Expectancies as predictors of symptom improvement after antimicrobial therapy for persistent symptoms attributed to Lyme disease

This study examined predictors of symptom improvement after antimicrobial therapy for persistent symptoms attributed to Lyme disease, hypothesizing particularly pre-treatment expectancies regarding symptom improvement to be predictive.MethodsA predictive study was performed on pre-treatment and post-treatment individual characteristics, including expectancies, and physical and mental health –related quality of life (HRQoL) from the PLEASE-trial comparing randomized 12-weeks of doxycycline, clarithromycin-hydroxychloroquine, or placebo following 2 weeks of intravenous ceftriaxone. At end-of-treatment (14 weeks after trial start) and follow-up (52 weeks), complete data of 231 and 17 0 (of initial 280) patients with persistent symptoms temporally related to a history of erythema migrans or otherwise confirmed symptomatic Lyme disease, or accompanied byB. burgdorferi IgG or IgM antibodies, were examined through hierarchical regression analyses.ResultsIn addition to pre-treatment HRQoL, pre-treatment expectancies regarding symptom improvement were consistently associated with stronger physical and mental HRQoL improvements at both end-of-treatment and follow-up (95% CI range: .09;.54,p 
Source: Clinical Rheumatology - Category: Rheumatology Source Type: research

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AbstractLyme disease is an infection caused byBorrelia burgdorferi sensu lato, which is transmitted to humans through the bite of an infected Ixodes tick. The majority of patients recover without complications with antibiotic therapy. However, for a minority of patients, accompanying non-specific symptoms can persist for months following completion of therapy. The constellation of symptoms such as fatigue, cognitive dysfunction, and musculoskeletal pain that persist beyond 6  months and are associated with disability have been termed post-treatment Lyme disease syndrome (PTLDS), a subset of a broader term “chron...
Source: Clinical Reviews in Allergy and Immunology - Category: Allergy & Immunology Source Type: research
Conclusions: Operative management of pediatric patients with Lyme arthritis is associated with increased resource utilization and costs while being similarly efficacious to nonoperative management. As the US Lyme epidemic expands, improved diagnosis and management of acute undifferentiated arthritis may prevent unneeded operative intervention. Level of Evidence: Level III—retrospective cohort study.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Infection Source Type: research
Submitted by Maura Corbett, PA-C, written by Alex Bracey, with some comments by Smith and MeyersA teenage male presented to the emergency department with the complaint of dizziness with near-syncope. He was stable and able to provide a history and mentioned that he was asymptomatic while seated but dizzy and weak when attempting to stand. An ECG was recorded:What do you think? There iscomplete (third degree) heart block with wide complex bradycardicescape.  The morphology is that of LBBB and so the escape is originating from the right bundle.The possible etiologies of this ECG are:- Structural/congenital heart di...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This article reviews the symptomatology, diagnosis, and treatment of neuroborreliosis. RECENT FINDINGS The most recent guidelines for the diagnosis and treatment of Lyme disease were published in 2020 by the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology. SUMMARY The most common neurologic complications of Lyme disease are cranial neuritis (most often a unilateral or bilateral facial nerve palsy), meningitis, and radiculoneuritis/mononeuropathy multiplex. Testing for Lyme disease begins with an enzyme-linked immunosorbent assay (ELISA). If t...
Source: CONTINUUM: Lifelong Learning in Neurology - Category: Neurology Tags: REVIEW ARTICLES Source Type: research
People in Denmark diagnosed with Lyme disease in a hospital went on to have 28% higher rates of mental disorders and were twice as likely to have attempted suicide, compared with those without the diagnosis, according to astudy published Wednesday inAJP in Advance. Having more than one episode of Lyme disease was associated with a higher rate of mental disorders, affective disorders, and suicide attempts.According to theCDC, nearly half a million people a year in the United States are treated for Lyme disease (also known as Lyme borreliosis), the most common vector-borne disease, and the areas where Lyme disease is common ...
Source: Psychiatr News - Category: Psychiatry Tags: ajp in advance CDC Denmark hospitalized infections lyme disease mental disorders suicide Source Type: research
We present a case of a patient who suffered from serious complications associated with the treatment of “chronic Lyme disease.” Lyme disease, a tick-borne infection caused by Borrelia burgdorferi, is characterized by dermatological, rheumatological, neurological, and/or cardiac manifestations responsive to antimicrobial therapy. “chronic Lyme disease”, by contrast, is a term used to describe a constellation of subjective symptoms, often without clinical or serological evidence of previous Lyme disease.
Source: Mayo Clinic Proceedings - Category: Internal Medicine Authors: Tags: Letter to the editor Source Type: research
Abstract Lyme disease (Lyme borreliosis) is a tick-borne, zoonosis of adults and children caused by genospecies of the Borrelia burgdorferi sensu lato complex. The ailment, widespread throughout the Northern Hemisphere, continues to increase globally due to multiple environmental factors, coupled with increased incursion of humans into habitats that harbor the spirochete. B. burgdorferi sensu lato is transmitted by ticks from the Ixodes ricinus complex. In North America, B. burgdorferi causes nearly all infections; in Europe, B. afzelii and B. garinii are most associated with human disease. The spirochete's unusua...
Source: Current Issues in Molecular Biology - Category: Molecular Biology Authors: Tags: Curr Issues Mol Biol Source Type: research
Abstract Erythema migrans is the most common clinical manifestation of Lyme disease, with concomitant subjective symptoms occurring in ∼65% of cases in the USA. We evaluated the impact on 12 particular symptoms of having been started on antibiotic treatment before enrollment for 38 subjects with erythema migrans versus 52 untreated subjects. There were no significant differences in the frequency of having at least one symptom or in the symptom severity score on study entry. However, the frequency of having at least one symptom was significantly greater for those who had received
Source: Antimicrobial Agents and Chemotherapy - Category: Microbiology Authors: Tags: Antimicrob Agents Chemother Source Type: research
ult D Abstract One quarter of all cancers are linked to infectious diseases. The link between viral infection and cancer has been widely studied, but few reports have focused on the carcinogenic role of bacterial infection. Nonetheless, Helicobacter pylori, Chlamydia psittaci, Coxiella burnetii, Borrelia burgdorferi and Campylobacter jejuni are bacteria that can be associated with non-Hodgkin's lymphoma (NHL), the most common haematologic malignancy. Here, we review the evidence in favour of a link between these bacterial infections and NHL. Sero-epidemiological observation makes it possible to identify a link bet...
Source: Critical Reviews in Microbiology - Category: Microbiology Authors: Tags: Crit Rev Microbiol Source Type: research
Authors: Rauer S, Kastenbauer S, Hofmann H, Fingerle V, Huppertz HI, Hunfeld KP, Krause A, Ruf B, Dersch R, Consensus group Abstract Lyme borreliosis is the most common tick-borne infectious disease in Europe. A neurological manifestation occurs in 3-15% of infections and can manifest as polyradiculitis, meningitis and (rarely) encephalomyelitis. This S3 guideline is directed at physicians in private practices and clinics who treat Lyme neuroborreliosis in children and adults. Twenty AWMF member societies, the Robert Koch Institute, the German Borreliosis Society and three patient organisations participated in its ...
Source: GMS German Medical Science - Category: General Medicine Tags: Ger Med Sci Source Type: research
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