled by our expert consultants. You’ll likely find the answer you seek.
  • If you desire more rounded information on a specific topic, log into www.SterlingMedicalAdvice.com and read the healthcare blog Straight, No Chaser. Hundreds of posts covering a wide variety of topics are available to educate and inform you.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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Straight, No Chaser: The Week In Review, Oct. 13, 2013

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I want to take a moment to thank my readers for support Straight, No Chaser and to inform you of a few new developments. The launch of www.SterlingMedicalAdvice.com occurs on Nov. 1st, 2013; you can actually head there now for a sneak peek. Straight, No Chaser was and is designed to provide a taste of what will be available within SterlingMedicalAdvice.com, which will also feature a Frequently Asked Question (FAQ) databank with thousands of pre-answered questions, as well as personalized, immediate, always available interactions with healthcare professionals on your urgent and non-urgent questions. Additional content is currently available on Google+ and Facebook at SterlingMedicalAdvice.com, and on Twitter @asksterlingmd.

Now to the week in review.

On Monday, we discussed angioedema, a condition often presenting with severe swelling of the lips, tongue and throat. This is to be considered a life-threatening emergency prompting immediate medical attention. The risk of the tongue occluding your airway, resulting in an ability to breathe is real.
On Tuesday, we began a series on breast cancer. The first post introduced Breast Cancer Awareness Month and called for more universal awareness.
On Wednesday, we presented two posts (check here and here) listing various myths regarding breast cancer. I’m encouraged that so many of you are aware that men can develop breast cancer as well as women.
On Thursday, we focused on demographic information and discussed risk factors relating to breast cancer. It’s not just being an older women that places you at risk. You can control certain things, such as alcohol intake and obesity.
On Friday, we began the self-empowerment process, giving you tools to self-assess for breast cancer and providing detailed instructions on how to perform the breast self-exam.
On Saturday, we discussed the actual signs, symptoms and long-term prognosis for breast cancer. There are more symptoms to worry about than just lumps. Also remember: the evidence is very clear that your survival rates directly relate to early detection and evaluation.
On Sunday, we discussed breast cancer treatment options. Although breast cancer is scary and deadly in many cases, be encouraged that nearly 3 million survivors are with us in the U.S.
In the next few weeks, we will continue to blog as well as provide additional information from the www.SterlingMedicalAdvice.com FAQ database and still more information about the new service. Thanks for supporting Straight, No Chaser, and be sure to check us out on the social media sites as well.
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Straight, No Chaser: Syphilis Prevention, Treatment and the Tuskegee Experience

tuskegee syphilis4
Syphilis should be a word derived from something meaning horrible. In an earlier post, we reviewed the rather horrific progression of the symptoms of syphilis. An additionally horrible consideration is that treatment is so very easy once identified. Of course, that’s not the most horrific aspect of the disease. Read on.
Looking back retrospectively, advanced syphilis is especially disheartening because it is so easily treated and prevented. Prevention is as simple as always wearing condoms, being in a monogamous relationship with someone confirmed not to have it, checking your sexual partner prior to sex and not engaging in sex if any type of sore/ulcer is in the mouth, genitalia or anal region. Regarding treatment, syphilis once upon a time was quite the plague until penicillin was discovered; treating syphilis is how penicillin ‘made a name’ for itself. Treatment with penicillin easily kills syphilis but unfortunately does nothing for damage that has already occurred. However, as discussed in the post discussing the symptoms of syphilis, remember that treating syphilis at any point can prevent the most severe complications that lead to death. Which brings us to Tuskegee – and keep in mind this is Straight, No Chaser.
In the early 1930s, the US Public Health Service working with the Tuskegee Institute in Alabama began a study to evaluate the effectiveness of current treatments for syphilis, which at the time, were thought to be at least as bad as the disease. The study was conducted on 600 Black men, who were convinced to participate in the study with the promise of free medical exams, meals and money for burial, ‘if’ it was necessary.
The study was initially meant to last 6 months, but at some point a governmental decision was made to continue the study and observe the natural progression of syphilis until all subjects died of the disease, with a commitment obtained from the subjects that they would be autopsied ‘if’ they died. There were several problems with this decision.

  • None of the patients participated under informed consent. They believed they were being treated as opposed to being observed and having medicine withheld while they were being allowed to die. In other words, the subjects were not aware of the purpose of the study.
  • Penicillin was established as a true, rapidly effective treatment for syphilis and the standard of care by 1947. The study continued 25 years beyond this treatment option being available.
  • Efforts by concerned individuals failed to end the study for 5 years prior to a whistleblower going to the press in 1972. The study was ended in a day.

The aftermath of the study includes the following:

  • Reparations averaging a mere $15,000 per individual were given ($9M total) as well as a formal apology, delivered by President Clinton. Yep, the victims received the equivalent of $15,000 per person on average for 40 years of carrying syphilis 25 years after there was a known cure, after infecting wives and unborn children in several documented cases.
  • Strict requirements for protocols for human study (i.e. Institutional Review Boards) were implemented for the first time.

It shouldn’t surprise anyone that many African-Americans remain distrustful of governmental public health efforts to this day; for many, this study continues to be the reason while vaccination isn’t optimally taken advantage of (e.g. HPV) and why organ donation rates are so relatively low in the African-American community. Even though this posture contributes to the adverse health outcomes that exist in the African-American community, it isn’t hard to see why the fear and distrust exists.
Let’s bring this full circle. When it comes to syphilis, prevention is best, and full treatment is available. At the very least, I certainly can say you’ve been warned. Folks have given their lives to make your warning possible. I welcome your questions and comments.
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