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Sanderson, Victoria P., Jennifer C. Miller, Vladimir V. Bamm, Manali Tilak, Vett K. Lloyd, Gurpreet Singh-Ranger, and Melanie K. B. Wills. "Profiling disease burden and Borrelia seroprevalence in Canadians with complex and chronic illness." PLOS ONE 18, no. 11 (November 8, 2023): e0291382. http://dx.doi.org/10.1371/journal.pone.0291382.
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Lyme disease, caused by vector-borne Borrelia bacteria, can present with diverse multi-system symptoms that resemble other conditions. The objective of this study was to evaluate disease presentations and Borrelia seroreactivity in individuals experiencing a spectrum of chronic and complex illnesses. We recruited 157 participants from Eastern Canada who reported one or more diagnoses of Lyme disease, neurological, rheumatic, autoimmune, inflammatory, gastrointestinal, or cardiovascular illnesses, or were asymptomatic and presumed healthy. Intake categories were used to classify participants based on their perceived proximity to Lyme disease, distinguishing between those with a disclosed history of Borrelia infection, those with lookalike conditions (e.g. fibromyalgia syndrome), and those with unrelated ailments (e.g. intestinal polyps). Participants completed three questionnaires, the SF-36 v1, SIQR, and HMQ, to capture symptoms and functional burden, and provided blood serum for analysis at an accredited diagnostic lab. Two-tiered IgG and IgM serological assessments (whole cell ELISA and Western blot) were performed in a blinded fashion on all samples. The pattern of symptoms and functional burden were similarly profound in the presumptive Lyme and Lyme-like disease categories. Borrelia seroprevalence across the study cohort was 10% for each of IgG and IgM, and occurred within and beyond the Lyme disease intake category. Western blot positivity in the absence of reactive ELISA was also substantial. Fibromyalgia was the most common individual diagnostic tag disclosed by two-tier IgG-positive participants who did not report a history of Lyme disease. Within the IgG seropositive cohort, the presence of antibodies against the 31 kDa Outer Surface Protein A (OspA) was associated with significantly better health outcomes. Previously, this marker has been linked to treatment-refractory Lyme arthritis. Overall, our findings support prior observations of phenotypic overlap between Lyme and other diseases. Seropositivity associated with non-specific symptoms and functional impairment warrants further mechanistic investigation and therapeutic optimization.
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Coiffier, Guillaume, and Pierre Tattevin. "Lyme disease: “End of the debate?”." Joint Bone Spine 88, no. 4 (July 2021): 105181. http://dx.doi.org/10.1016/j.jbspin.2021.105181.
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Yarema, Nadiya, Kateryna Myndziv, and Volodymyr Dzhyvak. "Lyme carditis in clinical practice." Acta Facultatis Medicae Naissensis 41, no. 1 (2024): 139–45. http://dx.doi.org/10.5937/afmnai41-39831.
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Introduction. Lyme disease is an infectious disease transmitted by the Ixodes ticks and is manifested by damaging various organs and systems (most often-migrating erythema, damage to the nervous system, musculoskeletal system, heart, liver and eyes). According to various authors, heart damage in Lyme borreliosis ranges from 4% to 10% and is an understudied pathology. Case report. The article describes a clinical case of infectious myocarditis associated with Lyme disease in a 51-year-old patient. The course of the disease and the results of treatment of the patient were analyzed. The severe rhythm and conduction disorders were revealed: antrioventricular (AV) block of the first degree, transient AV block of the II degree (Mobitz 2) and III degree, polytopic extrasystoles. Due to timely diagnosis, including serological, prescribed etiotropic antibacterial treatment, the patient achieved a significant improvement in both clinical condition and positive serological and electrocardiogram (ECG) dynamics with improved AV conduction. Conclusions. The most frequent ECG changes in Lyme carditis (LC) are conduction disorders with the development of blockades of various stages. For patients with myocarditis, which is accompanied by complex arrhythmias, and conduction disorders estimated as intermediate and high risk by Suspicious Index in Lyme Carditis (SILC) scale, serological examination should be recommended in order to verify the borreliosis etiology of myocarditis. In this particular case, early diagnostics and prescribed etiotropic treatment, in addition to treatment of heart failure, contributed to a significant improvement in both the clinical condition and positive serological and ECG dynamics.
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Kennel, Peter J., Melvin Parasram, Daniel Lu, Diane Zisa, Samuel Chung, Samuel Freedman, Katherine Knorr, Timothy Donahoe, Steven M. Markowitz, and Hadi Halazun. "A Case of Lyme Carditis Presenting with Atrial Fibrillation." Case Reports in Cardiology 2018 (September 2, 2018): 1–5. http://dx.doi.org/10.1155/2018/5265298.
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We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi. After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis.
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Shabbir, Muhammad Asim, Muhammad Hamza Saad Shaukat, Muhammad Hashaam Arshad, and Joseph Sacco. "Lyme carditis presenting as atrial fibrillation in a healthy young male." BMJ Case Reports 12, no. 6 (June 2019): e229261. http://dx.doi.org/10.1136/bcr-2019-229261.
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We present a case of a 23-year-old man coming with palpitations, found to be in atrial fibrillation (AF). He was initially managed with metoprolol for rate-controlled therapy—reverted to normal sinus rhythm and discharged home. He returned a few days later—this time in varying degrees of atrioventricular block including transient complete heart block. He was empirically started on intravenous ceftriaxone for suspected Lyme carditis, which subsequently led to the resolution of high-degree heart block. Lyme immunoglobulin G (IgG) and IgM returned positive. Follow-up ECG after the course of antibiotic exhibited normal sinus rhythm. AF is a rare presentation of Lyme disease but still exists. It should be considered in terms of appropriate treatment, especially in Lyme-endemic areas.
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Muhammad, Sheheryar, and Robert J. Simonelli. "Lyme Carditis: A Case Report and Review of Management." Hospital Pharmacy 53, no. 4 (January 2, 2018): 263–65. http://dx.doi.org/10.1177/0018578717749927.
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Purpose: A case report of a patient who presented with an acute onset, fluctuating atrioventricular (AV) block and was diagnosed with Lyme carditis is presented. Summary: A 55-year-old man with progressively worsening generalized malaise, flu-like symptoms, dyspnea on exertion, and near syncope was admitted with bradycardia (heart rate was between 20 and 30 beats per minute upon admission). He endorsed having several tick bites after which he developed erythema migrans on his arm and abdomen. An electrocardiogram (ECG) revealed a second-degree AV block, fluctuating between Mobitz type I and Mobitz type II heart block, with a P-R interval of 300 ms. A presumptive diagnosis of Lyme carditis was made based on a confirmed history of tick exposure, presence of erythema migrans, and AV block. The patient was started on ceftriaxone. On day 3 of hospitalization, patient’s heart rate was between 50 and 60 beats per minute. A diagnosis of Lyme disease was confirmed based on serologic testing. A repeat ECG revealed a first-degree AV block with a P-R interval of 300 ms. On day 5 of hospitalization, a peripherally inserted central catheter line was placed and the patient was discharged to his home on a 28-day course of ceftriaxone. Patient’s heart rate was 65 beats per minute on discharge day. Conclusion: Considering Lyme carditis as a differential diagnosis in patients with an AV block of an unknown etiology can result in a timely diagnosis and treatment of Lyme carditis.
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Dersch, R., M. H. Freitag, S. Schmidt, H. Sommer, S. Rauer, and J. J. Meerpohl. "Efficacy and safety of pharmacological treatments for acute Lyme neuroborreliosis - a systematic review." European Journal of Neurology 22, no. 9 (June 8, 2015): 1249–59. http://dx.doi.org/10.1111/ene.12744.
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Marx, Grace E., Anna M. Schotthoefer, Brian S. Schwartz, Evan Draper, Christina G. Rivera, John Zeuli, Erica Scotty, et al. "1198. Lyme Disease Post-Exposure Prophylaxis by Single-Dose Doxycycline in Three Healthcare Systems." Open Forum Infectious Diseases 8, Supplement_1 (November 1, 2021): S690. http://dx.doi.org/10.1093/ofid/ofab466.1390.
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Abstract Background Lyme disease, the most common tickborne disease in the United States, may be prevented by taking a single 200-mg dose of oral doxycycline after a high-risk bite from a blacklegged tick. Currently, it is not known how Lyme disease post-exposure prophylaxis (PEP) might vary by region and healthcare system. We identified single-dose doxycycline medication orders in three healthcare systems in states with high incidence of Lyme disease and compared associated patient and provider characteristics. Methods Electronic health record data during 2012 – 2016 were obtained from three healthcare systems: Geisinger (Pennsylvania), Marshfield Clinic (Wisconsin), and Mayo Clinic (Minnesota/Wisconsin). Creation of analytic variables and analysis were harmonized across the three sites. Medication orders for single-dose doxycycline ≤200 mg that were accompanied by specific key words or diagnostic codes (e.g., tick bite; Lyme disease prevention) were considered evidence of PEP. Manual chart review was performed from a random subset to evaluate the algorithms used to identify PEP. Results Among 2,937,585 patients with at least one medication order or clinical encounter during the study period, 14,102 single-dose doxycycline orders for Lyme disease PEP for 13,172 unique patients were identified. The typical patient receiving PEP was older (mean age 51 – 58 years), male (56 – 59%), and non-Hispanic White (81 – 98%). The annual seasonality of medication orders was bimodal, with peaks occurring during April – July and October – November. The most common encounter setting was an outpatient clinic or urgent care center (80 – 91%); medication orders after patient phone calls in the absence of an in-person visit occurred frequently (14 – 19%) in two health systems. Chart abstractions (n=600) revealed instances of PEP prescribed inappropriately (e.g., bite from a non-blacklegged tick; patient with symptoms of acute Lyme disease). Conclusion Lyme disease PEP with a single dose of doxycycline was frequently prescribed in healthcare systems where there is a high incidence of Lyme disease. PEP was most commonly prescribed to non-Hispanic Whites over the age of 50 years. Public health initiatives for tickborne disease prevention should include clinician education on the appropriate use of Lyme disease PEP. Disclosures Anna M. Schotthoefer, PhD, HelixBind (Other Financial or Material Support, salary support) John Zeuli, PharmD, INSMED (Other Financial or Material Support, honoraria for educational speaking)
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Michalski, Basia, and Adrian Umpierrez De Reguero. "Lyme Carditis Buried Beneath ST-Segment Elevations." Case Reports in Cardiology 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/9157625.
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Lyme disease is caused by the spirochete Borrelia burgdorferi and is carried to human hosts by infected ticks. There are nearly 30,000 cases of Lyme disease reported to the CDC each year, with 3-4% of those cases reporting Lyme carditis. The most common manifestation of Lyme carditis is partial heart block following bacterial-induced inflammation of the conducting nodes. Here we report a 45-year-old gentleman that presented to the hospital with intense nonradiating chest pressure and tightness. Lab studies were remarkable for elevated troponins. EKG demonstrated normal sinus rhythm with mild ST elevations. Three weeks prior to hospital presentation, patient had gone hunting near Madison. One week prior to admission, he noticed an erythematous lesion on his right shoulder. Because of his constellation of history, arthralgias, and carditis, he was started on ceftriaxone to treat probable Lyme disease. This case illustrates the importance of thorough history taking and extensive physical examination when assessing a case of possible acute myocardial infarction. Because Lyme carditis is reversible, recognition of this syndrome in young patients, whether in the form of AV block, myocarditis, or acute myocardial ischemia, is critical to the initiation of appropriate antibiotics in order to prevent permanent heart block, or even death.
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Ozdenerol, Esra, Rebecca Michelle Bingham-Byrne, and Jacob Daniel Seboly. "The Effects of Lifestyle on the Risk of Lyme Disease in the United States: Evaluation of Market Segmentation Systems in Prevention and Control Strategies." International Journal of Environmental Research and Public Health 18, no. 24 (December 7, 2021): 12883. http://dx.doi.org/10.3390/ijerph182412883.
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The aim of this study was to investigate lifestyles at risk of Lyme disease, and to geographically identify target populations/households at risk based on their lifestyle preferences. When coupled with geographically identified patient health information (e.g., incidence, diagnostics), lifestyle data provide a more solid base of information for directing public health objectives in minimizing the risk of Lyme disease and targeting populations with Lyme-disease-associated lifestyles. We used an ESRI Tapestry segmentation system that classifies U.S. neighborhoods into 67 unique segments based on their demographic and socioeconomic characteristics. These 67 segments are grouped within 14 larger “LifeModes” that have commonalities based on lifestyle and life stage. Our dataset contains variables denoting the dominant Tapestry segments within each U.S. county, along with annual Lyme disease incidence rates from 2000 through 2017, and the average incidence over these 18 years. K-means clustering was used to cluster counties based on yearly incidence rates for the years 2000–2017. We used analysis of variance (ANOVA) statistical testing to determine the association between Lyme disease incidence and LifeModes. We further determined that the LifeModes Affluent Estates, Upscale Avenues, GenXurban, and Cozy Country Living were associated with higher Lyme disease risk based on the results of analysis of means (ANOM) and Tukey’s post hoc test, indicating that one of these LifeModes is the LifeMode with the greatest Lyme disease incidence rate. We further conducted trait analysis of the high-risk LifeModes to see which traits were related to higher Lyme disease incidence. Due to the extreme regional nature of Lyme disease incidence, we carried out our national-level analysis at the regional level. Significant differences were detected in incidence rates and LifeModes in individual regions. We mapped Lyme disease incidence with associated LifeModes in the Northeast, Southeast, Midcontinent, Rocky Mountain, and Southwest regions to reflect the location-dependent nature of the relationship between lifestyle and Lyme disease.
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Bremell, D., and L. Dotevall. "Oral doxycycline for Lyme neuroborreliosis with symptoms of encephalitis, myelitis, vasculitis or intracranial hypertension." European Journal of Neurology 21, no. 9 (March 29, 2014): 1162–67. http://dx.doi.org/10.1111/ene.12420.
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Radesich, Cinzia, Eva Del Mestre, Kristen Medo, Giancarlo Vitrella, Paolo Manca, Mario Chiatto, Matteo Castrichini, and Gianfranco Sinagra. "Lyme Carditis: From Pathophysiology to Clinical Management." Pathogens 11, no. 5 (May 15, 2022): 582. http://dx.doi.org/10.3390/pathogens11050582.
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Cardiac involvement is a rare but relevant manifestation of Lyme disease that frequently presents as atrioventricular block (AVB). Immune-mediated injury has been implicated in the pathogenesis of Lyme carditis due to possible cross-reaction between Borrelia burgdorferi antigens and cardiac epitopes. The degree of the AVB can fluctuate rapidly, with two-thirds of patients progressing to complete AVB. Thus, continuous heart rhythm monitoring is essential, and a temporary pacemaker may be necessary. Routinely permanent pacemaker implantation, however, is contraindicated because of the frequent transient nature of the condition. Antibiotic therapy should be initiated as soon as the clinical suspicion of Lyme carditis arises to reduce the duration of the disease and minimize the risk of complications. Diagnosis is challenging and is based on geographical epidemiology, clinical history, signs and symptoms, serological testing, ECG and echocardiographic findings, and exclusion of other pathologies. This paper aims to explain the pathophysiological basis of Lyme carditis, describe its clinical features, and delineate the treatment principles.
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Nykytyuk, S., S. Klymnyuk, and L. Levytska. "SINUS BRADYCARDIA AS AN EARLY MARKER OF HEART DAMAGE IN A GIRL WITH LYME DISEASE (CASE REPORT AND MINI REVIEW)." East European Scientific Journal 3, no. 4(68) (May 14, 2021): 4–10. http://dx.doi.org/10.31618/essa.2782-1994.2021.3.68.22.
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Objectives Early clinical markers of Lyme carditis and other life-threatening prognostic factors due to complications of borreliа infection are still the beginning of active research by scientists. The literature describes a small number of cases of Lyme carditis with arrhythmias or cardiac conduction disorders. Material and methods We reviewed the case of a 14-year-old girl. LC was diagnosed on the basis of history of disease, physical examination, laboratory examination data (positive anti-borrelia IgM in ELISA with confirmation in immunoblot. The presence of B. burgdorferi s.l. was detected by the method of immunoassay analysis using the Euroimmun AG test systems (Germany). The presence of B. burgdorferi s.l. was detected by the method of immunoassay analysis using the Euroimmun AG test systems (Germany). 2 instrumental methods: (ECG,Echo-cor) were used. Results We described a case of Lyme borreliosis in a 14-year-old girl, accompanied by sinus bradyarrhythmia and pericardial fluid -(hydropericardium) (passed after a course of antibacterial therapy). Analysis of this case indicates early detection and adequate treatment of Lyme carditis in young people with minimal deviations of the cardiogram. A case of Lyme carditis , in a child was confirmed.Echocardiography of the heart (at the time of admission to the hospital andat the time of discharge from the hospital was made.
Conclusions 1. Lyme carditis should be suspected in patients with a history of Lyme disease and minimal Electrocardiographic abnormalities , such as sinus bradycardia. 2. For differential diagnosis of Lyme carditis, it is necessary to make ( carry out two-stage serological investigation of blood, especially using antibody screening tests by ELISA with subsequent confirmation by the Western blot assay.
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Packard, Russell C., and Lesley P. Ham. "EEG Biofeedback in the Treatment of Lyme Disease:." Journal of Neurotherapy 1, no. 3 (December 1995): 22–31. http://dx.doi.org/10.1300/j184v01n03_04.
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Zainal, Abir, Amir Hanafi, Ninad Nadkarni, Mahmood Mubasher, Deeraj Lingutla, and Ryan Hoefen. "Lyme carditis presenting as atrial fibrillation." BMJ Case Reports 12, no. 4 (April 2019): e228975. http://dx.doi.org/10.1136/bcr-2018-228975.
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The incidence of Lyme disease in the USA is 8 per 100 000 cases and 95% of those occur in the Northeastern region. Cardiac involvement occurs in only 1% of untreated patients. We describe the case of a 46-year-old man who presented with chest pressure, dyspnoea, palpitations and syncope. He presented initially with atrial fibrillation with rapid ventricular response, a rare manifestation of Lyme carditis. In another hospital presentation, he had varying degrees of atrioventricular block including Mobitz I second-degree heart block. After appropriate antibiotic treatment, he made a full recovery and his ECG normalised. The authors aim to urge physicians treating patients in endemic areas to consider Lyme carditis in the workup for patients with atrial fibrillation and unexplained heart block, as the associated atrioventricular nodal complications may be fatal.
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Kerndt, Connor C., John A. Bills, Zaid J. Shareef, Alexander M. Balinski, Daniel F. Summers, and Jose M. Tan. "Early Disseminated Lyme Carditis Inducing High-Degree Atrioventricular Block." Case Reports in Cardiology 2020 (June 4, 2020): 1–6. http://dx.doi.org/10.1155/2020/5309285.
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Lyme disease is the most common tick-borne illness in the United States due to Borrelia burgdorferi infection. This case demonstrates a 20-year-old male patient presenting with complaints of annular skin rash, malaise, fever, and lightheadedness after significant outdoor exposure. Physical exam revealed multiple large targetoid lesions on the back and extremities. The rash had raised borders and centralized clearing consistent with erythema migrans chronicum. Electrocardiogram (ECG) revealed a high-degree atrioventricular (AV) block. The patient was started on intravenous ceftriaxone due to clinical suspicion for Lyme carditis. ELISA and Western blot tests were reactive for Lyme IgM and IgG, confirming the diagnosis. The AV block resolved by hospital day four and the patient was discharged with outpatient follow-up. Early identification of disease allowed for effective treatment with no adverse outcomes or sequelae.
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Myndziv, K. V., N. I. Yarema, N. Ya Vereshchahina, V. I. Bondarchuk, U. P. Hevko, and O. V. Vayda. "Application of diagnostic methods in the verification of Lyme carditis (clinical case)." Medicni perspektivi 28, no. 3 (September 29, 2023): 205–12. http://dx.doi.org/10.26641/2307-0404.2023.3.289228.
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The aim of the reserch was to investigate the genotype of the pathogen in a patient with Lyme carditis and to analyze the course of the disease in the process of etiotropic treatment. The article describes a clinical case of infectious myocarditis associated with Lyme disease in a 49-year-old patient. The value of modern diagnostics technologies in diagnosis determination was described. The course of the disease and the results of treatment of the patient were analyzed. The severe rhythm and conduction disorders were revealed with the method of Holter monitoring: AV-block of the first degree, transient AV-block of the II degree (Mobitz 2) and III degree, polytopic extrasystoles. The morphological changes in the heart were diagnosed with ultrasonography and cardiac MRI in order to confirm the diagnosis and to monitor the patient's subsequent course. Total antibodies to antigens of the B. burgdorferi sensu lato complex in blood serum were determined by the ELISA method with test systems Euroimmun AG (Germany). At the second stage, the immunoblot method was applied using the EUROLINE Borrelia RN-AT test system. Due to timely diagnosis, including serological, prescribed etiotropic antibacterial treatment, the patient achieved a significant improvement in both clinical condition and positive serological and ECG dynamics with improved AV conduction. The most frequent ECG changes in Lyme carditis are conduction disorders with development of blockades of various stages. The application of the modern technologies in patients with myocarditis made it possible to determine the etiological factor of the disease with the establishment of genotypes, which caused Lyme carditis.
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Pritulina, Yu G., L. A. Chernyshova, G. G. Salomakhin, T. A. Ruzhentsova, V. V. Maleev, A. A. Ploskireva, and M. V. Bykov. "Cardiac lesions in patients with Lyme borreliosis." Infekcionnye bolezni 19, no. 1 (2021): 83–88. http://dx.doi.org/10.20953/1729-9225-2021-1-83-88.
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Acute infectious diseases can potentially affect the cardiovascular system. Objective. To demonstrate the need for dynamic monitoring and treatment of cardiovascular disorders in patients with tickborne borreliosis. Patients and methods. This study included 142 patients with laboratory-confirmed tick-borne borreliosis. We analyzed clinical symptoms, results of laboratory testing, and electrocardiography (ECG) findings. Results. Almost one-fifth of all patients (18%) had complaints indicating cardiovascular lesions (both in the group under 60 years of age and in the group of elderly patients). Thirteen patients (9.2%) presented with hypotension. Grade 1–2 hypertension was observed in 11 hospitalized patients (7.7%). Clinical manifestations were accompanied by various ECG abnormalities. Conclusion. We found that 13.4% of patients with confirmed borreliosis had symptoms of probable myocarditis with signs of coronary artery lesions. The disorders detected were shortly eliminated by basic therapy or additional treatment (when needed) by the time of discharge from hospital. Key words: borreliosis, Lyme borreliosis, myocarditis, ECG, extrasystole, erythema
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Lytvyn, Halyna, Natella Basa, Khrystyna Slivinska-Kurchak, and Iryna Avramenko. "First-degree atrioventricular block in 14-year-old child due to Lyme disease." Journal of Infection in Developing Countries 16, no. 04 (April 30, 2022): 726–28. http://dx.doi.org/10.3855/jidc.15071.
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Lyme disease is an infectious disease caused by bacteria of the Borrelia burgdorferi sensu lato (Bbsl) complex and is characterized by predominant lesions of the skin, cardiovascular system, nervous system and musculoskeletal system. We have described a clinical case of first-degree atrioventricular block in a 14-year-old boy caused by Lyme borreliosis. The disease started with the manifestations of cardiovascular system involvement. The patient and his parents did not recall observing a tick bite or manifestation of erythema migrans (EM). The boy was prescribed doxycycline. Three weeks after antibiotic therapy a second ECG examination was performed and showed no abnormalities.
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Dhliwayo, Nyembezi, Rana Wajahat, Andriy Havrylyan, Alvia Moid, Walid Khayr, and Charles P. Barsano. "Lyme Disease: An Autoimmunity-Based “Destructive Thyroiditis” or Just Another “Non-Thyroidal Illness”?" Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A940—A941. http://dx.doi.org/10.1210/jendso/bvab048.1922.
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Abstract There is considerable evidence that some Borrelial (Lyme spirochetal) proteins share significant antigenic properties with several thyroid-related proteins (e.g. TSH receptor, thyroglobulin, thyroid peroxidase) and can induce thyroid autoimmunity, sometimes associated with Hashimoto’s thyroiditis and perhaps also a “destructive thyroiditis” such as “silent” thyroiditis or “Hashitoxicosis.” As an acute illness, Lyme disease may also constitute a “non-thyroidal illness” capable of perturbing thyroid function tests without causing thyroid dysfunction. We report a 22-year old woman admitted with an acute paranoid schizophrenia, thyroid function tests consistent with autoimmunity, transient thyrotoxicosis (tachycardia, lid-lag, brisk DTR’s) and a greatly reduced radioiodine uptake. The thyroid was not palpably enlarged, nodular or tender. On screening assay, reactivity was demonstrated to 4 of 13 Borrelial proteins. Anti-Lyme IgM but not IgG, antibodies, were positive. This was consistent with recent Lyme disease infection. Serum TSH (NL: 0.358-3.74 mcU/ml), Free T4 (NL: 0.76-1.46 ng/dl), and Free T3 (NL: 2.18-3.98 pg/ml) were, respectively: Day1: 0.087 mcU/ml (suppressed), 1.52 ng/dl (slightly elevated), 2.07 pg/ml (slightly reduced); Day2: 0.148 (suppressed), 1.18 (normal), no FT3; Day4: 0.827 (normal), no FT4 or FT3; Day5: 1.66 (normal), 0.89 (normal), 1.77 (low). Anti-Tg and Anti-Peroxidase antibodies were both moderately elevated. Thyroid Stimulating Immunoglobulins were not elevated. The radioactive iodine uptake on Day4 was 2.8% (NL: 15-30% at 24 hr). Thyroid ultrasonogram was normal. An attractive explanation is that Lyme disease triggered a “destructive thyroiditis,” perhaps but not necessarily mediated by thyroid autoimmunity. This would account for the brief interval of thyrotoxicosis accompanied by a very low radioiodine uptake. Alternatively, Lyme disease, as an acute process, would expectedly be capable of eliciting the thyroid function abnormalities of “non-thyroidal illnesses” in general, as would acute psychosis, well-known to often resemble Graves’ disease at admission.
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Budaeva, Iryna, Heorhii Revenko, Liubov Kodola, and Svitlana Ryasik. "Modern Epidemiological Features of Lyme-borreliosis and Diagnostic Criteria of «Minor» Forms of Myocarditis." Family Medicine, no. 6 (December 30, 2016): 94–97. http://dx.doi.org/10.30841/2307-5112.6.2016.249523.
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This paper shows the epidemiological characteristics of Lyme-borreliosis in Dnipropetrovsk region, which presents urbanic environment. The greatest incidence of the disease was determined in working age population. The possibility of heart involvement in the «minor» forms is proved; the later are diagnosed with the means of ECG and CFK-MB evaluation.
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Chirva, D. V. "Does Olson’s animalism put end to personal identity debate?" Omsk Scientific Bulletin. Series Society. History. Modernity 6, no. 2 (2021): 107–12. http://dx.doi.org/10.25206/2542-0488-2021-6-2-107-112.
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Theory of Eric Olson’s animalism is evaluated in the article in relation to his debate with the proponents of psychological approach to personal identity problem. Olson aims to show the irrelevance of psychology to the issue and to finish the debate by means of introducing the fetus problem. It is argued that theory of animalism has its certain strong points in comparison with Lynne Baker’s constitution view and Jeff McMahan’s embodied part approach; it does not contain any contradictions and rests on few theoretical assumptions. Nevertheless, it is claimed that animalism does not finish the debate, because it does not take into consideration that a person has a strong self-concern about her future. So the essential part of the general personal identity problem is simply ignored by Olson’s animalism
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Sur, Maria Lucia, Bogdan-Stefan Moldovan, Diana Mocanu, Gabriel Samasca, Iulia Lupan, Ionel Armat, Marin Harabagiu, Genel Sur, and Calin Lazar. "Immune Responses to Some Viral Infections That Have a High Evolutionary Potential—A Case Report with Literature Review." Life 12, no. 7 (June 23, 2022): 940. http://dx.doi.org/10.3390/life12070940.
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Viral infections are a key issue in modern medicine. SARS-CoV-2 infection confirms that we are not sufficiently prepared for these unforeseen infections. The COVID-19 pandemic has cultivated a great sense of fear and distrust in patients. If viral infections, in this case, SARS-CoV-2, overlap with another infection, the symptoms are prolonged and worsened, and complications may occur. Starting from an objective clinical finding of a patient they had in follow-up and treatment, the authors present the problems of the diseases the patient suffered from. These are described as reviews so that readers can get an idea of the clinical methods of expression and the therapeutic possibilities. Therefore, this article describes Lyme disease and post-treatment Lyme disease syndrome, SARS-CoV-2 infection, and multisystem inflammatory syndrome in children (MISC-C), as the patient suffered from an incomplete form of Kawasaki disease. During the treatment for Lyme disease, the patient also contracted the influenza type A virus. Although any of these diseases could have the potential for serious evolution, our patient still went through these infections relatively well. This can be explained by the fact that the patient had a slow immune response to the aforementioned infections, which allowed him to survive these diseases relatively easily, unlike other individuals who have an exaggerated immune response or who suffer from serious immune involvement, e.g., hepatitis B with a fulminant response. The case was presented chronologically, but at the same time, all particular infection manifestations were accurately described. For these reasons, the article is presented in the form of a review, exemplified by the case itself. Of the 52 cases of MISC-C found in the Pediatrics Clinic II of Cluj-Napoca, we present the case of a male patient who presented with Lyme disease, post-treatment Lyme disease syndrome, Kawasaki disease, and MISC-C incomplete form.
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Wendel Neto, Silvano. "Current concepts on the transmission of bacteria and parasites by blood components." Sao Paulo Medical Journal 113, no. 6 (December 1995): 1036–52. http://dx.doi.org/10.1590/s1516-31801995000600007.
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Several bacterial and parasite transfusion-transmitted diseases have been described in the medical literature. This review deals with the main bacterial (Syphilis, Lyme disease, Gram positive and Gram negative agents), parasite (Chagas disease, malaria, leishmaniasis, toxoplasmosis and babesiosis) and rickettsial diseases that are carried by blood products. Preventional aspects (e.g. storage, screening tests, use of leukocyte-depleted components), diagnosis, geographical distribution and the incidence of these transfusional hazards are also discussed.
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Iyer, Radha, Ogori Kalu, Joye Purser, Steven Norris, Brian Stevenson, and Ira Schwartz. "Linear and Circular Plasmid Content in Borrelia burgdorferi Clinical Isolates." Infection and Immunity 71, no. 7 (July 2003): 3699–706. http://dx.doi.org/10.1128/iai.71.7.3699-3706.2003.
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ABSTRACT The genome of Borrelia burgdorferi, the etiologic agent of Lyme disease, is composed of a linear chromosome and more than 20 linear and circular plasmids. Typically, plasmid content analysis has been carried out by pulsed-field gel electrophoresis and confirmed by Southern hybridization. However, multiple plasmids of virtually identical sizes (e.g., lp28 and cp32) complicate the interpretation of such data. The present study was undertaken to investigate the complete plasmid complements of B. burgdorferi clinical isolates cultivated from patients from a single region where early Lyme disease is endemic. A total of 21 isolates obtained from the skin biopsy or blood samples of Lyme disease patients were examined for their complete plasmid complements by Southern hybridization and plasmid-specific PCR analysis. All clinical isolates harbored at least six of the nine previously characterized cp32s. Fourteen isolates harbored all B31-like linear plasmids, and seven isolates simultaneously lacked lp56, lp38, and some segments of lp28-1. The distinctive plasmid profile observed in these seven isolates was specific to organisms that had ribosomal spacer type 2 and pulsed-field gel type A, which implies a clonal origin for this genotype. The presence of nearly identical complements of multiple linear and circular plasmids in all of the human isolates suggests that these plasmids may be particularly necessary for infection, adaptation, and/or maintenance in the infected host.
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Rochlin, Ilia, and Alvaro Toledo. "Emerging tick-borne pathogens of public health importance: a mini-review." Journal of Medical Microbiology 69, no. 6 (June 1, 2020): 781–91. http://dx.doi.org/10.1099/jmm.0.001206.
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Ticks are the most important vectors of human pathogens, leading to increased public health burdens worldwide. Tick-borne pathogens include viruses (e.g. tick-borne encephalitis and Powassan); bacteria, such as the causative agents of Lyme disease, spotted fever rickettsiosis and human anaplasmosis; and malaria-like protozoan parasites causing babesiosis. Tick-borne diseases are emerging due to the geographical expansion of their tick vectors, especially in the northern hemisphere. Two examples of this phenomenon are Ixodes scapularis and Amblyomma americanum, which have expanded their ranges in the USA in recent decades and are responsible for the continuous emergence of Lyme disease and human ehrlichiosis, respectively. This phenomenon is also occurring worldwide and is reflected by the increasing number of tick-borne encephalitis and haemorrhagic fever cases in Europe and Asia. In this review, we provide a concise synopsis of the most medically important tick-borne pathogen worldwide, with a particular emphasis on emerging public health threats.
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Sapozhnikova, V. V., and A. L. Bondarenko. "Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans." Russian Medical Inquiry 4, no. 11 (2020): 676–81. http://dx.doi.org/10.32364/2587-6821-2020-4-11-676-681.
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Aim: to determine the association between clinical laboratory parameters, the production of cytokines (IL-17A, -23, -33, -35), and specific IgM and IgG in the serum of patients with Lyme borreliosis without erythema migrans. Patients and Methods: complete blood count, the concentrations of IL-17A, -23, -33, -35, and the levels of specific IgM and IgG were measured during acute infection and convalescence (n=30). The control group included age- and sex-matched healthy individuals (n=30). Statistical analysis was performed using the StatSoft Statistica v 10.0 software (parametric and non-parametric methods and multifactorial analysis, i.e., principal component analysis). Results: most (80%) patients with Lyme borreliosis without erythema migrans are the people of working age. In most patients, the combination of the specific antibodies against Borrelia afzelii and Borrelia garinii (76.7%) and severe intoxication and inflammatory process (100%) were detected. Moderate and severe disease associated with meningism was diagnosed in 90% and 10%, respectively. The mean duration of hectic period was 8.3±1.27 days. Abnormal ECG was reported in 40% of patients, i.e., conduction abnormalities in 20%, sinus bradycardia in 16.7%,and sinus tachycardia in 3.3%. The clinical laboratory signs of hepatitis without jaundice were identified in 26.7%. During treatment, the significant reduction in band and segmented neutrophil counts as well as the significant increase in platelet count were revealed compared to these parameters at admission. Abnormal cytokine levels (i.e., the increase in IL-17A, -23, -33 and the deficiency of IL-35) were detected. Conclusions: multifactorial analysis has demonstrated that the severity of immunological abnormalities in patients with Lyme borreliosis without erythema migrans is associated with fever, cardiac and liver disorders, the high levels of IL-23 and IL-33, and the lack of IL-35 and specific IgM and IgG. KEYWORDS: tick-borne borreliosis, Lyme disease without erythema migrans, clinical laboratory signs, cytokines, specific antibodies, multifactorial analysis, principal component analysis. FOR CITATION: Sapozhnikova V.V., Bondarenko A.L. Multifactorial analysis of clinical laboratory signs, the levels of IL-17A, IL-23, IL-33, IL-35, and specific antibodies in the serum of patients with Lyme borreliosis without erythema migrans. Russian Medical Inquiry. 2020;4(11):676–681. DOI: 10.32364/2587-6821-2020-4-11-676-681.
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Massara, M., L. Zappelli, A. Lanari, M. Pergolini, A. Giovagnoli, G. Refi, and G. Di Noto. "LYME AND DENGUE FEVER: FROM BANGLADESH TO ITALY." European Heart Journal Supplements 26, Supplement_2 (April 2024): ii59. http://dx.doi.org/10.1093/eurheartjsupp/suae036.134.
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Abstract Background Dengue fever (Flavivirus) and Lyme disease (Borrelia burgdorferi) are rare tropical infectious diseases transmitted by hematophagous vectors (Aedes mosquitoes and ticks, respectively), and they are extremely uncommon in Italy. In European countries, both represent a public health concern as they manifest as imported diseases. Case Report A 54–year–old man from Bangladesh was admitted with symptoms of fever, dyspnea, and pericarditic chest pain. Laboratory and imaging examinations revealed severe acute respiratory failure secondary to left lower lobe pneumonia and pleuropericardial effusion. Broad–spectrum antibiotic therapy and anti–inflammatory treatment were initiated, suspecting para–pneumonic pleuropericarditis. During hospitalization, there was a gradual improvement with a reduction in inflammatory indices and resolution of lung consolidation. The patient was discharged after 14 days with anti–inflammatory therapy (ibuprofen and colchicine). Approximately 7 days later, the patient returned to the emergency department complaining of a recurrence of symptoms and fatigue. The EKG showed phases of 2:1 AV block, EAS and EPS, complete de novo left bundle branch block (LBBB), alternating with an escape atrial rhythm, not evident in previous EKG. During hospitalization, complete AV block emerged with prolonged asystolic phases, requiring urgent placement of a temporary pacemaker. Concurrently, blood tests revealed anemia and increased levels of inflammatory markers, troponin, creatinine, transaminases, cholestatic indices, LDH, and lipase, indicative of multiple organ failure (MOF). Acute pathologies or active bleeding were ruled out by total body CT with contrast. Blood cultures and serological tests were performed to exclude infections by Trichinella, Mycoplasma, Borrelia, Dengue, and other rare infectious diseases. Due to progressive deterioration, the patient was transferred to a tertiary care hospital. In the following days, laboratory results showed positive IgG and IgM for Dengue (without serological evidence of viral RNA) and positive IgG and IgM antibodies for Borrelia burgdorferi. Conclusion In Italy, the incidence of these diseases is low, and their coexistence in the same host is even rarer (if not anecdotal). However, coinfection cannot be excluded in patients from areas where these diseases are endemic, such as Bangladesh.
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Porwancher, Richard B., C. Greg Hagerty, Jianqing Fan, Lisa Landsberg, Barbara J. B. Johnson, Mark Kopnitsky, Allen C. Steere, Karen Kulas, and Susan J. Wong. "Multiplex Immunoassay for Lyme Disease Using VlsE1-IgG and pepC10-IgM Antibodies: Improving Test Performance through Bioinformatics." Clinical and Vaccine Immunology 18, no. 5 (March 2, 2011): 851–59. http://dx.doi.org/10.1128/cvi.00409-10.
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ABSTRACTThe Centers for Disease Control and Prevention currently recommends a 2-tier serologic approach to Lyme disease laboratory diagnosis, comprised of an initial serum enzyme immunoassay (EIA) for antibody toBorrelia burgdorferifollowed by supplementary IgG and IgM Western blotting of EIA-positive or -equivocal samples. Western blot accuracy is limited by subjective interpretation of weakly positive bands, false-positive IgM immunoblots, and low sensitivity for detection of early disease. We developed an objective alternative second-tier immunoassay using a multiplex microsphere system that measures VlsE1-IgG and pepC10-IgM antibodies simultaneously in the same sample. Our study population comprised 79 patients with early acute Lyme disease, 82 patients with early-convalescent-phase disease, 47 patients with stage II and III disease, 34 patients post-antibiotic treatment, and 794 controls. A bioinformatic technique called partial receiver-operator characteristic (ROC) regression was used to combine individual antibody levels into a single diagnostic score with a single cutoff; this technique enhances test performance when a high specificity is required (e.g., ≥95%). Compared to Western blotting, the multiplex assay was equally specific (95.6%) but 20.7% more sensitive for early-convalescent-phase disease (89.0% versus 68.3%, respectively; 95% confidence interval [95% CI] for difference, 12.1% to 30.9%) and 12.5% more sensitive overall (75.0% versus 62.5%, respectively; 95% CI for difference, 8.1% to 17.1%). As a second-tier test, a multiplex assay for VlsE1-IgG and pepC10-IgM antibodies performed as well as or better than Western blotting for Lyme disease diagnosis. Prospective validation studies appear to be warranted.
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Stupica, Daša, Fajko F. Bajrović, Rok Blagus, Tjaša Cerar Kišek, Stefan Collinet‐Adler, Anja Lah, Eva Levstek, and Eva Ružić‐Sabljić. "Clinical manifestations and long‐term outcome of early Lyme neuroborreliosis according to the European Federation of Neurological Societies diagnostic criteria (definite versus possible) in central Europe. A retrospective cohort study." European Journal of Neurology 28, no. 9 (July 2021): 3155–66. http://dx.doi.org/10.1111/ene.14962.
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Gardner, Allison M., Natalie C. Pawlikowski, Sarah A. Hamer, Graham J. Hickling, James R. Miller, Anna M. Schotthoefer, Jean I. Tsao, and Brian F. Allan. "Landscape features predict the current and forecast the future geographic spread of Lyme disease." Proceedings of the Royal Society B: Biological Sciences 287, no. 1941 (December 23, 2020): 20202278. http://dx.doi.org/10.1098/rspb.2020.2278.
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Lyme disease, the most prevalent vector-borne disease in North America, is increasing in incidence and geographic distribution as the tick vector, Ixodes scapularis , spreads to new regions. We re-construct the spatial-temporal invasion of the tick and human disease in the Midwestern US, a major focus of Lyme disease transmission, from 1967 to 2018, to analyse the influence of spatial factors on the geographic spread. A regression model indicates that three spatial factors—proximity to a previously invaded county, forest cover and adjacency to a river—collectively predict tick occurrence. Validation of the predictive capability of this model correctly predicts counties invaded or uninvaded with 90.6% and 98.5% accuracy, respectively. Reported incidence increases in counties after the first report of the tick; based on this modelled relationship, we identify 31 counties where we suspect I. scapularis already occurs yet remains undetected. Finally, we apply the model to forecast tick establishment by 2021 and predict 42 additional counties where I. scapularis will probably be detected based upon historical drivers of geographic spread. Our findings leverage resources dedicated to tick and human disease reporting and provide the opportunity to take proactive steps (e.g. educational efforts) to prevent and limit transmission in areas of future geographic spread.
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Mesbah-Oskui, L., O. Marais, J. Alabkal, N. Randhawa, and MM Mezei. "P.066 A 65 year-old male with subacute asymmetric, proximal more than distal upper extremity weakness with associated paresthesias and pain." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 51, s1 (May 24, 2024): S34. http://dx.doi.org/10.1017/cjn.2024.172.
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Background: Neuroborreliosis affects approximately 10-15% of people with untreated Lyme disease and typically declares itself 2-18 weeks after infection. North American neuroborreliosis often manifests with cranial nerve palsy, meningitis, and/or radiculoneuritis. Methods: Here we describe a case of North American neuroborreliosis and also highlight some of the rare manifestations of systemic Lyme disease. A 65-year old male presented with a subacute history of progressive upper extremity weakness, neck pain, and headache. This occurred in the context of a recent tick exposure. Results: MRI of the brachial plexus, serology and CSF studies, and EMG/NCS were consistent with a diagnosis of polyradicular neuroborreliosis. However, whole body imaging identified some concerning features suggestive of lymphoma: specifically a large necrotic mediastinal lymph node and a number of vascular abnormalities. In light of these findings, the differential also included neurolymphomatosis and a PET scan was conducted. Reassuringly, there was no increase in FDG avidity in the distribution of his affected nerves. Moreover, his neurologic symptoms exhibited clinical improvement following treatment of his neuroborreliosis. Conclusions: This case provides an excellent example of the clinical features of neuroborreliosis, but more importantly also highlights some of the rarer potential manifestations, which warrant further investigation.
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Rudd-Barnard, Alexandra, Sarah Jarvandi, Roxanne Rapoport, Sue Smith, and Natalia Witkowska. "A-79 Case Series Evaluating Quantitative Electroencephalograph and Neuropsychological Function in Neurological Lyme Disease." Archives of Clinical Neuropsychology 36, no. 6 (August 30, 2021): 1123–24. http://dx.doi.org/10.1093/arclin/acab062.97.
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Abstract Objectives The purpose of this study was to investigate the characteristics of physician diagnosed Neurological Lyme disease (NLD) using Quantitative EEG and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). We hypothesize that findings would include more slow wave (Delta/Theta) activity that is consistent with the severity reported dysfunction. Methods Subjects consisted of four adult females with a physician provided diagnosis of NLD. EEG was recorded from 21 sites during an eyes open and eyes-closed resting conditions. Raw EEG data was made quantifiable (qEEG) through Fourier transformation to determine z-score derived cortical and subcortical slow wave activity. The RBANS was used to assess each subject’s functioning. Results (See Imaging). Subject 1. Theta: 3.7. Alpha: 2.3. Theta: 3.2. Alpha: 2.5. RBANS - 96. Subject 2. Theta: 1.9. Alpha: 3.1. Theta: 2.3. Alpha: 4.4. RBANS - 76. Subject 3. Theta: 3.4. Alpha: 2.8. Theta: 3.5. Alpha: 2.1. RBANS - 110. Subject 4. Theta: 3.6. Alpha: 3.0. Theta: 3.3. Alpha: 2.8. RBANS - 100. Conclusions NLD subjects within this study all demonstrated elevated subcortical frontal and frontotemporal theta and alpha. Elevation in cortical slow wave activity was found for subjects with greater reported symptomatology and may suggest either less severe course of disease or serve as a recovery marker. RBANS assessment variables were not completely sensitive in detection of subject reported challenges. Implications for conceptualization, treatment, and disease monitoring are highlighted. Directions for future research will also be discussed.
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Shushkovska, Yu Yu, O. I. Afanasiuk, and R. V. Matyash. "Clinical case of borreliosis myocarditis." Reports of Vinnytsia National Medical University 24, no. 2 (December 13, 2020): 232–35. http://dx.doi.org/10.31393/reports-vnmedical-2020-24(2)-06.
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Annotation. The purpose of the work is to demonstrate the peculiarities of its course, modern methods of diagnosis and treatment on the example of a clinical case of borreliosis myocarditis. According to the results of the patient's ECG, a transient atrio-ventricular block of the first degree was established. The results of general clinical methods of examination of the patient generally corresponded to the reference values. According to the results of Holter ECG monitoring, a diagnosis of mild myocarditis, heart failure I, functional class I, with preserved ejection fraction (50 %) of the left ventricle was made. Ventricular arrhythmia – 4th grade according to Laun. Competitive atrial rhythm, transient atrioventricular block. Because specific cardiovascular lesions occurred for no apparent reason and symptoms occurred during peak tick activity, the patient was re-interviewed for migratory erythema and tick bites. The patient confirmed being in the forest during the disease season and sucking the mite without specific skin lesions. To further search for the etiological factor that led to the identified changes, the patient was tested for antibodies to Burrelia burgdorferi by ELISA. The obtained positive result (Ig G – 3.89 IU/ml, Ig M – 33.74 IU/ml) indicated an acute period of Lyme disease. Thus, the final diagnosis was: Lyme disease, stage II (early disseminal). Subacute infectious (borreliosis) myocarditis, mild course, heart failure I, functional class I, with preserved ejection fraction (50 %) of the left ventricle. Ventricular arrhythmia – 4th grade according to Laun. Competitive atrial rhythm, transient atrioventricular block of the I degree. Treatment is prescribed: doxycycline 100 mg x 2 times/day, metoprolol 25 mg x 2 times/day, metabolic therapy and serological tests are recommended after 3, 6, 12 months and 2 years. Thus, the clinical case shows the difficulties of diagnosing “borreliosis myocarditis”, emphasizes the prospects for the development of algorithms for the diagnosis and treatment of borreliosis myocarditis.
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Tully, Brenden G., and Jason F. Huntley. "Mechanisms Affecting the Acquisition, Persistence and Transmission of Francisella tularensis in Ticks." Microorganisms 8, no. 11 (October 23, 2020): 1639. http://dx.doi.org/10.3390/microorganisms8111639.
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Over 600,000 vector-borne disease cases were reported in the United States (U.S.) in the past 13 years, of which more than three-quarters were tick-borne diseases. Although Lyme disease accounts for the majority of tick-borne disease cases in the U.S., tularemia cases have been increasing over the past decade, with >220 cases reported yearly. However, when comparing Borrelia burgdorferi (causative agent of Lyme disease) and Francisella tularensis (causative agent of tularemia), the low infectious dose (<10 bacteria), high morbidity and mortality rates, and potential transmission of tularemia by multiple tick vectors have raised national concerns about future tularemia outbreaks. Despite these concerns, little is known about how F. tularensis is acquired by, persists in, or is transmitted by ticks. Moreover, the role of one or more tick vectors in transmitting F. tularensis to humans remains a major question. Finally, virtually no studies have examined how F. tularensis adapts to life in the tick (vs. the mammalian host), how tick endosymbionts affect F. tularensis infections, or whether other factors (e.g., tick immunity) impact the ability of F. tularensis to infect ticks. This review will assess our current understanding of each of these issues and will offer a framework for future studies, which could help us better understand tularemia and other tick-borne diseases.
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Chojnowska, Sylwia, Alina Kępka, Sławomir Dariusz Szajda, Napoleon Waszkiewicz, Marcin Bierć, and Krzysztof Zwierz. "Exoglycosidase markers of diseases." Biochemical Society Transactions 39, no. 1 (January 19, 2011): 406–9. http://dx.doi.org/10.1042/bst0390406.
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Exoglycosidases are hydrolases involved in lysosomal degradation of oligosaccharide chains of glycoconjugates (glycoproteins, glycolipids and proteoglycans). In tissues and body fluids, a higher exoglycosidase specific activity is found in N-acetyl-β-hexosaminidase, than β-glucuronidase, α-L-fucosidase, β-galactosidase, α-mannosidase and α-glucosidase. Determination of exoglycosidases (especially N-acetyl-β-hexosaminidase and β-glucuronidase) in body fluids could be an inexpensive, easy to perform and sensitive test for pathological evaluation, as well as in screening and monitoring many diseases, including alcohol abuse, risk of arteriosclerosis, bacterial infections (e.g. Lyme borreliosis), chronic inflammatory processes, such as rheumatoid arthritis and juvenile idiopathic arthritis, asthma, autoimmune hepatitis and primary biliary cirrhosis, as well as cancers.
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Taylor, Michael A. "Lost & Found: 200.Thomas Hawkins FGS (22 July 1810 - 15 October 1889)." Geological Curator 5, no. 3 (July 1989): 112–14. http://dx.doi.org/10.55468/gc632.
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Michael Taylor (Leicestershire Museums, Arts and Records Service, 96 New Walk, Leicester LEI 6TD) writes: 'Thomas Hawkins of Glastonbury has generally been regarded as an archetypal eccentric collector, who accumulated one of the finest collections of Liassic fossil marine reptiles from around Street and Glastonbury in Somerset, with a smaller proportion from Lyme Regis and Charmouth in Dorset. Although by no means forgotten (e.g. Blanford 1890; Owen 1894; Howe et ^.1981; McGowan 1983; McGarvie 1987), he has been the subject of little if any primary research since the biography of Bulleid (1943), which is itself vague as to the existence of any original documents. Hawkins deseryes at least a brief reappraisal in time for 1989, the centenary of...
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Armstrong, Mary A. "NEXT WEEK!! — : DESIRE, DOMESTIC MELODRAMA, AND THE EXTRAVAGANT PROLIFERATIONS OFEAST LYNNE." Victorian Literature and Culture 43, no. 4 (August 5, 2015): 745–64. http://dx.doi.org/10.1017/s1060150315000248.
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Ellen Wood'sEast Lynne(1861) exhibits the exhilarating characteristics of a Victorian sensation novel and then some: degenerate aristocracy, a sneering villain, flight, adultery, a child born out of wedlock, disfigurement, disguise, extended deathbed scenes, murder, and more (e.g., fake accents, false identities, an electrifying homicide trial, and a spectacular train wreck). But at the center of all the disaster, transgression, pathos, coincidence, and extremity,East Lynneis (mainly) the story of the aptly-named Isabel Vane, the beloved but patently bored wife who abandons her husband and children to run away with a handsome seducer. Overcome by remorse (and conveniently both disfigured and presumed dead), she returns to the home of her remarried husband to act as governess to her own children and to witness (at length and in painful detail) the life she might have had if she had denied her perpetually irrepressible but inappropriate feelings — feelings not so much of lust for another man, but of annoyance and tedium with the man she actually has.East Lynneurges (usually in the form of multiple diatribes from the third person narrator) that the wives and mothers of mid-Victorian England be content with their lot, employing a moral didacticism that insists on female domestic responsibility — and the attendant obligation of female suffering — with sadistic pleasure. And yet, when not lingering over the agonies of Isabel, the narrative gushes, seemingly despite itself, with sympathy for the heroine's life of monotony and misery. Indeed,East Lynne's compelling power comes in large part from the novel's skillful, lingering walk on a ledge of its own making and its protracted vacillation between condemnation and empathy for an unhappy heroine gone astray.
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Shi, Wenyuan, Zhaomin Yang, Yongzhi Geng, Lawrence E. Wolinsky, and Michael A. Lovett. "Chemotaxis in Borrelia burgdorferi." Journal of Bacteriology 180, no. 2 (January 15, 1998): 231–35. http://dx.doi.org/10.1128/jb.180.2.231-235.1998.
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ABSTRACT Borrelia burgdorferi is a motile spirochete which has been identified as the causative microorganism in Lyme disease. The physiological functions which govern the motility of this organism have not been elucidated. In this study, we found that motility of B. burgdorferi required an environment similar to interstitial fluid (e.g., pH 7.6 and 0.15 M NaCl). Several methods were used to detect and measure chemotaxis of B. burgdorferi. A number of chemical compounds and mixtures were surveyed for the ability to induce positive and negative chemotaxis of B. burgdorferi. Rabbit serum was found to be an attractant for B. burgdorferi, while ethanol and butanol were found to be repellents. Unlike some free-living spirochetes (e.g., Spirochaeta aurantia), B. burgdorferi did not exhibit any observable chemotaxis to common sugars or amino acids. A method was developed to produce spirochete cells with a self-entangled end. These cells enabled us to study the rotation of a single flagellar bundle in response to chemoattractants or repellents. The study shows that the frequency and duration for pausing of flagella are important for chemotaxis of B. burgdorferi.
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Malenica, M., L. J. Cvitanović-Šojat, R. G. Juraški, and G. Tešović. "P22.11 EEG as a predictor of Lyme disease in a child with a peripheral facial palsy." European Journal of Paediatric Neurology 15 (May 2011): S122. http://dx.doi.org/10.1016/s1090-3798(11)70425-1.
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Gagné, Julie. "Henderson, Errol A., Democracy and War. The End of an Illusion ?, Boulder, co, Lynne Rienner, 2002, 165 p." Études internationales 34, no. 3 (2003): 478. http://dx.doi.org/10.7202/038666ar.
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Leite, R. Almeida, M. Almeida, A. Costa, J. Alcafache, and A. Mesquita. "First psychotic episode as first manifestation of lyme disease: Case report." European Psychiatry 64, S1 (April 2021): S813. http://dx.doi.org/10.1192/j.eurpsy.2021.2148.
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IntroductionLyme disease (LD) is caused by the spirochete Borrelia burgdorferi (Bb) and has been reported to be associated with various psychiatric presentations.ObjectivesTo report a case with LD and to highlight the importance of differential diagnosis in a first psychotic episode.MethodsCase report and non-systematic review of the literature.Results A woman aged 31 was admitted to the psychiatric department, after a car accident with a mortal victim, due to a first psychotic episode with visual hallucinations, disorientation in time and space, persecutory and grandiosity delusions. She had a personal psychiatric history of obsessive-compulsive disorder and no previous admission to an inpatient Unit. On psychotropic drugs the condition failed to improve, and subsequently neurological symptoms developed. EEG abnormalities prompted a lumbar puncture. In the CSF a strong plasma cell reaction with atypical cells was observed. The enzyme immunoassay for Borrelia burgdorferi was positive and after treatment with penicillin the psychiatric and neurological signs and symptoms remitted. Screening assessment followed by a thorough history, comprehensive psychiatric clinical exam, review of systems, mental status exam, neurological exam and physical exam relevant to the patient’s complaints and findings with clinical judgment, pattern recognition and knowledgeable interpretation of laboratory findings facilitates diagnosis. Psychotropics and antibiotics may help improve functioning and prevent further disease progression.ConclusionsLD is relatively rare, but awareness of the association between LD and neuropsychiatric presentations can improve understanding of the causes of mental illness and result in more effective prevention, diagnosis and treatment.DisclosureNo significant relationships.
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Lager, Malin, Peter Wilhelmsson, Andreas Matussek, Per-Eric Lindgren, and Anna J. Henningsson. "Molecular Detection of Borrelia Bacteria in Cerebrospinal Fluid-Optimisation of Pre-Analytical Sample Handling for Increased Analytical Sensitivity." Diagnostics 11, no. 11 (November 12, 2021): 2088. http://dx.doi.org/10.3390/diagnostics11112088.
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The main tools for clinical diagnostics of Lyme neuroborreliosis (LNB) are based on serology, i.e., detection of antibodies in cerebrospinal fluid (CSF). In some cases, PCR may be used as a supplement, e.g., on CSF from patients with early LNB. Standardisation of the molecular methods and systematic evaluation of the pre-analytical handling is lacking. To increase the analytical sensitivity for detection of Borrelia bacteria in CSF by PCR targeting the 16S rRNA gene, parameters were systematically evaluated on CSF samples spiked with a known amount of cultured Borrelia bacteria. The results showed that the parameters such as centrifugation time and speed, the use of complementary DNA as a template (in combination with primers and a probe aiming at target gene 16S rRNA), and the absence of inhibitors (e.g., erythrocytes) had the highest impact on the analytical sensitivity. Based on these results, a protocol for optimised handling of CSF samples before molecular analysis was proposed. However, no clinical evaluation of the proposed protocol has been done so far, and further investigations of the diagnostic sensitivity need to be performed on well-characterised clinical samples from patients with LNB.
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Dixon, Gabriel, Andrew S. Marriott, Graham Stelfox, Chris Dunkerley, and Sven P. Batke. "How do red deer react to increased visitor numbers? A case study on human-deer encounter probability and its effect on cortisol stress responses." Nature Conservation 43 (February 26, 2021): 55–78. http://dx.doi.org/10.3897/natureconservation.43.56266.
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The numbers of visitors to greenspaces in the United Kingdom has increased over the last few years as the health benefits of spending time in greenspaces have become better known. This has led to problems for conservation ecologists due to increased numbers of reported human-wildlife encounters. Deer are often found in public spaces and are of particular concern. Previous research suggests elevated levels of stress hormones (e.g., cortisol) in deer is a result of increased human activity. This has been linked to several negative effects on the deer’s health. From a practitioner’s point of view, it is therefore important to implement effective management strategies that are based on scientific evidence to help ensure the welfare of managed deer populations. In an effort to identify the impact of visitor numbers on faecal cortisol concentrations, samples from 2 red deer (Cervus elaphus) herds in Lyme Park (Cheshire), United Kingdom, were collected and analysed. A predictive spatial model was developed based on logistic regression to identify areas within the park of low and high human-deer encounter probability. The faecal cortisol levels were found to be significantly higher on days with a high number of visitors. In addition, landscape features such as buildings and roads increased the probability of human-deer encounters, whereas woodland and scrub decreased the probability. However, human-deer encounter probability changed with distance to the features. By providing local park managers with this scientific data, these findings can directly inform current management efforts to reduce deer stress levels in Lyme Park. In addition, the spatial modelling method has the capacity to be implemented in other parks across the country with minimal cost and effort.
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Gormally, M. J. "The effect of temperature on the duration of the egg stage of certain sciomyzid flies which predate Lymnae truncatula." Journal of Thermal Biology 10, no. 4 (December 1985): 199–203. http://dx.doi.org/10.1016/0306-4565(85)90040-3.
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Malla, P. "P.008 Triphasic waves in powassan encephalitis: a case report." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 46, s1 (June 2019): S15. http://dx.doi.org/10.1017/cjn.2019.109.
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Background: Powassan virus is a tick borne virus which can lead to encephalitis. Methods: 63 year old woman with history of migraine presented with 2 days of fever, headache, language difficulty and right sided facial droop. Her examination revealed right upper motor neuron type facial weakness and expressive aphasia. She rapidly deteriorated within 24 hours becoming non verbal and ultimately comatose. Results: MRI brain revealed T2 hyperintensities in bilateral caudate and putamen. Subsequent MRI brain showed progression of the caudate and basal ganglia changes and new T2 hyperintensities in bilateral thalami and midbrain with no abnormal enhancement. CSF revealed lymphocytic pleocytosis with normal protein and glucose. Viral Encephalitis was suspected and she was continued on Acyclovir until Varicella zoster and Herpes simplex virus serology in CSF returned negative. Prolonged video EEG showed near continuous generalized triphasic pattern without any evolution or seizure pattern. There was no improvement in clinical status or EEG with antiepileptic treatment. Paraneoplastic panel , serum HIV, Lyme and 14-3-3 protein were negative. Extensive viral serologies were sent and ultimately Powassan serology came back positive. Conclusions: This case highlights powassan virus as a cause of encephalitis and occurrence of triphasic waves in non metabolic causes of encephalopathy such as infectious encephalitis.
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Randolph, Sarah E. "The shifting landscape of tick-borne zoonoses: tick-borne encephalitis and Lyme borreliosis in Europe." Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences 356, no. 1411 (July 29, 2001): 1045–56. http://dx.doi.org/10.1098/rstb.2001.0893.
Full textAbstract:
The two major vector-borne diseases of northern temperate regions, tick-borne encephalitis (TBE) and Lyme borreliosis (LB), show very different epidemiological patterns, but both have increased significantly in incidence since the 1980s. Insight into the temporal dynamics of TBE, gained from statistical analysis of spatial patterns integrated with biological explanation, suggests that the recent increases in TBE cases in Central Europe and the Baltic States may have arisen largely from changes in human behaviour that have brought more people into contact with infected ticks. Under forecast climate change scenarios, it is predicted that enzootic cycles of TBE virus may not survive along the southern edge of their present range, e.g. in Slovenia, Croatia and Hungary, where case numbers are indeed decreasing. New foci, however, are predicted and have been observed in Scandinavia. At the same time, human impact on the landscape, increasing both the habitat and wildlife hosts of ticks, has allowed tick populations to multiply significantly. This probably accounts for a genuine emergence of LB, with its high potential transmission rate, in both the USA and Europe, although the rate of emergence has been exaggerated by improved surveillance and diagnosis.
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Gleysteen, William H. "The End of the Cold War in Northeast Asia. Edited by Stuart Harris and James Cotton. Boulder, Colo.: Lynne Rienner, 1991." Journal of Asian Studies 51, no. 3 (August 1992): 622–23. http://dx.doi.org/10.2307/2057955.
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Wang, Yujie, Camilo Diaz Cruz, and Barney J. Stern. "Approach to Facial Weakness." Seminars in Neurology 41, no. 06 (November 26, 2021): 673–85. http://dx.doi.org/10.1055/s-0041-1726358.
Full textAbstract:
AbstractFacial palsy is a common neurologic concern and is the most common cranial neuropathy. The facial nerve contains motor, parasympathetic, and special sensory functions. The most common form of facial palsy is idiopathic (Bell's palsy). A classic presentation requires no further diagnostic measures, and generally improves with a course of corticosteroid and antiviral therapy. If the presentation is atypical, or concerning features are present, additional studies such as brain imaging and cerebrospinal fluid analysis may be indicated. Many conditions may present with facial weakness, either in isolation or with other neurologic signs (e.g., multiple cranial neuropathies). The most important ones to recognize include infections (Ramsay-Hunt syndrome associated with herpes zoster oticus, Lyme neuroborreliosis, and complications of otitis media and mastoiditis), inflammatory (demyelination, sarcoidosis, Miller–Fisher variant of Guillain–Barré syndrome), and neoplastic. No matter the cause, individuals may be at risk for corneal injury, and, if so, should have appropriate eye protection. Synkinesis may be a bothersome residual phenomenon in some individuals, but it has a variety of treatment options including neuromuscular re-education and rehabilitation, botulinum toxin chemodenervation, and surgical intervention.
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Zaheer, Tean, Mahmoud Kandeel, Rao Zahid Abbas, Shanza Rauf Khan, Tauseef ur Rehman, and Amjad Islam Aqib. "Acaricidal Potential and Ecotoxicity of Metallic Nano-Pesticides Used against the Major Life Stages of Hyalomma Ticks." Life 12, no. 7 (June 29, 2022): 977. http://dx.doi.org/10.3390/life12070977.
Full textAbstract:
Ticks (Acari: Ixodidae) are blood-feeding parasites capable of transmitting diseases to animals (Piroplasmosis) and humans (Congo fever, Lyme disease). The non-judicious use of chemical acaricides has led to the development of acaricide-resistant ticks, making the control of ticks and tick-borne diseases difficult. This study reports the efficacy of magnesium oxide (MgO), iron oxide (Fe2O3), and zinc oxide (ZnO) nanoparticles (NPs) as alternatives to traditional acaricides/pesticides using in vitro tests against major representative stages of Hyalomma ticks. Nanopesticides were chemically synthesized as rods (Fe2O3), stars (ZnO), and spheres (MgO) and were characterized by XRD and SEM analysis. The in vitro bioassays included adult immersion, larval immersion, and larval packet tests. Non-target effects of the nanopesticides were evaluated using snails. The LC90 values of Fe2O3 NPs (4.21, 2.83, 0.89 mg/L) were lowest followed by MgO (4.27, 2.91, 0.93 mg/L) and ZnO (4.49, 3.05, 0.69 mg/L), for the tick adult, larval and egg stages, respectively. Fe2O3 NPs were capable of arresting oviposition and larval hatching in the study ticks in vitro. The snail toxicity experiments revealed minimum to mild off-target effects for all nanopesticides tested. This study is the first to report the comparative efficacy of magnesium, iron, and zinc nanomaterials for toxicity in egg, adult and larval stages of Hyalomma ticks. Further studies of NPs on establishing the efficacy against ticks and safety at host-human-environment interface could lead to promising nanopesticde applications.