[Lyme disease--clinical manifestations and treatment].

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Stock, Ingo

2016-05-01

Lyme disease (Lyme borreliosis) is a systemic infectious disease that can present in a variety of clinical manifestations. The disease is caused by a group of spirochaetes--Borrelia burgdorferi sensu lato or Lyme borrelia--that are transmitted to humans by the bite of Ixodes ticks. Lyme disease is the most common arthropode-borne infectious disease in many European countries including Germany. Early localized infection is typically manifested by an erythema migrans skin lesion, in rarer cases as a borrelial lymphocytoma. The most common early disseminated manifestation is (early) neuroborreliosis. In adults, neuroborreliosis appears typically as meningoradiculoneuritis. Neuroborreliosis in children, however, is typically manifested by meningitis. In addition, multiple erythema migrans lesions and Lyme carditis occur relatively frequently. The most common manifestation oflate Lyme disease is Lyme arthritis. Early manifestations (and usually also late manifestations) of Lyme disease can be treated successfully by application of suitable antibacterial agents. For the treatment of Lyme disease, doxycycline, certain penicillins such as amoxicillin and some cephalosporins (ceftriaxone, cefotaxime, cefuroxime axetil) are recommended in current guidelines. A major challenge is the treatment of chronic, non-specific disorders, i. e., posttreatment Lyme disease syndrome and "chronic Lyme disease". Prevention of Lyme disease is mainly accomplished by protecting against tick bites. Prophylactic administration of doxycycline after tick bites is generally not recommended in Germany. There is no vaccine available for human beings.

Lyme Disease Data

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... materials Why is CDC concerned about Lyme disease? Data and Statistics Recommend on Facebook Tweet Share Compartir ... sixth most common Nationally Notifiable disease . Lyme Disease Data File To facilitate the public health and research ...

Lyme disease antibody

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... JavaScript. The Lyme disease blood test looks for antibodies in the blood to the bacteria that causes ... needed. A laboratory specialist looks for Lyme disease antibodies in the blood sample using the ELISA test . ...

Lyme disease (image)

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Lyme disease is an acute inflammatory disease characterized by skin changes, joint inflammation and symptoms similar to the ... that is caused by the bacterium Borrelia burgdorferi . Lyme disease is transmitted by the bite of a deer ...

Lyme disease: case report of persistent Lyme disease from Pulaski County, Virginia

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Palmieri JR

2013-12-01

Full Text Available James R Palmieri,1 Scott King,1 Matthew Case,1 Arben Santo21Department of Microbiology, Infectious and Emerging Diseases, 2Department of Pathology, Edward Via College of Osteopathic Medicine, Blacksburg, VA, USAAbstract: A 50-year-old woman from Pulaski, Virginia, presented to a local clinic with headaches, fever, generalized joint pain, excessive thirst and fluid intake, and a progressing rash on her back. On physical examination, she had a large circular red rash on her back with a bull's-eye appearance, 16 × 18 cm in diameter. Serologic tests confirmed a diagnosis of Lyme disease. The patient could recall a walk through the woods 3 weeks prior, although she never noticed a tick on her body. Following a prolonged course of antibiotics, this case report presents a patient with ongoing symptoms consistent with post-treatment Lyme disease.Keywords: arthritis, chronic Lyme disease (CLD, ELISA, erythema migrans, ixodid ticks, Lyme disease, post-treatment Lyme disease syndrome (PTLDS, Western blotting

Lyme disease: the next decade

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Stricker, Raphael B; Johnson, Lorraine

2011-01-01

Although Lyme disease remains a controversial illness, recent events have created an unprecedented opportunity to make progress against this serious tick-borne infection. Evidence presented during the legally mandated review of the restrictive Lyme guidelines of the Infectious Diseases Society of America (IDSA) has confirmed the potential for persistent infection with the Lyme spirochete, Borrelia burgdorferi, as well as the complicating role of tick-borne coinfections such as Babesia, Anaplasma, Ehrlichia, and Bartonella species associated with failure of short-course antibiotic therapy. Furthermore, renewed interest in the role of cell wall-deficient (CWD) forms in chronic bacterial infection and progress in understanding the molecular mechanisms of biofilms has focused attention on these processes in chronic Lyme disease. Recognition of the importance of CWD forms and biofilms in persistent B. burgdorferi infection should stimulate pharmaceutical research into new antimicrobial agents that target these mechanisms of chronic infection with the Lyme spirochete. Concurrent clinical implementation of proteomic screening offers a chance to correct significant deficiencies in Lyme testing. Advances in these areas have the potential to revolutionize the diagnosis and treatment of Lyme disease in the coming decade. PMID:21694904

New insights into Lyme disease

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Brandon N. Peacock

2015-08-01

Full Text Available Lyme borreliosis is transmitted through the bite of a tick that is infected by the bacterial spirochete Borrelia burgdorferi. Clinical manifestation of the disease can lead to heart conditions, neurological disorders, and inflammatory disorders. Oxidative stress has been implicated in the pathogenesis of many human diseases. The aim of this study was to investigate the mechanisms of oxidative stress and intracellular communication in Lyme borreliosis patients. Mitochondrial superoxide and cytosolic ionized calcium was measured in peripheral blood mononuclear cells (PBMCs of Lyme borreliosis patients and healthy controls. Mitochondrial superoxide levels were significantly higher (p<0.0001 in Lyme borreliosis patients (n=32 as compared to healthy controls (n=30. Significantly low (p<0.0001 levels of cytosolic ionized calcium were also observed in Lyme borreliosis patients (n=11 when compared to healthy controls (n=11. These results indicate that there is an imbalance of reactive oxygen species and cytosolic calcium in Lyme borreliosis patients. The results further suggest that oxidative stress and interrupted intracellular communication may ultimately contribute to a condition of mitochondrial dysfunction in the immune cells of Lyme borreliosis patients.

Étendre la protection de la loi aux populations à risque au Canada ...

International Development Research Centre (IDRC) Digital Library (Canada)

14 juil. 2016 ... La juge en chef de la Cour suprême du Canada, la très honorable Beverley McLachlin, le procureur général de la Sierra Leone, l'honorable Joseph Kamara, et la correspondante parlementaire pour le réseau CBC, Alison Crawford, se sont joints au CRDI le 16 juin 2016 pour discuter des obstacles qui ...

Neurogenic Bladder in Lyme Disease

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Mi-hwa Kim

2012-12-01

Full Text Available Lyme disease is a multi-systemic, tick-borne infectious disease caused by a spirochete, Borrelia burgdorferi. Various urologic symptoms are associated with Lyme disease, which can be primary or late manifestations of the disease. Although voiding dysfunction is a rarely reported symptom in patients with Lyme disease, it is one of the most disabling complications of Lyme disease. Korea is not an endemic area of Lyme disease, thus, fewer cases have been reported. Herein, we report a case of a 32-year-old man with rapidly progressive bilateral ptosis, dysphagia, spastic paraparesis, and voiding difficulty in whom Lyme disease was diagnosed through serologic tests for antibodies and Western blot testing. A urodynamic study demonstrated detrusor areflexia and bulbocavernosus reflex tests showed delayed latency, indicating demyelination at S2-S4 levels. He received a 4-week course of intravenous ceftriaxone (2 g/day. The patient has recovered from the bilateral ptosis and spastic paraparesis but still suffers from neurogenic bladder.

Lyme disease and post-treatment Lyme disease syndrome: the neglected disease in our own backyard.

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Crowder, L A; Yedlin, V A; Weinstein, E R; Kortte, K B; Aucott, J N

2014-09-01

A survey was developed to assess experience and opinions about Lyme disease and post-treatment Lyme disease syndrome (PTLDS) among faculties in public health. No previous surveys of public health faculties have been found in the literature. This is a cross sectional study of public health school faculty members designed to measure knowledge and experience with Lyme disease and PTLDS using an internet survey instrument. Participants were recruited using all the publicly available e-mail addresses of faculty members in all the 50 accredited Schools of Public Health in the United States. A 15% response rate was seen for the survey. 50% of respondents were from Lyme endemic states. Less than 5% of faculty members consider themselves expert in Lyme or PTLDS. Many faculty members had known someone with Lyme disease or PTLDS, but few had been diagnosed themselves. Most believe that PTLDS can be severe and chronic, is not easy to treat, and does not resolve on its own, but were uncertain about its aetiology. Most respondents also felt that the incidence of Lyme disease will increase and that more education is needed. The need for further understanding and communication presents an opportunity for public health research and education in Lyme disease and the sequelae of PTLDS. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Lyme disease and conservation

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Ginsberg, H.

1994-01-01

Lyme disease is a tick-borne illness that is wide-spread in North America, especially in the northeastern and northcentral United States. This disease could negatively influence efforts to conserve natural populations in two ways: (1) the disease could directly affect wild animal health; and (2) tick control efforts could adversely affect natural populations and communities. Lyme disease affects several domestic animals, but symptoms have been reported in only a few wild species. Direct effects of Lyme disease on wild animal populations have not been reported, but the disease should be considered as a possible cause in cases of unexplained population declines in endemic areas. Methods available to manage ticks and Lyme disease include human self-protection techniques, manipulation of habitats and hosts species populations, biological control, and pesticide applications. The diversity of available techniques allows selection of approaches to minimize environmental effects by (1) emphasizing personal protection techniques, (2) carefully targeting management efforts to maximize efficiency, and (3) integrating environmentally benign techniques to improve management while avoiding broad-scale environmentally destructive approaches. The environmental effects of Lyme disease depend, to a large extent, on the methods chosen to minimize human exposure to infected ticks. Conservation biologists can help design tick management programs that effectively lower the incidence of human Lyme disease while simultaneously minimizing negative effects on natural populations.

An Unrecognized Rash Progressing to Lyme Carditis: Important Features and Recommendations Regarding Lyme Disease.

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Lee, Shawn; Singla, Montish

2016-01-01

We present a case report of 46-year-old man with no medical history, who complained of extreme fatigue, near-syncope, and palpitations. He initially presented in complete heart block. A transvenous pacemaker was placed in the emergency department, and he was started empirically on Ceftriaxone for Lyme disease. He was admitted and over the course of the next few days, his rhythm regressed to Mobitz type I first-degree atrioventricular block and then to normal sinus rhythm. This case report highlights some important features regarding Lyme carditis, a rare presentation of early disseminated Lyme disease (seen in a few weeks to months after the initial tick bite). In 25%-30% of patients, the characteristic targetoid rash may not be seen, a likely culprit of the disease not being detected early and progressing to disseminated disease. The most common cardiac complaint of Lyme disease is palpitations, occurring in 6.6% of patients, which may not accurately reflect progression into disseminated Lyme disease because it is a nonspecific finding. Conduction abnormality, occurring in 1.8% of patients, is a more specific finding of Borrelia invading cardiac tissue. Finally, this case report highlights a recommendation that patients with confirmed Lyme disease or those presenting with cardiac abnormalities or symptoms who have an atypical profile for a cardiac event should be screened with a 12-lead electrocardiogram, Lyme serology, and be considered for antibiotic therapy with the possibility of temporary pacing.

Lyme disease in children.

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Sood, Sunil K

2015-06-01

The diagnosis and management of Lyme disease in children is similar to that in adults with a few clinically relevant exceptions. The use of doxycycline as an initial empiric choice is to be avoided for children 8 years old and younger. Children may present with insidious onset of elevated intracranial pressure during acute disseminated Lyme disease; prompt diagnosis and treatment of this condition is important to prevent loss of vision. Children who acquire Lyme disease have an excellent prognosis even when they present with the late disseminated manifestation of Lyme arthritis. Guidance on the judicious use of serologic tests is provided. Pediatricians and family practitioners should be familiar with the prevention and management of tick bites, which are common in children. Copyright © 2015 Elsevier Inc. All rights reserved.

Management approaches for suspected and established Lyme disease used at the Lyme disease diagnostic center.

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Wormser, Gary P; McKenna, Donna; Nowakowski, John

2016-01-14

2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for Lyme disease-related facial palsy and/or radiculopathy is a 2-week course of doxycycline. Patients who are hospitalized for Lyme meningitis are usually treated at least initially with ceftriaxone. We have not seen convincing cases of encephalitis or myelitis solely due to Borrelia burgdorferi infection in the absence of laboratory evidence of concomitant deer tick virus infection (Powassan virus). We have also never seen Lyme encephalopathy or a diffuse axonal peripheral neuropathy and suggest that these entities are either very rare or nonexistent.We have found that Lyme disease rarely presents with fever without other objective clinical manifestations. Prior cases attributed to Lyme disease may have overlooked an asymptomatic erythema migrans skin lesion or the diagnosis may have been based on nonspecific IgM seroreactivity. More research is needed on the appropriate management and significance of IgG seropositivity in asymptomatic patients who have no history of Lyme disease.

Does Lyme disease exist in Australia?

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Collignon, Peter J; Lum, Gary D; Robson, Jennifer Mb

2016-11-07

There is no convincing evidence that classic Lyme disease occurs in Australia, nor is there evidence that the causative agent, Borrelia burgdorferi, is found in Australian animals or ticks. Lyme disease, however, can be acquired overseas but diagnosed in Australia; most people presenting with laboratory-confirmed Lyme disease in Australia were infected in Europe. Despite the lack of evidence that Lyme disease can be acquired in Australia, growing numbers of patients, their supporters, and some politicians demand diagnoses and treatment according to the protocols of the "chronic Lyme disease" school of thought. Antibiotic therapy for chronic "Lyme disease-like illness" can cause harm to both the individual (eg, cannula-related intravenous sepsis) and the broader community (increased antimicrobial resistance rates). Until there is strong evidence from well performed clinical studies that bacteria present in Australia cause a chronic debilitating illness that responds to prolonged antibiotics, treating patients with "Lyme disease-like illness" with prolonged antibiotic therapy is unjustified, and is likely to do much more harm than good.

Les estimations du capital humain au Canada : approche fondee sur le revenu de la vie entiere

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Gu, Wulong; Wong, Ambrose

2010-01-01

Dans le present document, nous produisons une estimation de l'investissement en capital humain fonde sur le marche et du stock de ce capital au Canada au cours de la periode s'etendant de 1970 a 2007 selon l'approche fondee sur le revenu de la vie entiere. Nous comparons cette estimation a celle de l'investissement en capital physique et naturel et du stock de ce capital. En suivant la methode elaboree par Jorgenson et Fraumeni, nous estimons le stock de capital humain sous forme du revenu de...

Major emerging vector-borne zoonotic diseases of public health importance in Canada.

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Kulkarni, Manisha A; Berrang-Ford, Lea; Buck, Peter A; Drebot, Michael A; Lindsay, L Robbin; Ogden, Nicholas H

2015-06-10

In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

Incidence du cancer au Canada : tendances et projections (1983-2032

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Lin Xie

2015-01-01

devrait continuer d'augmenter de 2 % entre 2003-2007 et 2008-2012, puis commencer à fléchir de 18 % au cours des 20 dernières années de projection. De tous les cancers féminins, on s'attend à ce que l'incidence du cancer du sein soit celle qui change le moins (une hausse de moins de 1 %. L'évolution prévue des taux pour le cancer colorectal est inférieure aux médianes pour l'ensemble des cancers, avec une diminution de 6 %, tant chez les hommes que chez les femmes, durant toute la période de projection. En ce qui concerne le cancer de la prostate, si la prévalence du dépistage se stabilise à l'avenir, les taux devraient demeurer stables. Augmentation prévue du nombre de nouveaux cas de cancer : Au Canada, on prévoit que le nombre annuel de nouveaux cas de cancer augmentera de 84 % chez les hommes, passant de 80 800 en 2003-2007 à 148 400 en 2028-2032, et de 74 % chez les femmes, passant de 74 200 à 128 800. Facteurs des variations dans les cas de cancer : La principale raison de la hausse du nombre de tous les cas de cancer nouvellement diagnostiqués sera le vieillissement de la population canadienne, et dans une moindre mesure la croissance démographique. Les variations du risque de cancer constitueront une composante relativement mineure de la hausse prévue du nombre de nouveaux cas. Les interventions préventives peuvent grandement influencer les taux d'incidence futurs de certains types de cancer. Cancers les plus courants : Les cancers les plus courants chez les hommes — cancers de la prostate, du poumon et de la vessie, cancer colorectal et lymphome non hodgkinien — devraient demeurer inchangés entre 2003-2007 et 2028-2032, mais on prévoit que le cancer colorectal remplacera le cancer du poumon au deuxième rang des cancers les plus fréquemment diagnostiqués d'ici 2028-2032. Chez les femmes, les cancers du sein, du poumon, de l'utérus ainsi que le cancer colorectal sont les quatre principaux cancers pour lesquels de nouveaux cas seront

Lyme disease in children in southeastern Connecticut. Pediatric Lyme Disease Study Group.

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Gerber, M A; Shapiro, E D; Burke, G S; Parcells, V J; Bell, G L

1996-10-24

Although the incidence of Lyme disease is highest in children, there are few prospective data on the clinical manifestations and outcomes in children. We conducted a prospective, longitudinal, community-based cohort study of children with newly diagnosed Lyme disease in an area of Connecticut in which the disease is highly endemic. We obtained clinical and demographic information and performed serial antibody tests and follow-up evaluations. Over a period of 20 months, 201 consecutive patients were enrolled; their median age was 7 years (range, 1 to 21). The initial clinical manifestations of Lyme disease were a single erythema migrans lesion in 66 percent, multiple erythema migrans lesions in 23 percent, arthritis in 6 percent, facial-nerve palsy in 3 percent, aseptic meningitis in 2 percent, and carditis in 0.5 percent. At presentation, 37 percent of the patients with a single erythema migrans lesion and 89 percent of those with multiple erythema migrans lesions had antibodies against Borrelia burgdorferi. All but 3 of the 201 patients were treated for two to four weeks with conventional antimicrobial therapy, which was administered orally in 96 percent. All had prompt clinical responses. After four weeks, 94 percent were completely asymptomatic (including the two patients whose parents had refused to allow antimicrobial treatment). At follow-up a mean of 25.4 months later, none of the patients had evidence of either chronic or recurrent Lyme disease. Six patients subsequently had a new episode of erythema migrans. About 90 percent of children with Lyme disease present with erythema migrans, which is an early stage of the disease. The prognosis is excellent for those with early Lyme disease who are treated promptly with conventional courses of antimicrobial agents.

Neuroimmunomodulators in neuroborreliosis and Lyme encephalopathy.

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Eckman, Elizabeth A; Pacheco-Quinto, Javier; Herdt, Aimee R; Halperin, John J

2018-01-11

Lyme encephalopathy, characterized by non-specific neurobehavioral symptoms including mild cognitive difficulties, may occur in patients with systemic Lyme disease and is often mistakenly attributed to CNS infection. Identical symptoms occur in innumerable other inflammatory states and may reflect the effect of systemic immune mediators on the CNS. Multiplex immunoassays were used to characterize the inflammatory profile in serum and CSF from Lyme and non-Lyme patients with a range of symptoms to determine if there are specific markers of active CNS infection (neuroborreliosis), or systemic inflammatory mediators associated with neurobehavioral syndromes. CSF CXCL13 was elevated dramatically in confirmed neuroborreliosis (n=8) and to a lesser extent in possible neuroborreliosis (n=11) and other neuroinflammatory conditions (n=44). Patients with Lyme (n=63) or non-Lyme (n=8) encephalopathy had normal CSF findings, but had elevated serum levels of IL-7, TSLP, IL-17A, IL-17F, and MIP-1α/CCL3. CSF CXCL13 is a sensitive and specific marker of neuroborreliosis in individuals with Borrelia-specific intrathecal antibody (ITAb) production. However, CXCL13 does not distinguish individuals strongly suspected of having neuroborreliosis, but lacking confirmatory ITAb, from those with other neuroinflammatory conditions. Patients with mild cognitive symptoms occurring during acute Lyme disease, and/or following appropriate treatment, have normal CSF but elevated serum levels of T-helper 17 markers and T-cell growth factors. These markers are also elevated in non-Lyme disease patients experiencing similar symptoms. Our results support that in the absence of CSF abnormalities, neurobehavioral symptoms are associated with systemic inflammation, not CNS infection or inflammation, and are not specific to Lyme disease. © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Evaluation of the C6 Lyme Enzyme Immunoassay for the Diagnosis of Lyme Disease in Children and Adolescents.

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Lipsett, Susan C; Branda, John A; McAdam, Alexander J; Vernacchio, Louis; Gordon, Caroline D; Gordon, Catherine R; Nigrovic, Lise E

2016-10-01

The commercially-available C6 Lyme enzyme immunoassay (EIA) has been approved to replace the standard whole-cell sonicate EIA as a first-tier test for the diagnosis of Lyme disease and has been suggested as a stand-alone diagnostic. However, the C6 EIA has not been extensively studied in pediatric patients undergoing evaluation for Lyme disease. We collected discarded serum samples from children and adolescents (aged ≤21 years) undergoing conventional 2-tiered testing for Lyme disease at a single hospital-based clinical laboratory located in an area endemic for Lyme disease. We performed a C6 EIA on all collected specimens, followed by a supplemental immunoblot if the C6 EIA result was positive but the whole-cell sonicate EIA result was negative. We defined a case of Lyme disease as either a clinician-diagnosed erythema migrans lesion or a positive standard 2-tiered serologic result in a patient with symptoms compatible with Lyme disease. We then compared the performance of the C6 EIA alone and as a first-tier test followed by immunoblot, with that of standard 2-tiered serology for the diagnosis of Lyme disease. Of the 944 specimens collected, 114 (12%) were from patients with Lyme disease. The C6 EIA alone had sensitivity similar to that of standard 2-tiered testing (79.8% vs 81.6% for standard 2-tiered testing; P = .71) with slightly lower specificity (94.2% vs 98.8% 2; P Lyme disease, the C6 EIA could guide initial clinical decision making, although a supplemental immunoblot should still be performed. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

First report of Lyme disease in Nepal.

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Pun, Sher Bahadur; Agrawal, Sumit; Jha, Santoshananda; Bhandari, Lila Nath; Chalise, Bimal Sharma; Mishra, Abadhesh; Shah, Rajesh

2018-03-01

Lyme disease is a tick-borne illness caused by the spirochete Borrelia burgdorferi and is widely reported in the USA, Central Europe, South East Asia and Latin America. Until recently, no scientific report regarding Lyme disease in Nepal had been published. A 32-year-old, previously healthy female visited the hospital with a history of joint pains, fatigue, neck stiffness, tingling sensation and headache. She was initially treated for typhoid fever, brucellosis and malaria, but did not show significant improvement. Doxycycline was prescribed empirically for 3 weeks for the treatment of suspected tick-borne illness. A two-tiered immunoglobulin laboratory testing confirmed Borrelia burgdorferi . She developed post-treatment Lyme disease syndrome after completion of antibiotic therapy. To the best of our knowledge, this is the first report of Lyme disease in Nepal and probably the first documented case of post-treatment Lyme disease syndrome in Asia. Lyme disease might have been overlooked in Nepal and, therefore, patients having clinical signs and symptoms similar to Lyme disease should not be disregarded in differential diagnosis.

Seroprevalence of equine granulocytic anaplasmosis and lyme borreliosis in Canada as determined by a point-of-care enzyme-linked immunosorbent assay (ELISA).

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Schvartz, Gili; Epp, Tasha; Burgess, Hilary J; Chilton, Neil B; Pearl, David L; Lohmann, Katharina L

2015-06-01

Equine granulocytic anaplasmosis (EGA) and Lyme borreliosis (LB) are an emerging concern in Canada. We estimated the seroprevalence of EGA and equine LB by testing 376 convenience serum samples from 3 provinces using a point-of-care SNAP(®) 4Dx(®) ELISA (IDEXX Laboratories, Westbrook, Maine, USA), and investigated the agreement between the point-of-care ELISA and laboratory-based serologic tests. The estimated seroprevalence for EGA was 0.53% overall (0.49% in Saskatchewan, 0.71% in Manitoba), while the estimated seroprevalence for LB was 1.6% overall (0.49% in Saskatchewan, 2.86% in Manitoba). There was limited agreement between the point-of-care ELISA and an indirect fluorescent antibody test for EGA (kappa 0.1, PABAK 0.47) and an ELISA/Western blot combination for LB (kappa 0.23, PABAK 0.71). While the SNAP(®) 4Dx(®) ELISA yielded expected seroprevalence estimates, further evaluation of serologic tests for the purposes of disease exposure recognition may be needed.

[Post-Lyme disease syndrome].

Science.gov (United States)

Błaut-Jurkowska, Justyna; Jurkowski, Marcin

2016-02-01

Lyme disease is a chronic infectious disease caused by the bacteria, spirochete of the Borrelia type. Skin, nervous system, musculoskeletal system and heart may be involved in the course of the disease. The prognosis for properly treated Lyme disease is usually good. However, in about 5% of patients so called Post-Lyme disease syndrome (PLSD) develops. It is defined as a syndrome of subjective symptoms persisting despite proper treatment of Borrelia burgdorferi infection. The most common symptoms include: fatigue, muscle and joint pain, and problems with memory and concentration. Pathogenesis of PLDS remains unknown. The differential diagnosis should include neurological, rheumatic and mental diseases. Till now there is no causative treatment of PLDS. In relieving symptom rehabilitation, painkillers, anti-inflammatory and antidepressants medicines are recommended. Emotional and psychological supports are also necessary. Non-specific symptoms reported by patients with post- Lyme disease syndrome raise the suspicion of other pathologies. This can lead to misdiagnosis and implementation of unnecessary, potentially harmful to the patient's therapy. An increase in tick-borne diseases needs to increase physicians awareness of these issues. © 2016 MEDPRESS.

Sternoclavicular Arthritis as a Clinical Presentation for Lyme Disease.

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Ramgopal, Sriram; Rosenkranz, Margalit; Nowalk, Andrew J; Zuckerbraun, Noel S

2018-04-01

Lyme disease is caused by Borrelia burgdorferi and can lead to dermatologic, neurologic, cardiac, and musculoskeletal manifestations. The arthritis of Lyme disease is typically monoarticular, with the knee being most commonly involved. Lyme arthritis of small joints has not previously been well described. We report 3 children who presented with sternoclavicular joint swelling and who were found to have Lyme disease based on enzyme-linked immunosorbent assay and Western blot. This description of sternoclavicular Lyme arthritis highlights the importance of considering Lyme disease in the differential and diagnostic workup of new onset, small joint arthritis in patients presenting from or with travel to Lyme endemic regions. Copyright © 2018 by the American Academy of Pediatrics.

Texas Occurrence of Lyme Disease and Its Neurological Manifestations.

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Dandashi, Jad A; Nizamutdinov, Damir; Dayawansa, Samantha; Fonkem, Ekokobe; Huang, Jason H

2016-06-01

Today, Lyme disease is the most commonly reported tick-borne disease in the United States and Europe. The culprits behind Lyme disease are the Borrelia species of bacteria. In the USA, Borrelia burgdorferi causes the majority of cases, while in Europe and Asia Borrelia afzelii and Borrelia garinii carry the greatest burden of disease. The clinical manifestations of Lyme disease have been identified as early localized, early disseminated, and late chronic. The neurological effects of Lyme disease include both peripheral and central nervous systems involvement, including focal nerve abnormalities, cranial neuropathies, painful radiculoneuritis, meningitis, and/or toxic metabolic encephalopathy, known as Lyme encephalopathy. Given the geographic predominance of Lyme disease in the Northeast and Midwest of the USA, no major studies have been conducted regarding Southern states. Between 2005 and 2014, the Center for Disease Control has reported 582 confirmed cases of Lyme disease in Texas. Because of the potential for increased incidence and prevalence in Texas, it has become essential for research and clinical efforts to be diverted to the region. The Texas A&M College of Veterinary Medicine and Biomedical Sciences Lyme Lab has been investigating the ecology of Lyme disease in Texas and developing a pan-specific serological test for Lyme diagnosis. This report aimed to exposure materials and raise awareness of Lyme disease to healthcare providers.

Epidemiology of Lyme Disease

Directory of Open Access Journals (Sweden)

Dennis J White

1991-01-01

Full Text Available Investigation of the epidemiology of Lyme disease depends upon information generated from several sources. Human disease surveillance can be conducted by both passive and active means involving physicians, public health agencies and laboratories. Passive and active tick surveillance programs can document the extent of tick-borne activity, identify the geographic range of potential vector species, and determine the relative risk of exposure to Lyme disease in specific areas. Standardized laboratory services can play an important role in providing data. Epidemiologists can gain a better understanding of Lyme disease through the collection of data from such programs. The interpretation of data and provision of information to the medical and general communities are important functions of public health agencies.

Posttreatment Lyme disease syndrome.

Science.gov (United States)

Aucott, John N

2015-06-01

The prognosis following appropriate antibiotic treatment of early or late Lyme disease is favorable but can be complicated by persistent symptoms of unknown cause termed posttreatment Lyme disease syndrome (PTLDS), characterized by fatigue, musculoskeletal pain, and cognitive complaints that persist for 6 months or longer after completion of antibiotic therapy. Risk factors include delayed diagnosis, increased severity of symptoms, and presence of neurologic symptoms at time of initial treatment. Two-tier serologic testing is neither sensitive nor specific for diagnosis of PTLDS because of variability in convalescent serologic responses after treatment of early Lyme disease. Optimal treatment of PTLDS awaits more precise understanding of the pathophysiologic mechanisms involved in this illness and future treatment trials. Copyright © 2015 Elsevier Inc. All rights reserved.

Entomologic index for human risk of Lyme disease.

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Mather, T N; Nicholson, M C; Donnelly, E F; Matyas, B T

1996-12-01

An entomologic index based on density estimates of Lyme disease spirochete-infected nymphal deer ticks (lxodes scapularis) was developed to assess human risk of Lyme disease. The authors used a standardized protocol to determine tick density and infection in numerous forested sites in six Rhode Island towns. An entomologic risk index calculated for each town was compared with the number of human Lyme disease cases reported to the Rhode Island State Health Department for the same year. A strong positive relation between entomologic risk index and the Lyme disease case rate for each town suggested that the entomologic index was predictive of Lyme disease risk.

Lyme borreliosis.

Science.gov (United States)

Steere, Allen C; Strle, Franc; Wormser, Gary P; Hu, Linden T; Branda, John A; Hovius, Joppe W R; Li, Xin; Mead, Paul S

2016-12-15

Lyme borreliosis is a tick-borne disease that predominantly occurs in temperate regions of the northern hemisphere and is primarily caused by the bacterium Borrelia burgdorferi in North America and Borrelia afzelii or Borrelia garinii in Europe and Asia. Infection usually begins with an expanding skin lesion, known as erythema migrans (referred to as stage 1), which, if untreated, can be followed by early disseminated infection, particularly neurological abnormalities (stage 2), and by late infection, especially arthritis in North America or acrodermatitis chronica atrophicans in Europe (stage 3). However, the disease can present with any of these manifestations. During infection, the bacteria migrate through the host tissues, adhere to certain cells and can evade immune clearance. Yet, these organisms are eventually killed by both innate and adaptive immune responses and most inflammatory manifestations of the infection resolve. Except for patients with erythema migrans, Lyme borreliosis is diagnosed based on a characteristic clinical constellation of signs and symptoms with serological confirmation of infection. All manifestations of the infection can usually be treated with appropriate antibiotic regimens, but the disease can be followed by post-infectious sequelae in some patients. Prevention of Lyme borreliosis primarily involves the avoidance of tick bites by personal protective measures.

Environnement politique et réglementaire des pharmacultures au Canada : la contamination pharmaceutique à l’horizon ?

OpenAIRE

Bacon, Marie-Hélène

2009-01-01

Depuis les années 1980, le gouvernement canadien a misé sur le développement des biotechnologies dans l’intention de faire du pays un "chef de file" dans ce secteur. Plusieurs programmes ainsi que des mesures réglementaires et financières ont été mis de l’avant afin d’atteindre cet objectif. Le Canada se situe donc aujourd’hui parmi les premiers pays au monde en termes de cultures d’organismes génétiquement modifiés (OGM) à visé agroalimentaire. Au sein des nombreux champs d’OGM canadiens se...

Obsessive-compulsive symptoms in adults with Lyme disease.

Science.gov (United States)

Johnco, Carly; Kugler, Brittany B; Murphy, Tanya K; Storch, Eric A

This study examined the phenomenology and clinical characteristics of obsessive compulsive symptoms (OCS) in adults diagnosed with Lyme disease. Participants were 147 adults aged 18-82 years (M = 43.81, SD = 12.98) who reported having been diagnosed with Lyme disease. Participants were recruited from online support groups for individuals with Lyme disease, and completed an online questionnaire about their experience of OCS, Lyme disease characteristics, and the temporal relationship between these symptoms. OCS were common, with 84% endorsing clinically significant symptoms, 26% of which endorsed symptoms onset during the six months following their Lyme disease diagnosis and another 51% believed their symptoms were temporally related. Despite the common occurrence of OCS, only 44% of these participants self-identified these symptoms as problematic. Greater frequency of Lyme disease symptoms and disease-related impairment was related to greater OCS. In the majority of cases, symptom onset was gradual, and responded well to psychological and pharmacological treatment. Around half of participants (51%) reported at least some improvement in OCS following antibiotic treatment. This study highlights the common co-occurrence of OCS in patients with Lyme disease. It is unclear whether OCS are due to the direct physiological effects of Lyme disease or associated immunologic response, a psychological response to illness, a functional somatic syndrome, or some combination of these. Copyright © 2018 Elsevier Inc. All rights reserved.

Beware of Ticks … & Lyme Disease

Science.gov (United States)

... Consumers Home For Consumers Consumer Updates Ticks and Lyme Disease: Symptoms, Treatment, and Prevention Share Tweet Linkedin Pin ... More sharing options Linkedin Pin it Email Print Lyme Disease: Diagnosis and Treatment for People and Pets How ...

Lyme neuroborreliosis in cases of non-specific neurological symptoms.

Science.gov (United States)

Roaldsnes, Erlend; Eikeland, Randi; Berild, Dag

2017-01-01

Analysis of cerebrospinal fluid is required in order to diagnose Lyme neuroborreliosis. We investigated the symptoms of patients in a highly endemic area who were referred for evaluation of possible Lyme neuroborreliosis, and explored whether cerebrospinal fluid analysis confirmed or ruled out the diagnosis. We reviewed the medical records of all patients who underwent lumbar puncture at Sørlandet Hospital Arendal in the period 1 January 2013 to 31 December 2013. A total of 140 patients were referred with suspected Lyme neuroborreliosis. Of these, 110 patients had non-specific neurological symptoms (e.g. fatigue, dizziness and headache), only one of whom received a diagnosis of possible Lyme neuroborreliosis. Thirty patients had symptoms typical of the condition (such as radiculitis or peripheral facial nerve palsy). Six of these were diagnosed with definite Lyme neuroborreliosis, and one with possible Lyme neuroborreliosis. None of those diagnosed with Lyme neuroborreliosis had had symptoms lasting more than six months. The probability of Lyme neuroborreliosis is low in the absence of typical symptoms of the condition, even when anti-Borrelia antibodies are detected in serum and especially when the symptoms are of long duration.

Lyme disease of the brainstem

Energy Technology Data Exchange (ETDEWEB)

Kalina, Peter [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Decker, Andrew [Northern Westchester Hospital Center, Department of Neurology, Mt. Kisco, NY (United States); Kornel, Ezriel [Northern Westchester Hospital Center, Division of Neurosurgery, Mt. Kisco, NY (United States); Halperin, John J. [North Shore University Hospital, Department of Neurology, Manhasset, NY (United States)

2005-12-01

Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. Magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of Lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe Lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand. (orig.)

Lyme disease of the brainstem

International Nuclear Information System (INIS)

Kalina, Peter; Decker, Andrew; Kornel, Ezriel; Halperin, John J.

2005-01-01

Lyme disease is a multisystem infectious disease caused by the tick-borne spirochete, Borrelia burgdorferi. Central nervous system (CNS) involvement typically causes local inflammation, most commonly meningitis, but rarely parenchymal brain involvement. We describe a patient who presented with clinical findings suggesting a brainstem process. Magnetic resonance imaging (MRI) and positron emission tomography (PET) suggested a brainstem neoplasm. Prior to biopsy, laboratory evaluation led to the diagnosis of Lyme disease. Clinical and imaging abnormalities improved markedly following antimicrobial therapy. We describe Lyme disease involvement of the cerebellar peduncles with hypermetabolism on PET. Although MRI is the primary imaging modality for most suspected CNS pathology, the practical applications of PET continue to expand. (orig.)

Lyme Carditis Buried Beneath ST-Segment Elevations

Directory of Open Access Journals (Sweden)

Basia Michalski

2017-01-01

Full Text Available 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.

Surveillance for Lyme Disease - United States, 2008-2015.

Science.gov (United States)

Schwartz, Amy M; Hinckley, Alison F; Mead, Paul S; Hook, Sarah A; Kugeler, Kiersten J

2017-11-10

Lyme disease is the most commonly reported vectorborne disease in the United States but is geographically focal. The majority of Lyme disease cases occur in the Northeast, mid-Atlantic, and upper Midwest regions. Lyme disease can cause varied clinical manifestations, including erythema migrans, arthritis, facial palsy, and carditis. Lyme disease occurs most commonly among children and older adults, with a slight predominance among males. 2008-2015. Lyme disease has been a nationally notifiable condition in the United States since 1991. Possible Lyme disease cases are reported to local and state health departments by clinicians and laboratories. Health department staff conduct case investigations to classify cases according to the national surveillance case definition. Those that qualify as confirmed or probable cases of Lyme disease are reported to CDC through the National Notifiable Diseases Surveillance System. States with an average annual incidence during this reporting period of ≥10 confirmed Lyme disease cases per 100,000 population were classified as high incidence. States that share a border with those states or that are located between areas of high incidence were classified as neighboring states. All other states were classified as low incidence. During 2008-2015, a total of 275,589 cases of Lyme disease were reported to CDC (208,834 confirmed and 66,755 probable). Although most cases continue to be reported from states with high incidence in the Northeast, mid-Atlantic, and upper Midwest regions, case counts in most of these states have remained stable or decreased during the reporting period. In contrast, case counts have increased in states that neighbor those with high incidence. Overall, demographic characteristics associated with confirmed cases were similar to those described previously, with a slight predominance among males and a bimodal age distribution with peaks among young children and older adults. Yet, among the subset of cases reported

What Teachers Need to Know about Lyme Disease

Science.gov (United States)

Cook, Lysandra

2009-01-01

Although widely misunderstood, Lyme disease is the most prevalent vector borne disease in the United States. Children are the most at-risk group for Lyme disease, which can impact every system in the body. It can produce the musculo-skeletal, neurologic, psychiatric, opthalmologic, and cardiac symptoms. The symptoms of Lyme disease can have a…

Accuracy of Clinician Suspicion of Lyme Disease in the Emergency Department.

Science.gov (United States)

Nigrovic, Lise E; Bennett, Jonathan E; Balamuth, Fran; Levas, Michael N; Chenard, Rachel L; Maulden, Alexandra B; Garro, Aris C

2017-12-01

To make initial management decisions, clinicians must estimate the probability of Lyme disease before diagnostic test results are available. Our objective was to examine the accuracy of clinician suspicion for Lyme disease in children undergoing evaluation for Lyme disease. We assembled a prospective cohort of children aged 1 to 21 years who were evaluated for Lyme disease at 1 of the 5 participating emergency departments. Treating physicians were asked to estimate the probability of Lyme disease (on a 10-point scale). We defined a Lyme disease case as a patient with an erythema migrans lesion or positive 2-tiered serology results in a patient with compatible symptoms. We calculated the area under the curve for the receiver operating curve as a measure of the ability of clinician suspicion to diagnose Lyme disease. We enrolled 1021 children with a median age of 9 years (interquartile range, 5-13 years). Of these, 238 (23%) had Lyme disease. Clinician suspicion had a minimal ability to discriminate between children with and without Lyme disease: area under the curve, 0.75 (95% confidence interval, 0.71-0.79). Of the 554 children who the treating clinicians thought were unlikely to have Lyme disease (score 1-3), 65 (12%) had Lyme disease, and of the 127 children who the treating clinicians thought were very likely to have Lyme disease (score 8-10), 39 (31%) did not have Lyme disease. Because clinician suspicion had only minimal accuracy for the diagnosis of Lyme disease, laboratory confirmation is required to avoid both under- and overdiagnosis. Copyright © 2017 by the American Academy of Pediatrics.

Hamster and Murine Models of Severe Destructive Lyme Arthritis

Science.gov (United States)

Munson, Erik; Nardelli, Dean T.; Du Chateau, Brian K.; Callister, Steven M.; Schell, Ronald F.

2012-01-01

Arthritis is a frequent complication of infection in humans with Borrelia burgdorferi. Weeks to months following the onset of Lyme borreliosis, a histopathological reaction characteristic of synovitis including bone, joint, muscle, or tendon pain may occur. A subpopulation of patients may progress to a chronic, debilitating arthritis months to years after infection which has been classified as severe destructive Lyme arthritis. This arthritis involves focal bone erosion and destruction of articular cartilage. Hamsters and mice are animal models that have been utilized to study articular manifestations of Lyme borreliosis. Infection of immunocompetent LSH hamsters or C3H mice results in a transient synovitis. However, severe destructive Lyme arthritis can be induced by infecting irradiated hamsters or mice and immunocompetent Borrelia-vaccinated hamsters, mice, and interferon-gamma- (IFN-γ-) deficient mice with viable B. burgdorferi. The hamster model of severe destructive Lyme arthritis facilitates easy assessment of Lyme borreliosis vaccine preparations for deleterious effects while murine models of severe destructive Lyme arthritis allow for investigation of mechanisms of immunopathology. PMID:22461836

Cerebrospinal Fluid Proteome of Patients with Acute Lyme Disease

Energy Technology Data Exchange (ETDEWEB)

Angel, Thomas E.; Jacobs, Jon M.; Smith, Robert P.; Pasternack, Mark S.; Elias, Susan; Gritsenko, Marina A.; Shukla, Anil K.; Gilmore, Edward C.; McCarthy, Carol; Camp, David G.; Smith, Richard D.

2012-10-05

Acute Lyme disease results from transmission of and infection by the bacterium Borrelia burgdorferi following a tick bite. During acute infection, bacteria can disseminate to the central nervous system (CNS) leading to the development of Lyme meningitis. Here we have analyzed pooled cerebrospinal fluid (CSF) allowing for a deep view into the proteome for a cohort of patients with early-disseminated Lyme disease and CSF inflammation leading to the identification of proteins that reflect host responses, which are distinct for subjects with acute Lyme disease. Additionally, we analyzed individual patient samples and quantified changes in protein abundance employing label-free quantitative mass spectrometry based methods. The measured changes in protein abundances reflect the impact of acute Lyme disease on the CNS as presented in CSF. We have identified 89 proteins that differ significantly in abundance in patients with acute Lyme disease. A number of the differentially abundant proteins have been found to be localized to brain synapse and thus constitute important leads for better understanding of the neurological consequence of disseminated Lyme disease.

A clinical approach to Lyme disease.

Science.gov (United States)

Nadelman, R B; Wormser, G P

1990-05-01

Lyme disease (also known as Lyme borreliosis) is an emerging, newly described infectious disease with diverse clinical manifestations. The disease is caused by the spirochetal agent Borrelia burgdorferi, which is transmitted to humans by the bite of certain species of Ixodes ticks harboring the organism. The most readily identifiable clinical feature is the distinctive skin lesion, erythema migrans. If recently infected patients go untreated, approximately 15% will develop neurologic conditions (most commonly facial nerve palsy), 8% will develop myocarditis (typically with heart block), and 60% will develop migratory mono- or pauci-articular arthritis. Diagnosis depends on clinical suspicion, recognition of the characteristic signs and symptoms, and appropriate testing for antibody to B. burgdorferi. Serology for Lyme disease, although in need of better standardization, is most useful in diagnosing patients with manifestations of Lyme disease other than erythema migrans. All manifestations of Lyme disease are potentially treatable with either a beta-lactam antibiotic (for instance penicillin, amoxicillin, or ceftriaxone) or a tetracycline preparation. However, the optimal antimicrobial regimen, including choice of drug, drug dose, route of administration, and length of therapy, is unknown. Other important areas for future research include Ixodes biology and control, improved laboratory tests for diagnosis and for assessing response to therapy, and vaccine development.

Antibody responses to Borrelia burgdorferi detected by western blot vary geographically in Canada

OpenAIRE

Ogden, Nicholas H.; Arsenault, Julie; Hatchette, Todd F.; Mechai, Samir; Lindsay, L. Robbin

2017-01-01

Lyme disease is emerging in eastern and central Canada, and most cases are diagnosed using the two-tier serological test (Enzyme Immuno Assay [EIA] followed by Western blot [WB]). Simplification of this algorithm would be advantageous unless it impacts test performance. In this study, accuracy of individual proteins of the IgG WB algorithm in predicting the overall test result in samples from Canadians was assessed. Because Borrelia burgdorferi strains vary geographically in Canada, geographi...

MRI features of Lyme arthritis of the hips

International Nuclear Information System (INIS)

Amini, Behrang; Geller, Matthew D.; Mathew, Manesh; Gerard, Perry

2007-01-01

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

MRI features of Lyme arthritis of the hips

Energy Technology Data Exchange (ETDEWEB)

Amini, Behrang [Maimonides Medical Center, Department of Surgery, Brooklyn, NY (United States); Geller, Matthew D. [New York College of Osteopathic Medicine, Old Westbury, NY (United States); Mathew, Manesh; Gerard, Perry [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States)

2007-11-15

Diagnosing Lyme arthritis without a history of travel to endemic regions or erythema migrans can be a challenge. Radiographic and ultrasonographic findings are nonspecific for the diagnosis of Lyme arthritis. We present the MRI features of Lyme disease of the hip in a 4-year-old boy who presented with hip pain and was found to have Lyme disease by Western blot. Our findings include bilateral hip effusions and synovial enhancement, normal bone marrow signal intensity without enhancement, minimal adjacent muscular and soft-tissue edema, and bilateral inguinal lymph nodes measuring up to 1 cm. (orig.)

Triple-phase bone image abnormalities in Lyme arthritis

International Nuclear Information System (INIS)

Brown, S.J.; Dadparvar, S.; Slizofski, W.J.; Glab, L.B.; Burger, M.

1989-01-01

Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities

Clinical Manifestations and Treatment of Lyme Disease.

Science.gov (United States)

Sanchez, Joyce L

2015-12-01

Lyme disease is the most common tick-borne illness in the United States and is also seen in areas of Europe and Asia. The growing deer and Ixodes species tick populations in many areas underscore the importance of clinicians to properly recognize and treat the different stages of Lyme disease. Controversy regarding the cause and management of persistent symptoms following treatment of Lyme disease persists and is highlighted in this review. Copyright © 2015 Elsevier Inc. All rights reserved.

Bestrijding van de ziekte van Lyme

NARCIS (Netherlands)

Hovius, Joppe W. R.; Sprong, Hein

2014-01-01

The prevalence of ticks seems to have increased with time, and the number of patients with Lyme disease in the Netherlands is also increasing. Lyme disease and other tick-transmitted diseases now attract a lot of attention. Several national initiatives at different levels are now in progress, with

Lyme disease in Poland in 2015

Science.gov (United States)

Paradowska-Stankiewicz, Iwona; Chrześcijańska, Irena

2017-01-01

Lyme disease is the most common tick-borne disease in Poland. Borrelia burgdorferi spirochete can occur in the whole country, which, according to ECDC, should be considered as an endemic area. Borrelia strains are transmitted to humans and certain other animals by Ixodes (1). Human infection is caused by saliva or tick vomit. Reservoir spirochete are numerous species of animals, mainly rodents. Lyme disease, due to its multifocal character, rich symptomatology and diagnostic problems, is a serious challenge for clinicians and epidemiologists The aim of this study was to assess the epidemiological situation of Lyme disease in Poland in 2015 in comparison to the previous years The descriptive analysis was based on data retrieved from routine mandatory surveillance system and published in the annual bulletin “Infectious diseases and poisonings in Poland in 2015” (2) Despite observed in recent years the tendency to growth of number of cases, in 2015 was marked by growth inhibition incidence of Lyme disease.In 2015, 13 625 cases were registered in Poland, ie by 0.7% less than in the previous year. The overall incidence in the country was 35.4 per 100 000 population - the highest was recorded in the Podlaskie voivodeship - 96.3 per 100 000 inhabitants. In 2015, 1905 (14%) people were hospitalized due to Lyme disease In 2015, for the first time in a few years, the growth rate of Lyme disease has been stopped. Registered 0.7% less cases than in the previous year. There is still a need for bringing awareness of the need for diagnostic laboratory testing according to recommendations, which will improve the accuracy of the diagnosis

Sexual transmission of Lyme disease: challenging the tickborne disease paradigm.

Science.gov (United States)

Stricker, Raphael B; Middelveen, Marianne J

2015-01-01

Lyme disease caused by the spirochete Borrelia burgdorferi has become a major worldwide epidemic. In this article, we explore the clinical, epidemiological and experimental evidence for sexual transmission of Lyme disease in animal models and humans. Although the likelihood of sexual transmission of the Lyme spirochete remains speculative, the possibility of Lyme disease transmission via intimate human contact merits further study.

Cogan's syndrome mimicking acute Lyme arthritis.

Science.gov (United States)

Schwegmann, J P; Enzenauer, R J

1995-05-01

A pediatric case of Cogan's syndrome mimicking acute Lyme arthritis is described. A 12-year-old black boy was admitted to the pediatric service for presumed right knee septic arthritis. Symptoms included acute pain and swelling with decreased range-of-motion. Although the patient's right knee symptoms and positive Lyme serology were consistent with a diagnosis of Lyme arthritis, the presence of sensorineural hearing loss and interstitial keratitis with inflammatory arthritis suggested a diagnosis of Cogan's syndrome. Subsequent Western blot analysis was negative for Borrelia burgdorferi antigens. The patient had dramatic clinical improvement of musculoskeletal and ophthalmologic complaints shortly after receiving high-dose corticosteroids, although residual sensorineural hearing loss persisted.

Health Care Costs, Utilization and Patterns of Care following Lyme Disease

Science.gov (United States)

Adrion, Emily R.; Aucott, John; Lemke, Klaus W.; Weiner, Jonathan P.

2015-01-01

Background Lyme disease is the most frequently reported vector borne infection in the United States. The Centers for Disease Control have estimated that approximately 10% to 20% of individuals may experience Post-Treatment Lyme Disease Syndrome – a set of symptoms including fatigue, musculoskeletal pain, and neurocognitive complaints that persist after initial antibiotic treatment of Lyme disease. Little is known about the impact of Lyme disease or post-treatment Lyme disease symptoms (PTLDS) on health care costs and utilization in the United States. Objectives 1) to examine the impact of Lyme disease on health care costs and utilization, 2) to understand the relationship between Lyme disease and the probability of developing PTLDS, 3) to understand how PTLDS may impact health care costs and utilization. Methods This study utilizes retrospective data on medical claims and member enrollment for persons aged 0-64 years who were enrolled in commercial health insurance plans in the United States between 2006-2010. 52,795 individuals treated for Lyme disease were compared to 263,975 matched controls with no evidence of Lyme disease exposure. Results Lyme disease is associated with $2,968 higher total health care costs (95% CI: 2,807-3,128, pLyme disease, having one or more PTLDS-related diagnosis is associated with $3,798 higher total health care costs (95% CI: 3,542-4,055, pLyme disease is associated with increased costs above what would be expected for an easy to treat infection. The presence of PTLDS-related diagnoses after treatment is associated with significant health care costs and utilization. PMID:25650808

Unusual Presentation of Unilateral Isolated Probable Lyme Optic Neuritis

Directory of Open Access Journals (Sweden)

Ahmet Z. Burakgazi

2016-01-01

Full Text Available Optic neuritis (ON is one of the most common manifestations of central nervous system involvement caused by various etiologies. Lyme ON is an exceedingly rare ocular manifestation of Lyme disease (LD and only a few cases have been published in the literature. Lyme ON is very rare but should be included in the differential diagnosis in unexplained cases, particularly in Lyme endemic areas. Careful and detailed examination and investigation are warranted to make the diagnosis. We report this case to increase awareness of clinicians to include Lyme disease in differential diagnosis of ON for unexplained cases of ON. Herein we present a unique case with a unilateral ON caused by LD along with pre- and posttreatment findings and literature review.

Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

Directory of Open Access Journals (Sweden)

Jones William

2010-11-01

Full Text Available Abstract Background A sensitive and analytically specific nucleic acid amplification test (NAAT is valuable in confirming the diagnosis of early Lyme disease at the stage of spirochetemia. Findings Venous blood drawn from patients with clinical presentations of Lyme disease was tested for the standard 2-tier screen and Western Blot serology assay for Lyme disease, and also by a nested polymerase chain reaction (PCR for B. burgdorferi sensu lato 16S ribosomal DNA. The PCR amplicon was sequenced for B. burgdorferi genomic DNA validation. A total of 130 patients visiting emergency room (ER or Walk-in clinic (WALKIN, and 333 patients referred through the private physicians' offices were studied. While 5.4% of the ER/WALKIN patients showed DNA evidence of spirochetemia, none (0% of the patients referred from private physicians' offices were DNA-positive. In contrast, while 8.4% of the patients referred from private physicians' offices were positive for the 2-tier Lyme serology assay, only 1.5% of the ER/WALKIN patients were positive for this antibody test. The 2-tier serology assay missed 85.7% of the cases of early Lyme disease with spirochetemia. The latter diagnosis was confirmed by DNA sequencing. Conclusion Nested PCR followed by automated DNA sequencing is a valuable supplement to the standard 2-tier antibody assay in the diagnosis of early Lyme disease with spirochetemia. The best time to test for Lyme spirochetemia is when the patients living in the Lyme disease endemic areas develop unexplained symptoms or clinical manifestations that are consistent with Lyme disease early in the course of their illness.

Not All Erythema Migrans Lesions Are Lyme Disease.

Science.gov (United States)

Goddard, Jerome

2017-02-01

Lyme disease is the number one arthropod-transmitted disease in the US, and one of the diagnostic criteria for the illness is development of an erythematous bull's-eye rash around a tick bite that may expand over time, hence the term erythema migrans. However, there are other erythema migrans-like rashes, such as those from a condition known as southern tick-associated rash illness. This article describes a patient with an erythema migrans-like lesion similar to that associated with Lyme disease, resulting from a bite by a nymphal-stage lone star tick, Amblyomma americanum. A tick removed from the center of an erythema migrans-like lesion in a patient was identified to species and then submitted to the Centers for Disease Control and Prevention for testing for the agent of Lyme disease, Borrelia burgdorferi. The patient was evaluated by an internist 7 weeks later. After another 3 weeks, the patient's blood was tested serologically for Lyme disease by American Esoteric Laboratories, Memphis, Tenn. Both the tick and human blood sample from this patient were negative for evidence of Lyme disease. Clinically, other than the erythema migrans-like lesion, the patient displayed no signs or symptoms consistent with Lyme disease. This case presents clinical, serological, and molecular evidence that erythema migrans lesions may occur after tick bites in patients and that these lesions may not be due to infection with the agent of Lyme disease. Copyright © 2016 Elsevier Inc. All rights reserved.

Urinary Bladder Detrusor Dysfunction Symptoms in Lyme Disease

Directory of Open Access Journals (Sweden)

Basant K. Puri

2013-09-01

Full Text Available Purpose Symptoms of urinary bladder detrusor dysfunction have been rarely reported in Lyme disease. The aim was to carry out the first systematic study to compare the prevalence of such symptoms in a group of Lyme disease patients and a group of matched controls. Methods A questionnaire relating to detrusor function was administered to 17 serologically positive Lyme disease patients and to 18 control subjects. Results The two groups were matched in respect of age, sex, body mass, and mean arterial blood pressure. None of the 35 subjects was taking medication which might affect urinary function and none had undergone a previous operative procedure on the lower urinary tract. Six of the Lyme patients (35% and none of the controls (0% had symptoms of detrusor dysfunction (P<0.01. Conclusions This first systematic controlled study confirms that Lyme disease is associated with urinary bladder detrusor dysfunction. Further evaluation of detrusor function is warranted in this disease.

Lyme Disease Presenting as a Spontaneous Knee Effusion.

Science.gov (United States)

Matzkin, Elizabeth; Suslavich, Kaytelin; Curry, Emily J

2015-11-01

Musculoskeletal complaints, which are frequently associated with Lyme disease, often prompt patients to see a physician. In particular, transient episodes of spontaneous knee effusion are common early in the progression of Lyme disease, and, if left untreated, 60% of patients diagnosed with the disease develop Lyme arthritis. This disease is easily treated with antibiotics; therefore, inclusion of Lyme disease in the differential diagnosis as a potential cause of a spontaneous knee effusion can prevent the development of more severe symptoms associated with the disease. However, the time required to receive test results and the inconsistencies between serum and synovial tests can complicate diagnosis of the disease. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Lyme carditis. Electrophysiologic and histopathologic study

International Nuclear Information System (INIS)

Reznick, J.W.; Braunstein, D.B.; Walsh, R.L.; Smith, C.R.; Wolfson, P.M.; Gierke, L.W.; Gorelkin, L.; Chandler, F.W.

1986-01-01

To further define the nature of Lyme carditis, electrophysiologic study and endomyocardial biopsy were performed in a patient with Lyme disease, whose principal cardiac manifestation was high-degree atrioventricular block. Intracardiac recording demonstrated supra-Hisian block and complete absence of an escape mechanism. Gallium 67 scanning demonstrated myocardial uptake, and right ventricular endomyocardial biopsy revealed active lymphocytic myocarditis. A structure compatible with a spirochetal organism was demonstrated in one biopsy specimen. It is concluded that Lyme disease can produce active myocarditis, as suggested by gallium 67 imaging and confirmed by endomyocardial biopsy. Furthermore, the presence of high-grade atrioventricular block in this disease requires aggressive management with temporary pacemaker and corticosteroid therapy

Lyme neuroborreliosis

DEFF Research Database (Denmark)

Correll, Mette Hedegaard; Datta, N; Arvidsson, Henrik Sven Strandbygaard

2015-01-01

BACKGROUND: Lyme neuroborreliosis (LNB) designates central nervous system involvement caused by the tick-borne spirochaete Borrelia burgdorferi (Bb). The present study describes a spectrum of acquired ocular motor disorders in children with LNB. METHODS: Six paediatric patients (age 3-15 years...

Lyme disease: a rigorous review of diagnostic criteria and treatment.

Science.gov (United States)

Borchers, Andrea T; Keen, Carl L; Huntley, Arthur C; Gershwin, M Eric

2015-02-01

Lyme disease was originally identified in Lyme, Connecticut, based upon an unusual cluster of what appeared to be patients with juvenile rheumatoid arthritis. It was subsequently identified as a new clinical entity originally called Lyme arthritis based on the observation that arthritis was a major clinical feature. However, Lyme arthritis is now called Lyme disease based upon the understanding that the clinical features include not only arthritis, but also potential cardiac, dermatologic and neurologic findings. Lyme disease typically begins with an erythematous rash called erythema migrans (EM). Approximately 4-8% of patients develop cardiac, 11% develop neurologic and 45-60% of patients manifest arthritis. The disease is transmitted following exposure to a tick bite containing a spirochete in a genetically susceptible host. There is considerable data on spirochetes, including Borrelia burgdorferi (Bb), the original bacteria identified in this disease. Lyme disease, if an organism had not been identified, would be considered as a classic autoimmune disease and indeed the effector mechanisms are similar to many human diseases manifest as loss of tolerance. The clinical diagnosis is highly likely based upon appropriate serology and clinical manifestations. However, the serologic features are often misinterpreted and may have false positives if confirmatory laboratory testing is not performed. Antibiotics are routinely and typically used to treat patients with Lyme disease, but there is no evidence that prolonged or recurrent treatment with antibiotics change the natural history of Lyme disease. Although there are animal models of Lyme disease, there is no system that faithfully recapitulates the human disease. Further research on the effector mechanisms that lead to pathology in some individuals should be further explored to develop more specific therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

Will Culling White-Tailed Deer Prevent Lyme Disease?

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Kugeler, K J; Jordan, R A; Schulze, T L; Griffith, K S; Mead, P S

2016-08-01

White-tailed deer play an important role in the ecology of Lyme disease. In the United States, where the incidence and geographic range of Lyme disease continue to increase, reduction of white-tailed deer populations has been proposed as a means of preventing human illness. The effectiveness of this politically sensitive prevention method is poorly understood. We summarize and evaluate available evidence regarding the effect of deer reduction on vector tick abundance and human disease incidence. Elimination of deer from islands and other isolated settings can have a substantial impact on the reproduction of blacklegged ticks, while reduction short of complete elimination has yielded mixed results. To date, most studies have been conducted in ecologic situations that are not representative to the vast majority of areas with high human Lyme disease risk. Robust evidence linking deer control to reduced human Lyme disease risk is lacking. Currently, there is insufficient evidence to recommend deer population reduction as a Lyme disease prevention measure, except in specific ecologic circumstances. © 2015 Blackwell Verlag GmbH.

Unorthodox alternative therapies marketed to treat Lyme disease.

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Lantos, Paul M; Shapiro, Eugene D; Auwaerter, Paul G; Baker, Phillip J; Halperin, John J; McSweegan, Edward; Wormser, Gary P

2015-06-15

Some patients with medically unexplained symptoms or alternative medical diagnoses suspect that they chronically suffer from the tick-borne infection Lyme disease. These patients are commonly targeted by providers of alternative therapies. This study was designed to identify and characterize the range of unorthodox alternative therapies advertised to patients with a diagnosis of Lyme disease. Internet searches using the Google search engine were performed to identify the websites of clinics and services that marketed nonantimicrobial therapies for Lyme disease. We subsequently used the PubMed search engine to identify any scientific studies evaluating such treatments for Lyme disease. Websites were included in our review so long as they advertised a commercial, nonantimicrobial product or service that specifically mentioned utility for Lyme disease. Websites with patient testimonials (such as discussion groups) were excluded unless the testimonial appeared as marketing on a commercial site. More than 30 alternative treatments were identified, which fell into several broad categories: these included oxygen and reactive oxygen therapy; energy and radiation-based therapies; nutritional therapy; chelation and heavy metal therapy; and biological and pharmacological therapies ranging from certain medications without recognized therapeutic effects on Borrelia burgdorgeri to stem cell transplantation. Review of the medical literature did not substantiate efficacy or, in most cases, any rationale for the advertised treatments. Providers of alternative therapies commonly target patients who believe they have Lyme disease. The efficacy of these unconventional treatments for Lyme disease is not supported by scientific evidence, and in many cases they are potentially harmful. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Lyme disease: diagnostic issues and controversies.

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Aguero-Rosenfeld, Maria E; Wormser, Gary P

2015-01-01

The diagnosis of Lyme disease is a controversial topic. Most practitioners and scientists recognize that Lyme disease is associated with certain objective clinical manifestations supported by laboratory evidence of infection with Borrelia burgdorferi sensu lato (the etiologic agent). There are others, however, who believe that patients with Lyme disease may have a wide variety of entirely nonspecific symptoms without any objective clinical manifestation and that laboratory evidence of infection by B. burgdorferi is not required to support the diagnosis. In reality, this perspective is not evidence based and would inevitably lead to innumerable misdiagnoses, given the high frequency of medically unexplained symptoms, such as fatigue and musculoskeletal pains, in the general population. Although those espousing this viewpoint do not believe that a positive laboratory test is required, nevertheless, they often seek out and promote alternative, unapproved testing methods that frequently provide false-positive results to justify their diagnosis. Herein, we provide a brief overview of Lyme disease testing, emphasizing current usage and limitations. We also discuss the use of nonvalidated procedures and the prospects for a reduction in such testing practices in the future.

Brave New Worlds: The Expanding Universe of Lyme Disease.

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Stone, Brandee L; Tourand, Yvonne; Brissette, Catherine A

2017-09-01

Projections around the globe suggest an increase in tick-vectored disease incidence and distribution, and the potential for emergence of novel tick-borne pathogens. Lyme disease is the most common reported tick-borne illness in the Unites States and is prevalent throughout much of central Europe. In recent years, the worldwide burden of Lyme disease has increased and extended into regions and countries where the disease was not previously reported. In this review, we discuss the trends for increasing Lyme disease, and examine the factors driving Lyme disease expansion, including the effect of climate change on the spread of vector Ixodid ticks and reservoir hosts; and the impacts of increased awareness on disease reporting and diagnosis. To understand the growing threat of Lyme disease, we need to study the interplay between vector, reservoir, and pathogen. In addition, we need to understand the contributions of climate conditions to changes in disease risk.

Probable late lyme disease: a variant manifestation of untreated Borrelia burgdorferi infection

Science.gov (United States)

2012-01-01

Background Lyme disease, a bacterial infection with the tick-borne spirochete Borrelia burgdorferi, can cause early and late manifestations. The category of probable Lyme disease was recently added to the CDC surveillance case definition to describe patients with serologic evidence of exposure and physician-diagnosed disease in the absence of objective signs. We present a retrospective case series of 13 untreated patients with persistent symptoms of greater than 12 weeks duration who meet these criteria and suggest a label of ‘probable late Lyme disease’ for this presentation. Methods The sample for this analysis draws from a retrospective chart review of consecutive, adult patients presenting between August 2002 and August 2007 to the author (JA), an infectious disease specialist. Patients were included in the analysis if their current illness had lasted greater than or equal to 12 weeks duration at the time of evaluation. Results Probable late Lyme patients with positive IgG serology but no history of previous physician-documented Lyme disease or appropriate Lyme treatment were found to represent 6% of our heterogeneous sample presenting with ≥ 12 weeks of symptom duration. Patients experienced a range of symptoms including fatigue, widespread pain, and cognitive complaints. Approximately one-third of this subset reported a patient-observed rash at illness onset, with a similar proportion having been exposed to non-recommended antibiotics or glucocorticosteroid treatment for their initial disease. A clinically significant response to antibiotics treatment was noted in the majority of patients with probable late Lyme disease, although post-treatment symptom recurrence was common. Conclusions We suggest that patients with probable late Lyme disease share features with both confirmed late Lyme disease and post-treatment Lyme disease syndrome. Physicians should consider the recent inclusion of probable Lyme disease in the CDC Lyme disease surveillance

Geographic Expansion of Lyme Disease in the Southeastern United States, 2000-2014.

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Lantos, Paul M; Nigrovic, Lise E; Auwaerter, Paul G; Fowler, Vance G; Ruffin, Felicia; Brinkerhoff, R Jory; Reber, Jodi; Williams, Carl; Broyhill, James; Pan, William K; Gaines, David N

2015-12-01

Background.  The majority of Lyme disease cases in the United States are acquired on the east coast between northern Virginia and New England. In recent years the geographic extent of Lyme disease has been expanding, raising the prospect of Lyme disease becoming endemic in the southeast. Methods.  We collected confirmed and probable cases of Lyme disease from 2000 through 2014 from the Virginia Department of Health and North Carolina Department of Public Health and entered them in a geographic information system. We performed spatial and spatiotemporal cluster analyses to characterize Lyme disease expansion. Results.  There was a marked increase in Lyme disease cases in Virginia, particularly from 2007 onwards. Northern Virginia experienced intensification and geographic expansion of Lyme disease cases. The most notable area of expansion was to the southwest along the Appalachian Mountains with development of a new disease cluster in the southern Virginia mountain region. Conclusions.  The geographic distribution of Lyme disease cases significantly expanded in Virginia between 2000 and 2014, particularly southward in the Virginia mountain ranges. If these trends continue, North Carolina can expect autochthonous Lyme disease transmission in its mountain region in the coming years.

Bibrachial plegia due to Lyme radiculopoliomyelitis-myelitis.

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Akbik, Feras; Matiello, Marcelo; Piquet, Amanda; Cho, Tracey; Cohen, Adam; Venna, Nagagopal

2017-07-15

Nervous system involvement occurs in up to 15% of patients with Lyme disease, most commonly manifested as cranial neuropathy, lymphocytic meningitis, and or radiculoneuritis. We describe a patient with subacute radiculopoliomyelitis-myelitis matching the selective involvement of the anterior horns and roots of the cervical spinal cord seen on MRI and on electrodiagnostic studies. We demonstrate positive CSF Lyme antibodies and document a near-complete recovery with antibiotics. This case highlights the importance of recognizing an atypical presentation of Lyme disease in the setting of initial radiculitis and or myelitis, particularly given the potential for favorable outcomes with appropriate treatment. Copyright © 2017. Published by Elsevier B.V.

Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report.

Science.gov (United States)

Tumminello, Richard; Glaspey, Lindsey; Bhamidipati, Anita; Sheehan, Patrick; Patel, Sundip

2017-12-01

Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis. A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias. He was diagnosed with mononucleosis via a positive rapid heterophile agglutination antibody test to the Epstein-Barr virus at a walk-in clinic and was started on medications, but then subsequently developed left hip pain, a facial droop, and a very long first-degree atrioventricular conduction block. He went to the Emergency Department, where he had testing that confirmed disseminated Lyme disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the difficulty in early diagnosis of disseminated Lyme disease and how a potentially false-positive laboratory test can lead to the complications of Borrelia meningitis and Lyme carditis in untreated young healthy patients. Emergency physicians need to consider Lyme disease in patients with nonspecific signs and symptoms, especially if they have been outdoors for prolonged periods of time in Lyme-endemic areas. Copyright © 2017 Elsevier Inc. All rights reserved.

Intentions to receive a potentially available Lyme disease vaccine in an urban sample.

Science.gov (United States)

Fogel, Joshua; Kusz, Martin

2016-01-01

The only human Lyme disease vaccine of LYMErix was voluntarily removed from the market in the United States in 2002 for a number of reasons. A new human Lyme disease vaccine is currently being developed. We would like any future approved human Lyme disease vaccine to be of interest and marketable to consumers. We surveyed 714 participants to determine variables associated with intentions to receive a Lyme disease vaccine. Predictor variables included demographics, protection motivational theory, Lyme disease knowledge, Lyme disease preventive behaviors, beliefs and perceived health. We found in multivariate linear regression analyses that Asian/Asian American race/ethnicity (p Lyme disease vaccine. Although pharmaceutical companies may benefit by advertising a Lyme disease vaccine to Asian/Asian Americans and South Asians, marketers need to address and use approaches to interest those from other race/ethnicities. Also, marketers need to address the erroneous belief that vaccines are typically not safe in order to interest those with such beliefs to use a Lyme disease vaccine.

LYME CARDITIS - CLINICAL CHARACTERISTICS OF 105 CASES

NARCIS (Netherlands)

VANDERLINDE, MR

1991-01-01

105 North American and European cases of Lyme carditis, being documented and in part published in the period 1977-1990, are reviewed and compared. The male: female ratio was 3:1, as well in Europe as in the USA. Transient atrioventricular block is the most frequent manifestation of Lyme carditis,

Lyme Disease Transmission

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... not known to transmit Lyme disease include Lone star ticks ( Amblyomma americanum ), the American dog tick ( Dermacentor ... of Vector-Borne Diseases (DVBD) Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs ...

Borrelia burgdorferi-specific IgA in Lyme Disease

Directory of Open Access Journals (Sweden)

Christina D'Arco

2017-05-01

Full Text Available The laboratory diagnosis of Lyme disease is currently dependent on the detection of IgM and IgG antibodies against Borrelia burgdorferi, the causative agent of the disease. The significance of serum IgA against B. burgdorferi remains unclear. The production of intrathecal IgA has been noted in patients with the late Lyme disease manifestation, neuroborreliosis, but production of antigen-specific IgA during early disease has not been evaluated. In the current study, we assessed serum IgA binding to the B. burgdorferi peptide antigens, C6, the target of the FDA-cleared C6 EIA, and FlaB(211-223-modVlsE(275-291, a peptide containing a Borrelia flagellin epitope linked to a modified VlsE sequence, in patients with early and late Lyme disease. Specific IgA was detected in 59 of 152 serum samples (38.8% from early Lyme disease patients. Approximately 50% of early Lyme disease patients who were seropositive for peptide-specific IgM and/or IgG were also seropositive for peptide-specific IgA. In a subpopulation of patients, high peptide-specific IgA could be correlated with disseminated disease, defined as multiple erythema migrans lesions, and neurological disease complications. These results suggest that there may be an association between elevated levels of antigen-specific IgA and particular disease manifestations in some patients with early Lyme disease.

Borrelia burgdorferi-specific IgA in Lyme Disease.

Science.gov (United States)

D'Arco, Christina; Dattwyler, Raymond J; Arnaboldi, Paul M

2017-05-01

The laboratory diagnosis of Lyme disease is currently dependent on the detection of IgM and IgG antibodies against Borrelia burgdorferi, the causative agent of the disease. The significance of serum IgA against B. burgdorferi remains unclear. The production of intrathecal IgA has been noted in patients with the late Lyme disease manifestation, neuroborreliosis, but production of antigen-specific IgA during early disease has not been evaluated. In the current study, we assessed serum IgA binding to the B. burgdorferi peptide antigens, C6, the target of the FDA-cleared C6 EIA, and FlaB(211-223)-modVlsE(275-291), a peptide containing a Borrelia flagellin epitope linked to a modified VlsE sequence, in patients with early and late Lyme disease. Specific IgA was detected in 59 of 152 serum samples (38.8%) from early Lyme disease patients. Approximately 50% of early Lyme disease patients who were seropositive for peptide-specific IgM and/or IgG were also seropositive for peptide-specific IgA. In a subpopulation of patients, high peptide-specific IgA could be correlated with disseminated disease, defined as multiple erythema migrans lesions, and neurological disease complications. These results suggest that there may be an association between elevated levels of antigen-specific IgA and particular disease manifestations in some patients with early Lyme disease. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Lyme Disease.

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Taylor, George C.

1991-01-01

This overview of the public health significance of Lyme disease includes the microbiological specifics of the infectious spirochete, the entomology and ecology of the ticks which are the primary disease carrier, the clinical aspects and treatment stages, the known epidemiological patterns, and strategies for disease control and for expanded public…

Lyme Carditis: A Case Involving the Conduction System and Mitral Valve.

Science.gov (United States)

Patel, Lakir D; Schachne, Jay S

2017-02-01

Lyme disease is the most common tick-borne infection in the Northern hemisphere. Cardiac manifestations of Lyme disease typically include variable atrioventricular nodal block and rarely structural heart pathology. The incidence of Lyme carditis may be underestimated based on current reporting practices of confirmed cases. This case of a 59-year-old man with Lyme carditis demonstrates the unique presentation of widespread conduction system disease, mitral regurgitation, and suspected ischemic disease. Through clinical data, electrocardiograms, and cardiac imaging, we show the progression, and resolution, of a variety of cardiac symptoms attributable to infection with Lyme. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].

Unraveling Diagnostic Uncertainty Surrounding Lyme Disease in Children with Neuropsychiatric Illness.

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Koster, Michael P; Garro, Aris

2018-01-01

Lyme disease is endemic in parts of the United States, including New England, the Atlantic seaboard, and Great Lakes region. The presentation has various manifestations, many of which can mimic psychiatric diseases in children. Distinguishing manifestations of Lyme disease from those of psychiatric illnesses is complicated by inexact diagnostic tests and misuse of these tests when they are not clinically indicated. This article aims to describe manifestations of Lyme disease in children with an emphasis on Lyme neuroborreliosis. Clinical scenarios will be presented and discussed. Finally, recommendations for clinical psychiatrists who encounter children with possible Lyme disease are presented. Copyright © 2017 Elsevier Inc. All rights reserved.

Tick Talk: Block Tick Bites and Lyme Disease

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... this issue Tick Talk Block Tick Bites and Lyme Disease En español Send us your comments When warm ... mainly in the mid-Atlantic and southern states. Lyme disease is the most common tick-borne illness. It’s ...

Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

Science.gov (United States)

Merkac, Maja Ivartnik; Tomazic, Janez; Strle, Franc

2015-12-01

A 57-year-old woman, receiving TNF-alpha inhibitor adalimumab for psoriasis, presented with early Lyme neuroborreliosis (Bannwarth's syndrome). Discontinuation of adalimumab and 14-day therapy with ceftriaxone resulted in a smooth course and favorable outcome of Lyme borreliosis. This is the first report on Lyme neuroborreliosis in a patient treated with TNF-alpha inhibitor.

Assessing peridomestic entomological factors as predictors for Lyme disease

Science.gov (United States)

Connally, N.P.; Ginsberg, H.S.; Mather, T.N.

2006-01-01

The roles of entomologic risk factors, including density of nymphal blacklegged ticks (Ixodes scapularis), prevalence of nymphal infection with the etiologic agent (Borrelia burgdorferi), and density of infected nymphs, in determining the risk of human Lyme disease were assessed at residences in the endemic community of South Kingstown, RI. Nymphs were sampled between May and July from the wooded edge around 51 and 47 residential properties in 2002 and 2003, respectively. Nymphs were collected from all residences sampled. Tick densities, infection rates, and densities of infected nymphs were all significantly higher around homes reporting Lyme disease histories in 2003, while only infection rates were significantly higher in 2002. However, densities of infected nymphs did not significantly predict the probability of Lyme disease at a residence (by logistic regression) in either year. There were no significant differences in entomologic risk factors between homes with state-confirmed Lyme disease histories and homes with self-reported cases (not reported to the state health department). Therefore, although entomologic risk factors tended to be higher at residences with cases of Lyme disease, entomological indices, in the absence of human behavior measures, were not useful predictors of Lyme disease at the scale of individual residences in a tick-endemic community.

Vaccination against Lyme disease: Are we ready for it?

Science.gov (United States)

Kaaijk, Patricia; Luytjes, Willem

2016-03-03

Lyme disease is the most common tick-borne illness in the Northern hemisphere and is caused by spirochetes of the Borrelia burgdorferi sensu lato complex. A first sign of Borrelia infection is a circular skin rash, erythema migrans, but it can develop to more serious manifestations affecting skin, nervous system, joints, and/or heart. The marked increase in Lyme disease incidence over the past decades, the severity of the disease, and the associated high medical costs of, in particular, the persistent forms of Lyme disease requires adequate measures for control. Vaccination would be the most effective intervention for prevention, but at present no vaccine is available. In the 1990s, 2 vaccines against Lyme disease based on the OspA protein from the predominant Borrelia species of the US showed to be safe and effective in clinical phase III studies. However, failed public acceptance led to the demise of these monovalent OspA-based vaccines. Nowadays, public seem to be more aware of the serious health problems that Lyme disease can cause and seem more ready for the use of a broadly protective vaccine. This article discusses several aspects that should be considered to enable the development and implementation of a vaccine to prevent Lyme disease successfully.

Sunburn and Lyme Disease: Two Preventable Injuries.

Science.gov (United States)

Pavlicin, Karen M.

1995-01-01

Stresses the importance of educating campers and staff about the dangers of overexposure to the sun and the transmission of Lyme disease. Discusses the importance of using an appropriate sunscreen and avoiding outdoor activities during peak hours of sunlight. Discusses how Lyme disease is transmitted, the life cycle of a tick, and how to remove…

A Risk Model for the Lyme Disease Vector Ixodes scapularis (Acari: Ixodidae) in the Prairie Provinces of Canada.

Science.gov (United States)

Gabriele-Rivet, Vanessa; Koffi, Jules K; Pelcat, Yann; Arsenault, Julie; Cheng, Angela; Lindsay, L Robbin; Lysyk, Timothy J; Rochon, Kateryn; Ogden, Nicholas H

2017-07-01

Lyme disease is emerging in Canada due to geographic range expansion of the tick vector Ixodes scapularis Say. Recent areas of emergence include parts of the southeastern Canadian Prairie region. We developed a map of potential risk areas for future I. scapularis establishment in the Canadian Prairie Provinces. Six I. scapularis risk algorithms were developed using different formulations of three indices for environmental suitability: temperature using annual cumulative degree-days > 0 °C (DD > 0 °C; obtained from Moderate Resolution Imaging Spectroradiometer satellite data as an index of conditions that allow I. scapularis to complete its life cycle), habitat as a combined geolayer of forest cover and agricultural land use, and rainfall. The relative performance of these risk algorithms was assessed using receiver-operating characteristic (ROC) area under the curve (AUC) analysis with data on presence-absence of I. scapularis obtained from recent field surveillance in the Prairie Provinces accumulated from a number of sources. The ROC AUC values for the risk algorithms were significantly different (P  0 °C, habitat as a simple dichotomous variable of presence or absence of forest, and normalized rainfall had the highest AUC of 0.74, representing "fair to good" performance of the risk algorithm. This algorithm had good (>80%) sensitivity in predicting positive I. scapularis surveillance sites, but low (50%) specificity as expected in this region where not all environmentally suitable habitats are expected to be occupied. Further prospective studies are needed to validate and perhaps improve the risk algorithm. © Crown copyright 2017.

Detection of Lyme Disease Bacterium, Borrelia burgdorferi sensu lato, in Blacklegged Ticks Collected in the Grand River Valley, Ontario, Canada

Science.gov (United States)

Scott, John D.; Foley, Janet E.; Anderson, John F.; Clark, Kerry L.; Durden, Lance A.

2017-01-01

We document the presence of blacklegged ticks, Ixodes scapularis, in the Grand River valley, Centre Wellington, Ontario. Overall, 15 (36%) of 42 I. scapularis adults collected from 41 mammalian hosts (dogs, cats, humans) were positive for the Lyme disease bacterium, Borrelia burgdorferi sensu lato (s.l.). Using real-time PCR testing and DNA sequencing of the flagellin (fla) gene, we determined that Borrelia amplicons extracted from I. scapularis adults belonged to B. burgdorferi sensu stricto (s.s.), which is pathogenic to humans and certain domestic animals. Based on the distribution of I. scapularis adults within the river basin, it appears likely that migratory birds provide an annual influx of I. scapularis immatures during northward spring migration. Health-care providers need to be aware that local residents can present with Lyme disease symptoms anytime during the year. PMID:28260991

Lyme Disease: What the Wilderness Provider Needs to Know.

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Forrester, Joseph D; Vakkalanka, J Priyanka; Holstege, Christopher P; Mead, Paul S

2015-12-01

Lyme disease is a multisystem tickborne illness caused by the spirochete Borrelia burgdorferi and is the most common vectorborne disease in the United States. Prognosis after initiation of appropriate antibiotic therapy is typically good if treated early. Wilderness providers caring for patients who live in or travel to high-incidence Lyme disease areas should be aware of the basic biology, epidemiology, clinical manifestations, and treatment of Lyme disease. Published by Elsevier Inc.

Development of a metabolic biosignature for detection of early Lyme disease.

Science.gov (United States)

Molins, Claudia R; Ashton, Laura V; Wormser, Gary P; Hess, Ann M; Delorey, Mark J; Mahapatra, Sebabrata; Schriefer, Martin E; Belisle, John T

2015-06-15

Early Lyme disease patients often present to the clinic prior to developing a detectable antibody response to Borrelia burgdorferi, the etiologic agent. Thus, existing 2-tier serology-based assays yield low sensitivities (29%-40%) for early infection. The lack of an accurate laboratory test for early Lyme disease contributes to misconceptions about diagnosis and treatment, and underscores the need for new diagnostic approaches. Retrospective serum samples from patients with early Lyme disease, other diseases, and healthy controls were analyzed for small molecule metabolites by liquid chromatography-mass spectrometry (LC-MS). A metabolomics data workflow was applied to select a biosignature for classifying early Lyme disease and non-Lyme disease patients. A statistical model of the biosignature was trained using the patients' LC-MS data, and subsequently applied as an experimental diagnostic tool with LC-MS data from additional patient sera. The accuracy of this method was compared with standard 2-tier serology. Metabolic biosignature development selected 95 molecular features that distinguished early Lyme disease patients from healthy controls. Statistical modeling reduced the biosignature to 44 molecular features, and correctly classified early Lyme disease patients and healthy controls with a sensitivity of 88% (84%-95%), and a specificity of 95% (90%-100%). Importantly, the metabolic biosignature correctly classified 77%-95% of the of serology negative Lyme disease patients. The data provide proof-of-concept that metabolic profiling for early Lyme disease can achieve significantly greater (P Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Hip Synovial Fluid Cell Counts in Children From a Lyme Disease Endemic Area.

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Dart, Arianna H; Michelson, Kenneth A; Aronson, Paul L; Garro, Aris C; Lee, Thomas J; Glerum, Kimberly M; Nigrovic, Peter A; Kocher, Mininder S; Bachur, Richard G; Nigrovic, Lise E

2018-05-01

Patients with septic hip arthritis require surgical drainage, but they can be difficult to distinguish from patients with Lyme arthritis. The ability of synovial fluid white blood cell (WBC) counts to help discriminate between septic and Lyme arthritis of the hip has not been investigated. We assembled a retrospective cohort of patients ≤21 years of age with hip monoarticular arthritis and a synovial fluid culture obtained who presented to 1 of 3 emergency departments located in Lyme disease endemic areas. Septic arthritis was defined as a positive synovial fluid culture result or synovial fluid pleocytosis (WBC count ≥50 000 cells per µL) with a positive blood culture result. Lyme arthritis was defined as positive 2-tiered Lyme disease serology results and negative synovial fluid bacterial culture results. All other patients were classified as having other arthritis. We compared median synovial fluid WBC counts by arthritis type. Of the 238 eligible patients, 26 (11%) had septic arthritis, 32 (13%) had Lyme arthritis, and 180 (76%) had other arthritis. Patients with septic arthritis had a higher median synovial fluid WBC count (126 130 cells per µL; interquartile range 83 303-209 332 cells per µL) than patients with Lyme arthritis (53 955 cells per µL; interquartile range 33 789-73 375 cells per µL). Eighteen patients (56%) with Lyme arthritis had synovial fluid WBC counts ≥50 000 cells per µL. Of the 94 patients who underwent surgical drainage, 13 were later diagnosed with Lyme arthritis. In Lyme disease endemic areas, synovial fluid WBC counts cannot always help differentiate septic from Lyme arthritis. Rapid Lyme diagnostics could help avoid unnecessary operative procedures in patients with Lyme arthritis. Copyright © 2018 by the American Academy of Pediatrics.

75 FR 42608 - Safety Zone; Lyme Community Days, Chaumont Bay, NY

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2010-07-22

...-AA00 Safety Zone; Lyme Community Days, Chaumont Bay, NY AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Coast Guard is establishing a temporary safety zone for Lyme Community Days Fireworks on Chaumont Bay, Lyme, New York. All vessels are prohibited from transiting the zone except as...

77 FR 6465 - Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT

Science.gov (United States)

2012-02-08

... Operation Regulations; Connecticut River, Old Lyme, CT AGENCY: Coast Guard, DHS. ACTION: Notice of temporary... deviation from the regulation governing the operation of the Old Saybrook-Old Lyme RR Bridge, mile 3.4, across the Connecticut River at Old Lyme, Connecticut. The deviation is necessary to facilitate bridge...

76 FR 35978 - Drawbridge Operation Regulations; Connecticut River, Old Lyme, CT

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2011-06-21

... Operation Regulations; Connecticut River, Old Lyme, CT AGENCY: Coast Guard, DHS. ACTION: Notice of temporary... Connecticut River at Old Lyme, Connecticut. The deviation is necessary to facilitate scheduled maintenance at... the Connecticut River at mile 3.4, at Old Lyme, Connecticut, has a vertical clearance in the closed...

Management of Lyme Disease in European Children: a Review for Practical Purpose.

Science.gov (United States)

D'Alessandro, Matteo; Loy, Anna; Castagnola, Elio

2017-08-01

Lyme disease is a tick-borne zoonosis transmitted through a bite of a tick carrying a spirochete belonging to Borrelia species. In the last 20 years, the reported incidence of Lyme disease is increased by three times in Europe. Clinically, the illness develops through a primary stage with a typical skin rash (erythema marginatum), then a secondary stage with possible neurologic or cardiac involvement. The last stage (chronic Lyme disease) is mainly represented by arthritis or late neurological complications but nowadays is rarely seen due to precocious antibiotic use. The diagnosis of Lyme disease is essentially based on history in agreement with tick exposure (living/recent traveling in endemic area or tick bite) and clinical findings compatible with the disease. At present, no laboratory diagnostic tool available can neither establish nor exclude the diagnosis of Lyme disease. The management of Lyme disease should comprise a prophylactic administration of antibiotic in selected population (patients exposed to a tick bite in endemic regions) in which the typical signs of Lyme disease are not yet appeared; conversely, patients with current signs of Lyme disease should undergo a standard therapeutic course. First-line therapy should be oral tetracycline or oral penicillin/cephalosporin (in pediatric populations, beta-lactamic drugs are preferred). In severe courses, intravenous route should be preferred. The aim of this review is to provide an updated guide to the management of pediatric Lyme patients, from prophylaxis to first- and second-line therapy in European setting.

Correlation between chronic arthritis patients confirmed with questionnaire and serologic test of Lyme disease

Science.gov (United States)

Rotan, H.; Ginting, Y.; Loesnihari, R.; Kembaren, T.; Marpaung, B.

2018-03-01

Lyme borreliosis is the most common tick-borne disease, and frequency of arthritis complication later. The objective of this study was to determine the seroprevalence of Lyme disease and to evaluate its correlation with chronic arthritis. This epidemiologic cross sectional study included 41 healthy individuals who had chronic arthritis and bitten by ticks underwent questionnaires, and laboratory tests consisted of a routine blood sample, serum uric acid, and IgG ELISA for Lyme. There was 7.32% presence of positive IgG for Lyme. Samples with positive IgG for Lyme were further evaluated for rheumatology marker. We found three samples with a positive rheumatoid factor, two samples had positive anti-MCV, and 1 sample had slightly increased CRP. Three Lyme positive samples had normal EULAR scoring. It was the first Lyme disease case found in Indonesia, particularly in 4 villages of Sibolangit, Deli Serdang, North Sumatera. The assessment made by analysis the questionnaire, evaluation the blood test, and confirmed positive Lyme disease, and at last, we found the correlation between chronic arthritis with positive test Lyme.

Lyme disease: the promise of Big Data, companion diagnostics and precision medicine

Science.gov (United States)

Stricker, Raphael B; Johnson, Lorraine

2016-01-01

Lyme disease caused by the spirochete Borrelia burgdorferi has become a major worldwide epidemic. Recent studies based on Big Data registries show that >300,000 people are diagnosed with Lyme disease each year in the USA, and up to two-thirds of individuals infected with B. burgdorferi will fail conventional 30-year-old antibiotic therapy for Lyme disease. In addition, animal and human evidence suggests that sexual transmission of the Lyme spirochete may occur. Improved companion diagnostic tests for Lyme disease need to be implemented, and novel treatment approaches are urgently needed to combat the epidemic. In particular, therapies based on the principles of precision medicine could be modeled on successful “designer drug” treatment for HIV/AIDS and hepatitis C virus infection featuring targeted protease inhibitors. The use of Big Data registries, companion diagnostics and precision medicine will revolutionize the diagnosis and treatment of Lyme disease. PMID:27672336

Diagnostic challenges of early Lyme disease: Lessons from a community case series

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Schwarzwalder Alison

2009-06-01

Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

TOWARDS LANDSCAPE DESIGN GUIDELINES FOR REDUCING LYME DISEASE RISK

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Incidence of Lyme disease in the United States continues to grow. Low-density development is also increasing in endemic regions, raising questions about the relationship between development pattern and disease. This study sought to model Lyme disease incidence rate using quanti...

Le suicide et les hospitalisations associées à des blessures auto-infligées au Canada (1979 à 2014-2015

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R. Skinner

2016-01-01

Full Text Available Introduction : Cette étude a pour objet de décrire, à l’aide de données administratives canadiennes, les tendances et les caractéristiques des blessures auto-infligées entre 1979 et 2014-2015, afin d’orienter et d’améliorer les mesures de prévention du suicide. Méthodologie : Les données sur la mortalité par suicide et sur les congés des patients ont été extraites des fonds de données de l’Agence de la santé publique du Canada (ASPC provenant de la Base canadienne de données sur l’état civil – Décès (BCDEC-D de Statistique Canada (1979 à 2012, du Système canadien d’information socioéconomique (CANSIM 2011, 2012, de la Base de données sur la morbidité hospitalière (BDMH, 1994- 1995 à 2010-2011 et de la Base de données sur les congés des patients (BDCP, 2011-2012 à 2014-2015. Le nombre de cas et les taux de décès et d’hospitalisation ont été répartis par sexe, tranche d’âge de 5 ans et méthode. Résultats : Le taux de suicide au Canada (hommes et femmes confondus, tous âges, et taux normalisé selon l’âge et le sexe a diminué, passant de 14,4/100 000 (n = 3 355 en 1979 à 10,4/100 000 (n = 3 926 en 2012, soit une variation annuelle en pourcentage (VAP de –1,2 % (IC à 95 % : –1,3 à –1,0. Cependant, cette tendance n’a pas été observée chez les deux sexes : chez les femmes, les taux de suicide se sont stabilisés vers les années 1990, tandis que chez les hommes, ils ont continué de décliner au fil du temps – malgré le fait que les suicides chez les hommes constituent toujours 75,7 % de tous les suicides en 2012. La suffocation (pendaison et strangulation était en 2012 la principale méthode de suicide (46,9 % chez les Canadiens de tous âges, suivie de l’intoxication (23,3 %. Au cours de l’exercice 2014-2015, il y a eu 13 438 hospitalisations au Canada (à l’exclusion du Québec associées à des blessures auto-infligées – ce qui représente plus de trois fois le

Susceptibility, likelihood to be diagnosed, worry and fear for contracting Lyme disease.

Science.gov (United States)

Fogel, Joshua; Chawla, Gurasees S

Risk perception and psychological concerns are relevant for understanding how people view Lyme disease. This study investigates the four separate outcomes of susceptibility, likelihood to be diagnosed, worry, and fear for contracting Lyme disease. University students (n=713) were surveyed about demographics, perceived health, Lyme disease knowledge, Lyme disease preventive behaviors, Lyme disease history, and Lyme disease miscellaneous variables. We found that women were associated with increased susceptibility and fear. Asian/Asian-American race/ethnicity was associated with increased worry and fear. Perceived good health was associated with increased likelihood to be diagnosed, worry, and fear. Correct knowledge was associated with increased susceptibility and likelihood to be diagnosed. Those who typically spend a lot of time outdoors were associated with increased susceptibility, likelihood to be diagnosed, worry, and fear. In conclusion, healthcare providers and public health campaigns should address susceptibility, likelihood to be diagnosed, worry, and fear about Lyme disease, and should particularly target women and Asians/Asian-Americans to address any possible misconceptions and/or offer effective coping strategies. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

The Financial Implications of a Well-Hidden and Ignored Chronic Lyme Disease Pandemic.

Science.gov (United States)

Davidsson, Marcus

2018-02-13

1 million people are predicted to get infected with Lyme disease in the USA in 2018. Given the same incidence rate of Lyme disease in Europe as in the USA, then 2.4 million people will get infected with Lyme disease in Europe in 2018. In the USA by 2050, 55.7 million people (12% of the population) will have been infected with Lyme disease. In Europe by 2050, 134.9 million people (17% of the population) will have been infected with Lyme disease. Most of these infections will, unfortunately, become chronic. The estimated treatment cost for acute and chronic Lyme disease for 2018 for the USA is somewhere between 4.8 billion USD and 9.6 billion USD and for Europe somewhere between 10.1 billion EUR and 20.1 billion EUR. If governments do not finance IV treatment with antibiotics for chronic Lyme disease, then the estimated government cost for chronic Lyme disease for 2018 for the USA is 10.1 billion USD and in Europe 20.1 billion EUR. If governments in the USA and Europe want to minimize future costs and maximize future revenues, then they should pay for IV antibiotic treatment up to a year even if the estimated cure rate is as low as 25%. The cost for governments of having chronic Lyme patients sick in perpetuity is very large.

Clinical characteristics, treatment and outcome of children with Lyme arthritis in Nova Scotia.

Science.gov (United States)

Glaude, Pier Diane; Huber, Adam M; Mailman, Timothy; Ramsey, Suzanne; Lang, Bianca; Stringer, Elizabeth

2015-10-01

Lyme disease is an emerging problem in Nova Scotia. Lyme arthritis is a late manifestation of Lyme disease. To describe the demographic characteristics, referral patterns and clinical course of children diagnosed with Lyme arthritis in a tertiary care pediatric rheumatology clinic in Nova Scotia. In the present retrospective chart review, subjects diagnosed with Lyme arthritis between 2006 and 2013 were identified through the clinic database. Demographic variables, referral patterns, clinical presentation and information regarding treatment course and outcome were collected. Seventeen patients were identified; 76% presented in 2012 and 2013. In 37.5% of cases, the referring physician suspected Lyme disease. Most patients presented with one or more painful and/or swollen joints; 94% had knee involvement. Only three of 17 patients had a history of erythema migrans and four of 17 recalled a tick bite. Five patients had a history of neurological manifestations consistent with Lyme disease, although, none had a diagnosis made at the time. Arthritis usually resolved after treatment with standard antibiotics; however, at last follow-up, two patients had antibiotic refractory Lyme arthritis, with one having joint damage despite aggressive arthritis treatment. A significant increase in cases of Lyme arthritis has recently been recognized in a pediatric rheumatology clinic in Nova Scotia. A history of a tick bite or erythema migrans were not sensitive markers of Lyme arthritis, and this diagnosis was often not considered by the referring physician. Educational initiatives should be undertaken to increase local awareness of this treatable cause of arthritis in children.

Detecting Lyme disease using antibody-functionalized carbon nanotubes

Science.gov (United States)

Dailey, Jennifer; Lerner, Mitchell; Goldsmith, Brett; Brisson, Dustin; Johnson, A. T. Charlie

2011-03-01

We combine antibodies for Lyme flagellar protein with carbon nanotube transistors to create an electronic sensor capable of definitive detection of Lyme disease. Over 35,000 cases of Lyme disease are reported in the United States each year, of which more than 23 percent are originally misdiagnosed. Rational design of the coupling of the biological system to the electronic system gives us a flexible sensor platform which we can apply to several biological systems. By coupling these antibodies to carbon nanotubes in particular, we allow for fast, sensitive, highly selective, electronic detection. Unlike antibody or biomarker detection, bacterial protein detection leads to positive identification of both early and late stage bacterial infections, and is easily expandable to environmental monitoring.

Reduction in human Lyme neuroborreliosis associated with a major epidemic among roe deer

DEFF Research Database (Denmark)

Andersen, Nanna Skaarup; Skarphédinsson, Sigurdur; Knudtzen, Fredrikke C

2018-01-01

Lyme neuroborreliosis is the most severe clinical manifestation of Lyme borreliosis. In most of Denmark, and also Europe, the overall prevalence of Lyme borreliosis seems to be stabilising. This is not the case on the island of Funen, Denmark, where the number of human Lyme neuroborreliosis cases...... has markedly declined throughout the last decade. We propose the reason for the decline is a major epidemic among roe deer, killing almost half of their population, resulting in a reduction in the tick population which make it less likely to get a tick bite and therefore to contract Lyme...

HISTORIOGRAPHIES ET FÉDÉRALISME AU CANADA

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Xavier Dionne

2009-10-01

Full Text Available This article studies the historical representation of the two main national communities in Canada; that is, the English-Canadian and the French-Canadian.Throughout the history of the English Canadian community, one cansee an ambitious national project. The national construction of Canada suggests the existence of a neutral model of government but, when looking at this carefully, it is possible to see something quite different. English-speaking historians from Canada have normally introduced the concept of a unitary federalism as the most perfect form of the Canadian integration project. This integrating federalism, that does not lead to emancipation, stems from thecentralist views of John Macdonald, one of the fathers of Canadian federalism. This approach has been kept for over 140 years of common history and, to this date, continues to be one of the main obstacles for minority nations within Canada. To strengthen their thesis, the authors base their work on an extensive analysis exploring the three big strategies used by the central government to assert its authority on the member States of the Canadian Federation in the long term: using the judicial power, centralizing powers andglobalization. The strategies used have varied depending on the economic scenario, political leaders and the political power relations regarding the links between the Federation and the provinces.

LymeDisease_9211_county

Data.gov (United States)

U.S. Department of Health & Human Services — To facilitate the public health and research community's access to NNDSS data on Lyme disease, CDC has developed a public use dataset. Based on reports submitted to...

Lyme Disease Manifestations in the Foot and Ankle: A Retrospective Case Series.

Science.gov (United States)

Miller, Jason R; Dunn, Karl W; Braccia, Domenick; Ciliberti, Louis J; Becker, Dina K; Hollinger, Joshua K; Brand, Shelley M

Lyme disease is the result of Borrelia burgdorferi bacterial infection after exposure from a tick bite. A pathognomonic finding in early-stage Lyme disease is an expanding, red macular ring known as erythema migrans. Lyme arthritis is a late-stage manifestation of this disease, affecting the large, weightbearing joints with intermittent pain and swelling. The existing data on Lyme disease and subsequent arthritis have reported manifestations in the lower extremity, primarily in the knee and ankle and less commonly the small joints of the foot. We present a retrospective case series of 11 cases of painful arthritis in the foot and ankle with confirmatory Lyme disease testing. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Long-term assessment of fatigue in patients with culture-confirmed Lyme disease.

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Wormser, Gary P; Weitzner, Erica; McKenna, Donna; Nadelman, Robert B; Scavarda, Carol; Nowakowski, John

2015-02-01

Fatigue is a common symptom with numerous causes. Severe fatigue is thought to be an important manifestation of post-treatment Lyme disease syndrome. The frequency with which severe fatigue occurs as a long-term sequela in prospectively followed patients with Lyme disease is unknown. Patients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fatigue using an 11-item Fatigue Severity Scale (FSS-11) that has been used in studies of post-treatment Lyme disease syndrome. An FSS-11 score of ≥4.0 is indicative of severe fatigue. A total of 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (range, 42-86 years). The mean duration of follow-up was 15.4 years (range, 11-20 years). Nine subjects had severe fatigue but in none as a consequence of Lyme disease. Only 3 subjects were thought to possibly have persistent fatigue from Lyme disease. The FSS-11 value for these 3 individuals was less than 4, averaging 2.27, and none had functional impairment. Severe fatigue was found in 9 patients (9%) with culture-confirmed early Lyme disease at 11 to 20 years after presentation, but was due to causes other than Lyme disease. Fatigue of lesser severity was possibly due to Lyme disease, but was found in only 3% of 100 patients, and therefore is rarely a long-term complication of this infection. Copyright © 2015 Elsevier Inc. All rights reserved.

La légalisation du cannabis au Canada: Les défis politiques

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Line Beauchesne

Full Text Available Résumé Le gouvernement libéral du Canada élu majoritaire le 19 octobre 2015 avait dans ses promesses électorales la légalisation du cannabis. Il tiendra parole. Un Document de discussion fut publié en juin 2016 donnant les assises au Groupe de Travail sur la Légalisation et la Réglementation du Cannabis qui a rendu son rapport le 30 novembre 2016. Ce rapport, a expliqué le gouvernement, sera un des outils pour élaborer son cadre législatif et servira de base aux discussions avec les provinces et territoires, de même que les experts qui auront à gérer ce cadre réglementaire. Dans cet article, nous verrons les principaux défis politiques qui attendent le gouvernement dans ces discussions avec les provinces et territoires, de même que les experts, considérant les questions posées sur les cinq aspects de la réglementation dans le Document de discussion. Pour identifier ces défis, en plus des apprentissages retenus par les études sur la situation au Colorado et à Washington, se grefferont les apprentissages des études quant à la gestion actuelle des drogues légales. En premier lieu sont exposés les défis liés à l’arrivée même de cette loi, puis ceux qui touchent à l’objectif de santé publique, au système de production, de transformation et de distribution, au contrôle du cadre réglementaire, et enfin, à la question plus spécifique du cannabis à des fins thérapeutiques. Nous verrons pourquoi l’application de cette loi sera complexe, coûteuse et pourra aisément dévier des objectifs de départ. Une surveillance à court et à long terme sera nécessaire pour s’assurer que les différents niveaux de gouvernement conservent la primauté de la santé publique et considèrent l’usage du pénal en dernier recours.

Lyme Disease: Emergency Department Considerations.

Science.gov (United States)

Applegren, Nathan D; Kraus, Chadd K

2017-06-01

Lyme disease (LD) is the most common vector-borne illness in North America. Reported cases of LD have increased from approximately 10,000 cases annually in 1991 to >25,000 cases in 2014. Greater recognition, enhanced surveillance, and public education have contributed to the increased prevalence, as have geographic expansion and the number of infected ticks. Cases are reported primarily in the Northeastern United States, Wisconsin, and Minnesota, with children having the highest incidence of LD among all age groups. The increased incidence and prevalence of LD in the United States makes it increasingly more common for patients to present to the emergency department (ED) for tick bites and LD-related chief complaints, such as the characteristic erythema migrans skin manifestation. We sought to review the etiology of LD, describe its clinical presentations and sequela, and provide a practical classification and approach to ED management of patients with LD-related presentations. In this review, ED considerations for LD are presented and clinical presentations and management of the disease at different stages is discussed. Delayed sequelae that have significant morbidity, including Lyme carditis and Lyme neuroborreliosis, are discussed. Diagnostic tests and management are described in detail. The increasing prevalence and growing geographic reach of Lyme disease makes it critically important for emergency physicians to consider the diagnosis in patients presenting with symptoms suggestive of LD and to initiate appropriate treatment to minimize the potential of delayed sequelae. Special consideration should be made for the epidemiology of LD and a high clinical suspicion should be present for patients in endemic areas or with known exposures to ticks. Emergency physicians can play a critical role in the recognition, diagnosis, and treatment of LD. Copyright © 2017 Elsevier Inc. All rights reserved.

Lyme Disease: Is It or Is It Not?

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BL Johnston

2005-01-01

Full Text Available This past summer, Lyme disease was the topic of a Focus section in the Globe and Mail (1. In this section, the reporter described her experience of having physicians unable and then unwilling to diagnose her symptoms of "skin on fire, dizziness and chest pains, twitching muscles, and trouble keeping balance" as Lyme disease following a tick bite three years previously on Prince Edward Island. She reported finding support for her diagnosis after obtaining a positive test from a California laboratory and after seeing approximately 20 physicians. In her article, she speaks to the controversy surrounding the diagnosis and treatment of Lyme disease, and the tension it creates between those who believe they have it and the physicians they see.

Progress in the molecular diagnosis of Lyme disease.

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Ružić-Sabljić, Eva; Cerar, Tjaša

2017-01-01

Current laboratory testing of Lyme borreliosis mostly relies on serological methods with known limitations. Diagnostic modalities enabling direct detection of pathogen at the onset of the clinical signs could overcome some of the limitations. Molecular methods detecting borrelial DNA seem to be the ideal solution, although there are some aspects that need to be considered. Areas covered: This review represent summary and discussion of the published data obtained from literature searches from PubMed and The National Library of Medicine (USA) together with our own experience on molecular diagnosis of Lyme disease. Expert commentary: Molecular methods are promising and currently serve as supporting diagnostic testing in Lyme borreliosis. Since the field of molecular diagnostics is under rapid development, molecular testing could become an important diagnostic modality.

Prevalence of Lyme disease among forestry workers

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Piotr Paweł Kocbach

2014-06-01

Full Text Available Background: The aim of the study is to assess the incidence of Lyme disease, established diagnosis based on medical history and clinical symptoms, serology, duration of exposure in the workplace and occupational disease certification among forestry workers in selected districts of the Warmia and Mazury region. Material and Methods: The study consisted of annual screening of 332 employees in 6 forest districts under the supervision of the Health Center Medica in Ostróda. Serological tests were performed in all serum samples and IgG and IgM antibodies were determined by ELISA test. Positive results were confirmed by Western-blot test. Diagnosis was made based on medical history and clinical symptoms. Results were presented by the division of selected forest districts, gender, duration of exposure in the workplace and genospecies of spirochete Borrelia responsible for the disease development. Results: Lyme disease incidence was found in all selected forest districts. Positive results in Western-blot test were determined in 120 people (63.1% of all the surveyed. However, after taking a detailed medical history of the patients Lyme disease was diagnosed in 91 people which makes 27.4% of all the examined. Among patients with diagnosed disease, IgG antibodies were found in 76 people, IgM in 25 people, while both IgM and IgG in 10 people. There was also variation in the involvement of genospecies generating the disease; spirochete B. afzeli – 46% for IgG antibodies, whereas spirochete B. burgdorferi – 50% of all cases for IgM antibodies. At the same time the relationship between the extended duration of occupational exposure to tick bites and the increased incidence of Lyme disease was confirmed, indicating the group of workers employed for at least 25 years. Conclusions: Forestry districts of the Warmia and Mazury region, creates extremely dangerous occupational conditions because of exposure to tick bites. At the same time the duration of

Multiple sclerosis and positive lyme serology

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Marco Aurélio Lana-Peixoto

1994-12-01

Full Text Available As Lyme neuroborreliosis (LNB may clinically mimick multiple sclerosis (MS the presence of antibodies to Borrelia burgdorferi in serum of patients with a MS-like disease in non-edemic areas for Lyme disease may be troublesome. We report the case of a 45-year-old white female with the diagnosis of relapsing/ remitting form of MS due to a 15-year history of optic neuritis and recurrent episodes of motor and sensation disturbance in the upper right limb and in both lower extremites associated with bladder dysfunction. A magnetic resonance imaging of the brain revealed multiple high intensity periventricular white matter lesions. The patient had been exposed to ticks but did not recall the presence of erythema migrans. ELISA for Lyme disease was positive in two different laboratories and the positive serology was confirmed by Western blotting. No convincing reponse followed treatment with ceftriaxone. Although it is clear that the patient had been infect by Borrelia burgdorferi the relationship of this spirochetal infection with the neurological disease could not be ascertained.

Chronic Lyme disease: misconceptions and challenges for patient management

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Halperin JJ

2015-05-01

Full Text Available John J HalperinDepartment of Neurosciences, Overlook Medical Center, Summit, NJ, USAAbstract: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%–15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease. Keywords: Lyme disease, Borrelia burgdorferi, chronic, diagnosis, treatment, chronic

Depressive Symptoms in Patients Referred to a Tertiary Lyme Center: High Prevalence in Those Without Evidence of Lyme Borreliosis.

Science.gov (United States)

Zomer, Tizza P; Vermeeren, Yolande M; Landman, Gijs W; Zwerink, Marlies; van Hees, Babette C; van Bemmel, Thomas; van Kooten, Barend

2017-10-30

Controversy exists whether mood disorders, such as depression, are associated with Lyme borreliosis (LB). The study objective was to assess prevalence of depressive symptoms in subgroups of patients referred to a tertiary Lyme center, to investigate whether depressive symptoms can be used in clinical practice to discriminate for LB. This cohort study included adult patients who visited a tertiary Lyme center between January 2008 and December 2014. Prior to medical consultation, serum samples were taken and the Beck Depression Inventory II was completed to assess depressive symptoms. Lyme diagnosis was retrospectively extracted from the patient's medical record. Patients were classified based on clinical LB and serology results. Prevalence of moderate/severe depressive symptoms was calculated. Using logistic regression, odds ratios with 95% confidence intervals (CIs) were calculated for moderate/severe depressive symptoms. In total, 1454 patients were included. Prevalence of moderate/severe depressive symptoms was lowest in patients with no clinical LB and positive serology (15.3%), higher in patients with clinical LB with positive and negative serology (19.3% and 20.9% respectively), and highest in patients with no clinical LB and negative serology (29.3%). The odds ratio for moderate/severe depressive symptoms in patients with LB and positive serology was 0.71 (95% CI, .50-1.03) compared to patients with no LB and negative serology. The prevalence of depressive symptoms was similar in patients with LB compared to patients with no evidence of infection. This suggests that depressive symptoms cannot be used to discriminate for LB in a tertiary Lyme center. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

The clinical spectrum of Lyme neuroborreliosis.

LENUS (Irish Health Repository)

Elamin, M

2010-02-01

Lyme disease is a multisystem infectious disease, endemic in parts of Europe, including the West of Ireland. Neurological manifestions (neuroborreliosis) are variable. Presenting neurological syndromes include meningitis, cranial neuropathies, myeloradiculitis and mononeuritis multiplex. A lack of specificity in serological diagnosis may add to diagnostic confusion. We reviewed thirty cases of acute Lyme disease in the West of Ireland and found neurological syndromes in 15 (50%), with painful radiculopathy (12 patients; 80%) and cranial neuropathy (7 patients; 46%) occurring frequently. Neuroborreliosis needs to be considered in the differential diagnosis of these neurological syndromes in the appropriate clinical context.

Lyme carditis mimicking giant cell arteritis

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Krati Chauhan

2015-10-01

Full Text Available Presenting an interesting case of a patient who complained of myalgias, fatigue, headache, jaw claudication and scalp tenderness. Patient’s physical examination was unremarkable. Laboratory findings showed elevated erythrocyte sedimentation rate and C-reactive protein, bilateral temporal artery biopsy results were negative and first degree atrioventricular block was seen on electrocardiogram. Serology for Borrelia burgdorferi was positive; patient was diagnosed with Lyme carditis and treated with doxycycline. Lyme is a tick-borne, multi-system disease and occasionally its presentation may mimic giant cell arteritis. On follow-up there was complete resolution of symptoms and electrocardiogram findings.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease.

Science.gov (United States)

Middelveen, Marianne J; Sapi, Eva; Burke, Jennie; Filush, Katherine R; Franco, Agustin; Fesler, Melissa C; Stricker, Raphael B

2018-04-14

Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi , in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR)-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

The impact of strain-specific immunity on Lyme disease incidence is spatially heterogeneous.

Science.gov (United States)

Khatchikian, Camilo E; Nadelman, Robert B; Nowakowski, John; Schwartz, Ira; Wormser, Gary P; Brisson, Dustin

2017-12-01

Lyme disease, caused by the bacterium Borrelia burgdorferi, is the most common tick-borne infection in the US. Recent studies have demonstrated that the incidence of human Lyme disease would have been even greater were it not for the presence of strain-specific immunity, which protects previously infected patients against subsequent infections by the same B. burgdorferi strain. Here, spatial heterogeneity is incorporated into epidemiological models to accurately estimate the impact of strain-specific immunity on human Lyme disease incidence. The estimated reduction in the number of Lyme disease cases is greater in epidemiologic models that explicitly include the spatial distribution of Lyme disease cases reported at the county level than those that utilize nationwide data. strain-specific immunity has the greatest epidemiologic impact in geographic areas with the highest Lyme disease incidence due to the greater proportion of people that have been previously infected and have developed strain-specific immunity. Copyright © 2017 Elsevier Inc. All rights reserved.

Reduction in human Lyme neuroborreliosis associated with a major epidemic among roe deer.

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Andersen, Nanna Skaarup; Skarphédinsson, Sigurdur; Knudtzen, Fredrikke C; Olesen, Carsten Riis; Jensen, Thøger Gorm; Jensen, Per Moestrup

2018-02-01

Lyme neuroborreliosis is the most severe clinical manifestation of Lyme borreliosis. In most of Denmark, and also Europe, the overall prevalence of Lyme borreliosis seems to be stabilising. This is not the case on the island of Funen, Denmark, where the number of human Lyme neuroborreliosis cases has markedly declined throughout the last decade. We propose the reason for the decline is a major epidemic among roe deer, killing almost half of their population, resulting in a reduction in the tick population which make it less likely to get a tick bite and therefore to contract Lyme neuroborreliosis. This is the first time such a relationship is described as a naturally occurring phenomenon in Europe. Copyright © 2017 Elsevier GmbH. All rights reserved.

In silico evaluation of PCR - primers for detection of Lyme Borrelia

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Sultan, Nasir

2016-01-01

Lyme borreliosis (LB) or Lyme disease is the most prevalent vector-borne disease in US and Europe. The etiologic is some species of tick-borne spirochetes Borrelia burgdorferi sensu lato (B. burgdorferi sl) complex. The most common clinical symptoms of LB is the erythema migrans (EM). The pathogen is transmitted to humans through the tick bite of Ixodes species, and spread to cause more severe manifestations such as Acrodermatitis Chronica Atrophicans (ACA), Lyme arthritis, and neuroborrelios...

Climate change influences on the annual onset of Lyme disease in the United States

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Monaghan, A. J.; Moore, S. M.; Sampson, K. M.; Beard, C. B.; Eisen, R. J.

2015-12-01

Lyme disease is the most commonly reported vector-borne illness in the United States. Lyme disease occurrence is highly seasonal and the annual springtime onset of cases is modulated by meteorological conditions in preceding months. A meteorological-based empirical model for Lyme disease onset week in the United States is driven with downscaled simulations from five global climate models and four greenhouse gas emissions scenarios to project the impacts of 21st century climate change on the annual onset week of Lyme disease. Projections are made individually and collectively for the 12 eastern States where >90% of cases occur. The national average annual onset week of Lyme disease is projected to become 0.4-0.5 weeks earlier for 2025-2040 (pLyme disease spirochete Borrelia burgdorferi in the eastern United States, may alter the disease transmission cycle in unforeseen ways. The results suggest 21st century climate change will make environmental conditions suitable for earlier annual onset of Lyme disease cases in the United States with possible implications for the timing of public health interventions.

Persistent Borrelia Infection in Patients with Ongoing Symptoms of Lyme Disease

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Marianne J. Middelveen

2018-04-01

Full Text Available Introduction: Lyme disease is a tickborne illness that generates controversy among medical providers and researchers. One of the key topics of debate is the existence of persistent infection with the Lyme spirochete, Borrelia burgdorferi, in patients who have been treated with recommended doses of antibiotics yet remain symptomatic. Persistent spirochetal infection despite antibiotic therapy has recently been demonstrated in non-human primates. We present evidence of persistent Borrelia infection despite antibiotic therapy in patients with ongoing Lyme disease symptoms. Methods: In this pilot study, culture of body fluids and tissues was performed in a randomly selected group of 12 patients with persistent Lyme disease symptoms who had been treated or who were being treated with antibiotics. Cultures were also performed on a group of ten control subjects without Lyme disease. The cultures were subjected to corroborative microscopic, histopathological and molecular testing for Borrelia organisms in four independent laboratories in a blinded manner. Results: Motile spirochetes identified histopathologically as Borrelia were detected in culture specimens, and these spirochetes were genetically identified as Borrelia burgdorferi by three distinct polymerase chain reaction (PCR-based approaches. Spirochetes identified as Borrelia burgdorferi were cultured from the blood of seven subjects, from the genital secretions of ten subjects, and from a skin lesion of one subject. Cultures from control subjects without Lyme disease were negative for Borrelia using these methods. Conclusions: Using multiple corroborative detection methods, we showed that patients with persistent Lyme disease symptoms may have ongoing spirochetal infection despite antibiotic treatment, similar to findings in non-human primates. The optimal treatment for persistent Borrelia infection remains to be determined.

Lyme carditis with isolated left bundle branch block and myocarditis successfully treated with oral doxycycline.

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Cunha, Burke A; Elyasi, Maekal; Singh, Prince; Jimada, Ismail

2018-01-01

Lyme disease may present with a variety of cardiac manifestations ranging from first degree to third degree heart block. Cardiac involvement with Lyme disease may be asymptomatic, or symptomatic. Atrioventrical conduction abnormalities are the most common manifestation of Lyme carditis. Less common, are alternating right bundle branch block (RBBB) and left bundle branch block (LBBB). We present an interesting case of a young male whose main manifestation of Lyme carditis was isolated LBBB. He also had mild Lyme myocarditis. The patient was successfully treated with oral doxycycline, and his isolated LBBB and myocarditis rapidly resolved.

Lyme borreliosis : reviewing potential vaccines, clinical aspects and health economics

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Smit, Renata; Postma, Maarten J.

2015-01-01

Lyme borreliosis (LB) is a multisystem infectious disease with a growing burden in many parts of North America, Asia and Europe. Persistent infection of LB can usually be treated effectively with antibiotic therapy, but it may be followed by post-treatment Lyme disease syndrome. Therefore, it is

Lyme Disease and YouTube TM: A Cross-Sectional Study of Video Contents.

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Basch, Corey H; Mullican, Lindsay A; Boone, Kwanza D; Yin, Jingjing; Berdnik, Alyssa; Eremeeva, Marina E; Fung, Isaac Chun-Hai

2017-08-01

Lyme disease is the most common tick-borne disease. People seek health information on Lyme disease from YouTube TM videos. In this study, we investigated if the contents of Lyme disease-related YouTube TM videos varied by their sources. Most viewed English YouTube TM videos (n = 100) were identified and manually coded for contents and sources. Within the sample, 40 videos were consumer-generated, 31 were internet-based news, 16 were professional, and 13 were TV news. Compared with consumer-generated videos, TV news videos were more likely to mention celebrities (odds ratio [OR], 10.57; 95% confidence interval [CI], 2.13-52.58), prevention of Lyme disease through wearing protective clothing (OR, 5.63; 95% CI, 1.23-25.76), and spraying insecticides (OR, 7.71; 95% CI, 1.52-39.05). A majority of the most popular Lyme disease-related YouTube TM videos were not created by public health professionals. Responsible reporting and creative video-making facilitate Lyme disease education. Partnership with YouTube TM celebrities to co-develop educational videos may be a future direction.

The HUMTICK study: protocol for a prospective cohort study on post-treatment Lyme disease syndrome and the disease and cost burden of Lyme borreliosis in Belgium.

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Geebelen, Laurence; Lernout, Tinne; Kabamba-Mukadi, Benoît; Saegeman, Veroniek; Sprong, Hein; Van Gucht, Steven; Beutels, Philippe; Speybroeck, Niko; Tersago, Katrien

2017-01-01

In Belgium, different routine surveillance systems are in place to follow-up Lyme borreliosis trends. However, accurate data on the disease and monetary burden for the different clinical manifestations are lacking. Despite recommended antibiotic treatment, a proportion of Lyme patients report

Post-Treatment Lyme Disease Syndrome

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... is not known. The term “chronic Lyme disease” (CLD) has been used to describe people with different ... Because of the confusion in how the term CLD in this field is employed, experts do not ...

To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis

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Dessau, R. B.; van Dam, A. P.; Fingerle, V.; Gray, J.; Hovius, J. W.; Hunfeld, K.-P.; Jaulhac, B.; Kahl, O.; Kristoferitsch, W.; Lindgren, P.-E.; Markowicz, M.; Mavin, S.; Ornstein, K.; Rupprecht, T.; Stanek, G.; Strle, F.

2018-01-01

Lyme borreliosis (LB) is a tick-borne infection caused by Borrelia burgdorferi sensu lato. The most frequent clinical manifestations are erythema migrans and Lyme neuroborreliosis. Currently, a large volume of diagnostic testing for LB is reported, whereas the incidence of clinically relevant

Metabolic differentiation of early Lyme disease from southern tick-associated rash illness (STARI).

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Molins, Claudia R; Ashton, Laura V; Wormser, Gary P; Andre, Barbara G; Hess, Ann M; Delorey, Mark J; Pilgard, Mark A; Johnson, Barbara J; Webb, Kristofor; Islam, M Nurul; Pegalajar-Jurado, Adoracion; Molla, Irida; Jewett, Mollie W; Belisle, John T

2017-08-16

Lyme disease, the most commonly reported vector-borne disease in the United States, results from infection with Borrelia burgdorferi. Early clinical diagnosis of this disease is largely based on the presence of an erythematous skin lesion for individuals in high-risk regions. This, however, can be confused with other illnesses including southern tick-associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States. By applying an unbiased metabolomics approach with sera retrospectively obtained from well-characterized patients, we defined biochemical and diagnostic differences between early Lyme disease and STARI. Specifically, a metabolic biosignature consisting of 261 molecular features (MFs) revealed that altered N -acyl ethanolamine and primary fatty acid amide metabolism discriminated early Lyme disease from STARI. Development of classification models with the 261-MF biosignature and testing against validation samples differentiated early Lyme disease from STARI with an accuracy of 85 to 98%. These findings revealed metabolic dissimilarity between early Lyme disease and STARI, and provide a powerful and new approach to inform patient management by objectively distinguishing early Lyme disease from an illness with nearly identical symptoms. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Fatal Lyme carditis and endodermal heterotopia of the atrioventricular node.

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Cary, N. R.; Fox, B.; Wright, D. J.; Cutler, S. J.; Shapiro, L. M.; Grace, A. A.

1990-01-01

A fatal case of Lyme carditis occurring in a Suffolk farmworker is reported. Post-mortem examination of the heart showed pericarditis, focal myocarditis and prominent endocardial and interstitial fibrosis. The additional finding of endodermal heterotopia ('mesothelioma') of the atrioventricular node raises the possibility that this could also be related to Lyme infection and account for the relatively frequent occurrence of atrioventricular block in this condition. Lyme disease should always be considered in a case of atrioventricular block, particularly in a young patient from a rural area. The heart block tends to improve and therefore only temporary pacing may be required. Images Figure 1 Figure 2 Figure 3 PMID:2349186

Lyme borreliosis: A neglected zoonosis in Egypt.

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Elhelw, Rehab A; El-Enbaawy, Mona I; Samir, Ahmed

2014-12-01

Borrelia burgdorferi, the causal organism of Lyme borreliosis. In Egypt, available data about the occurrence of Lyme disease are scarce and no structured studies documented the presence of Lyme borreliosis in Egyptian animals and tick reservoirs verifying its zoonotic evidence. Besides, no successful trials to isolate B. burgdorferi from clinical samples have occurred. This study was conducted to investigate B. burgdorferi infection as an emerging zoonosis neglected in Egypt. A total number of 92 animals, tick and human companion specimens were collected and subjected for culture, PCR and/or serodetection. B. burgdorferi has been detected and isolated from Egyptian animal breeds. We also detected the presence of outer surface protein A gene of B. burgdorferi by PCR as well as anti-B. burgdorferi IgM by ELISA in human contacts who were suffering from fever of unknown origin. This report represents the first systematic study on animals associated with patients suffering from febrile illness to confirm the emerging of such neglected zoonosis in Egypt. Copyright © 2014 Elsevier B.V. All rights reserved.

[Prediction of potential geographic distribution of Lyme disease in Qinghai province with Maximum Entropy model].

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Zhang, Lin; Hou, Xuexia; Liu, Huixin; Liu, Wei; Wan, Kanglin; Hao, Qin

2016-01-01

To predict the potential geographic distribution of Lyme disease in Qinghai by using Maximum Entropy model (MaxEnt). The sero-diagnosis data of Lyme disease in 6 counties (Huzhu, Zeku, Tongde, Datong, Qilian and Xunhua) and the environmental and anthropogenic data including altitude, human footprint, normalized difference vegetation index (NDVI) and temperature in Qinghai province since 1990 were collected. By using the data of Huzhu Zeku and Tongde, the prediction of potential distribution of Lyme disease in Qinghai was conducted with MaxEnt. The prediction results were compared with the human sero-prevalence of Lyme disease in Datong, Qilian and Xunhua counties in Qinghai. Three hot spots of Lyme disease were predicted in Qinghai, which were all in the east forest areas. Furthermore, the NDVI showed the most important role in the model prediction, followed by human footprint. Datong, Qilian and Xunhua counties were all in eastern Qinghai. Xunhua was in hot spot areaⅡ, Datong was close to the north of hot spot area Ⅲ, while Qilian with lowest sero-prevalence of Lyme disease was not in the hot spot areas. The data were well modeled in MaxEnt (Area Under Curve=0.980). The actual distribution of Lyme disease in Qinghai was in consistent with the results of the model prediction. MaxEnt could be used in predicting the potential distribution patterns of Lyme disease. The distribution of vegetation and the range and intensity of human activity might be related with Lyme disease distribution.

Poor Positive Predictive Value of Lyme Disease Serologic Testing in an Area of Low Disease Incidence.

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Lantos, Paul M; Branda, John A; Boggan, Joel C; Chudgar, Saumil M; Wilson, Elizabeth A; Ruffin, Felicia; Fowler, Vance; Auwaerter, Paul G; Nigrovic, Lise E

2015-11-01

Lyme disease is diagnosed by 2-tiered serologic testing in patients with a compatible clinical illness, but the significance of positive test results in low-prevalence regions has not been investigated. We reviewed the medical records of patients who tested positive for Lyme disease with standardized 2-tiered serologic testing between 2005 and 2010 at a single hospital system in a region with little endemic Lyme disease. Based on clinical findings, we calculated the positive predictive value of Lyme disease serology. Next, we reviewed the outcome of serologic testing in patients with select clinical syndromes compatible with disseminated Lyme disease (arthritis, cranial neuropathy, or meningitis). During the 6-year study period 4723 patients were tested for Lyme disease, but only 76 (1.6%) had positive results by established laboratory criteria. Among 70 seropositive patients whose medical records were available for review, 12 (17%; 95% confidence interval, 9%-28%) were found to have Lyme disease (6 with documented travel to endemic regions). During the same time period, 297 patients with a clinical illness compatible with disseminated Lyme disease underwent 2-tiered serologic testing. Six of them (2%; 95% confidence interval, 0.7%-4.3%) were seropositive, 3 with documented travel and 1 who had an alternative diagnosis that explained the clinical findings. In this low-prevalence cohort, fewer than 20% of positive Lyme disease tests are obtained from patients with clinically likely Lyme disease. Positive Lyme disease test results may have little diagnostic value in this setting. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Tick borne illness-Lyme disease.

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Bush, Larry M; Vazquez-Pertejo, Maria T

2018-05-01

Lyme disease is the most commonly reported tick-borneillness in the United States. Thecausative spirochete, Borrelia burgdorferi is transmitted by 4 species of Ixodes tick species. Over 90% of US cases occur in northeasternstates from Maine to Virginia, and in Wisconsin, Minnesota, and Michigan. Infection also takes place in northern California and Oregon. Lyme borreliosis is also diagnosed in parts of Europe, China, and Japan. The white-footed mouse is the primary animal reservoir for B. burgdorferi in the U.S. and the preferred host for nymphal and larval forms of the deer tick. Deer are hosts for the adult ticks but do not carry the spirochete. Signs and symptomsof infection occur in 3 stages; early localized, typified by erythema migrans; early disseminated with a flu-like syndrome, neurologic, and cardiac manifestations; and late, characteristically with arthritis. Although, the term 'Chronic Lyme Disease' has been assigned to many patients with a variety of unexplained symptoms, experts in the field question the validity of this diagnosis and warn against prolonged unproven antimicrobial therapies. Diagnosis relies upon clinical evaluation and is supported by serologic testing using a 2-step process which requires careful interpretation. Treatmentvaries with stage of disease, but normally includes doxycycline, amoxicillin,and ceftriaxone. Currently, no preventative vaccine is available. In some geographic areas, patients may be confected with Babesia, Ehrlichia, and Anaplasma since the same Ixodes ticks transmit these pathogens. Copyright © 2018 Mosby, Inc. All rights reserved.

Characteristics of seroconversion and implications for diagnosis of post-treatment Lyme disease syndrome: acute and convalescent serology among a prospective cohort of early Lyme disease patients.

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Rebman, Alison W; Crowder, Lauren A; Kirkpatrick, Allison; Aucott, John N

2015-03-01

Two-tier serology is often used to confirm a diagnosis of Lyme disease. One hundred and four patients with physician diagnosed erythema migrans rashes had blood samples taken before and after 3 weeks of doxycycline treatment for early Lyme disease. Acute and convalescent serologies for Borrelia burgdorferi were interpreted according to the 2-tier antibody testing criteria proposed by the Centers for Disease Control and Prevention. Serostatus was compared across several clinical and demographic variables both pre- and post-treatment. Forty-one patients (39.4%) were seronegative both before and after treatment. The majority of seropositive individuals on both acute and convalescent serology had a positive IgM western blot and a negative IgG western blot. IgG seroconversion on western blot was infrequent. Among the baseline variables included in the analysis, disseminated lesions (p Lyme disease. Furthermore, these findings underline the difficulty for rheumatologists in identifying a prior exposure to Lyme disease in caring for patients with medically unexplained symptoms or fibromyalgia-like syndromes.

TGF-β1 of no avail as prognostic marker in lyme disease

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Julia Schumann

2014-05-01

Full Text Available Background. Within the present in vivo study using the wild type mouse strains C3H/HeN and FVB/N it was intended to (1 measure TGF-β1 expression in the course of lyme disease, (2 examine the potential correlation of TGF-β1 expression with the clinical outcome of a Borrelia infection (with a focus on lyme arthritis, (3 develop a diagnostic tool based on the endogenous factor TGF-β1 to predict the progressivity of lyme disease.Findings. In the course of lyme disease there was an increase in the serum content of active TGF-β1, which became significant 56 days post infection (p < 0.001. The serum concentration of total TGF-β1 in the course of infection initially decreased then rebounded and subsequently dropped again. Despite considerable individual variations in active TGF-β1 serum concentrations there were no identifiable dissimilarities in the clinical appearance of the mice. Likewise, no correlation could be seen between the serum content of active TGF-β1 and the severity of lyme arthritis of tibiotarsal joints of infected mice.Conclusions. The present study clearly shows that TGF-β1 is of no avail as prognostic marker in lyme disease. Hence, the search for an endogenous predictive factor, which can be determined in an easy and reliable manner, remains open.

Lyme Disease in West Virginia: An Assessment of Distribution and Clinicians' Knowledge of Disease and Surveillance.

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Singh, Sarah; Parker, David; Mark-Carew, Miguella; White, Robert; Fisher, Melanie

2016-01-01

Lyme disease case misclassification, a top public health concern, may be attributed to the current disconnect between clinical diagnosis and surveillance. This study examines Lyme disease distribution in West Virginia (WV) and determines clinicians' knowledge of both disease and surveillance. Lyme disease surveillance data for 2013 were obtained from the WV Bureau for Public Health. A validated survey, distributed to clinicians at an academic medical center, assessed clinicians' knowledge of disease diagnosis and surveillance. There were 297 adult Lyme disease cases of which 83 were confirmed. Clinician survey responses resulted in a correct response rate of 70% for Lyme disease knowledge questions. Fewer than half of all clinicians were aware of the surveillance criteria for confirming Lyme disease cases. Neither medical specialty nor previous treatment of patients with Lyme disease were significantly associated with clinicians' knowledge of the disease. Clinicians in WV are familiar with symptoms and clinical management of Lyme disease. However, they are less knowledgeable about diagnosis and public health surveillance comprising reporting and confirming cases of the disease. Clinicians and public health authorities should collaborate more closely to promote education and awareness as a key step to successfully reducing the burden of Lymne disease.

Lyme myocarditis diagnosed by indium-111-antimyosin antibody scintigraphy

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Casans, I.; Villar, A.; Almenar, V.; Blanes, A.

1989-06-01

We report a new case of Lyme disease with cardiac manifestations, which has been possible to follow during the long period of 12 years. We have detected the usual ECG abnormalities, and concentric hypertrophic myocardiopathy, by echocardiography. The acute myocarditis was demonstrated by /sup 111/In-antimyosin scintigraphy, which showed global myocardial uptake of the tracer, constituting the first report, to our knowledge, of Lyme myocarditis diagnosed by this method.

Bilateral Facial Diplegia: A Rare Presenting Symptom of Lyme

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John Ashurst

2017-01-01

Full Text Available Lyme disease is a common disease that is faced by the physician but also acts a mimicker of many other disease processes. Facial palsies, especially bilateral, are a relatively rare presenting symptom of Lyme disease and may warrant further investigation. A thorough history and physical examination coupled with precision testing may aid the physician when faced with a patient with the diagnostic dilemma of facial diplegia.

Lyme myocarditis diagnosed by indium-111-antimyosin antibody scintigraphy

International Nuclear Information System (INIS)

Casans, I.; Villar, A.; Almenar, V.; Blanes, A.

1989-01-01

We report a new case of Lyme disease with cardiac manifestations, which has been possible to follow during the long period of 12 years. We have detected the usual ECG abnormalities, and concentric hypertrophic myocardiopathy, by echocardiography. The acute myocarditis was demonstrated by 111 In-antimyosin scintigraphy, which showed global myocardial uptake of the tracer, constituting the first report, to our knowledge, of Lyme myocarditis diagnosed by this method. (orig.)

Bedrock Geologic Map of the Old Lyme Quadrangle, New London and Middlesex Counties, Connecticut

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Walsh, Gregory J.; Scott, Robert B.; Aleinikoff, John N.; Armstrong, Thomas R.

2009-01-01

The bedrock geology of the Old Lyme quadrangle consists of Neoproterozoic and Permian gneisses and granites of the Gander and Avalon terranes, Silurian metasedimentary rocks of the Merrimack terrane, and Silurian to Devonian metasedimentary rocks of uncertain origin. The Avalon terrane rocks crop out within the Selden Neck block, and the Gander terrane rocks crop out within the Lyme dome. The Silurian to Devonian rocks crop out between these two massifs. Previous mapping in the Old Lyme quadrangle includes the work by Lawrence Lundgren, Jr. Lundgren's work provides an excellent resource for rock descriptions and detailed modal analyses of rock units that will not be duplicated in this current report. New research that was not covered in detail by Lundgren is the focus of this report and includes (1) evaluation of the rocks in the core of the Lyme dome in an effort to subdivide units in this area; (2) structural analysis of foliations and folds in and around the Lyme dome; (3) geochronology of selected units within the Lyme dome; and (4) analysis of joints and the fracture properties of the rocks.

Lyme disease and Bell's palsy: an epidemiological study of diagnosis and risk in England.

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Cooper, Lilli; Branagan-Harris, Michael; Tuson, Richard; Nduka, Charles

2017-05-01

Lyme disease is caused by a tick-borne spirochaete of the Borrelia species. It is associated with facial palsy, is increasingly common in England, and may be misdiagnosed as Bell's palsy. To produce an accurate map of Lyme disease diagnosis in England and to identify patients at risk of developing associated facial nerve palsy, to enable prevention, early diagnosis, and effective treatment. Hospital episode statistics (HES) data in England from the Health and Social Care Information Centre were interrogated from April 2011 to March 2015 for International Classification of Diseases 10th revision (ICD-10) codes A69.2 (Lyme disease) and G51.0 (Bell's palsy) in isolation, and as a combination. Patients' age, sex, postcode, month of diagnosis, and socioeconomic groups as defined according to the English Indices of Deprivation (2004) were also collected. Lyme disease hospital diagnosis increased by 42% per year from 2011 to 2015 in England. Higher incidence areas, largely rural, were mapped. A trend towards socioeconomic privilege and the months of July to September was observed. Facial palsy in combination with Lyme disease is also increasing, particularly in younger patients, with a mean age of 41.7 years, compared with 59.6 years for Bell's palsy and 45.9 years for Lyme disease ( P = 0.05, analysis of variance [ANOVA]). Healthcare practitioners should have a high index of suspicion for Lyme disease following travel in the areas shown, particularly in the summer months. The authors suggest that patients presenting with facial palsy should be tested for Lyme disease. © British Journal of General Practice 2017.

Clinical evaluation of guidelines and two-test approach for lyme disease

NARCIS (Netherlands)

Blaauw, A. A.; van Loon, A. M.; Schellekens, J. F.; Bijlsma, J. W.

1999-01-01

The diagnosis of Lyme disease should be based on objective clinical signs and symptoms. In a clinical study, we have evaluated whether the recommended two-step approach for serodiagnosis of Lyme disease is useful in daily clinical practice and can influence clinical decision making. The signs and

Forest fragmentation and Lyme disease

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Lyme disease is the most commonly reported vectorborne disease in the United States. It is associated with human exposure to infected Ixodes ticks which exist even in degraded forest and herbaceous habitat. We provide an overview of the epidemiology, ecology and landscape charact...

Articular manifestations in patients with Lyme disease.

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Vázquez-López, María Esther; Díez-Morrondo, Carolina; Sánchez-Andrade, Amalia; Pego-Reigosa, Robustiano; Díaz, Pablo; Castro-Gago, Manuel

To determine the percentage of Lyme patients with articular manifestations in NW Spain and to know their evolution and response to treatment. A retrospective study (2006-2013) was performed using medical histories of confirmed cases of Lyme disease showing articular manifestations. Clinical and laboratory characteristics, together with the treatment and evolution of the patients, were analysed. Seventeen out of 108 LD confirmed patients (15.7%) showed articular manifestations. Regarding those 17 patients, 64.7%, 29.4% and 5.9% presented arthritis, arthralgia and bursitis, respectively. The knee was the most affected joint. Articular manifestations were often associated to neurological, dermatological and cardiac pathologies. Otherwise, most patients were in Stage III. The 11.8% of the cases progressed to a recurrent chronic arthritis despite the administration of an appropriate treatment. Lyme disease patients showing articular manifestations should be included in the diagnosis of articular affections in areas of high risk of hard tick bite, in order to establish a suitable and early treatment and to avoid sequels. Copyright © 2015 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Autoimmune Arthritides, Rheumatoid Arthritis, Psoriatic Arthritis, or Peripheral Spondyloarthritis Following Lyme Disease.

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Arvikar, Sheila L; Crowley, Jameson T; Sulka, Katherine B; Steere, Allen C

2017-01-01

To describe systemic autoimmune joint diseases that develop following Lyme disease, and to compare their clinical features with those of Lyme arthritis (LA). We reviewed records of all adult patients referred to our LA clinic over a 13-year period, in whom we had diagnosed a systemic autoimmune joint disease following Lyme disease. For comparison, records of patients enrolled in our LA cohort over the most recent 2-year period were analyzed. Levels of IgG antibodies to Borrelia burgdorferi and to 3 Lyme disease-associated autoantigens were measured. We identified 30 patients who had developed a new-onset systemic autoimmune joint disorder a median of 4 months after Lyme disease (usually manifested by erythema migrans [EM]). Fifteen had rheumatoid arthritis (RA), 13 had psoriatic arthritis (PsA), and 2 had peripheral spondyloarthritis (SpA). The 30 patients typically had polyarthritis, and those with PsA or SpA often had previous psoriasis, axial involvement, or enthesitis. In the comparison group of 43 patients with LA, the usual clinical picture was monoarticular knee arthritis, without prior EM. Most of the patients with systemic autoimmune joint disorders were positive for B burgdorferi IgG antibodies, as detected by enzyme-linked immunosorbent assay, but had significantly lower titers and lower frequencies of Lyme disease-associated autoantibodies than patients with LA. Prior to our evaluation, these patients had often received additional antibiotics for presumed LA, without benefit. We prescribed antiinflammatory agents, most commonly disease-modifying antirheumatic drugs, resulting in improvement. Systemic autoimmune joint diseases (i.e., RA, PsA, SpA) may follow Lyme disease. Development of polyarthritis after antibiotic-treated EM, previous psoriasis, or low-titer B burgdorferi antibodies may provide insight into the correct diagnosis. © 2016, American College of Rheumatology.

Acute lyme infection presenting with amyopathic dermatomyositis and rapidly fatal interstitial pulmonary fibrosis: a case report

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Nguyen Hanh

2010-06-01

Full Text Available Abstract Introduction Dermatomyositis has been described in the setting of lyme infection in only nine previous case reports. Although lyme disease is known to induce typical clinical findings that are observed in various collagen vascular diseases, to our knowledge, we believe that our case is the first presentation of acute lyme disease associated with amyopathic dermatomyositis, which was then followed by severe and fatal interstitial pulmonary fibrosis only two months later. Case presentation We present a case of a 64-year-old African-American man with multiple medical problems who was diagnosed with acute lyme infection after presenting with the pathognomonic rash and confirmatory serology. In spite of appropriate antimicrobial therapy for lyme infection, he developed unexpected amyopathic dermatomyositis and then interstitial lung disease. Conclusions This case illustrates a potential for lyme disease to produce clinical syndromes that may be indistinguishable from primary connective tissue diseases. An atypical and sequential presentation (dermatomyositis and interstitial lung disease of a common disease (lyme infection is discussed. This case illustrates that in patients who are diagnosed with lyme infection who subsequently develop atypical muscular, respiratory or other systemic complaints, the possibility of severe rheumatological and pulmonary complications should be considered.

Le don après un décès d'origine cardiocirculatoire au Canada

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Shemie, Sam D.; Baker, Andrew J.; Knoll, Greg; Wall, William; Rocker, Graeme; Howes, Daniel; Davidson, Janet; Pagliarello, Joe; Chambers-Evans, Jane; Cockfield, Sandra; Farrell, Catherine; Glannon, Walter; Gourlay, William; Grant, David; Langevin, Stéphan; Wheelock, Brian; Young, Kimberly; Dossetor, John

2006-01-01

Résumé Ces recommandations sont le fruit d'un processus multidisciplinaire national ayant duré un an et visant à déterminer si et comment l'on pourrait procéder au don d'organes après un décès d'origine cardiocirculatoire («don après le décès cardiocirculatoire», ou DDC) au Canada. Le forum national organisé en février 2005 a permis aux participants de discuter et d'élaborer des recommandations sur les principes, interventions et pratiques se rapportant au DDC. Les aspects éthiques et juridiques ont été abordés dans les discussions. À la fin du Forum, la majorité des participants ont été favorables à l'implantation de programmes de DDC au Canada. Les participants du Forum ont également convenu qu'il fallait formuler et prôner des valeurs fondamentales pour orienter l'élaboration de programmes et de protocoles basés sur le cadre médical, éthique et juridique établi lors de cette réunion. Même si la possibilité d'un don d'organes et de tissus doit faire partie intégrante des soins de fin de vie, il faut insister sur le fait que le devoir de diligence envers les patients mourants et leurs familles doit demeurer la priorité des équipes soignantes. La complexité et les répercussions profondes du décès sont reconnues et doivent être respectées, de même que les différences personnelles, ethnoculturelles et religieuses face à la mort et au don d'organes. Les décisions d'arrêter le traitement de maintien des fonctions vitales, la prise en charge des derniers moments de la vie et le diagnostic de décès selon des critères cardiocirculatoires doivent être distincts et indépendants des processus de don et transplantation. Ce rapport contient des recommandations destinées aux gestionnaires de program, aux autorités sanitaires régionales et aux instances appelés à élaborer les protocoles de DDC. Les programmes doivent être conçus en fonction des éléments suivants : direction et planification locales, éducation et

Serum Inflammatory Mediators as Markers of Human Lyme Disease Activity

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Soloski, Mark J.; Crowder, Lauren A.; Lahey, Lauren J.; Wagner, Catriona A.

2014-01-01

Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low) of acute Lyme patients with distinct cytokine signatures that also differed significantly (pLyme disease (p = 0.01) and the decrease correlates with chemokine levels (p = 0.0375). The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations. PMID:24740099

An Unexpected Case of Lyme Disease in a Soldier Serving in Northern Iraq

Science.gov (United States)

2010-05-01

MILITARY MEDICINE, 175,5:367,2010 An Unexpected Case of Lyme Disease in a Soldier Serving in Northern Iraq CPT Jeremy B. Fisher, SP USA *; CPT...Christopher E. Curtis, MC USAt 188143 ABSTRACT Lyme disease is a tick-transmitted disease caused by the spirochete Borrelia burgdorferi. Cases have been...Turkey.3-S We report an unexpected case of Lyme disease from Iraq. CASE REPORT A 28-year-old active duty Army male, on a deployment to northern Iraq

Lyme Disease Frequently Asked Questions (FAQ)

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... the Northeast and upper Midwest, with 14 states accounting for over 96% of cases reported to CDC. ... of Notifiable Diseases . What is a surveillance case definition? Reporting of all nationally notifiable diseases, including Lyme ...

Empirical validation of the Horowitz Multiple Systemic Infectious Disease Syndrome Questionnaire for suspected Lyme disease.

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Citera, Maryalice; Freeman, Phyllis R; Horowitz, Richard I

2017-01-01

Lyme disease is spreading worldwide, with multiple Borrelia species causing a broad range of clinical symptoms that mimic other illnesses. A validated Lyme disease screening questionnaire would be clinically useful for both providers and patients. Three studies evaluated such a screening tool, namely the Horowitz Multiple Systemic Infectious Disease Syndrome (MSIDS) Questionnaire. The purpose was to see if the questionnaire could accurately distinguish between Lyme patients and healthy individuals. Study 1 examined the construct validity of the scale examining its factor structure and reliability of the questionnaire among 537 individuals being treated for Lyme disease. Study 2 involved an online sample of 999 participants, who self-identified as either healthy (N=217) or suffering from Lyme now (N=782) who completed the Horowitz MSIDS Questionnaire (HMQ) along with an outdoor activity survey. We examined convergent validity among components of the scale and evaluated discriminant validity with the Big Five personality characteristics. The third study compared a sample of 236 patients with confirmed Lyme disease with an online sample of 568 healthy individuals. Factor analysis results identified six underlying latent dimensions; four of these overlapped with critical symptoms identified by Horowitz - neuropathy, cognitive dysfunction, musculoskeletal pain, and fatigue. The HMQ showed acceptable levels of internal reliability using Cronbach's coefficient alpha and exhibited evidence of convergent and divergent validity. Components of the HMQ correlated more highly with each other than with unrelated traits. The results consistently demonstrated that the HMQ accurately differentiated those with Lyme disease from healthy individuals. Three migratory pain survey items (persistent muscular pain, arthritic pain, and nerve pain/paresthesias) robustly identified individuals with verified Lyme disease. The results support the use of the HMQ as a valid, efficient, and low

Distribution and presentation of Lyme borreliosis in Scotland - analysis of data from a national testing laboratory.

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Mavin, S; Watson, E J; Evans, R

2015-01-01

This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland. Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period. Results The number of laboratory-confirmed cases of Lyme borreliosis in Scotland peaked at 440 in 2010. From 2008 to 2013 the estimated average annual incidence was 6.8 per 100,000 (44.1 per 100,000 in NHS Highland). Of 594 questionnaires from NHS Highland patients: 76% had clinically confirmed Lyme borreliosis; 48% erythema migrans; 17% rash, 25% joint, 15% neurological and 1% cardiac symptoms. Only 61% could recall a tick bite. Conclusion The incidence of Lyme borreliosis may be stabilising in Scotland but NHS Highland remains an area of high incidence. Lyme borreliosis should be considered in symptomatic patients that have had exposure to ticks and not just those with a definite tick bite.

Variability in results from negative binomial models for Lyme disease measured at different spatial scales.

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Tran, Phoebe; Waller, Lance

2015-01-01

Lyme disease has been the subject of many studies due to increasing incidence rates year after year and the severe complications that can arise in later stages of the disease. Negative binomial models have been used to model Lyme disease in the past with some success. However, there has been little focus on the reliability and consistency of these models when they are used to study Lyme disease at multiple spatial scales. This study seeks to explore how sensitive/consistent negative binomial models are when they are used to study Lyme disease at different spatial scales (at the regional and sub-regional levels). The study area includes the thirteen states in the Northeastern United States with the highest Lyme disease incidence during the 2002-2006 period. Lyme disease incidence at county level for the period of 2002-2006 was linked with several previously identified key landscape and climatic variables in a negative binomial regression model for the Northeastern region and two smaller sub-regions (the New England sub-region and the Mid-Atlantic sub-region). This study found that negative binomial models, indeed, were sensitive/inconsistent when used at different spatial scales. We discuss various plausible explanations for such behavior of negative binomial models. Further investigation of the inconsistency and sensitivity of negative binomial models when used at different spatial scales is important for not only future Lyme disease studies and Lyme disease risk assessment/management but any study that requires use of this model type in a spatial context. Copyright © 2014 Elsevier Inc. All rights reserved.

Urban and rural risks of Lyme disease in the Scottish Highlands.

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Mavin, S; Hopkins, P C; MacLennan, A; Joss, A W L; Ho-Yen, D O

2009-05-01

This paper investigates the pattern of Lyme disease testing and infection within the Highland region of Scotland. Data from all Highland samples tested during 2004-2006 were analysed according to result and patient's residence in relation to the eight fold Scottish Executive's urban/rural classification, and distance from woodland. In total, 1602 patients were tested for Lyme disease, 0.71% of the Highland population. From these, 104 (6.5%) were seropositive. There were more patients tested, and seropositive patients from rural than urban locations, 1113 vs 489, and 79 vs 25 respectively. There were also significantly more seropositive patients per patients tested from rural locations (chi2, prural areas become more remote. The likelihood of being tested for Lyme disease also increased as the distance between a patient's residence and woodland decreased. The relative risk of being tested elevated by 74% for those patients living within 200 metres of woodland. Those living in the most rural areas of Highland and those living closest to woodland have an increased risk of being tested and having Lyme disease.

Epidemiology of Lyme borreliosis and other tick-borne diseases in the Netherlands

NARCIS (Netherlands)

Hofhuis, Agnetha

2017-01-01

Lyme borreliosis is caused by Borrelia burgdorferi sensu lato bacteria, and transmitted through tick bites. The disease most commonly manifests as erythema migrans, a slowly expanding skin lesion at the site of the tick bite. Disseminated Lyme borreliosis can develop when the infection spreads to

Association of immune response to endothelial cell growth factor with early disseminated and late manifestations of Lyme disease but not posttreatment Lyme disease syndrome.

Science.gov (United States)

Tang, Kevin S; Klempner, Mark S; Wormser, Gary P; Marques, Adriana R; Alaedini, Armin

2015-12-01

Endothelial cell growth factor has been recently proposed as a potential autoantigen in manifestations of Lyme disease that are thought to involve immune-mediated mechanisms. Our findings indicate that a humoral immune response to this protein is not associated with posttreatment Lyme disease syndrome. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Lyme Disease Comes to Camp.

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Peterson, Michael

1989-01-01

Describes one summer camp's plan for dealing with Lyme disease. Describes the disease and the deer tick. Recommends avoiding tick exposure through clothing, frequent examination, showers, and avoiding high grass and brushy areas, and using chemical insect repellents and chemicals to kill ticks in deer mouse nests. (DHP)

A case of Lyme disease in a Japanese woman

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Seki M

2018-04-01

Full Text Available Masafumi Seki,1 Yuji Watanabe,2 Hiroki Kawabata3 1Division of Infectious Diseases and Infection Control, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Miyagi, Japan; 2Laboratory for Clinical Microbiology, Tohoku Medical and Pharmaceutical University Hospital, Sendai City, Miyagi, Japan; 3Department of Bacteriology-1, National Institute of Infectious Diseases, Tokyo, Japan Abstract: This report presents the case of a Japanese patient who developed Lyme disease. The patient was a 44-year-old woman who had general fatigue and the inability to open her mouth. She was initially suspected of having mild tetanus with lockjaw; however, she reported a past history of a tick bite while camping in the USA and had erythema migrans 2 months before this visit. Finally, Lyme disease was serologically confirmed. A few cases of Lyme disease are annually reported in Japan; however, this infectious disease should also be suspected. Keywords: Borrelia burgdorferi, Clostridium tetani, tetracycline, facial nerve palsy, erythema migrans

No Geographic Correlation between Lyme Disease and Death Due to 4 Neurodegenerative Disorders, United States, 2001-2010.

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Forrester, Joseph D; Kugeler, Kiersten J; Perea, Anna E; Pastula, Daniel M; Mead, Paul S

2015-11-01

Associations between Lyme disease and certain neurodegenerative diseases have been proposed, but supportive evidence for an association is lacking. Similar geographic distributions would be expected if 2 conditions were etiologically linked. Thus, we compared the distribution of Lyme disease cases in the United States with the distributions of deaths due to Alzheimer disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), and Parkinson disease; no geographic correlations were identified. Lyme disease incidence per US state was not correlated with rates of death due to ALS, MS, or Parkinson disease; however, an inverse correlation was detected between Lyme disease and Alzheimer disease. The absence of a positive correlation between the geographic distribution of Lyme disease and the distribution of deaths due to Alzheimer disease, ALS, MS, and Parkinson disease provides further evidence that Lyme disease is not associated with the development of these neurodegenerative conditions.

T cells exacerbate Lyme borreliosis in TLR2-deficient mice

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Carrie E. Lasky

2016-11-01

Full Text Available Infection of humans with the spirochete, Borrelia burgdorferi, causes Lyme borreliosis and can lead to clinical manifestations such as, arthritis, carditis and neurological conditions. Experimental infection of mice recapitulates many of these symptoms and serves as a model system for the investigation of disease pathogenesis and immunity. Innate immunity is known to drive the development of Lyme arthritis and carditis, but the mechanisms driving this response remain unclear. Innate immune cells recognize B. burgdorferi surface lipoproteins primarily via Toll-like receptor (TLR2; however, previous work has demonstrated TLR2-/- mice had exacerbated disease and increased bacterial burden. We demonstrate increased CD4 and CD8 T cell infiltrates in B. burgdorferi-infected joints and hearts of C3H TLR2-/- mice. In vivo depletion of either CD4 or CD8 T cells reduced Borrelia-induced joint swelling and lowered tissue spirochete burden, while depletion of CD8 T cells alone reduced disease severity scores. Exacerbation of Lyme arthritis correlated with increased production of CXCL9 by synoviocytes and this was reduced with CD8 T cell depletion. These results demonstrate T cells can exacerbate Lyme disease pathogenesis and prolong disease resolution possibly through dysregulation of inflammatory responses and inhibition of bacterial clearance.

Hispathologic aspects of Lyme Borreliosis.

NARCIS (Netherlands)

Koning, Johannes de

1994-01-01

As a result of the recent interest in Lyme disease a large number of papers has been published on its different aspects. The purpose of this thesis is to present a comprehensive study of the most important histopathological manifestations based on the experience obtained during the last 11 years. In

Cancers attribuables à l’excès de poids au Canada en 2010

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Dianne Zakaria

2017-01-01

Full Text Available Introduction : L’excès de poids (indice de masse corporelle [IMC] de 25,00 kg/m2 ou plus est un facteur de risque bien connu de diabète, d’hypertension et de maladie cardiovasculaire, mais on en sait moins sur son lien avec le cancer. Dans cette étude, nous avons utilisé le risque attribuable dans la population (RAP pour estimer le fardeau des cancers attribuables à l’excès de poids chez les adultes canadiens (de 25 ans ou plus en 2010. Méthodologie : Nous avons estimé les RAP en utilisant des estimations du risque relatif (RR tirées du Continuous Update Project du World Cancer Research Fund International, des estimations du surpoids et de l’obésité fondées sur l’IMC tirées de l’Enquête sur la santé dans les collectivités canadiennes de 2000-2001 (surpoids : 25,00 à 29,99 kg/m2; obésité : 30,00 kg/m2 et plus et nous avons utilisé les nombres de cas de cancer figurant dans le Registre canadien du cancer. Les RAP ont été fondés sur des IMC corrigés pour tenir compte du biais associé à l’autodéclaration de la taille et du poids. Résultats : Au Canada, en 2010, on peut attribuer environ 9 645 cas de cancer à un excès de poids, ce qui représente 5,7 % de tous les cas de cancer (hommes : 4,9 %; femmes : 6,5 %. En limitant l’analyse aux types de cancer associés à un IMC élevé, le RAP augmente à 14,9 % (hommes : 17,5 %; femmes : 13,3 %. Les types de cancer pour lesquels le RAP était le plus élevé étaient l’adénocarcinome de l’oesophage (42,2 %, le cancer du rein (25,4 %, le cancer du cardia (20,7 %, le cancer du foie (20,5 %, le cancer du côlon (20,5 % et le cancer de la vésicule biliaire (20,2 % chez les hommes, et l’adénocarcinome de l’oesophage (36,1 %, le cancer de l’utérus (35,2 %, le cancer de la vésicule biliaire (23,7 % et le cancer du rein (23,0 % chez les femmes. Les types de cancer pour lesquels le nombre de cas attribuables était le plus élevé étaient le cancer du c

Hyperbaric oxygen therapy as an effective adjunctive treatment for chronic Lyme disease

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Chien-Yu Huang

2014-05-01

Full Text Available Lyme disease is the most commonly reported vector-borne illness in the United States, but it is relatively rare in Taiwan. Lyme disease can be treated with antibiotic agents, but approximately 20% of these patients experience persistent or intermittent subjective symptoms, so-called chronic Lyme disease (CLD. The mechanisms of CLD remain unclear and the symptoms related to CLD are difficult to manage. Hyperbaric oxygen therapy (HBOT was applied in CLD therapy in the 1990s. However, reported information regarding the effectiveness of HBOT for CLD is still limited. Here, we present a patient with CLD who was successfully treated with HBOT.

Expression of C-Reactive Protein and Serum Amyloid A in Early to Late Manifestations of Lyme Disease.

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Uhde, Melanie; Ajamian, Mary; Li, Xueting; Wormser, Gary P; Marques, Adriana; Alaedini, Armin

2016-12-01

 Infection with Borrelia burgdorferi, the causative agent of Lyme disease, triggers host immune responses that affect the clinical outcome and are a source of biomarkers with diagnostic utility. Although adaptive immunity to B. burgdorferi has been extensively characterized, considerably less information is available about the development of innate acute-phase responses in Lyme disease. Our aim in this study was to evaluate the expression of C-reactive protein (CRP) and serum amyloid A (SAA), the prototype acute-phase response proteins, in the context of the varying manifestations associated with Lyme borreliosis.  Circulating concentrations of CRP and SAA in patients with a range of early to late objective manifestations of Lyme disease and in individuals with post-treatment Lyme disease syndrome were compared with those in healthy control groups.  CRP and SAA levels were significantly elevated in early localized and early disseminated Lyme disease but not in the later stages of active infection. Levels of CRP, but not SAA, were also found to be significantly increased in patients with antibiotic-refractory Lyme arthritis and in those with post-treatment Lyme disease syndrome.  These findings indicate that circulating CRP and SAA levels are highest when the concentration of spirochetes is greatest in skin and/or blood and that levels decline after the dissemination of the organism to extracutaneous sites in subsequent stages of infection. The data also suggest that antibiotic-refractory Lyme arthritis and post-treatment Lyme disease syndrome are associated with elevated CRP responses that are driven by inflammatory mechanisms distinct from those in active infection. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Interferon-γ-induced protein 10 in Lyme disease.

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Fallahi, P; Elia, G; Bonatti, A

2017-01-01

Lyme disease is an infectious disease caused by bacteria of the Borrelia type, that affects about 300,000 people a year in the USA and 65,000 people a year in Europe. Borrelia infection, and Lyme disease, following occupational exposure has been frequently reported in USA, Europe and Asia. The manifestations of Lyme disease include erythema migrans (EM), arthritis, neuroborrelliosis (NB), and others. Cytokines and chemokines primarily orchestrate leukocyte recruitment to the areas of Borrelia infection, and they are critical mediators of immune and inflammatory responses, in particular of the induction of interferon (IFN)-γ and IFN-γ dependent chemokines. In EM high levels of T helper (Th) 1 cells chemoattranctants [monokine induced by IFN-γ (MIG), IFN-γ-induced protein 10 (IP- 10), and IFN-inducible T cell alpha chemoattractant (I-TAC)] have been shown. Synovial tissues and fluids of patients with Lyme Arthritis (LA) (overall with antibiotic-refractory LA) contained exceptionally high levels of Th1 chemoattractants and cytokines, particularly MIG and IFN-γ. In NB concentrations of IP-10 and I-TAC in the cerebrospinal fluid (CSF) were significantly higher, suggesting that IP-10 and I-TAC create a chemokine gradient between the CSF and serum and recruite C-X-C chemokine receptor 3-expressing memory CD4+ T-cells into the CSF of these patients. A positive association between the disseminating capacity of B. burgdorferi and early type I IFN induction has also been shown. These results suggest that IFN-γ dependent chemokines are important biomarkers to monitor the progression and diffusion of the disease in patients with Borrelia infection; further larger studies are needed.

Gallium-positive Lyme disease myocarditis

International Nuclear Information System (INIS)

Alpert, L.I.; Welch, P.; Fisher, N.

1985-01-01

In the course of a work-up for fever of unknown origin associated with intermittent arrhythmias, a gallium scan was performed which revealed diffuse myocardial uptake. The diagnosis of Lyme disease myocarditis subsequently was confirmed by serologic titers. One month following recovery from the acute illness, the abnormal myocardial uptake completely resolved

Neuropsychological deficits in patients with Lyme borreliosis

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Katja Pruša

2001-09-01

Full Text Available Slovenia is an endemic area for Lyme borreliosis, a disease that affects many organic systems. Decline in cognitive abilities and emotional changes can appear in acute and chronic stage of the disease beside somatic difficulties. Early antibiotic therapy is of great importance in recovery. Attention and concentration deficits, memory deficits, impaired executive functioning, depression and other symptoms reduce work efficiency and life quality of people with Lyme borreliosis. Neuropsychological deficits can be explained with central nervous system impairment and partly also with reactive psychological factors. On account of symptomatic complexity, broad differential diagnostic and unreliable diagnostic technology neuropsychological evaluation can help to correctly diagnose and accurately treat this disease, and thus to enable appropriate cognitive rehabilitation and psychotherapeutic assistance.

MRI in Lyme disease of the spinal cord

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Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C. [Dept. of Diagnostic and Therapeutic Neuroradiology, Hopital Purpan, Toulouse (France); Albucher, J.F. [Dept. of Neurology, Hopital Purpan, Toulouse (France)

2001-06-01

We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

MRI in Lyme disease of the spinal cord

International Nuclear Information System (INIS)

Mantienne, C.; Catalaa, I.; Sevely, A.; Cognard, C.; Manelfe, C.; Albucher, J.F.

2001-01-01

We report a case of Lyme myelitis in a 31-year-old man, presenting with a conus medullaris syndrome. MRI demonstrated contrast enhancement on the pial surface of the lower thoracic cord and conus medullaris. Elevated blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid (CSF) were found. Leptomeningitis may be the first stage of spinal infection in Lyme disease, preceding parenchymal infection leading to myelitis. Vasculitis is probably the major mechanism. MRI findings are nonspecific and the diagnosis is given by serum and CSF analyses. Early treatment with antibiotics and high doses steroids may result in complete recovery, as in this case. (orig.)

Proceedings of the 2nd workshop on lyme disease in the Southeast

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Apperson, C.S. [ed.] [North Carolina State Univ., Raleigh, NC (United States). Dept. of Entomology; Levine, J.F. [ed.] [North Carolina State Univ., Raleigh, NC (United States). Dept. of Microbiology, Pathology, and Parasitology; Snoddy, E.L. [ed.] [Tennessee Valley Authority, Muscle Shoals, AL (United States)

1993-12-31

This volume provides author prepared abstracts of oral presentation at the Second Workshop on Lyme Disease in the Southeast head in Raleigh, North Carolina September 7-9, 1993. The 33 presentations covered various aspects of the epidemic including geographical distribution of various species of ticks, transmission risks, Lyme Disease epidemiology, and taxonomic aspects.

Borrelia burgdorferi Infection and Lyme Disease in North American Horses: A Consensus Statement

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Gardner, R.B.; Madigan, J.E.; Witonsky, S.G.; Bertone, J.J.; Swinebroad, E.L.; Schutzer, S.E.; Johnson, A.L.

2018-01-01

Borrelia burgdorferi infection is common in horses living in Lyme endemic areas and the geographic range for exposure is increasing. Morbidity after B. burgdorferi infection in horses is unknown. Documented, naturally occurring syndromes attributed to B. burgdorferi infection in horses include neuroborreliosis, uveitis, and cutaneous pseudolymphoma. Although other clinical signs such as lameness and stiffness are reported in horses, these are often not well documented. Diagnosis of Lyme disease is based on exposure to B. burgdorferi, cytology or histopathology of infected fluid or tissue and antigen detection. Treatment of Lyme disease in horses is similar to treatment of humans or small animals but treatment success might not be the same because of species differences in antimicrobial bioavailability and duration of infection before initiation of treatment. There are no approved equine label Lyme vaccines but there is strong evidence that proper vaccination could prevent infection in horses. PMID:29469222

To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis

DEFF Research Database (Denmark)

Dessau, Ram B; van Dam, Alje P; Fingerle, Volker

2018-01-01

rational use of laboratory testing in patients with clinically suspected Lyme borreliosis. SOURCES: This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national...... and international guidelines and supplemented with specific citations. IMPLICATIONS: The main recommendations according to current European case definitions for Lyme borreliosis are as follows: Typical erythema migrans should be diagnosed clinically and does not require laboratory testing, the diagnosis of Lyme...

NNDSS - Table II. Lyme disease to Meningococcal

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U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2016. In this Table, provisional* cases of selected† notifiable diseases (≥1,000 cases reported during the...

An Examination of the Demographic and Environmental Variables Correlated with Lyme Disease Emergence in Virginia.

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Seukep, Sara E; Kolivras, Korine N; Hong, Yili; Li, Jie; Prisley, Stephen P; Campbell, James B; Gaines, David N; Dymond, Randel L

2015-12-01

Lyme disease is the United States' most significant vector-borne illness. Virginia, on the southern edge of the disease's currently expanding range, has experienced an increase in Lyme disease both spatially and temporally, with steadily increasing rates over the past decade and disease spread from the northern to the southwestern part of the state. This study used a Geographic Information System and a spatial Poisson regression model to examine correlations between demographic and land cover variables, and human Lyme disease from 2006 to 2010 in Virginia. Analysis indicated that herbaceous land cover is positively correlated with Lyme disease incidence rates. Areas with greater interspersion between herbaceous and forested land were also positively correlated with incidence rates. In addition, income and age were positively correlated with incidence rates. Levels of development, interspersion of herbaceous and developed land, and population density were negatively correlated with incidence rates. Abundance of forest fragments less than 2 hectares in area was not significantly correlated. Our results support some findings of previous studies on ecological variables and Lyme disease in endemic areas, but other results have not been found in previous studies, highlighting the potential contribution of new variables as Lyme disease continues to emerge southward.

NNDSS - Table II. Lyme disease to Meningococcal

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U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2015.In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding...

Stroke as an Unusual First Presentation of Lyme Disease

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Mohamad Almoussa

2015-01-01

Full Text Available Introduction. Lyme neuroborreliosis is a nervous system infection caused by spirochete Borrelia burgdorferi with diverse neurological complications. Stroke due to cerebral vasculitis is a rare consequence of neuroborreliosis and has been described in just a few case reports. Case Presentation. Here, we report the case of a 43-year-old patient who presented with discrete left-sided hemiparesis and amnestic cognitive impairment. Brain magnetic resonance imaging showed a thalamic infarct, and serological and cerebrospinal fluid (CSF tests confirmed the diagnosis of active neuroborreliosis. The antibiotic treatment with intravenous ceftriaxone for three weeks led to an improvement of the symptoms and remarkable regression of radiological findings, but not to full recovery of the amnestic cognitive disorder. Conclusion. Lyme neuroborreliosis should be suspected in patients with cerebrovascular events without obvious risk factors, especially those living in endemic areas such as northern Europe or those who have been exposed to ticks and those with clinical or radiological findings suggesting Lyme neuroborreliosis, in order to establish the diagnosis and start a proper antibiotic therapy.

Lyme Disease: Implications for Health Educators.

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Harbit, Maryanne Drake; Willis, Dawn

1990-01-01

Lyme disease may be one of the most commonly misdiagnosed diseases of this decade. Health educators should be knowledgeable about this new disease and be able to share with the public information about prevention, early signs and symptoms, and treatment of the disease (Author/IAH)

Diagnostic impact of routine Lyme serology in recent-onset arthritis: results from the ESPOIR cohort

Science.gov (United States)

Guellec, Dewi; Narbonne, Valérie; Cornec, Divi; Marhadour, Thierry; Varache, Sophie; Dougados, Maxime; Daurès, Jean Pierre; Jousse-Joulin, Sandrine; Devauchelle-Pensec, Valérie; Saraux, Alain

2016-01-01

Objectives Lyme disease may be considered by rheumatologists in patients with recent-onset arthritis, even in the absence of suggestive symptoms. The aim of this study was to determine the diagnostic impact of routine Lyme serology in a French cohort of patients with recent-onset arthritis affecting at least 2 joints. Methods We performed an ancillary study of a French prospective multicentre cohort established to monitor clinical, biological and radiographic data in patients with inflammatory arthritis in at least 2 joints, lasting for 6 weeks to 6 months. Borrelia IgM and IgG antibodies were sought routinely at baseline, using ELISA tests, independently from the physician's strategy for detecting a spirochetal infection. We recorded the proportion of patients with a final diagnosis of Lyme arthritis and evaluated the diagnostic performance of Lyme serology in this particular context. The clinical and biological characteristics of patients according to the Lyme serology results were analysed. Results Of 810 patients, 657 (81.1%) were negative for IgM and IgG antibodies, 91 (11.2%) had only IgM antibodies, 49 (6%) had only IgG antibodies, and 13 (1.6%) had IgG and IgM antibodies. Thus, 7.6% had IgG positivity, consistent with exposure to Borrelia infection. IgG positivity was significantly more prevalent in the North and North-East regions of France (χ2=14.6, pLyme arthritis. Conclusions This study does not support routine Lyme serological testing in patients with recent-onset inflammatory arthritis affecting more than 1 joint. PMID:26819751

Seroprevalence of Babesia microti in Individuals with Lyme Disease.

Science.gov (United States)

Curcio, Sabino R; Tria, Laurel P; Gucwa, Azad L

2016-12-01

Babesiosis is an emerging tick-borne disease (TBD) caused by Babesia microti, an intracellular parasite of red blood cells. Currently, it is the highest ranked pathogen transmitted by blood transfusion. Most healthy individuals infected with B. microti are asymptomatic, but may be at risk for chronic infection. Similar to Lyme disease transmitted by Borrelia burgdorferi, B. microti is spread by Ixodes scapularis ticks. The rate of coinfection with these TBDs in humans is unclear as most studies have focused their prevalence in ticks or rodent reservoirs. In this study, we aimed to determine the seroprevalence of B. microti infection in individuals who tested positive for Lyme disease. Serum samples obtained from 130 subjects in New York were tested by immunofluorescence assay (IFA) for the presence of IgM and IgG antibodies against B. microti. Overall, 26.9% of the serum samples tested were positive for IgM and IgG antibodies against B. microti, suggesting exposure to TBD. Individuals who tested positive for Lyme disease as determined by two-tiered serological testing and the presence of both IgM and IgG antibodies directed against B. burgdorferi, were significantly increased for antibodies directed against B. microti (28.6%; p Lyme disease-negative control group had only 6.7% of samples seropositive for B. microti. These findings suggest the need for more extensive studies investigating infection rates with multiple TBDs in areas where they are endemic and further support for the need to implement an FDA-approved screening test for blood products to help prevent transfusion-transmitted babesiosis.

[Clinical manifestation of Lyme borreliosis in children with positive and negatiwe western blot results].

Science.gov (United States)

Ołdak, Elzbieta; Rozkiewicz, Doroto; Sulik, Artur

2008-01-01

In the afforested area of North-Eastern Poland the risk of Borrelia burgdorferi infection seems to be higher compared to the other regions. Because of unspecific clinical manifestation of Lyme borreliosis in children the positive ELISA IgM results should be confirmed with Western blot IgM tests. Retrospective analysis of clinical signs and symptoms of Lyme borreliosis in children with positive ELISA IgM and positive Western blot IgM results and in children with positive ELISA IgM and negative Western blot IgM results. The study included 20 children reactive with ELISA IgM (Bellco Biomedica, Austria), hospitalized in Pediatric Infectious Diseases Clinic in 2007 due to probable diagnosis of Lyme disease. All children were tested with B. burgdorferi Western blot IgM and/or IgG assay (DRG, Diagnostics, Germany) as a second-step diagnosis. In 10 (50% females, 50% males) out of 20 children the results were positive (borreliosis) and in other 10 (80% females, 20% males) the results were negative (controls). In both groups of patients the retrospective analysis of signs and symptoms was done. The most often clinical manifestation of Lyme borreliosis in children was neuroborreliosis. Children presented Lyme meningitis (30%), facial nerve palsy (10%) and chronic or recurrent headaches (40%), associated with vertigo (20%), weakness (30%), fever (40%), and fatigue syndrome (30%). One patient presented Lyme arthritis. Children of control group presented with unspecific symptoms like isolated headaches (40%), arthralgias (70%), myalgias (10%) and abdomen pain (20%) (1) The most frequent clinical presentation of Lyme borreliosis in analyzed children was neuroborreliosis; (2) Isolated arthralgias in children reactive with B. burgdorferi ELISA IgM need to be confirmed with Western blot assay before implementing the antibiotic therapy.

Bull's-Eye and Nontarget Skin Lesions of Lyme Disease: An Internet Survey of Identification of Erythema Migrans

Science.gov (United States)

Aucott, John N.; Crowder, Lauren A.; Yedlin, Victoria; Kortte, Kathleen B.

2012-01-01

Introduction. Lyme disease is an emerging worldwide infectious disease with major foci of endemicity in North America and regions of temperate Eurasia. The erythema migrans rash associated with early infection is found in approximately 80% of patients and can have a range of appearances including the classic target bull's-eye lesion and nontarget appearing lesions. Methods. A survey was designed to assess the ability of the general public to distinguish various appearances of erythema migrans from non-Lyme rashes. Participants were solicited from individuals who visited an educational website about Lyme disease. Results. Of 3,104 people who accessed a rash identification survey, 72.7% of participants correctly identified the classic target erythema migrans commonly associated with Lyme disease. A mean of 20.5% of participants was able to correctly identify the four nonclassic erythema migrans. 24.2% of participants incorrectly identified a tick bite reaction in the skin as erythema migrans. Conclusions. Participants were most familiar with the classic target erythema migrans of Lyme disease but were unlikely to correctly identify the nonclassic erythema migrans. These results identify an opportunity for educational intervention to improve early recognition of Lyme disease and to increase the patient's appropriate use of medical services for early Lyme disease diagnosis. PMID:23133445

Borrelia burgdorferi in small mammal reservoirs in Kentucky, a traditionally non-endemic state for Lyme disease.

Science.gov (United States)

Buchholz, Matthew J; Davis, Cheryl; Rowland, Naomi S; Dick, Carl W

2018-04-01

The incidence of tick-borne zoonoses such as Lyme disease has steadily increased in the southeastern United States. Southeastern states accounted for 1500 of over 28,000 confirmed cases of Lyme disease reported in the United States during 2015. Borrelia burgdorferi, the etiologic agent of Lyme disease, is maintained in small mammal reservoirs and vectored to new hosts by ixodid ticks. This study examined ecological relationships of the B. burgdorferi/vector/reservoir system in order to understand the dynamics of Lyme disease risk in Kentucky. Small mammals were captured using live traps from November 2014 to October 2015. Ticks were removed and blood and tissue collected from small mammals were screened for B. burgdorferi DNA by PCR with primers specific to the OspA gene. Prevalence of B. burgdorferi (21.8%) in Kentucky small mammals was comparable to the lowest recorded prevalence in regions where Lyme disease is endemic. Moreover, infestation of small mammals by Ixodes scapularis, the primary vector of B. burgdorferi, was rare, while Dermacentor variabilis comprised the majority of ticks collected. These findings provide ecological insight into the relative paucity of Lyme disease in Kentucky.

Are the current notification criteria for Lyme borreliosis in Norway suitable? Results of an evaluation of Lyme borreliosis surveillance in Norway, 1995–2013

Directory of Open Access Journals (Sweden)

Emily MacDonald

2016-08-01

Full Text Available Abstract Background The approach to surveillance of Lyme borreliosis varies between countries, depending on the purpose of the surveillance system and the notification criteria used, which prevents direct comparison of national data. In Norway, Lyme borreliosis is notifiable to the Surveillance System for Communicable Diseases (MSIS. The current notification criteria include a combination of clinical and laboratory results for borrelia infection (excluding Erythema migrans but there are indications that these criteria are not followed consistently by clinicians and by laboratories. Therefore, an evaluation of Lyme borreliosis surveillance in Norway was conducted to describe the purpose of the system and to assess the suitability of the current notification criteria in order to identify areas for improvement. Methods The CDC Guidelines for Evaluation of Surveillance Systems were used to develop the assessment of the data quality, representativeness and acceptability of MSIS for surveillance of Lyme borreliosis. Data quality was assessed through a review of data from 1996 to 2013 in MSIS and a linkage of MSIS data from 2008 to 2012 with data from the Norwegian Patient Registry (NPR. Representativeness and acceptability were assessed through a survey sent to 23 diagnostic laboratories. Results Completeness of key variables for cases reported to MSIS was high, except for geographical location of exposureThe NPR-MSIS linkage identified 1047 cases in both registries, while 363 were only reported to MSIS and 3914 were only recorded in NPR. A higher proportion of cases found in both registries were recorded as neuroborreliosis in MSIS (84.4 % than those cases found only in MSIS (20.1 %. The trend (average yearly increase or decrease in reported cases of neuroborreliosis in MSIS was not significantly different from the trend for all other clinical manifestations recorded in MSIS in negative binomial regression (p = 0.3. The 16 surveyed laboratories

Perpetuation of the Lyme Disease Spirochete Borrelia lusitaniae by Lizards

Science.gov (United States)

Richter, Dania; Matuschka, Franz-Rainer

2006-01-01

To determine whether the Lyme disease spirochete Borrelia lusitaniae is associated with lizards, we compared the prevalence and genospecies of spirochetes present in rodent- and lizard-associated ticks at a site where this spirochete frequently infects questing ticks. Whereas questing nymphal Ixodes ricinus ticks were infected mainly by Borrelia afzelii, one-half of the infected adult ticks harbored B. lusitaniae at our study site. Lyme disease spirochetes were more prevalent in sand lizards (Lacerta agilis) and common wall lizards (Podarcis muralis) than in small rodents. Although subadult ticks feeding on rodents acquired mainly B. afzelii, subadult ticks feeding on lizards became infected by B. lusitaniae. Genetic analysis confirmed that the spirochetes isolated from ticks feeding on lizards are members of the B. lusitaniae genospecies and resemble type strain PotiB2. At our central European study site, lizards, which were previously considered zooprophylactic for the agent of Lyme disease, appear to perpetuate B. lusitaniae. PMID:16820453

Antiscience and ethical concerns associated with advocacy of Lyme disease.

Science.gov (United States)

Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O'Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P

2011-09-01

Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health. Copyright © 2011 Elsevier Ltd. All rights reserved.

Antiscience and ethical concerns associated with advocacy of Lyme disease

Science.gov (United States)

Auwaerter, Paul G; Bakken, Johan S; Dattwyler, Raymond J; Dumler, J Stephen; Halperin, John J; McSweegan, Edward; Nadelman, Robert B; O’Connell, Susan; Shapiro, Eugene D; Sood, Sunil K; Steere, Allen C; Weinstein, Arthur; Wormser, Gary P

2015-01-01

Advocacy for Lyme disease has become an increasingly important part of an antiscience movement that denies both the viral cause of AIDS and the benefits of vaccines and that supports unproven (sometimes dangerous) alternative medical treatments. Some activists portray Lyme disease, a geographically limited tick-borne infection, as a disease that is insidious, ubiquitous, difficult to diagnose, and almost incurable; they also propose that the disease causes mainly non-specific symptoms that can be treated only with long-term antibiotics and other unorthodox and unvalidated treatments. Similar to other antiscience groups, these advocates have created a pseudoscientific and alternative selection of practitioners, research, and publications and have coordinated public protests, accused opponents of both corruption and conspiracy, and spurred legislative efforts to subvert evidence-based medicine and peer-reviewed science. The relations and actions of some activists, medical practitioners, and commercial bodies involved in Lyme disease advocacy pose a threat to public health. PMID:21867956

PERIPHERAL FACIAL PALSY IN CHILDHOOD - LYME BORRELIOSIS TO BE SUSPECTED UNLESS PROVEN OTHERWISE

NARCIS (Netherlands)

CHRISTEN, HJ; BARTLAU, N; HANEFELD, F; EIFFERT, H; THOMSSEN, R

1990-01-01

27 consecutive cases with acute peripheral facial palsy were studied for Lyme borreliosis. In 16 out of 27 children Lyme borreliosis could be diagnosed by detection of specific IgM antibodies in CSF. CSF findings allow a clear distinction according to etiology. All children with facial palsy due to

Established Population of Blacklegged Ticks with High Infection Prevalence for the Lyme Disease Bacterium, Borrelia burgdorferi Sensu Lato, on Corkscrew Island, Kenora District, Ontario

Science.gov (United States)

Scott, John D.; Foley, Janet E.; Clark, Kerry L.; Anderson, John F.; Durden, Lance A.; Manord, Jodi M.; Smith, Morgan L.

2016-01-01

We document an established population of blacklegged ticks, Ixodes scapularis, on Corkscrew Island, Kenora District, Ontario, Canada. Primers of the outer surface protein A (OspA) gene, the flagellin (fla) gene, and the flagellin B (flaB) gene were used in the PCR assays to detect Borrelia burgdorferi sensu lato (s.l.), the Lyme disease bacterium. In all, 60 (73%) of 82 adult I. scapularis, were infected with B. burgdorferi s.l. As well, 6 (43%) of 14 unfed I. scapularis nymphs were positive for B. burgdorferi s.l. An I. scapularis larva was also collected from a deer mouse, and several unfed larvae were gathered by flagging leaf litter. Based on DNA sequencing of randomly selected Borrelia amplicons from six nymphal and adult I. scapularis ticks, primers for the flagellin (fla) and flagellin B (flaB) genes reveal the presence of B. burgdorferi sensu stricto (s.s.), a genospecies pathogenic to humans and certain domestic animals. We collected all 3 host-feeding life stages of I. scapularis in a single year, and report the northernmost established population of I. scapularis in Ontario. Corkscrew Island is hyperendemic for Lyme disease and has the highest prevalence of B. burgdorferi s.l. for any established population in Canada. Because of this very high infection prevalence, this population of I. scapularis has likely been established for decades. Of epidemiological significance, cottage owners, island visitors, outdoors enthusiasts, and medical professionals must be vigilant that B. burgdorferi s.l.-infected I. scapularis on Corkscrew Island pose a serious public health risk. PMID:27877080

NNDSS - Table II. Lyme disease to Meningococcal

Data.gov (United States)

U.S. Department of Health & Human Services — NNDSS - Table II. Lyme disease to Meningococcal - 2014In this Table, all conditions with a 5-year average annual national total of more than or equals 1,000 cases...

The Lyme disease as the increasing health problem in Małopolskie voivodeship compared with Poland in 1998-2014

Science.gov (United States)

Bandoła, Katarzyna; Koperny, Magdalena; Seweryn, Michał; Żak, Jacek; Bała, Małgorzata M

Lyme disease is one of the most known tick borne diseases in Poland caused by spirochetes of the genus Borrelia burgdorferi. Most cases of Lyme disease are diagnosed in the northeastern Poland and the south of Poland, in Śląskie, Małopolskie, Podkarpackie voivodeship. The aim of the study was to evaluate epidemiological data of Lyme disease in Małopolskie voivodeship and other voivodeships in Poland and frequency analysis of the Lyme disease as an occupational disease. The authors analyzed prevalence from 1998 to 2014. Incidence of the Lyme disease was evaluated through review data from „Choroby zakaźne i zatrucia” Bulletin and Lyme disease as an occupational disease obtained data from the Nofer Institute of Occupational Medicine in Łódź. It is estimated that the number of Lyme disease cases in Poland increased 18 times between 1998 and 2014 year (2,0 to 36 per 100,000 population), in the same period it was over 35 times of sudden rise in Lyme disease incidence in Małopolskie voivodeship. In years 2005-2014 the number of cases of Lyme disease as an occupational disease fluctuated with a slight upward trend both in Poland and Małopolskie voivoideship. In Poland number of reported cases is systematically increasing. Podlaskie and Warmińsko- Mazurskie voivodeships are areas of high prevalence. Exponential increase in the number of cases is observed in southern Poland, especially in Małopolskie voivodeship from 2013.

Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'.

Science.gov (United States)

De Wilde, Maarten; Speeckaert, Marijn; Callens, Rutger; Van Biesen, Wim

2017-04-01

'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'

Lyme disease in the Dutch policy context: patient consultation in government research agenda setting

NARCIS (Netherlands)

den Oudendammer, W.M.; Broerse, J.E.W.

2017-01-01

Prevalence of Lyme disease (LD) is increasing in the Netherlands. The Dutch Association for Lyme Disease Patients (NVLP) presented a petition to the Dutch Parliament for more LD research and political attention. The Parliament requested advice from the Health Council of the Netherlands, which among

Tekenradar.nl: een webplatform voor wetenschappelijk onderzoek naar tekenbeten en de ziekte van Lyme

NARCIS (Netherlands)

Wijngaard, van den C.C.; Vliet, van A.J.H.; Vrijmoeth, H.D.; Ursinus, J.; Harms, Margriet

2016-01-01

Tekenradar.nl is een webplatform voor onderzoek naar teken en tekenoverdraagbare aandoeningen zoals de ziekte van Lyme. Het RIVM en Wageningen University hebben de website in 2012 gezamenlijk opgericht. De website geeft informatie over tekenbeten en de ziekte van Lyme en een voorspelling van de

Diagnosis of Lyme-associated uveitis: value of serological testing in a tertiary centre.

Science.gov (United States)

Bernard, Alexia; Kodjikian, Laurent; Abukhashabh, Amro; Roure-Sobas, Chantal; Boibieux, Andre; Denis, Philippe; Broussolle, Christiane; Seve, Pascal

2018-03-01

To determine the frequency and clinical presentation of Lyme disease in patients with uveitis and to assess the value of Borrelia burgdorferi serological testing. Retrospective study on all patients with uveitis who were referred to our tertiary hospital were serologically tested for Lyme in our laboratory between 2003 and 2016. Screening consisted of determining B. burgdorferi serum IgG and IgM by ELISA method. The patient's serology was considered as positive if the ELISA-positive result in IgM and/or IgG was confirmed by an immunoblot positive in IgM and/or IgG. Lyme-associated uveitis was diagnosed based on serological results as well as response to antibiotics and exclusion of other diagnosis. Of the 430 patients with uveitis (60% women, mean age 49 years) fulfilling inclusion criteria, 63 (14.7%) had an ELISA-positive serology, confirmed by immunoblot for 34 patients (7.9%). The diagnosis of Lyme-associated uveitis was finally retained in seven patients (1.6%). These patients reported either a previous exposure including tick bite or forest walks (n=5), symptoms suggestive of Lyme disease (n=5) and resistance to local and/or systemic steroids (n=7). Among the remaining 27 positive patients, 22 had other established aetiologies and 5 other were unclassified. The seroprevalence of B. burgdorferi among our patients with uveitis was 7.9% compared with 6 to 8.5% in the general French population which leads to a low predictive value of serological testing. Its use should be reserved for patients with unexplained uveitis, an exposure history, systemic findings suggestive of Lyme disease and steroids resistance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Genomic insights into the Ixodes scapularis tick vector of Lyme disease

DEFF Research Database (Denmark)

Gulia-Nuss, Monika; Nuss, Andrew B.; Meyer, Jason M.

2016-01-01

Ticks transmit more pathogens to humans and animals than any other arthropod. We describe the 2.1 Gbp nuclear genome of the tick, Ixodes scapularis (Say), which vectors pathogens that cause Lyme disease, human granulocytic anaplasmosis, babesiosis and other diseases. The large genome reflects...... proteins associated with the agent of human granulocytic anaplasmosis, an emerging disease, and the encephalitis-causing Langat virus, and a population structure correlated to life-history traits and transmission of the Lyme disease agent....

Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease

Science.gov (United States)

Bouquet, Jerome; Soloski, Mark J.; Swei, Andrea; Cheadle, Chris; Federman, Scot; Billaud, Jean-Noel; Rebman, Alison W.; Kabre, Beniwende; Halpert, Richard; Boorgula, Meher

2016-01-01

ABSTRACT Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls) enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs) in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the “window period” of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets. PMID:26873097

Lyme Disease Diagnosed by Alternative Methods: A Phenotype Similar to That of Chronic Fatigue Syndrome.

Science.gov (United States)

Patrick, David M; Miller, Ruth R; Gardy, Jennifer L; Parker, Shoshana M; Morshed, Muhammad G; Steiner, Theodore S; Singer, Joel; Shojania, Kam; Tang, Patrick

2015-10-01

A subset of patients reporting a diagnosis of Lyme disease can be described as having alternatively diagnosed chronic Lyme syndrome (ADCLS), in which diagnosis is based on laboratory results from a nonreference Lyme specialty laboratory using in-house criteria. Patients with ADCLS report symptoms similar to those reported by patients with chronic fatigue syndrome (CFS). We performed a case-control study comparing patients with ADCLS and CFS to each other and to both healthy controls and controls with systemic lupus erythematosus (SLE). Subjects completed a history, physical exam, screening laboratory tests, 7 functional scales, reference serology for Lyme disease using Centers for Disease Control and Prevention criteria, reference serology for other tick-associated pathogens, and cytokine expression studies. The study enrolled 13 patients with ADCLS (12 of whom were diagnosed by 1 alternative US laboratory), 25 patients with CFS, 25 matched healthy controls, and 11 SLE controls. Baseline clinical data and functional scales indicate significant disability among ADCLS and CFS patients and many important differences between these groups and controls, but no significant differences between each other. No ADCLS patient was confirmed as having positive Lyme serology by reference laboratory testing, and there was no difference in distribution of positive serology for other tick-transmitted pathogens or cytokine expression across the groups. In British Columbia, a setting with low Lyme disease incidence, ADCLS patients have a similar phenotype to that of CFS patients. Disagreement between alternative and reference laboratory Lyme testing results in this setting is most likely explained by false-positive results from the alternative laboratory. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Whole-Genome Sequences of Two Borrelia afzelii and Two Borrelia garinii Lyme Disease Agent Isolates

Energy Technology Data Exchange (ETDEWEB)

Casjens, S.R.; Dunn, J.; Mongodin, E. F.; Qiu, W.-G.; Luft, B. J.; Fraser-Liggett, C. M.; Schutzer, S. E.

2011-12-01

Human Lyme disease is commonly caused by several species of spirochetes in the Borrelia genus. In Eurasia these species are largely Borrelia afzelii, B. garinii, B. burgdorferi, and B. bavariensis sp. nov. Whole-genome sequencing is an excellent tool for investigating and understanding the influence of bacterial diversity on the pathogenesis and etiology of Lyme disease. We report here the whole-genome sequences of four isolates from two of the Borrelia species that cause human Lyme disease, B. afzelii isolates ACA-1 and PKo and B. garinii isolates PBr and Far04.

Aggressiveness, violence, homicidality, homicide, and Lyme disease

Directory of Open Access Journals (Sweden)

Greenberg R

2018-05-01

Full Text Available Rosalie Greenberg Medical Arts Psychotherapy Associates PA, Summit, NJ, USAI read with great interest the article by Bransfield,1 wherein the author reviewed potential contributors to and manifestations of heightened loss of control in Lyme disease patients. As a child psychiatrist living in a Lyme-endemic state, New Jersey, in the USA, I have seen a number of children and adolescents who exhibit significant acute or gradual onset of highly oppositional behaviors often both at home and at school. Refusal to do classwork or homework, heightened paranoia or feeling rejected by others is often present. In addition, they often demonstrate increased irritability, extreme temper tantrums, problems concentrating, elevated impulsivity, sensory hypersensitivity (sound, touch, smell, taste and/or light and intense emotional lability. Parents describe these behaviors as either a sudden change or a period of worsening of a previous condition, such as attention-deficit hyperactivity disorder or mood disorder. During periods of intense anger over minimal issues, they can appear menacing and threaten to kill a sibling, parent or a friend or state that they want to die themselves. In a recent record review of 69 youth evaluated in my private psychopharmacology practice, 49 of these new patients, without a known history of Lyme disease or other tick-borne disorders, demonstrated evidence of exposure to one or more of the pathogens Borrelia burgdorferi, Bartonella, Babesia, Ehrlichia and Anaplasma on serologic testing performed by multiple laboratories. In addition, 6 of the 69 patients were initially referred because of psychiatric difficulties observed by other physicians during the active treatment of tick-borne infections. Supporting this connection of childhood neuropsychiatric symptoms and tick-borne illness is a recent article looking at 27 youth diagnosed with bipolar disorder I or II, which found that 74% or 20/27 were diagnosed with at least one tick

A Review of the Centers for Disease Control and Prevention's Guidelines for the Clinical Laboratory Diagnosis of Lyme Disease.

Science.gov (United States)

Miraglia, Caterina M

2016-12-01

The purpose of this paper is to review information regarding the current guidelines for the clinical laboratory diagnosis of Lyme disease as set forth by the Centers for Disease Control and Prevention (CDC) to chiropractic physicians and to discuss the clinical utility of this testing. The CDC's website was reviewed to determine what their current recommendations are for the clinical laboratory testing of Lyme disease. The CDC's established guidelines recommend the use of a 2-tiered serologic testing algorithm for the evaluation of patients with suspected Lyme disease. This review provides doctors of chiropractic with information to remain current with the CDC's recommended guidelines for Lyme disease testing because patients may present to their office with the associated signs and symptoms of Lyme disease.

Longitudinal Transcriptome Analysis Reveals a Sustained Differential Gene Expression Signature in Patients Treated for Acute Lyme Disease.

Science.gov (United States)

Bouquet, Jerome; Soloski, Mark J; Swei, Andrea; Cheadle, Chris; Federman, Scot; Billaud, Jean-Noel; Rebman, Alison W; Kabre, Beniwende; Halpert, Richard; Boorgula, Meher; Aucott, John N; Chiu, Charles Y

2016-02-12

Lyme disease is a tick-borne illness caused by the bacterium Borrelia burgdorferi, and approximately 10 to 20% of patients report persistent symptoms lasting months to years despite appropriate treatment with antibiotics. To gain insights into the molecular basis of acute Lyme disease and the ensuing development of post-treatment symptoms, we conducted a longitudinal transcriptome study of 29 Lyme disease patients (and 13 matched controls) enrolled at the time of diagnosis and followed for up to 6 months. The differential gene expression signature of Lyme disease following the acute phase of infection persisted for at least 3 weeks and had fewer than 44% differentially expressed genes (DEGs) in common with other infectious or noninfectious syndromes. Early Lyme disease prior to antibiotic therapy was characterized by marked upregulation of Toll-like receptor signaling but lack of activation of the inflammatory T-cell apoptotic and B-cell developmental pathways seen in other acute infectious syndromes. Six months after completion of therapy, Lyme disease patients were found to have 31 to 60% of their pathways in common with three different immune-mediated chronic diseases. No differential gene expression signature was observed between Lyme disease patients with resolved illness to those with persistent symptoms at 6 months post-treatment. The identification of a sustained differential gene expression signature in Lyme disease suggests that a panel of selected human host-based biomarkers may address the need for sensitive clinical diagnostics during the "window period" of infection prior to the appearance of a detectable antibody response and may also inform the development of new therapeutic targets. Lyme disease is the most common tick-borne infection in the United States, and some patients report lingering symptoms lasting months to years despite antibiotic treatment. To better understand the role of the human host response in acute Lyme disease and the

AWARENESS OF LYME BORRELIOSIS OF THE PATIENTS OF TERNOPIL REGIONAL TB DISPENSARY

Directory of Open Access Journals (Sweden)

L. P. Melnyk

2017-07-01

Full Text Available Background. Lyme disease has many clinical features similar tothose in sarcoidosis and tuberculosis. Epidemiological data in the world, in particular in Ukraine, proves the increase in Lyme borreliosis incidence. Ternopil region is endemic with Lyme borreliosis. Objective. The research was aimed to investigate the prevalence of infection with Borrelia burgdorferi and epidemiology features of borreliosis among the patients of Ternopil Regional TB Dispensary. Methods. In total, 29 patients were admitted to Departments of Differential Diagnostic, TB Therapy and TB Surgery of Ternopil Regional TB Dispensary in October 2016-January 2017. All the surveyed answered the questions of an integrated international questionnaire, where they noted the area and a number of tick bites, described the removal method, noted the survey for borreliosis pathogen and complaints after tick bites. Results. It was established that 5 respondents had a history of tick bites episodes, but only in one case the patient was examined of borreliosis. Tick bites were noticed in 3 patients with sarcoidosis and 1 with tuberculosis (TB and exudative pleurisy, respectively. Conclusions. The absence of appeals for medical care, lack of sufficient information on Lyme borreliosis and disuse of preventive measures for tick bites by the interviewed patients of Ternopil regional TB dispensary departments proves the need of improvement of health education on Lyme borreliosis (LB among this category of population. 24 (82.7% of 29 respondents did not remember the tick bite. The symptoms of (LB are similar to those in sarcoidosis and tuberculosis (pleural lesions, heart, joints, nervous system, skin, and the presence of tick bites gives the reasons to examine these patients of Borrelia burgdorferi senso lato.

Subacute transverse myelitis with Lyme profile dissociation

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Ajjan, Mohammed

2008-06-01

Full Text Available Introduction: Transverse myelitis is a very rare neurologic syndrome with an incidence per year of 1-5 per million population. We are presenting an interesting case of subacute transverse myelitis with its MRI (magnetic resonance imaging and CSF (cerebrospinal fluid findings. Case: A 46-year-old African-American woman presented with decreased sensation in the lower extremities which started three weeks ago when she had a 36-hour episode of sore throat. She reported numbness up to the level just below the breasts. Lyme disease antibodies total IgG (immunoglobulin G and IgM (immunoglobulin M in the blood was positive. Antinuclear antibody profile was within normal limits. MRI of the cervical spine showed swelling in the lower cervical cord with contrast enhancement. Cerebrospinal fluid was clear with negative Borrelia Burgdorferi IgG and IgM. Herpes simplex, mycoplasma, coxiella, anaplasma, cryptococcus and hepatitis B were all negative. No oligoclonal bands were detected. Quick improvement ensued after she was given IV Ceftriaxone for 7 days. The patient was discharged on the 8th day in stable condition. She continued on doxycycline for 21 days. Conclusions: Transverse myelitis should be included in the differential diagnosis of any patient presenting with acute or subacute myelopathy in association with localized contrast enhancement in the spinal cord especially if flu-like prodromal symptoms were reported. Lyme disease serology is indicated in patients with neurological symptoms keeping in mind that dissociation in Lyme antibody titers between the blood and the CSF is possible.

Predictive Factors for Differentiating Between Septic Arthritis and Lyme Disease of the Knee in Children.

Science.gov (United States)

Baldwin, Keith D; Brusalis, Christopher M; Nduaguba, Afamefuna M; Sankar, Wudbhav N

2016-05-04

Differentiating between septic arthritis and Lyme disease of the knee in endemic areas can be challenging and has major implications for patient management. The purpose of this study was to identify a prediction rule to differentiate septic arthritis from Lyme disease in children presenting with knee pain and effusion. We retrospectively reviewed the records of patients younger than 18 years of age with knee effusions who underwent arthrocentesis at our institution from 2005 to 2013. Patients with either septic arthritis (positive joint fluid culture or synovial white blood-cell count of >60,000 white blood cells/mm(3) with negative Lyme titer) or Lyme disease (positive Lyme immunoglobulin G on Western blot analysis) were included. To avoid misclassification bias, undiagnosed knee effusions and joints with both a positive culture and positive Lyme titers were excluded. Historical, clinical, and laboratory data were compared between groups to identify variables for comparison. Binary logistic regression analysis was used to identify independent predictive variables. One hundred and eighty-nine patients were studied: 23 with culture-positive septic arthritis, 26 with culture-negative septic arthritis, and 140 with Lyme disease. Multivariate binary logistic regression identified pain with short arc motion, history of fever reported by the patient or a family member, C-reactive protein of >4 mg/L, and age younger than 2 years as independent predictive factors for septic arthritis. A simpler model was developed that showed that the risk of septic arthritis with none of these factors was 2%, with 1 of these factors was 18%, with 2 of these factors was 45%, with 3 of these factors was 84%, or with all 4 of these factors was 100%. Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of >4.0 mg/L, patient-reported history of

An Enzyme-Linked Immunosorbent Spot Assay Measuring Borrelia burgdorferi B31-Specific Interferon Gamma-Secreting T Cells Cannot Discriminate Active Lyme Neuroborreliosis from Past Lyme Borreliosis: a Prospective Study in the Netherlands.

Science.gov (United States)

van Gorkom, T; Sankatsing, S U C; Voet, W; Ismail, D M; Muilwijk, R H; Salomons, M; Vlaminckx, B J M; Bossink, A W J; Notermans, D W; Bouwman, J J M; Kremer, K; Thijsen, S F T

2018-04-01

Two-tier serology testing is most frequently used for the diagnosis of Lyme borreliosis (LB); however, a positive result is no proof of active disease. To establish a diagnosis of active LB, better diagnostics are needed. Tests investigating the cellular immune system are available, but studies evaluating the utility of these tests on well-defined patient populations are lacking. Therefore, we investigated the utility of an enzyme-linked immunosorbent spot (ELISpot) assay to diagnose active Lyme neuroborreliosis. Peripheral blood mononuclear cells (PBMCs) of various study groups were stimulated by using Borrelia burgdorferi strain B31 and various recombinant antigens, and subsequently, the number of Borrelia -specific interferon gamma (IFN-γ)-secreting T cells was measured. We included 33 active and 37 treated Lyme neuroborreliosis patients, 28 healthy individuals treated for an early manifestation of LB in the past, and 145 untreated healthy individuals. The median numbers of B. burgdorferi B31-specific IFN-γ-secreting T cells/2.5 × 10 5 PBMCs did not differ between active Lyme neuroborreliosis patients (6.0; interquartile range [IQR], 0.5 to 14.0), treated Lyme neuroborreliosis patients (4.5; IQR, 2.0 to 18.6), and treated healthy individuals (7.4; IQR, 2.3 to 14.9) ( P = 1.000); however, the median number of B. burgdorferi B31-specific IFN-γ-secreting T cells/2.5 × 10 5 PBMCs among untreated healthy individuals was lower (2.0; IQR, 0.5 to 3.9) ( P ≤ 0.016). We conclude that the Borrelia ELISpot assay, measuring the number of B. burgdorferi B31-specific IFN-γ-secreting T cells/2.5 × 10 5 PBMCs, correlates with exposure to the Borrelia bacterium but cannot be used for the diagnosis of active Lyme neuroborreliosis. Copyright © 2018 van Gorkom et al.

Effects of intravenous ketamine in a patient with post-treatment Lyme disease syndrome

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Hanna AF

2017-08-01

Full Text Available Ashraf F Hanna, Bishoy Abraham, Andrew Hanna, Adam J Smith Department of Pain Management, Florida Spine Institute, Clearwater, FL, USA Abstract: Post-treatment Lyme disease syndrome (PTLDS is a pain disorder for which there remains no gold standard treatment option. Here, we report a case of PTLDS in a female patient whose pain was refractory to treatment options such as radiofrequency ablation, vitamin infusion therapy, opioid analgesics, and other pharmacotherapies. The patient commenced an experimental intravenous ketamine infusion therapy at the Florida Spine Institute (Clearwater, FL, USA and achieved relief from her chronic pain, an improved quality of life, reduced depression and suicidal ideation, and reduced opioid consumption. Keywords: chronic Lyme, late Lyme, pain, analgesic, suicidality, depression

Simple Objective Detection of Human Lyme Disease Infection Using Immuno-PCR and a Single Recombinant Hybrid Antigen

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Halpern, Micah D.; Molins, Claudia R.; Schriefer, Martin

2014-01-01

A serology-based tiered approach has, to date, provided the most effective means of laboratory confirmation of clinically suspected cases of Lyme disease, but it lacks sensitivity in the early stages of disease and is often dependent on subjectively scored immunoblots. We recently demonstrated the use of immuno-PCR (iPCR) for detecting Borrelia burgdorferi antibodies in patient serum samples that were positive for Lyme disease. To better understand the performance of the Lyme disease iPCR assay, the repeatability and variability of the background of the assay across samples from a healthy population (n = 36) were analyzed. Both of these parameters were found to have coefficients of variation of Lyme disease patient serum samples (n = 12) demonstrated a strong correlation with that of 2-tier testing. Furthermore, a simplified iPCR approach using a single hybrid antigen and detecting only IgG antibodies confirmed the 2-tier diagnosis in the Lyme disease patient serum samples (n = 12). Validation of the hybrid antigen IgG iPCR assay using a blinded panel of Lyme disease and non-Lyme disease patient serum samples (n = 92) resulted in a sensitivity of 69% (95% confidence interval [CI], 50% to 84%), compared to that of the 2-tier analysis at 59% (95% CI, 41% to 76%), and a specificity of 98% (95% CI, 91% to 100%) compared to that of the 2-tier analysis at 97% (95% CI, 88% to 100%). A single-tier hybrid antigen iPCR assay has the potential to be an improved method for detecting host-generated antibodies against B. burgdorferi. PMID:24899074

Lyme disease presenting with facial palsy and myocarditis mimicking myocardial infarction.

Science.gov (United States)

Gilson, Julieta; Khalighi, Koroush; Elmi, Farhad; Krishnamurthy, Mahesh; Talebian, Amirsina; Toor, Rubinder S

2017-01-01

A 45-year-old woman presented with a sudden episode of typical chest pain, radiating to her neck. The patient denied premature coronary artery disease in the family. Initial EKG showed normal sinus rhythm with a 1 mm ST-elevation involving lead II and lead aVF and a 1 mm ST-depression in lead V1 with associated T-wave inversion. Initial Troponin I (normal disease. Two days later the patient developed right-sided facial palsy. Diagnosis of Lyme disease was confirmed by ELISA with positive IgM and IgG antibodies. Treatment with intravenous ceftriaxone and oral steroids was started. Eventually resolution of symptoms and, normalization of cardiac markers and EKG changes, were achieved. This is a rare case of Lyme myocarditis associated with markedly elevated Troponin I, normal left ventricle function, and an absence of conduction abnormalities. To the best of our knowledge, Lyme myocarditis mimicking acute coronary syndrome with such high levels of Troponin I and neurologic compromise has not been previously described. Lyme myocarditis may be a challenging diagnosis in endemic areas especially in patients with coronary artery disease risk factors, presenting with typical chest pain, EKG changes and positive cardiac biomarkers. Therefore, it should be considered a differential diagnosis in patients presenting with clinical symptoms suggestive of acute coronary syndrome. Abbreviations AV: Atrioventricular; CK-MB: Creatinine Kinase-MB; EKG: Electrocardiogram; ELISA: Enzyme-Linked Immunosorbent Assay; IgG: Immunoglobulin G; IgM: Immunoglobulin M.

Klinik, diagnostik og behandling af Lyme-borreliose

DEFF Research Database (Denmark)

Ocias, Lukas Frans; Jensen, Bo Bødker; Knudtzen, Fredrikke Christie

2017-01-01

Lyme borreliosis is an infection caused by the Borrelia burgdorferi sensu lato complex and transmitted by Ixodes ricinus ticks in Denmark. It can manifest itself in several different forms of which erythema migrans is the most common and is diagnosed by clinical assessment of the characteristic...

Lyme Disease: A Challenge for Outdoor Educators.

Science.gov (United States)

Whitcombe, Mark

1989-01-01

Describes signs and symptoms of Lyme disease; life cycle and feeding habits of the deer tick (Ixodes dammini), which transmits the spirochete bacterium; tick control measures; outdoor precautions; and veterinary considerations. Discusses the disease's potential impact on outdoor education, and suggests a reasoned, nonhysterical approach. Contains…

Lyme disease: why the controversy?

Science.gov (United States)

Beaman, M H

2016-12-01

Some Australians have become convinced of the existence of locally acquired Lyme disease (LD). The history of LD, since its recognition in the early 1970s, is reviewed as a model for investigative approaches to unknown syndromes. Australian Management Guidelines for LD include the requirement for diagnostic testing by National Association of Testing Authorities-accredited laboratories using Therapeutic Goods Administration-licensed tests, which result in the efficient diagnosis of LD in overseas travellers. Despite this, patients who have not left Australia pay many thousands of dollars for non-specialist consultations and testing at overseas laboratories. Unproven long-term therapy with multiple antibiotics has resulted in serious complications, including allergies, line sepsis, pancreatitis and pseudomembranous colitis. Studies have shown that LD vectors are not found in Australia, and Lyme Borrelia has not been found in Australian vectors, animals or patients with autochthonous illnesses. I propose that (i) A non-controversial name for the chronic syndrome should be adopted, 'Australian Multisystem Disorder'. (ii) Research funding should enable the development of a consensus case definition and studies of the epidemiology of this syndrome with laboratory investigations to identify an aetiology and surrogate markers of disease. Prospective, randomised treatment studies could then be undertaken using ethical protocols. © 2016 Royal Australasian College of Physicians.

Induction of lyme arthritis in LSH hamsters

International Nuclear Information System (INIS)

Schmitz, J.L.; Schell, R.F.; Hejka, A.; England, D.M.; Konick, L.

1988-01-01

In studies of experimental Lyme disease, a major obstacle has been the unavailability of a suitable animal model. We found that irradiated LSH/Ss Lak hamsters developed arthritis after injection of Borrelia burgdorferi in the hind paws. When nonirradiated hamsters were injected in the hind paws with B. burgdorferi, acute transient synovitis was present. A diffuse neutrophilic infiltrate involved the synovia and periarticular structures. The inflammation was associated with edema, hyperemia, and granulation tissue. Numerous spirochetes were seen in the synovial and subsynovial tissues. The histopathologic changes were enhanced in irradiated hamsters. The onset and duration of the induced swelling were dependent on the dose of radiation and the inoculum of spirochetes. Inoculation of irradiated hamsters with Formalin-killed spirochetes or medium in which B. burgdorferi had grown for 7 days failed to induce swelling. This animal model should prove useful for studies of the immune response to B. burgdorferi and the pathogenesis of Lyme arthritis

Vaccination of horses with Lyme vaccines for dogs induces short-lasting antibody responses.

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Guarino, Cassandra; Asbie, Sanda; Rohde, Jennifer; Glaser, Amy; Wagner, Bettina

2017-07-24

Borrelia burgdorferi can induce Lyme disease. Approved Lyme vaccines for horses are currently not available. In an effort to protect horses, veterinarians are using Lyme vaccines licensed for dogs. However, data to assess the response of horses to, or determine the efficacy of this off-label vaccine use are missing. Here, antibodies against outer surface protein A (OspA), OspC, and OspF were quantified in diagnostic serum submissions from horses with a history of vaccination with canine Lyme vaccines. The results suggested that many horses respond with low and often short-lasting antibody responses. Subsequently, four experimental vaccination trials were performed. First, we investigated antibody responses to three canine vaccines in B. burgdorferi-naïve horses. One killed bacterin vaccine induced antibodies against OspC. OspA antibodies were low for all three vaccines and lasted less than 16weeks. The second trial tested the impact of the vaccine dose using the OspA/OspC inducing bacterin vaccine in horses. A 2mL dose produced higher OspA and OspC antibody values than a 1mL dose. However, the antibody response again quickly declined, independent of dose. Third, the horses were vaccinated with 2 doses of a recombinant OspA vaccine. Previous vaccination and/or environmental exposure enhanced the magnitude and longevity of the OspA antibody response to about 20weeks. Last, the influence of intramuscular versus subcutaneous vaccine administration was investigated for the recombinant OspA vaccine. OspA antibody responses were not influenced by injection route. The current work highlights that commercial Lyme vaccines for dogs induce only transient antibody responses in horses which can also be of low magnitude. Protection from infection with B. burgdorferi should not be automatically assumed after vaccinating horses with Lyme vaccines for dogs. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Sympatric Ehrlichiosis and Lyme Disease in New Jersey

Centers for Disease Control (CDC) Podcasts

2017-08-15

Dr. Andrea Egizi, a tick specialist, discusses ehrlichiosis and Lyme disease in New Jersey.  Created: 8/15/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/15/2017.

Intensité du travail salarié et abandon des études universitaires au Canada The Intensity of Salaried Work and the Abandonment of University Studies in Canada. A Longitudinal Approach

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Stéphane Moulin

2012-06-01

Full Text Available Dans de nombreux pays, les élèves et les étudiants ont augmenté le temps consacré au travail rémunéré durant leurs études. Ils ne travaillent plus uniquement l’été, au moment des vacances, mais aussi pendant l’année scolaire. Les recher­ches portant sur l’effet du travail salarié sur les parcours scolaires tendent à montrer qu’il existe une relation convexe entre l’intensité du travail salarié et les départs sans diplôme du système scolaire : les taux d’abandon semblent plus élevés pour les étudiants qui ne travaillent pas et pour ceux qui travaillent plus de 25 heures. Cependant, le caractère transversal des données utilisées fait qu’elles ne permettent pas de saisir l’effet causal de la variation du temps de travail sur la poursuite des études. Dans cet article, nous utilisons une méthodologie quantitative longitudinale pour examiner les effets de l’intensité du travail rémunéré sur la persévérance dans le premier programme universitaire suivi au Canada. Les résultats montrent qu’il y a bien une relation causale entre le fait de travailler plus de 25 heures et l’abandon, mais qu’elle est seulement observée pour les hommes, et que cet effet n’est significatif qu’au début du program­me. Par ailleurs, l’association avec le fait de ne pas travailler semble s’inter­préter davantage comme un effet de sélection.In many countries, pupils and students have increased the time devoted to remunerated work during their studies. They no longer work just in summer, during vacations, but also during the school year. Research relating to the effect of salaried work on the school courses tends to show that there exists a convex relationship between the intensity of the salaried work and the departures without diplomas from the school system: the rates of abandonment seem higher for students who do not work and for those who do not work or work over 25 hours weekly. However, the

Lyme Carditis: An Interesting Trip to Third-Degree Heart Block and Back

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Maxwell Eyram Afari

2016-01-01

Full Text Available Carditis is an uncommon presentation of the early disseminated phase of Lyme disease. We present the case of a young female who presented with erythema migrans and was found to have first-degree heart block which progressed to complete heart block within hours. After receiving ceftriaxone, there was complete resolution of the heart block in sequential fashion. Our case illustrates the importance of early recognition and anticipation of progressive cardiac conduction abnormalities in patients presenting with Lyme disease.

Forward Genetic Approaches for Elucidation of Novel Regulators of Lyme Arthritis Severity

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Kenneth K.C. Bramwell

2014-06-01

Full Text Available Patients experiencing natural infection with Borrelia burgdorferi display a spectrum of associated symptoms and severity, strongly implicating the impact of genetically determined host factors in the pathogenesis of Lyme disease. Herein, we provide a summary of the host genetic factors that have been demonstrated to influence the severity and chronicity of Lyme arthritis symptoms, and a review of the resources available, current progress, and added value of a forward genetic approach for identification of novel genetic regulators.

Current Guidelines, Common Clinical Pitfalls, and Future Directions for Laboratory Diagnosis of Lyme Disease, United States.

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Moore, Andrew; Nelson, Christina; Molins, Claudia; Mead, Paul; Schriefer, Martin

2016-07-01

In the United States, Lyme disease is caused by Borrelia burgdorferi and transmitted to humans by blacklegged ticks. Patients with an erythema migrans lesion and epidemiologic risk can receive a diagnosis without laboratory testing. For all other patients, laboratory testing is necessary to confirm the diagnosis, but proper interpretation depends on symptoms and timing of illness. The recommended laboratory test in the United States is 2-tiered serologic analysis consisting of an enzyme-linked immunoassay or immunofluorescence assay, followed by reflexive immunoblotting. Sensitivity of 2-tiered testing is low (30%-40%) during early infection while the antibody response is developing (window period). For disseminated Lyme disease, sensitivity is 70%-100%. Specificity is high (>95%) during all stages of disease. Use of other diagnostic tests for Lyme disease is limited. We review the rationale behind current US testing guidelines, appropriate use and interpretation of tests, and recent developments in Lyme disease diagnostics.

Lyme neuroborreliosis in HIV-1 positive men successfully treated with oral doxycycline: a case series and literature review

OpenAIRE

Gisslén Magnus; Säll Christer; Bremell Daniel; Hagberg Lars

2011-01-01

Abstract Introduction Lyme neuroborreliosis is the most common bacterial central nervous system infection in the temperate parts of the northern hemisphere. Even though human immunodeficiency virus (HIV) -1 infection is common in Lyme borreliosis endemic areas, only five cases of co-infection have previously been published. Four of these cases presented with typical Lyme neuroborreliosis symptoms such as meningoradiculitis and facial palsy, while a fifth case had more severe symptoms of encep...

Observation of Au + Au → Au + Au + ρ0 and Au + Au → Au* + Au* + ρ0 with STAR

International Nuclear Information System (INIS)

Spencer, K.

2002-01-01

First observation of the reactions Au + Au → Au + Au + ρ 0 and Au + Au → Au* + Au* + ρ 0 with the STAR detector are reported. The ρ are produced at small perpendicular momentum, as expected if they couple coherently to both nuclei. Models of vector meson production and the correlation with nuclear breakup are discussed, as well as a fundamental test of quantum mechanics that is possible with the system. (author)

Gender Differences in Childhood Lyme Neuroborreliosis

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Dag Tveitnes

2015-01-01

Full Text Available Background. Many neurological diseases show differences between genders. We studied gender differences in childhood Lyme neuroborreliosis (LNB in an endemic area of Lyme borreliosis in Norway. Methods. In a population based study, all children (<14 years of age with symptoms suspicious of LNB, including all children with acute facial nerve palsy, were evaluated for LNB by medical history, clinical examination, blood tests, and lumbar puncture. LNB was diagnosed according to international criteria. Results. 142 children were diagnosed with LNB during 2001–2009. Facial nerve palsy was more common in girls (86% than in boys (62% p<0.001, but headache and/or neck stiffness as the only symptom was more common in boys (30% than in girls (10% p=0.003. The girls were younger than boys and had a shorter duration of symptoms, but boys had a higher level of pleocytosis than girls. In a multivariate analysis, both gender and having headache and neck stiffness were associated with a higher level of pleocytosis. Conclusion. Girls and boys have different clinical presentations of LNB, and boys have a higher level of inflammation than girls independent of the clinical presentation.

Renforcer les capacités de recherche sur les politiques au Myanmar ...

International Development Research Centre (IDRC) Digital Library (Canada)

En 2017, le CRDI et Affaires mondiales Canada ont lancé une nouvelle initiative, Le savoir au service de la démocratie au Myanmar (K4DM), afin de soutenir la démocratisation dans ce pays. Cette initiative vise à encourager un dialogue constructif dans le cadre de la transition démocratique et à promouvoir une ...

Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

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Cécile Aenishaenslin

Full Text Available Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or

Adaptation and Evaluation of a Multi-Criteria Decision Analysis Model for Lyme Disease Prevention.

Science.gov (United States)

Aenishaenslin, Cécile; Gern, Lise; Michel, Pascal; Ravel, André; Hongoh, Valérie; Waaub, Jean-Philippe; Milord, François; Bélanger, Denise

2015-01-01

Designing preventive programs relevant to vector-borne diseases such as Lyme disease (LD) can be complex given the need to include multiple issues and perspectives into prioritizing public health actions. A multi-criteria decision aid (MCDA) model was previously used to rank interventions for LD prevention in Quebec, Canada, where the disease is emerging. The aim of the current study was to adapt and evaluate the decision model constructed in Quebec under a different epidemiological context, in Switzerland, where LD has been endemic for the last thirty years. The model adaptation was undertaken with a group of Swiss stakeholders using a participatory approach. The PROMETHEE method was used for multi-criteria analysis. Key elements and results of the MCDA model are described and contrasted with the Quebec model. All criteria and most interventions of the MCDA model developed for LD prevention in Quebec were directly transferable to the Swiss context. Four new decision criteria were added, and the list of proposed interventions was modified. Based on the overall group ranking, interventions targeting human populations were prioritized in the Swiss model, with the top ranked action being the implementation of a large communication campaign. The addition of criteria did not significantly alter the intervention rankings, but increased the capacity of the model to discriminate between highest and lowest ranked interventions. The current study suggests that beyond the specificity of the MCDA models developed for Quebec and Switzerland, their general structure captures the fundamental and common issues that characterize the complexity of vector-borne disease prevention. These results should encourage public health organizations to adapt, use and share MCDA models as an effective and functional approach to enable the integration of multiple perspectives and considerations in the prevention and control of complex public health issues such as Lyme disease or other vector

Serum inflammatory mediators as markers of human Lyme disease activity.

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Mark J Soloski

Full Text Available Chemokines and cytokines are key signaling molecules that orchestrate the trafficking of immune cells, direct them to sites of tissue injury and inflammation and modulate their states of activation and effector cell function. We have measured, using a multiplex-based approach, the levels of 58 immune mediators and 7 acute phase markers in sera derived from of a cohort of patients diagnosed with acute Lyme disease and matched controls. This analysis identified a cytokine signature associated with the early stages of infection and allowed us to identify two subsets (mediator-high and mediator-low of acute Lyme patients with distinct cytokine signatures that also differed significantly (p<0.0005 in symptom presentation. In particular, the T cell chemokines CXCL9 (MIG, CXCL10 (IP-10 and CCL19 (MIP3B were coordinately increased in the mediator-high group and levels of these chemokines could be associated with seroconversion status and elevated liver function tests (p = 0.027 and p = 0.021 respectively. There was also upregulation of acute phase proteins including CRP and serum amyloid A. Consistent with the role of CXCL9/CXCL10 in attracting immune cells to the site of infection, CXCR3+ CD4 T cells are reduced in the blood of early acute Lyme disease (p = 0.01 and the decrease correlates with chemokine levels (p = 0.0375. The levels of CXCL9/10 did not relate to the size or number of skin lesions but elevated levels of serum CXCL9/CXCL10 were associated with elevated liver enzymes levels. Collectively these results indicate that the levels of serum chemokines and the levels of expression of their respective chemokine receptors on T cell subsets may prove to be informative biomarkers for Lyme disease and related to specific disease manifestations.

Diagnosis, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: A Review.

Science.gov (United States)

Sanchez, Edgar; Vannier, Edouard; Wormser, Gary P; Hu, Linden T

2016-04-26

Lyme disease, human granulocytic anaplasmosis (HGA), and babesiosis are emerging tick-borne infections. To provide an update on diagnosis, treatment, and prevention of tick-borne infections. Search of PubMed and Scopus for articles on diagnosis, treatment, and prevention of tick-borne infections published in English from January 2005 through December 2015. The search yielded 3550 articles for diagnosis and treatment and 752 articles for prevention. Of these articles, 361 were reviewed in depth. Evidence supports the use of US Food and Drug Administration-approved serologic tests, such as an enzyme immunoassay (EIA), followed by Western blot testing, to diagnose extracutaneous manifestations of Lyme disease. Microscopy and polymerase chain reaction assay of blood specimens are used to diagnose active HGA and babesiosis. The efficacy of oral doxycycline, amoxicillin, and cefuroxime axetil for treating Lyme disease has been established in multiple trials. Ceftriaxone is recommended when parenteral antibiotic therapy is recommended. Multiple trials have shown efficacy for a 10-day course of oral doxycycline for treatment of erythema migrans and for a 14-day course for treatment of early neurologic Lyme disease in ambulatory patients. Evidence indicates that a 10-day course of oral doxycycline is effective for HGA and that a 7- to 10-day course of azithromycin plus atovaquone is effective for mild babesiosis. Based on multiple case reports, a 7- to 10-day course of clindamycin plus quinine is often used to treat severe babesiosis. A recent study supports a minimum of 6 weeks of antibiotics for highly immunocompromised patients with babesiosis, with no parasites detected on blood smear for at least the final 2 weeks of treatment. Evidence is evolving regarding the diagnosis, treatment, and prevention of Lyme disease, HGA, and babesiosis. Recent evidence supports treating patients with erythema migrans for no longer than 10 days when doxycycline is used and prescription

Mimicry of lyme arthritis by synovial hemangioma.

Science.gov (United States)

Hospach, Toni; Langendörfer, M; Kalle, T V; Tewald, F; Wirth, T; Dannecker, G E

2011-12-01

To report on the differential diagnosis of lyme arthritis and synovial hemangioma due to similar clinical and radiological signs and symptoms. A 15-year-old boy presented at the age of 9 with recurrent rather painless swelling of the right knee. Altogether four episodes lasting for 1-2 weeks each occurred over a period of 18 months before medical advice was sought. Physical examination revealed only a slightly limited range of motion. Living in an endemic area of borreliosis, he reported a tick bite 6 months prior to onset of his symptoms with erythema migrans and was treated for 10 days with amoxicillin. Serology revealed two positive unspecific bands in IgG immunoblot (p41 and 66) with slight positivity for ELISA. Ultrasound revealed synovial thickening and increased fluid. Despite the weak positive serology a diagnosis of lyme arthritis could not be excluded and intravenous antibiotic treatment with ceftriaxone was started. After two further relapses antiinflammatory therapy including intraarticular steroids were introduced with no long lasting effect. A chronical disease developed with alternate periods of swelling and almost complete remission. Ultrasound as well as MRI demonstrated ongoing signs of synovitis, therefore after further progression, a diagnostic arthroscopy was performed showing an inconspicuous knee joint. A second MRI showed focal suprapatellar enhancement and was followed by open arthrotomy revealing a histopathological proven synovial cavernous juxtaarticular hemangioma. To our knowledge, the differential diagnosis of lyme arthritis and synovial hemangioma has not yet been reported despite obvious clinical similarities. In conclusion, in children and adolescents synovial hemangioma has to be considered in differential diagnosis of recurrent knee swelling. Early diagnosis is important to prevent prolonged suffering from chronic joint swelling with probable joint damages, unnecessary treatment procedures and as well school and sports

Evaluation of Two Commercial Systems for Automated Processing, Reading, and Interpretation of Lyme Borreliosis Western Blots▿

Science.gov (United States)

Binnicker, M. J.; Jespersen, D. J.; Harring, J. A.; Rollins, L. O.; Bryant, S. C.; Beito, E. M.

2008-01-01

The diagnosis of Lyme borreliosis (LB) is commonly made by serologic testing with Western blot (WB) analysis serving as an important supplemental assay. Although specific, the interpretation of WBs for diagnosis of LB (i.e., Lyme WBs) is subjective, with considerable variability in results. In addition, the processing, reading, and interpretation of Lyme WBs are laborious and time-consuming procedures. With the need for rapid processing and more objective interpretation of Lyme WBs, we evaluated the performances of two automated interpretive systems, TrinBlot/BLOTrix (Trinity Biotech, Carlsbad, CA) and BeeBlot/ViraScan (Viramed Biotech AG, Munich, Germany), using 518 serum specimens submitted to our laboratory for Lyme WB analysis. The results of routine testing with visual interpretation were compared to those obtained by BLOTrix analysis of MarBlot immunoglobulin M (IgM) and IgG and by ViraScan analysis of ViraBlot and ViraStripe IgM and IgG assays. BLOTrix analysis demonstrated an agreement of 84.7% for IgM and 87.3% for IgG compared to visual reading and interpretation. ViraScan analysis of the ViraBlot assays demonstrated agreements of 85.7% for IgM and 94.2% for IgG, while ViraScan analysis of the ViraStripe IgM and IgG assays showed agreements of 87.1 and 93.1%, respectively. Testing by the automated systems yielded an average time savings of 64 min/run compared to processing, reading, and interpretation by our current procedure. Our findings demonstrated that automated processing and interpretive systems yield results comparable to those of visual interpretation, while reducing the subjectivity and time required for Lyme WB analysis. PMID:18463211

Evaluation of two commercial systems for automated processing, reading, and interpretation of Lyme borreliosis Western blots.

Science.gov (United States)

Binnicker, M J; Jespersen, D J; Harring, J A; Rollins, L O; Bryant, S C; Beito, E M

2008-07-01

The diagnosis of Lyme borreliosis (LB) is commonly made by serologic testing with Western blot (WB) analysis serving as an important supplemental assay. Although specific, the interpretation of WBs for diagnosis of LB (i.e., Lyme WBs) is subjective, with considerable variability in results. In addition, the processing, reading, and interpretation of Lyme WBs are laborious and time-consuming procedures. With the need for rapid processing and more objective interpretation of Lyme WBs, we evaluated the performances of two automated interpretive systems, TrinBlot/BLOTrix (Trinity Biotech, Carlsbad, CA) and BeeBlot/ViraScan (Viramed Biotech AG, Munich, Germany), using 518 serum specimens submitted to our laboratory for Lyme WB analysis. The results of routine testing with visual interpretation were compared to those obtained by BLOTrix analysis of MarBlot immunoglobulin M (IgM) and IgG and by ViraScan analysis of ViraBlot and ViraStripe IgM and IgG assays. BLOTrix analysis demonstrated an agreement of 84.7% for IgM and 87.3% for IgG compared to visual reading and interpretation. ViraScan analysis of the ViraBlot assays demonstrated agreements of 85.7% for IgM and 94.2% for IgG, while ViraScan analysis of the ViraStripe IgM and IgG assays showed agreements of 87.1 and 93.1%, respectively. Testing by the automated systems yielded an average time savings of 64 min/run compared to processing, reading, and interpretation by our current procedure. Our findings demonstrated that automated processing and interpretive systems yield results comparable to those of visual interpretation, while reducing the subjectivity and time required for Lyme WB analysis.

Cases of Lyme disease reported in a military community.

Science.gov (United States)

Underwood, P K; Armour, V M

1993-02-01

Lyme disease, a growing public health problem in the United States, is also an increasing threat in Europe. Cases identified in a military community in West Germany are presented and problems of diagnosis and treatment discussed.

Affaires mondiales Canada | CRDI - Centre de recherches pour le ...

International Development Research Centre (IDRC) Digital Library (Canada)

En tant que société d'État du gouvernement du Canada, nous jouons un rôle important dans les activités du Canada liées aux affaires étrangères et au développement. Nos partenariats appuient la recherche portant sur la santé des mères et des enfants, l'agriculture et la sécurité alimentaire et les données ouvertes pour le ...

2012-2013 CAUT Almanac of Post-Secondary Education in Canada = 2012-2013 Almanach de l'enseignement postsecondaire au Canada de l'ACPPU

Science.gov (United States)

Canadian Association of University Teachers, 2013

2013-01-01

In previous editions of the CAUT Almanac, data for provincial postsecondary education expenditures, total expenditures and university and college revenues and expenditures was reported from Statistics Canada's Financial Management System (FMS), which Statistics Canada last published for the 2008-2009 fiscal year. Statistics Canada will be adopting…

L'entrepreneuriat au Canada dans le contexte mondial | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

24 nov. 2014 ... Grâce au Global Entrepreneurship Monitor (GEM), des chercheurs canadiens et étrangers acquièrent et mettent en commun des connaissances sur les motivations des entrepreneurs et sur la façon de les aider à prospérer. Les gouvernements s'appuient sur leurs constatations pour élaborer des politiques ...

Field Studies on Lyme Disease in North America

Directory of Open Access Journals (Sweden)

Joseph Piesman

1991-01-01

Full Text Available The primary tick vector of Borrelia burgdorferi in eastern and central North America is Ixodes dammini; in western North America, Ixodes pacificus. Searching for the appropriate vector is the first step in determining whether a region is endemic and enzootic for the spirochete B burgdorferi, the etiological agent of Lyme disease, followed by examination of the ticks (questing or already attached to hosts and wildlife for the spirochete. Questing ticks can be collected through a variety of methods. The two major animal hosts for I dammini are the white-footed mouse Peromyscus leucopus and the white-tailed deer Odocoileus virginianus. Sampling strategies should consider habitat and season. All three life stages of the vector tick should be located, indicating a self-sustaining population. Although B burgdorferi can be detected in many ways, there is no substitute for isolating the spirochete in Barbour-Stoenner-Kelly II medium for definitive proof of the presence of the Lyme disease spirochete.

Clinical association: Lyme disease and Guillain-Barre syndrome.

Science.gov (United States)

Patel, Kinner; Shah, Siddharth; Subedi, Dinesh

2017-10-01

Guillain-Barre Syndrome (GBS) is a life-threatening condition in which patients may present to the Emergency Department in respiratory distress leading to death. The early identification and treatment of such a condition is paramount in preventing mortality. While there are many infections associated with GBS, the association with Lyme disease is uncommon. Through our case we aim to highlight Borrelia burgdorferi as an important antecedent infection associated with the development of GBS. In this case we report a 31-year-old male who was diagnosed with Lyme disease and GBS with relevant clinical presentation including progressive numbness and weakness in bilateral hands and feet for the past 1week along with areflexia. Initiation of medical therapy with intravenous immunoglobulin and parenteral ceftriaxone resulted in resolution of his symptoms. The treatment of both diseases early can help prevent further central nervous complications leading to high morbidity and mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

Chronic unremitting headache associated with Lyme disease-like illness

Directory of Open Access Journals (Sweden)

Pedro Andre Kowacs

2013-07-01

Full Text Available The Brazilian Lyme-disease-like illness (BLDLI or Baggio-Yoshinari syndrome is a unique zoonosis found in Brazil. It reproduces all the clinical symptoms of Lyme disease except for the high frequencies of relapse and the presence of autoimmune manifestations. Two cases of borreliosis manifesting with unremitting headache, which is a symptom associated with late-stage BLDLI, were presented. Clinical, therapeutic, and prognostic aspects of the BLDLI and its associated headaches were showed and discussed in this article. BLDLI diagnosis requires additional attention by physicians, since the disease has a tendency to progress to the late, recurrent stage or the chronic form, and the associated headache can be confused with chronic primary headache or with analgesic-overuse one. Special attention should be paid to patients with headaches who have traveled to endemic areas.

Update to: Application of Bayesian decision-making to laboratory testing for Lyme disease and comparison with testing for HIV

Directory of Open Access Journals (Sweden)

Cook MJ

2017-09-01

Full Text Available Michael J Cook,1 Basant K Puri21Independent researcher, Highcliffe, UK; 2Department of Medicine, Hammersmith Hospital, Imperial College London, London, UKIn our recent Bayesian analysis paper, false-negative results were compared between Lyme disease and HIV using a recommended test algorithm.1 When the two-tier test methodology for Lyme disease was compared with HIV two-stage testing, false negatives could be more than 500 times higher for Lyme disease testing.

Carbamazepine in the treatment of Lyme disease-induced hyperacusis.

Science.gov (United States)

Nields, J A; Fallon, B A; Jastreboff, P J

1999-01-01

Lyme disease-induced hyperacusis can be an intensely disabling, chronic condition that is accompanied by posttraumatic stress disorder-like psychobehavioral sequelae. The authors describe effective treatment of 2 patients with carbamazepine. Speculations regarding a mode of action are offered.

Developing Scenarios for Uncertain Complex Risks : Using SD to Explore Futures of Lyme Disease in the Netherlands

NARCIS (Netherlands)

Pruyt, E.; Coumou, J.

2012-01-01

Lyme disease due to infection with Lyme borreliosis poses an uncertain dynamic threat to the Dutch and their public health system. This risk was used to develop and illustrate two variants of a National Risk Assessment approaches for slumbering/latent risks. This paper explains and illustrates the

Controversies in Persistent (Chronic) Lyme Disease

Science.gov (United States)

2016-01-01

The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses. PMID:27755213

Disagreement between the results from three commercial tests for the detection of Borrelia-specific serum antibodies in the Netherlands associated with antibiotic treatment for Lyme borreliosis: a retrospective study.

Science.gov (United States)

van Gorkom, T; Kremer, K; Voet, W; Notermans, D W; Vlaminckx, B J M; Sankatsing, S U C; Thijsen, S F T

2017-11-01

The diagnosis of Lyme borreliosis is challenging because of the often non-specific symptoms and persisting antibodies after infection. We investigated the diagnostic characteristics of two enzyme-linked immunosorbent assays (ELISAs) and an immunoblot for the detection of Borrelia-specific serum antibodies using different test strategies in individuals with and without antibiotic treatment for Lyme borreliosis. This retrospective study included healthy individuals, patients with active Lyme neuroborreliosis and patients treated for Lyme neuroborreliosis. Two ELISAs were compared: the C6 ELISA and the SERION ELISA. Equivocal and positive results were confirmed by immunoblot. We included 174 healthy individuals, of whom 27 (15.5%) were treated for Lyme borreliosis in the past, 36 patients were treated for Lyme neuroborreliosis and 27 patients had active Lyme neuroborreliosis. All the active Lyme neuroborreliosis patients were reactive in both ELISAs (100% sensitivity); less reactivity was seen in the other three groups (range 17.7% to 69.4%). The concordance between the ELISA results was high in active Lyme neuroborreliosis patients (26/27; 96.3%) and healthy individuals (131/147; 89.1%), but lower in treated healthy individuals (18/27; 66.7%) and treated Lyme neuroborreliosis patients (18/36; 50.0%) (p ≤ 0.005). This study showed that antibiotic treatment against Lyme borreliosis was strongly associated with discordant ELISA and test strategy results (odds ratio: 10.52; p Lyme serology.

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease

Science.gov (United States)

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-01-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1–13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols. PMID:25077519

Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.

Science.gov (United States)

Cameron, Daniel J; Johnson, Lorraine B; Maloney, Elizabeth L

2014-09-01

Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions - the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1-13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.

Lyme Neuroborreliosis: Preliminary Results from an Urban Referral Center Employing Strict CDC Criteria for Case Selection

Directory of Open Access Journals (Sweden)

David S. Younger

2010-01-01

Full Text Available Lyme neuroborreliosis or “neurological Lyme disease” was evidenced in 2 of 23 patients submitted to strict criteria for case selection of the Centers for Disease Control and Prevention employing a two-tier test to detect antibodies to Borrelia burgdorferi at a single institution. One patient had symptomatic polyradiculoneuritis, dysautonomia, and serological evidence of early infection; and another had symptomatic small fiber sensory neuropathy, distal polyneuropathy, dysautonomia, and serological evidence of late infection. In the remaining patients symptoms initially ascribed to Lyme disease were probably unrelated to B. burgdorferi infection. Our findings suggest early susceptibility and protracted involvement of the nervous system most likely due to the immunological effects of B. burgdorferi infection, although the exact mechanisms remain uncertain.

Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

Science.gov (United States)

Weitzner, Erica; McKenna, Donna; Nowakowski, John; Scavarda, Carol; Dornbush, Rhea; Bittker, Susan; Cooper, Denise; Nadelman, Robert B; Visintainer, Paul; Schwartz, Ira; Wormser, Gary P

2015-12-15

Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years. Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS. One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi. PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Isolation of live Borrelia burgdorferi sensu lato spirochaetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis.

Science.gov (United States)

Rudenko, N; Golovchenko, M; Vancova, M; Clark, K; Grubhoffer, L; Oliver, J H

2016-03-01

Lyme borreliosis is a multisystem disorder with a diverse spectrum of clinical manifestations, caused by spirochaetes of the Borrelia burgdorferi sensu lato complex. It is an infectious disease that can be successfully cured by antibiotic therapy in the early stages; however, the possibility of the appearance of persistent signs and symptoms of disease following antibiotic treatment is recognized. It is known that Lyme borreliosis mimics multiple diseases that were never proven to have a spirochaete aetiology. Using complete modified Kelly-Pettenkofer medium we succeeded in cultivating live B. burgdorferi sensu lato spirochaetes from samples taken from people who suffered from undefined disorders, had symptoms not typical for Lyme borreliosis, but who had undergone antibiotic treatment due to a suspicion of having Lyme disease even though they were seronegative. We report the first recovery of live B. burgdorferi sensu stricto from residents of southeastern USA and the first successful cultivation of live Borrelia bissettii-like strain from residents of North America. Our results support the fact that B. bissettii is responsible for human Lyme borreliosis worldwide along with B. burgdorferi s.s. The involvement of new spirochaete species in Lyme borreliosis changes the understanding and recognition of clinical manifestations of this disease. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

allocution de son excellence l'ambassadeur du canada au burkina ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ali Anwer

Population et Coordonnateur de l'Unité d'Appui Régional du. PARSEP ... habilitées à concevoir et à produire les instruments nécessaires au suivi de la ... Ces outils permettent le traitement et l'analyse des données relatives à la pauvreté qui ...

Lyme disease risk in dogs in New Brunswick

OpenAIRE

Bjurman, Natalie K.; Bradet, Gina; Lloyd, Vett K.

2016-01-01

This study assessed the seroprevalence of anti-Borrelia burgdorferi antibodies in New Brunswick dogs. Testing of 699 serum samples from dogs across the province revealed a 6% province-wide seropositivity, more than 6 times higher than that found in 2008. The rapid increase in seropositivity indicates increased Lyme disease risk to both canine and human health.

Isolation of Borrelia burgdorferi from the blood of seven patients with Lyme disease.

Science.gov (United States)

Nadelman, R B; Pavia, C S; Magnarelli, L A; Wormser, G P

1990-01-01

Borrelia burgdorferi, the etiologic agent of Lyme disease, has rarely been successfully cultured from blood. We report on seven patients from Westchester County, New York, with B. burgdorferi bacteremia diagnosed between April 1987 and August 1987. One hundred thirty-two attempts to isolate spirochetes were made on blood specimens obtained from 104 patients. Twenty-two of these specimens were obtained from nine patients who had recently been bitten by Ixodes ticks but who were asymptomatic. Heparinized blood or serum specimens (0.2 to 0.4 mL) were inoculated onto 6 mL of modified Barbour-Stoenner-Kelly medium. Lyme serology was performed by enzyme-linked immunosorbent polyvalent, IgM, and IgG assays, fluorescent immunoassay, and microhemagglutination. Four of the seven patients had erythema migrans, two had facial nerve palsy, and one had a flu-like syndrome without rash. These patients represented 21% (four of 19) of all patients with the characteristic skin lesion who had blood cultures for B. burgdorferi, and 40% (two of five) of all those with facial nerve palsy. Serologic testing was frequently nonreactive; two patients had no detectable antibody on multiple sera by five different assays. All patients improved with antibiotic treatment, and had negative subsequent blood cultures, but five of seven had persistent complaints after completion of therapy. Culturing blood for B. burgdorferi may be useful in confirming the diagnosis of Lyme disease in selected patients. Use of spirochete blood cultures may facilitate a better understanding of the pathogenesis and natural history of Lyme disease.

canada : tous les projets | Page 7 | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

Sujet: BIOTECHNOLOGY, AGRICULTURAL ENGINEERING, NATIONAL INCOME, AGRICULTURAL PRODUCTIVITY, FOOD SECURITY, RURAL ECONOMY. Région: South Africa, South of Sahara, Canada. Programme: Agriculture et sécurité alimentaire. Financement total : CA$ 3,146,230.00. Mise au point d'un vaccin en ...

Distinguishing Pediatric Lyme Arthritis of the Hip from Transient Synovitis and Acute Bacterial Septic Arthritis: A Systematic Review and Meta-analysis.

Science.gov (United States)

Cruz, Aristides I; Anari, Jason B; Ramirez, Jose M; Sankar, Wudbhav N; Baldwin, Keith D

2018-01-25

Objective Lyme arthritis is an increasingly recognized clinical entity that often prompts orthopaedic evaluation in pediatric patients. While Lyme arthritis is most common in the knee, the clinical presentation of Lyme arthritis of the hip can be similar to both acute bacterial septic arthritis and transient synovitis. Accurately distinguishing these clinical entities is important since the definitive treatment of each is distinct. Because there is limited literature on monoarticular Lyme arthritis of the hip, the purpose of this study was to perform a systematic review and meta-analysis of clinical and laboratory parameters associated with Lyme arthritis (LA) of the hip and compare them to septic arthritis (SA) and transient synovitis (TS).  Study design A systematic review of the literature was performed using the following search terms, including the variants and plural counterparts "hip" and "Lyme arthritis." A final database of individual patients was assembled from the published literature and direct author correspondence, when available. A previously published cohort of patients with hip transient synovitis or septic arthritis was used for comparative analysis. A comparative statistical analysis was performed to the assembled database to assess differences in laboratory and clinical variables between the three diagnoses.  Results Data on 88 patients diagnosed with Lyme arthritis of the hip was collected and consolidated from the 12 articles meeting inclusion criteria. The average age of patients presenting with Lyme arthritis was 7.5 years (± 3.5 years), the mean erythrocyte sedimentation rate (ESR), and the C-reactive protein (CRP) was 41 mm/hr and 3.9 mg/L, respectively. Peripheral white blood cell (WBC) count averaged 10.6 x 10 9 cells/L with the synovial WBC count averaging 55,888 cells/mm 3 . Compared to a previous cohort of patients with confirmed transient synovitis or septic arthritis, the 95% confidence interval for ESR was 21 - 33 mm

The future role of the automobile in Canada. Le role future de l'automobile au Canada

Energy Technology Data Exchange (ETDEWEB)

Khan, A.M.

1982-03-01

This paper describes the future role of the automobile from an intercity transportation perspective in multimodal contexts; it identifies courses of action open to Transport Canada officials in support of the suggested role. Discussed here is the automobile's multifaceted role, focussing mainly on its use as a mode of door-to-door travel for short trips, a feeder as well as an adjunct to public modes, a means of avoiding excessible public expenditure in highly subsidized public modes (e.g., rail), and a means for providing basic mobility in regional travel contexts. This study goes beyond the 1979 Transport Canada report with the same title by recommending courses of action that might assist officials in formulating policy, planning and other endeavours. At the outset, updated information is provided on the current status and future outlook of selected important factors that affect the future transportation role of the automobile. Against this background, the relevance of major findings of the 1979 automobile report are reviewed and gaps in knowledge identified. On the basis of this information, a future role for the automobile is discussed, with appropriate courses of action recommended. These recommendations and their institutional/program implications are addressed to Transport Canada in the areas of strategic planning and policy, energy planning, safety and coordination of actions/programs with other federal government departments and provincial governments. 48 refs., 8 tabs.

Politique internationale et défense au Canada et au Québec

OpenAIRE

Nossal, Kim Richard; Roussel, Stéphane; Paquin, Stéphane

2018-01-01

La politique étrangère et de défense du Canada a connu des changements de cap ces dernières années, s'adaptant aux nombreux événements qui ont marqué aussi bien le pays que le monde, en particulier la fin de la Guerre froide et les attentats du 11 septembre 2001. Ces transformations ont-elles des répercussions sur la nature de la tâche qui incombe à ceux qui dirigent la politique étrangère canadienne ? Quels sont les facteurs qui structurent le contenu et l'évolution des activités internation...

Geology and assessment of undiscovered oil and gas resources of the West Greenland-East Canada Province, 2008

Science.gov (United States)

Schenk, Christopher J.; Moore, Thomas E.; Gautier, Donald L.

2018-01-05

The U.S. Geological Survey (USGS) recently assessed the potential for undiscovered oil and gas resources of the West Greenland-East Canada Province as part of the USGS Circum-Arctic Resource Appraisal program. The province lies in the offshore area between western Greenland and eastern Canada and includes Baffin Bay, Davis Strait, Lancaster Sound, and Nares Strait west of, and including, part of Kane Basin. A series of major tectonic events led to the formation of several distinct structural domains that are the geologic basis for defining five assessment units (AU ) in the province, all of which are within the Mesozoic-Cenozoic Composite Total Petroleum System (TPS). Potential petroleum source rocks within the TPS include strata of Ordovician, Lower and Upper Cretaceous, and Paleogene ages. The five AUs defined for this study—the Eurekan Structures AU, Northwest Greenland Rifted Margin AU, Northeast Canada Rifted Margin AU, Baffin Bay Basin AU, and the Greater Ungava Fault Zone AU— encompass the entire province and were assessed for undiscovered, technically recoverable resources. The estimated mean volumes of undiscovered resources for the West GreenlandEast Canada Province are 10.7 billion barrels of oil, 75 trillion cubic feet of gas, and 1.7 billion barrels of natural gas liquids. For the part of the province that is north of the Arctic Circle, the estimated mean volumes of these undiscovered resources are 7.3 billion barrels of oil, 52 trillion cubic feet of natural gas, and 1.1 billion barrels of natural-gas liquids.

Serological studies on the infection of dogs in Ontario with Borrelia burgdorferi, the etiological agent of Lyme disease

Science.gov (United States)

Artsob, Harvey; Barker, Ian K.; Fister, Richard; Sephton, Gregory; Dick, Daryl; Lynch, John A.; Key, Doug

1993-01-01

A serological study was undertaken to determine whether dogs in Ontario are being exposed to Borrelia burgdorferi, the etiological agent of Lyme disease. This study consisted of a survey of randomly selected dogs and testing of diagnostic submissions from candidate Lyme disease cases. The survey of 1,095 dogs, bled between January 1988 and August 1989, revealed a total of 65 (5.9%) enzyme-linked immunosorbent assay (ELISA) reactors, of which 22 had immuno-fluorescent antibody assay (IFA) titers ≥1:32. All but one of the IFA-positive and 10 of the ELISA-positive, IFA-negative sera were further tested by western blot. Eight western blot positive and three equivocal reactors were obtained. Three of the eight confirmed reactors had visited areas known to be endemic for Lyme disease, leaving five reactors that might have been infected in previously undocumented areas for B. burgdorferi activity in Ontario. Diagnostic submissions of sera from 223 dogs were received between August 1987 and February 1992. Test results revealed 21 (9.4%) IFA reactors, of which only six had significant titers (≥1:256) and were reactive by an immunodot Borrelia test. All six dogs had travelled to known Lyme endemic areas. Based on results obtained from this study, it seems likely that the agent of Lyme disease is not widespread in Ontario. PMID:17424284

Effects of Forest Fragmentation on Human Risk of Lyme Disease

Science.gov (United States)

Percent forest-herbaceous edge repeatedly explained most of the variability in reported Lyme disease rates within a rural-to-urban study gradient across central Maryland and southeastern Pennsylvania. A one-percent increase in forest-herbaceous edge was associated with an increas...

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

Science.gov (United States)

This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has been estimated from the average annual rate of change in each state. This map is limited to the 14 states where Lyme disease is most common, where annual rates are consistently above 10 cases per 100,000. Connecticut, New York, and Rhode Island had too much year-to-year variation in reporting practices to allow trend calculation. For more information: www.epa.gov/climatechange/science/indicators

Borrelia sp. phylogenetically different from Lyme disease- and relapsing fever-related Borrelia spp. in Amblyomma varanense from Python reticulatus.

Science.gov (United States)

Trinachartvanit, Wachareeporn; Hirunkanokpun, Supanee; Sudsangiem, Ronnayuth; Lijuan, Wanwisa; Boonkusol, Duangjai; Baimai, Visut; Ahantarig, Arunee

2016-06-24

Species of the genus Borrelia are causative agents of Lyme disease and relapsing fever. Lyme disease is the most commonly reported vector-borne disease in the northern hemisphere. However, in some parts of the world Lyme borreliosis and relapsing fever may be caused by novel Borrelia genotypes. Herein, we report the presence of a Borrelia sp. in an Amblyomma varanense collected from Python reticulatus. Ticks were collected from snakes, identified to species level and examined by PCR for the presence of Borrelia spp. flaB and 16S rRNA genes. Phylogenetic trees were constructed using the neighbour-joining method. Three A. varanense ticks collected from P. reticulatus were positive for a unique Borrelia sp., which was phylogenetically divergent from both Lyme disease- and relapsing fever-associated Borrelia spp. The results of this study suggest for the first time that there is a Borrelia sp. in A. varanense tick in the snake P. reticulatus that might be novel.

Ultra-relativistic Au+Au and d+Au collisions:

Science.gov (United States)

Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Chai, Z.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Hauer, M.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Seals, H.; Sedykh, I.; Skulski, W.; Smith, C. E.; Stankiewicz, M. A.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tang, J.-L.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Vaurynovich, S. S.; Verdier, R.; Veres, G. I.; Wenger, E.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.

In this talk I will review PHOBOS data on charged particle multiplicities, obtained in Au+Au and d+Au collisions at RHIC. The general features of the Au+Au pseudorapidity distributions results will be discussed and compared to those of /line{p}p collisions. The total charged particle multiplicity, scaled by the number of participant pairs, is observed to be about 40% higher in Au+Au collisions than in /line{p}p and d+Au systems, but, surprisingly at the same level of e+e- collisions. Limiting fragmentation scaling is seen to be obeyed in Au+Au collisions.

Une collaboration Canada-Chine favorise la circulation des ...

International Development Research Centre (IDRC) Digital Library (Canada)

29 avr. 2016 ... Ils recommandent également l'élaboration d'une stratégie de mise en commun des talents dans le but d'augmenter le bien-être économique et les investissements au Canada comme en Chine. De plus, les chercheurs chinois sollicitent désormais la participation d'homologues canadiens à leurs projets de ...

Alpha fucosidase and beta galactosidase in serum of a Lyme disease patients as a possible marker of accelerated senescence — a preliminary study

Directory of Open Access Journals (Sweden)

Anna Wasiluk

2012-07-01

Full Text Available Lyme disease (LD is the most prevalent tick-borne disease in Europe. LD is caused by the spirochete Borrelia burgdorferi. LD is a chronic disease which can attack a number of organs: skin, heart, brain, joints. Chronic, low-grade inflammation involves general production of pro-inflammatory cytokines and inflammatory markers and is a typical feature of aging. So far, the best method of diagnosing LD is a time-consuming and expensive two-stage serological method. The aim of our study was to evaluate the activity of two lysosomal exoglycosidases: α-fucosidase (FUC and β-galactosidase (GAL in the serum of patients with Lyme disease, as potential markers of LD. Due to the increasing number of patients with Lyme disease and a number of false results, new ways to diagnose this disease are still being sought. As elevated level of β-galactosidase is a manifestation of residual lysosomal activity in senescent cells, the increase in its activity in serum during chronic Lyme disease might be a marker of a potentially accelerated senescence process. The study was performed on serum taken from cubital veins of 15 patients with Lyme disease and eight healthy subjects (control group. FUC and GAL activity was measured by the method of Chatterjee et al. as modified by Zwierz et al. In the serum of patients with Lyme disease, GAL activity significantly increased (p = 0.029, and the activity of FUC had a tendency to increase (p = 0.153, compared to the control group. A significant increase in GAL activity in the serum of patients with Lyme disease indicates an increased catabolism of glycoconjugates (glycoproteins, glycolipids, proteoglycans and could be helpful in the diagnosis of Lyme disease, although this requires confirmation in a larger group of patients. As GAL is the most widely used assay for detection of senescent cells, an elevated level of β-galactosidase might be a manifestation of accelerated senescence process in the course of Lyme

Cultural influence, economic security, and the fertility behavior of the Chinese in Canada

Directory of Open Access Journals (Sweden)

Tang, Zongli

2001-01-01

Full Text Available EnglishThis study explores interactions of cultural influence and economic insecurity and their effects on the fertility behavior of the Chinese in Canada. The importance of group context on the actions of individuals is measured through data from the PUST of the 1971 and1991 Canadian Censuses. Contextual analysis and random coefficient models are the major statistical tools employed to achieve the above objectives. The Chinese-Canadians are compared to the British-Canadians, who are used as the reference group. The findings suggest that Chinese reproductive norms with pronatalist endowments exert strong influence on the fertility behavior of the Chinese in Canada.This influence effectively counteracts the negative effects of economic insecurity and encourages Chinese immigrants to quickly recover their fertility deficit after the initial immigration stage. The effects of the origin culture on fertility diminish with increasing exposure to the host society.However, even among the native-born or Canadian-born Chinese, the influence of Chinese reproductive norms is still present though not as strong as among the foreign-born Chinese.FrenchCette étude explore les interactions de l'influence culturelle et de l'insécuritééconomique et leurs effets sur le comportement procréateur des Chinois auCanada. L'importance d'un contexte de groupe sur les actions des individus estmesurée au moyen de données provenant de la BEGD (bande-échantillon àgrande diffusion des recensements canadiens de 1971 et 1991. L'analysecontextuelle et les coefficients de modèles au hasard constituent les principauxoutils statistiques employés pour atteindre les objectifs susmentionnés. Les Sino-Canadiens sont comparés aux habitants de la Colombie-Britannique qui serventde groupe témoin. Les conclusions indiquent que les normes de reproduction àaction nataliste exercent une forte influence sur le comportement procréateur desChinois au Canada. Cette influence

Redefining the "Normal" Worker: Law and Policy Choices for Work-Family Balance in Canada: Redéfinir le 'travailleur normal': Regard sur les choix législatifs et de politiques publiques en matière de conciliation travail-famille au Canada.

Science.gov (United States)

Bernstein, Stéphanie; Valentini, Mathilde

2017-11-01

While the need to reconcile work and family life has been recognized in discrete ways in legislation and policy over the years, there has not been a substantial shift away from the archetype of the "unencumbered" (male) worker to a new model of the "normal" worker. In Canada and elsewhere, legislative protection does not allow women or men to effectively reconcile work and family responsibilities over the life cycle. This paper examines the different ways in which work-family balance is regulated, with a focus on the Canadian federal jurisdiction and the province of Quebec, and underlines the need for coherent labor and social policy. The paper also explores the development of multi-stakeholder initiatives on work-family balance, including the development of voluntary standards and a proposal for a work-family "framework" law to ensure coherence among different laws and programs affecting work-family balance. The paper concludes by confirming the need to move away from an individualized approach toward a more mainstreamed and collectivized approach to work-family balance. Résumé Bien que la nécessité de concilier travail et vie familiale ait fait l'objet d'une reconnaissance timide dans la législation et les politiques publiques au fil des ans, il n'y a pas eu de changement substantiel de l'archétype du travailleur « sans engagements » (homme) vers un nouveau modèle de « travailleur normal ». Au Canada et ailleurs, la protection législative ne permet pas aux femmes ou aux hommes d'arrimer efficacement leurs responsabilités professionnelles et familiales au cours de leur vie. Cet article examine les différentes façons dont la conciliation travail-famille est réglementée, particulièrement en droit fédéral canadien et dans la province de Québec, et souligne la nécessité d'une politique sociale et de travail cohérente. Le texte explore également le développement d'initiatives multipartites, y compris l'élaboration de normes volontaires de

Lyme disease testing in children in an endemic area.

Science.gov (United States)

Al-Sharif, Bashar; Hall, Matthew C

2011-10-01

The purpose of this study was to determine clinician adherence to recommendations regarding diagnostic testing for Lyme disease (LD). The specific aims were to determine the rate of inappropriate test ordering for a diagnosis of erythema migrans and tack of confirmatory test ordering for positive LD screening tests. Using the data warehouse of Marshfield Clinic Research Foundation's Bioinformatics Research Center, cases were identified from 2002 through 2007. A retrospective chart abstraction was performed using Marshfield Clinic's electronic medical record. The study involved children (testing occurred after a clinical diagnosis of erythema migrans was made. Patients with any symptom in addition to erythema migrans were more likely to have testing (odds ratio (OR) = 3.52, 1.75-7.08). A positive LD screening test was not confirmed 24% of the time. Lack of ordering confirmatory testing was not associated with any clinical factors or site of the evaluation. This study found that some clinicians in an LD-endemic area do not follow guidelines for diagnosing children suspected to have Lyme disease.

Lyme Disease: Knowledge and Practices of Family Practitioners in Southern Quebec

Directory of Open Access Journals (Sweden)

Cécile Ferrouillet

2015-01-01

Full Text Available BACKGROUND: Public health authorities in Quebec have responded to the progressive emergence of Lyme disease (LD with surveillance activities and education for family physicians (FPs who are key actors in both vigilance and case management.

Absence of Lyme disease spirochetes in larval ixodes ricinus ticks

Czech Academy of Sciences Publication Activity Database

Richter, D.; Debski, A.; Hubálek, Zdeněk; Matuschka, F.-R.

2012-01-01

Roč. 12, č. 1 (2012), s. 21-27 ISSN 1530-3667 EU Projects: European Commission(XE) 10284 - EDEN Institutional research plan: CEZ:AV0Z60930519 Keywords : blood meal * Borrelia * Ixodes * Lyme disease * Vertical transmission Subject RIV: EE - Microbiology, Virology Impact factor: 2.277, year: 2012

The diagnostic accuracy of serological tests for Lyme borreliosis in Europe

DEFF Research Database (Denmark)

Leeflang, M M G; Ang, C W; Berkhout, J

2016-01-01

-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50 % (95......BACKGROUND: Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe....... We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. RESULTS: Seventy...

Bourse du CRDI aux chercheurs candidats au doctorat 2017 | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

Cet appel à propositions s'adresse aux citoyens canadiens, aux résidents permanents du Canada et aux citoyens de pays en développement inscrits au doctorat dans une université canadienne. Qui peut présenter une demande. Pour être admissible, vous devez remplir les conditions suivantes : Être citoyen canadien ou ...

Les agriculteurs tracent une nouvelle voie au Kenya | CRDI - Centre ...

International Development Research Centre (IDRC) Digital Library (Canada)

20 janv. 2014 ... L'équipe est soutenue par le Fonds canadien de recherche sur la sécurité alimentaire internationale (FCRSAI), initiative concertée du CRDI et d'Affaires étrangères, Commerce et Développement Canada. Le FCRSAI supervise 21 projets ... Kenya food security agriculture. Des organismes oeuvrant au ...

[Pathway to diagnosis and real-life experience of patients believing they are affected by "chronic Lyme disease"].

Science.gov (United States)

Forestier, E; Gonnet, F; Revil-Signorat, A; Zipper, A C

2018-04-26

Chronic Lyme disease is a subject of scientific and social controversy in both Europe and the United States. The aim of our study was to analyze the pathway to diagnosis of patients believing they were affected by the disease, and to describe their real-life experience. A qualitative study was performed with 13 patients declaring themselves to be affected by chronic Lyme disease. Interviews were analyzed by 2 general medical practice interns, supervised by a general practitioner with a diploma in socio-anthropology and an infectious diseases specialist. Internet and other media played a major role in informing the patients or their doctor about the existence and the characteristics of chronic Lyme disease. The diagnosis was confirmed by features considered objective (chronic infection by Borrelia, tick bite, positive serology, beneficial or worsening effects of antibiotics). The long medical diagnosis and treatment process of those interviewed was marked by a conflicted relationship with the medical profession, caused by a feeling of non-recognition and abandonment. They reported their experience as being very painful, both because of the physical pain and also the psychological consequences of their condition. Improving the diagnosis and therapeutic management of patients believing themselves to be affected by chronic Lyme disease appears highly necessary both to limit their search for diagnosis and their experience of pain. It could be based on existing guidelines concerning medically unexplained symptoms to which the chronic Lyme disease issue appears quite similar on several points. Copyright © 2018 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Les médiations sociales, culturelles et technologiques dans la production et l’appropriation des intergiciels de l’industrie du jeu vidéo au Canada

OpenAIRE

Charrieras, Damien

2011-01-01

Le secteur industriel des intergiciels de jeux vidéo (game middleware) est très lié au développement des industries du jeu vidéo dans lequel le Canada est très actif et dont l’importance économique ne cesse de croître. Dans son étude du rôle des industries de l’intergiciel dans la filière de production d’un jeu vidéo l’auteur s'est penché sur la circulation des intergiciels de jeux vidéo pour explorer les multiples relations existantes entre les sociétés d’intergiciel, les entreprises de déve...

Comprendre l'expérience de lecteurs désengagés lors d'un projet de cercle de lecture au sein d'une équipe de hockey de jeunes garçons au Canada

Directory of Open Access Journals (Sweden)

Jolicoeur Manon

2015-01-01

Full Text Available Cette recherche collaborative réunissant un entraineur de hockey et une chercheuse vise à décrire l'impact de l'expérimentation d'un dispositif de cercle de lecture auprès d'une équipe de jeunes garçons francophones de 9 et 10 ans du Nouveau-Brunswick (Canada. L'étude se penche particulièrement sur le vécu de trois lecteurs désengagés participant au projet. L'analyse qualitative des données recueillies par entrevues, questionnaires et observations démontre que la motivation a été soutenue et généralisée durant toute la tenue du cercle de lecture et que les lecteurs désengagés ont évolué vers l'engagement.

A description of 'Australian Lyme disease' epidemiology and impact: an analysis of submissions to an Australian senate inquiry.

Science.gov (United States)

Brown, Jeremy D

2018-04-01

Many Australian patients are diagnosed and treated for the scientifically and politically controversial diagnosis of an endemic form of 'Australian Lyme Disease'. Patient advocacy led Senator John Madigan to propose an Australian Senate Inquiry into this illness. To describe the symptomology and outcomes of patients diagnosed and treated with Lyme disease in Australia. All public, first-person submissions (n = 698) to the inquiry were reviewed and responses analysed for epidemiology, symptoms and impact against structured criteria. The most common symptoms described were fatigue (62.6%), disordered thinking (51.9%) and sensory disturbance (46.1%). Respondents reported experiencing symptoms for a median of 10 years and spent a median of $30 000 on diagnosis and treatment. Almost 10% of respondents self-diagnosed after being exposed to a media report of Australian Lyme disease. Patients diagnosed with Lyme disease in Australia display a symptomology similar to 'medically unexplained physical symptoms' syndromes, experience social and financial harms, and are at risk of nosocomial harms. Negative medical interactions and the media may contribute to patients seeking alternative and potentially non-evidence-based diagnoses and treatments. © 2018 Royal Australasian College of Physicians.

Antibody responses to Borrelia burgdorferi detected by western blot vary geographically in Canada.

Science.gov (United States)

Ogden, Nicholas H; Arsenault, Julie; Hatchette, Todd F; Mechai, Samir; Lindsay, L Robbin

2017-01-01

Lyme disease is emerging in eastern and central Canada, and most cases are diagnosed using the two-tier serological test (Enzyme Immuno Assay [EIA] followed by Western blot [WB]). Simplification of this algorithm would be advantageous unless it impacts test performance. In this study, accuracy of individual proteins of the IgG WB algorithm in predicting the overall test result in samples from Canadians was assessed. Because Borrelia burgdorferi strains vary geographically in Canada, geographic variations in serological responses were also explored. Metrics of relative sensitivity, specificity and the kappa statistic measure of concordance were used to assess the capacity of responses to individual proteins to predict the overall IgG WB result of 2524 EIA (C6)-positive samples from across Canada. Geographic and interannual variations in proportions of samples testing positive were explored by logistic regression. No one protein was highly concordant with the IgG WB result. Significant variations were found amongst years and geographic regions in the prevalence of samples testing positive using the overall IgG WB algorithm, and for individual proteins of the algorithm. In most cases the prevalence of samples testing positive were highest in Nova Scotia, and lower in samples from Manitoba westwards. These findings suggest that the current two tier test may not be simplified and continued use of the current two-tier test method and interpretation is recommended. Geographic and interannual variations in the prevalence of samples testing positive may be consistent with B. burgdorferi strain variation in Canada, and further studies are needed to explore this.

Antibody responses to Borrelia burgdorferi detected by western blot vary geographically in Canada.

Directory of Open Access Journals (Sweden)

Nicholas H Ogden

Full Text Available Lyme disease is emerging in eastern and central Canada, and most cases are diagnosed using the two-tier serological test (Enzyme Immuno Assay [EIA] followed by Western blot [WB]. Simplification of this algorithm would be advantageous unless it impacts test performance. In this study, accuracy of individual proteins of the IgG WB algorithm in predicting the overall test result in samples from Canadians was assessed. Because Borrelia burgdorferi strains vary geographically in Canada, geographic variations in serological responses were also explored. Metrics of relative sensitivity, specificity and the kappa statistic measure of concordance were used to assess the capacity of responses to individual proteins to predict the overall IgG WB result of 2524 EIA (C6-positive samples from across Canada. Geographic and interannual variations in proportions of samples testing positive were explored by logistic regression. No one protein was highly concordant with the IgG WB result. Significant variations were found amongst years and geographic regions in the prevalence of samples testing positive using the overall IgG WB algorithm, and for individual proteins of the algorithm. In most cases the prevalence of samples testing positive were highest in Nova Scotia, and lower in samples from Manitoba westwards. These findings suggest that the current two tier test may not be simplified and continued use of the current two-tier test method and interpretation is recommended. Geographic and interannual variations in the prevalence of samples testing positive may be consistent with B. burgdorferi strain variation in Canada, and further studies are needed to explore this.

Evaluating the utility of companion animal tick surveillance practices for monitoring spread and occurrence of human Lyme disease in West Virginia, 2014-2016.

Science.gov (United States)

Hendricks, Brian; Mark-Carew, Miguella; Conley, Jamison

2017-11-13

Domestic dogs and cats are potentially effective sentinel populations for monitoring occurrence and spread of Lyme disease. Few studies have evaluated the public health utility of sentinel programmes using geo-analytic approaches. Confirmed Lyme disease cases diagnosed by physicians and ticks submitted by veterinarians to the West Virginia State Health Department were obtained for 2014-2016. Ticks were identified to species, and only Ixodes scapularis were incorporated in the analysis. Separate ordinary least squares (OLS) and spatial lag regression models were conducted to estimate the association between average numbers of Ix. scapularis collected on pets and human Lyme disease incidence. Regression residuals were visualised using Local Moran's I as a diagnostic tool to identify spatial dependence. Statistically significant associations were identified between average numbers of Ix. scapularis collected from dogs and human Lyme disease in the OLS (β=20.7, PLyme disease. Findings reinforce the utility of spatial analysis of surveillance data, and highlight West Virginia's unique position within the eastern United States in regards to Lyme disease occurrence.

From Lyme Disease to Art and Advocacy | NIH MedlinePlus the Magazine

Science.gov (United States)

... Tick Bites Follow us From Lyme Disease to Art and Advocacy Bruce Davidson always enjoyed the outdoors. ... his recovery, Davidson has become "hyper-focused" on art and uses these talents to help others. "I ...

MR findings in acute Lyme disease affecting the knee. A case report

International Nuclear Information System (INIS)

Cavallaro, A.; Harrer, T.; Richter, H.; Bautz, W.; Fellner, F.A.

2002-01-01

In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

MR findings in acute Lyme disease affecting the knee. A case report

Energy Technology Data Exchange (ETDEWEB)

Cavallaro, A.; Harrer, T.; Richter, H.; Bautz, W.; Fellner, F.A. [Friedrich-Alexander-Univ., Erlangen-Nuernberg (Germany)

2002-07-01

In this paper we report a case with primarily unspecific arthralgia after surgical therapy of hallux valgus deformity and consecutive reflex sympathetic dystrophy in which MR led to the diagnosis of Lyme disease. (orig.)

Canine infection with Borrelia burgdorferi, Dirofilaria immitis, Anaplasma spp. and Ehrlichia spp. in Canada, 2013-2014.

Science.gov (United States)

Herrin, Brian H; Peregrine, Andrew S; Goring, Jonas; Beall, Melissa J; Little, Susan E

2017-05-19

Canine test results generated by veterinarians throughout Canada from 2013-2014 were evaluated to assess the geographical distribution of canine infection with Borrelia burgdorferi, Dirofilaria immitis, Ehrlichia spp., and Anaplasma spp. The percent positive test results of 115,636 SNAP® 4Dx® Plus tests from dogs tested were collated by province and municipality to determine the distribution of these vector-borne infections in Canada. A total of 2,844/115,636 (2.5%) dogs tested positive for antibody to B. burgdorferi. In contrast, positive test results for D. immitis antigen and antibodies to Ehrlichia spp. and Anaplasma spp. were low, with less than 0.5% of dogs testing positive for any one of these three agents nationwide. Provincial seroprevalence for antibodies to B. burgdorferi ranged from 0.5% (Saskatchewan)-15.7% (Nova Scotia); the areas of highest percent positive test results were in proximity to regions in the USA considered endemic for Lyme borreliosis, including Nova Scotia (15.7%) and Eastern Ontario (5.1%). These high endemic foci, which had significantly higher percent positive test results than the rest of the nation (P Canada. Using dogs as sentinels for these pathogens can aid in recognition of the public and veterinary health threat that each pose.

The effect of artesunate on short-term memory in Lyme borreliosis.

Science.gov (United States)

Puri, B K; Hakkarainen-Smith, J S; Monro, J A

2017-08-01

Lyme borreliosis is associated with memory deficits. While this may be related to cerebral infection by Borrelia bacteria, it may also be caused by concomitant co-infection by Babesia protozoa. The anti-malarial artemisinin-derivative artesunate has been shown to be effective against a number of Babesia species and to have efficacy against human cerebral malaria. We hypothesised that concomitant administration of artesunate in Lyme borreliosis patients would help alleviate the severity of self-reported short-term memory impairment. This hypothesis was tested in a small pilot study in which patients were treated with both an intravenous antibiotic and oral artesunate (20mg four times per day); treatment was associated with a reduction in the severity of short-term memory difficulties (P≃0.08). In light of these findings, we recommend that a formal randomised, placebo-controlled study be carried out. Copyright © 2017 Elsevier Ltd. All rights reserved.

The effectiveness of permethrin-treated deer stations for control of the Lyme disease vector Ixodes scapularis on Cape Cod and the Islands

Science.gov (United States)

The use of animal host-targeted pesticide application to control blacklegged ticks, which transmit the Lyme disease bacterium between wildlife hosts and humans, is receiving increased attention as an approach to Lyme disease risk management. Included among the attractive feature...

The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis.

Science.gov (United States)

Leeflang, M M G; Ang, C W; Berkhout, J; Bijlmer, H A; Van Bortel, W; Brandenburg, A H; Van Burgel, N D; Van Dam, A P; Dessau, R B; Fingerle, V; Hovius, J W R; Jaulhac, B; Meijer, B; Van Pelt, W; Schellekens, J F P; Spijker, R; Stelma, F F; Stanek, G; Verduyn-Lunel, F; Zeller, H; Sprong, H

2016-03-25

Interpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe. We searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy. Seventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50% (95% CI 40% to 61%); neuroborreliosis 77% (95% CI 67% to 85%); acrodermatitis chronica atrophicans 97% (95% CI 94% to 99%); unspecified Lyme borreliosis 73% (95% CI 53% to 87%). Specificity was around 95% in studies with healthy controls, but around 80% in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches. The observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.

Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease

Science.gov (United States)

Weiner, Zachary P.; Crew, Rebecca M.; Brandt, Kevin S.; Ullmann, Amy J.; Schriefer, Martin E.; Molins, Claudia R.

2015-01-01

Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. PMID:26376927

Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease.

Science.gov (United States)

Weiner, Zachary P; Crew, Rebecca M; Brandt, Kevin S; Ullmann, Amy J; Schriefer, Martin E; Molins, Claudia R; Gilmore, Robert D

2015-11-01

Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Antialarmin effect of tick saliva during the transmission of Lyme disease

NARCIS (Netherlands)

Marchal, Claire; Schramm, Frederic; Kern, Aurélie; Luft, Benjamin J.; Yang, Xiaohua; Schuijt, Tim J.; Hovius, Joppe W.; Jaulhac, Benoît; Boulanger, Nathalie

2011-01-01

Tick saliva has potent immunomodulatory properties. In arthropod-borne diseases, this effect is largely used by microorganisms to increase their pathogenicity and to evade host immune responses. We show that in Lyme borreliosis, tick salivary gland extract and a tick saliva protein, Salp15, inhibit

canada : tous les projets | Page 2 | CRDI - Centre de recherches ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ce projet vise à atténuer l'insécurité alimentaire et la malnutrition en Colombie. Sujet: AGRICULTURE, MALNUTRITION. Région: Colombia, Canada. Programme: Agriculture and Food Security. Financement total : CA$ 1,497,700.00. ​Passage à grande échelle de la production d'aliments enrichis et thérapeutiques au ...

Le ministre du Commerce international du Canada rencontre des ...

International Development Research Centre (IDRC) Digital Library (Canada)

17 juil. 2017 ... La promotion de l'entrepreneuriat, la façon dont le commerce peut profiter aux femmes et à leur famille, et la création d'emplois pour les plus vulnérables étaient au coeur de la discussion en table ronde du ministre du Commerce international du Canada, l'honorable François-Philippe Champagne, et des ...

Zaman Talukder : L'autonomisation des femmes au moyen de la ...

International Development Research Centre (IDRC) Digital Library (Canada)

27 mars 2015 ... ... household food security and nutrition in Cambodia » (renforcer la production alimentaire de subsistance afin d'améliorer la sécurité alimentaire des ménages et la nutrition au Cambodge). Le projet est financé par le CRDI et le gouvernement du Canada par l'entremise d'affaires étrangères, Commerce et ...

DAMAGE OF NERVOUS SYSTEM IN TICK-BITE BORRELIOSIS (LYME DISEASE IN СHILDREN IN THE KIROV REGION

Directory of Open Access Journals (Sweden)

T. V. Egorova

2017-01-01

Full Text Available During 1993—2016 there were treated 1255 children 9 months — 14 ages old with tick-bite infections in Kirov Infectious Clinical Hospital and 1214 children from them with the verified diagnosis of Lyme disease. Damage of nervous system was detected in 98 (8.1% patients in the forms of serous meningitis, meningoencephalitis, polyneuropathies, neuropathies, disseminated encephalomyelitis, diencephalic syndrome with impaired thermal regulation. 45.9 % of cases were mixed-infection (tick-bite encephalitis and Lyme disease. 

Early Disseminated Lyme Disease Causing False-Positive Serology for Primary Epstein-Barr Virus Infection: Report of 2 Cases.

Science.gov (United States)

Pavletic, Adriana J; Marques, Adriana R

2017-07-15

False-positive serology for Lyme disease was reported in patients with acute infectious mononucleosis. Here we describe 2 patients with early disseminated Lyme disease who were misdiagnosed with infectious mononucleosis based on false-positive tests for primary Epstein-Barr virus infection. Published by Oxford University Press for the Infectious Diseases Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Different populations of blacklegged tick nymphs exhibit differences in questing behavior that have implications for human lyme disease risk

Science.gov (United States)

Arsnoe, Isis M.; Hickling, Graham J.; Ginsberg, Howard S.; McElreath, Richard; Tsao, Jean I.

2015-01-01

Animal behavior can have profound effects on pathogen transmission and disease incidence. We studied the questing (= host-seeking) behavior of blacklegged tick (Ixodes scapularis) nymphs, which are the primary vectors of Lyme disease in the eastern United States. Lyme disease is common in northern but not in southern regions, and prior ecological studies have found that standard methods used to collect host-seeking nymphs in northern regions are unsuccessful in the south. This led us to hypothesize that there are behavior differences between northern and southern nymphs that alter how readily they are collected, and how likely they are to transmit the etiological agent of Lyme disease to humans. To examine this question, we compared the questing behavior of I. scapularis nymphs originating from one northern (Lyme disease endemic) and two southern (non-endemic) US regions at field sites in Wisconsin, Rhode Island, Tennessee, and Florida. Laboratory-raised uninfected nymphs were monitored in circular 0.2 m2 arenas containing wooden dowels (mimicking stems of understory vegetation) for 10 (2011) and 19 (2012) weeks. The probability of observing nymphs questing on these stems (2011), and on stems, on top of leaf litter, and on arena walls (2012) was much greater for northern than for southern origin ticks in both years and at all field sites (19.5 times greater in 2011; 3.6-11.6 times greater in 2012). Our findings suggest that southern origin I. scapularis nymphs rarely emerge from the leaf litter, and consequently are unlikely to contact passing humans. We propose that this difference in questing behavior accounts for observed geographic differences in the efficacy of the standard sampling techniques used to collect questing nymphs. These findings also support our hypothesis that very low Lyme disease incidence in southern states is, in part, a consequence of the type of host-seeking behavior exhibited by southern populations of the key Lyme disease vector.

Genomic insights into the Ixodes scapularis tick vector of Lyme disease

Science.gov (United States)

Gulia-Nuss, Monika; Nuss, Andrew B.; Meyer, Jason M.; Sonenshine, Daniel E.; Roe, R. Michael; Waterhouse, Robert M.; Sattelle, David B.; de la Fuente, José; Ribeiro, Jose M.; Megy, Karine; Thimmapuram, Jyothi; Miller, Jason R.; Walenz, Brian P.; Koren, Sergey; Hostetler, Jessica B.; Thiagarajan, Mathangi; Joardar, Vinita S.; Hannick, Linda I.; Bidwell, Shelby; Hammond, Martin P.; Young, Sarah; Zeng, Qiandong; Abrudan, Jenica L.; Almeida, Francisca C.; Ayllón, Nieves; Bhide, Ketaki; Bissinger, Brooke W.; Bonzon-Kulichenko, Elena; Buckingham, Steven D.; Caffrey, Daniel R.; Caimano, Melissa J.; Croset, Vincent; Driscoll, Timothy; Gilbert, Don; Gillespie, Joseph J.; Giraldo-Calderón, Gloria I.; Grabowski, Jeffrey M.; Jiang, David; Khalil, Sayed M. S.; Kim, Donghun; Kocan, Katherine M.; Koči, Juraj; Kuhn, Richard J.; Kurtti, Timothy J.; Lees, Kristin; Lang, Emma G.; Kennedy, Ryan C.; Kwon, Hyeogsun; Perera, Rushika; Qi, Yumin; Radolf, Justin D.; Sakamoto, Joyce M.; Sánchez-Gracia, Alejandro; Severo, Maiara S.; Silverman, Neal; Šimo, Ladislav; Tojo, Marta; Tornador, Cristian; Van Zee, Janice P.; Vázquez, Jesús; Vieira, Filipe G.; Villar, Margarita; Wespiser, Adam R.; Yang, Yunlong; Zhu, Jiwei; Arensburger, Peter; Pietrantonio, Patricia V.; Barker, Stephen C.; Shao, Renfu; Zdobnov, Evgeny M.; Hauser, Frank; Grimmelikhuijzen, Cornelis J. P.; Park, Yoonseong; Rozas, Julio; Benton, Richard; Pedra, Joao H. F.; Nelson, David R.; Unger, Maria F.; Tubio, Jose M. C.; Tu, Zhijian; Robertson, Hugh M.; Shumway, Martin; Sutton, Granger; Wortman, Jennifer R.; Lawson, Daniel; Wikel, Stephen K.; Nene, Vishvanath M.; Fraser, Claire M.; Collins, Frank H.; Birren, Bruce; Nelson, Karen E.; Caler, Elisabet; Hill, Catherine A.

2016-01-01

Ticks transmit more pathogens to humans and animals than any other arthropod. We describe the 2.1 Gbp nuclear genome of the tick, Ixodes scapularis (Say), which vectors pathogens that cause Lyme disease, human granulocytic anaplasmosis, babesiosis and other diseases. The large genome reflects accumulation of repetitive DNA, new lineages of retro-transposons, and gene architecture patterns resembling ancient metazoans rather than pancrustaceans. Annotation of scaffolds representing ∼57% of the genome, reveals 20,486 protein-coding genes and expansions of gene families associated with tick–host interactions. We report insights from genome analyses into parasitic processes unique to ticks, including host ‘questing', prolonged feeding, cuticle synthesis, blood meal concentration, novel methods of haemoglobin digestion, haem detoxification, vitellogenesis and prolonged off-host survival. We identify proteins associated with the agent of human granulocytic anaplasmosis, an emerging disease, and the encephalitis-causing Langat virus, and a population structure correlated to life-history traits and transmission of the Lyme disease agent. PMID:26856261

Lyme neuroborreliosis in 2 horses.

Science.gov (United States)

Imai, D M; Barr, B C; Daft, B; Bertone, J J; Feng, S; Hodzic, E; Johnston, J M; Olsen, K J; Barthold, S W

2011-11-01

Lyme neuroborreliosis--characterized as chronic, necrosuppurative to nonsuppurative, perivascular to diffuse meningoradiculoneuritis--was diagnosed in 2 horses with progressive neurologic disease. In 1 horse, Borrelia burgdorferi sensu stricto was identified by polymerase chain reaction amplification of B burgdorferi sensu stricto-specific gene targets (ospA, ospC, flaB, dbpA, arp). Highest spirochetal burdens were in tissues with inflammation, including spinal cord, muscle, and joint capsule. Sequence analysis of ospA, ospC, and flaB revealed 99.9% sequence identity to the respective genes in B burgdorferi strain 297, an isolate from a human case of neuroborreliosis. In both horses, spirochetes were visualized in affected tissues with Steiner silver impregnation and by immunohistochemistry, predominantly within the dense collagenous tissue of the dura mater and leptomeninges.

Newly recognized Leptospira species ("Leptospira inadai" serovar lyme) isolated from human skin.

OpenAIRE

Schmid, G P; Steere, A C; Kornblatt, A N; Kaufmann, A F; Moss, C W; Johnson, R C; Hovind-Hougen, K; Brenner, D J

1986-01-01

Leptospira strain 10, which represents a new Leptospira species, was isolated from a skin biopsy of a patient with Lyme disease. Although pathogenic for laboratory animals, the organism was not considered to have a significant role in the patient's illness.

Erythema multiforme and persistent erythema as early cutaneous manifestations of Lyme disease

NARCIS (Netherlands)

Schuttelaar, M L; Laeijendecker, R; Heinhuis, R J; Van Joost, T

1997-01-01

We report two cases of borreliosis (Lyme disease) with unusual cutaneous manifestations, erythema multiforme, and persistent erythema. The lesions in both of our patients had distinctive histopathologic features. To our knowledge, this is the first report of erythema multiforme and persistent

Genetic characterization of the human relapsing fever spirochete Borrelia miyamotoi in vectors and animal reservoirs of Lyme disease spirochetes in France.

Science.gov (United States)

Cosson, Jean-François; Michelet, Lorraine; Chotte, Julien; Le Naour, Evelyne; Cote, Martine; Devillers, Elodie; Poulle, Marie-Lazarine; Huet, Dominique; Galan, Maxime; Geller, Julia; Moutailler, Sara; Vayssier-Taussat, Muriel

2014-05-20

In France as elsewhere in Europe the most prevalent TBD in humans is Lyme borreliosis, caused by different bacterial species belonging to Borrelia burgdorferi sensu lato complex and transmitted by the most important tick species in France, Ixodes ricinus. However, the diagnosis of Lyme disease is not always confirmed and unexplained syndromes occurring after tick bites have become an important issue. Recently, B. miyamotoi belonging to the relapsing fever group and transmitted by the same Ixodes species has been involved in human disease in Russia, the USA and the Netherlands. In the present study, we investigate the presence of B. miyamotoi along with other Lyme Borreliosis spirochetes, in ticks and possible animal reservoirs collected in France. We analyzed 268 ticks (Ixodes ricinus) and 72 bank voles (Myodes glareolus) collected and trapped in France for the presence of DNA from B. miyamotoi as well as from Lyme spirochetes using q-PCR and specific primers and probes. We then compared the French genotypes with those found in other European countries. We found that 3% of ticks and 5.55% of bank voles were found infected by the same B. miyamotoi genotype, while co-infection with other Lyme spirochetes (B. garinii) was identified in 12% of B. miyamotoi infected ticks. Sequencing showed that ticks and rodents carried the same genotype as those recently characterized in a sick person in the Netherlands. The genotype of B. miyamotoi circulating in ticks and bank voles in France is identical to those already described in ticks from Western Europe and to the genotype isolated from a sick person in The Netherlands. This results suggests that even though no human cases have been reported in France, surveillance has to be improved. Moreover, we showed that ticks could simultaneously carry B. miyamotoi and Lyme disease spirochetes, increasing the problem of co-infection in humans.

Serological studies on the infection of dogs in Ontario with Borrelia burgdorferi, the etiological agent of Lyme disease

OpenAIRE

Artsob, Harvey; Barker, Ian K.; Fister, Richard; Sephton, Gregory; Dick, Daryl; Lynch, John A.; Key, Doug

1993-01-01

A serological study was undertaken to determine whether dogs in Ontario are being exposed to Borrelia burgdorferi, the etiological agent of Lyme disease. This study consisted of a survey of randomly selected dogs and testing of diagnostic submissions from candidate Lyme disease cases. The survey of 1,095 dogs, bled between January 1988 and August 1989, revealed a total of 65 (5.9%) enzyme-linked immunosorbent assay (ELISA) reactors, of which 22 had immuno-fluorescent antibody assay (IFA) tite...

Lignée de Soja MON87708 Tolérant Au Dicamba

OpenAIRE

Canada, Publié par la Direction des aliments de Santé

2014-01-01

Santé Canada a avisé Monsanto Canada Inc. qu’il ne s’oppose pas à la vente d’aliments dérivés du soja MON87708 tolérant au Dicamba. Le Ministère a réalisé une évaluation approfondie de cette lignée de soja, conformément aux Lignes directrices sur l’évaluation de l’innocuité des aliments nouveaux. Ces lignes directrices sont fondées sur des principes admis internationalement pour l’établissement de l’innocuité des aliments à caractères nouveaux....

Evaluating the utility of companion animal tick surveillance practices for monitoring spread and occurrence of human Lyme disease in West Virginia, 2014-2016

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Brian Hendricks

2017-11-01

Full Text Available Domestic dogs and cats are potentially effective sentinel populations for monitoring occurrence and spread of Lyme disease. Few studies have evaluated the public health utility of sentinel programmes using geo-analytic approaches. Confirmed Lyme disease cases diagnosed by physicians and ticks submitted by veterinarians to the West Virginia State Health Department were obtained for 2014-2016. Ticks were identified to species, and only Ixodes scapularis were incorporated in the analysis. Separate ordinary least squares (OLS and spatial lag regression models were conducted to estimate the association between average numbers of Ix. scapularis collected on pets and human Lyme disease incidence. Regression residuals were visualised using Local Moran’s I as a diagnostic tool to identify spatial dependence. Statistically significant associations were identified between average numbers of Ix. scapularis collected from dogs and human Lyme disease in the OLS (β=20.7, P<0.001 and spatial lag (β=12.0, P=0.002 regression. No significant associations were identified for cats in either regression model. Statistically significant (P≤0.05 spatial dependence was identified in all regression models. Local Moran’s I maps produced for spatial lag regression residuals indicated a decrease in model over- and under-estimation, but identified a higher number of statistically significant outliers than OLS regression. Results support previous conclusions that dogs are effective sentinel populations for monitoring risk of human exposure to Lyme disease. Findings reinforce the utility of spatial analysis of surveillance data, and highlight West Virginia’s unique position within the eastern United States in regards to Lyme disease occurrence.

Características clínico-epidemiológicas da doença Lyme-símile em crianças Epidemiological characteristics of Lyme-like disease in children

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Saulo Duarte Passos

2009-01-01

Full Text Available OBJETIVO: Determinar a prevalência, distribuição etária, sazonalidade, características clínicas da doença Lyme-símile em menores de 15 anos. MÉTODOS: De julho/1998 a dezembro/2000 foi conduzido um estudo transversal em 333 pacientes, com exantema e febre. Foram coletadas amostras pareadas de sangue para a identificação de patógenos. Somente em 193 amostras, negativas aos outros patógenos (Parvovirus B19, Herpesvírus 6 humano, Sarampo, Rubéola, Dengue, Escarlatina e Enterovírus, foram realizadas a pesquisa da borreliose pelos métodos de Enzyme-Linked Immunosorbent Assay e Western-blotting. Outras variáveis clínicas, socioeconômicas, demográficas e climáticas foram estudadas. RESULTADOS: A prevalência da doença foi de 6,2%(12/193. Das variáveis estudadas, houve predomínio em BACKGROUND: To determine the prevalence, age distribution, seasonality and clinical characteristics of Lyme-simile disease in Brazilians less than 15 years of age. METHODS. From July, 1998 to November, 2000, a cross-sectional study was conducted in 333 patients with skin rash and fever. Paired blood samples were collected for identification of the pathogens. Only 193 samples which were negative for other pathogens (Parvovirus B19 Human, Herpesvirus 6 Human, Measles, Rubella, Dengue, Scarlet fever and Enterovirus, were tested for borreliosis by Enzyme-Linked Immunosorbent Assay and Western-blotting. Other clinical, socioeconomic, demographic and climatic variables were studied. RESULTS: Prevalence of the disease was 6.2%(12/193. Of the variables studied, there was predominance in: <6 years old (83.2%; females (66.7%; being from the city of Franco da Rocha (58.3 %; and a summer/fall seasonality. The duration of care was 4 days. Signs and symptoms with statistical significance were itching; absence of lip notch and ocular pain; irritability and good clinical condition. Other clinical data presented were: pruritus (90%, irritability (80% and fever (?38º

The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research.

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Lisa A Waddell

Full Text Available There has been an increasing incidence of Lyme disease (LD in Canada and the United States corresponding to the expanding range of the Ixodes tick vector and Lyme disease agent (Borrelia burgdorferi sensu stricto. There are many diagnostic tests for LD available in North America, all of which have some performance issues, and physicians are concerned about the appropriate use and interpretation of these tests. The objective of this systematic review is to summarize the North American evidence on the accuracy of diagnostic tests and test regimes at various stages of LD. Included in the review are 48 studies on diagnostic tests used in North America published since 1995. Thirteen studies examined a two-tier serological test protocol vs. clinical diagnosis, 24 studies examined single assays vs. clinical diagnosis, 9 studies examined single immunoblot vs. clinical diagnosis, 7 studies compared culture or PCR direct detection methods vs. clinical diagnosis, 22 studies compared two or more tests with each other and 8 studies compared a two-tiered serological test protocol to another test. Recent studies examining the sensitivity and specificity of various test protocols noted that the Immunetics® C6 B. burgdorferi ELISA™ and the two tier approach have superior specificity compared to proposed replacements, and the CDC recommended western blot algorithm has equivalent or superior specificity over other proposed test algorithms. There is a dramatic increase in test sensitivity with progression of B. burgdorferi infection from early to late LD. Direct detection methods, culture and PCR of tissue or blood samples were not as sensitive or timely compared to serological testing. It was also noted that there are a large number of both commercial (n = 42 and in-house developed tests used by private laboratories which have not been evaluated in the primary literature.

The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research

Science.gov (United States)

Lindsay, Robbin; Ogden, Nicholas

2016-01-01

There has been an increasing incidence of Lyme disease (LD) in Canada and the United States corresponding to the expanding range of the Ixodes tick vector and Lyme disease agent (Borrelia burgdorferi sensu stricto). There are many diagnostic tests for LD available in North America, all of which have some performance issues, and physicians are concerned about the appropriate use and interpretation of these tests. The objective of this systematic review is to summarize the North American evidence on the accuracy of diagnostic tests and test regimes at various stages of LD. Included in the review are 48 studies on diagnostic tests used in North America published since 1995. Thirteen studies examined a two-tier serological test protocol vs. clinical diagnosis, 24 studies examined single assays vs. clinical diagnosis, 9 studies examined single immunoblot vs. clinical diagnosis, 7 studies compared culture or PCR direct detection methods vs. clinical diagnosis, 22 studies compared two or more tests with each other and 8 studies compared a two-tiered serological test protocol to another test. Recent studies examining the sensitivity and specificity of various test protocols noted that the Immunetics® C6 B. burgdorferi ELISA™ and the two tier approach have superior specificity compared to proposed replacements, and the CDC recommended western blot algorithm has equivalent or superior specificity over other proposed test algorithms. There is a dramatic increase in test sensitivity with progression of B. burgdorferi infection from early to late LD. Direct detection methods, culture and PCR of tissue or blood samples were not as sensitive or timely compared to serological testing. It was also noted that there are a large number of both commercial (n = 42) and in-house developed tests used by private laboratories which have not been evaluated in the primary literature. PMID:28002488

Spatial Analysis of Environmental Factors Related to Lyme Disease in Alabama by Means of NASA Earth Observation Systems

Science.gov (United States)

Renneboog, Nathan; Capilouto, Emily G.; Firsing, Stephen L., III; Levy, Kyle; McAllister, Marilyn; Roa, Kathryn; Setia,Shveta; Xie, Lili; Burnett, Donna; Luvall, Jeffrey C.

2009-01-01

This slide presentation reviews the epidemiology of Lyme Disease that accounts for more than 95% or vector borne diseases in the United States. The history, symptoms and the life cycle of the tick, the transmitting agent of Lyme Disease, a map that shows the cases reported to the CDC between1990 and 2006 and the number of cases in Alabama by year from 1986 to 2007. A NASA project is described, the goals of which are to (1) Demonstrate the presence of the chain of infection of Lyme disease in Alabama (2) Identify areas with environmental factors that support tick population using NASA Earth Observation Systems data in selected areas of Alabama and (3) Increase community awareness of Lyme disease and recommend primary and secondary prevention strategies. The remote sensing methods included: Analyzed Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) and DigitalGlobe Quickbird satellite imagery from summer months and Performed image analyses in ER Mapper 7.1. Views from the ASTER and Quickbird land cover are shown, the Normalized Difference Vegetation Index (NDVI) algorithm was applied to all ASTER and Quickbird imagery. The use of the images to obtain the level of soil moisture is reviewed, and this analysis was used along with the NDVI, was used to identify the areas that support the tick population.

Predictive value of Borrelia burgdorferi IgG antibody levels in patients referred to a tertiary Lyme centre.

Science.gov (United States)

Zwerink, M; Zomer, T P; van Kooten, B; Blaauw, G; van Bemmel, T; van Hees, B C; Vermeeren, Y M; Landman, G W

2018-03-01

A two-step testing strategy is recommended in serological testing for Lyme borreliosis; positive and indeterminate enzyme-linked immunosorbent assay (ELISA) results are confirmed with immunoblots. Several ELISAs quantify the concentration of antibodies tested, however, no recommendation exists for an upper cut-off value at which an IgG ELISA is sufficient and the immunoblot can be omitted. The study objective was to determine at which IgG antibody level an immunoblot does not have any additional predictive value compared to ELISA results. Data of adult patients who visited a tertiary Lyme centre between 2008 and 2014 were analysed. Both an ELISA (Enzygnost Lyme link VlsE IgG) and immunoblot (recomLine blot Borrelia) were performed. Clinical data were extracted from the patient's digital medical record. Positive predictive values (PPVs) for either previous or active infection with Borrelia burgdorferi s.l. were calculated for different cut-off ELISA IgG antibody levels where the immunoblot was regarded as reference test. In total, 1454 patients were included. According to the two-step test strategy, 486 (33%), 69 (5%) and 899 (62%) patients had positive, indeterminate and negative Borrelia IgG serology, respectively. At IgG levels of 500 IU/ml and higher, all immunoblots were positive, resulting in a 100% PPV (95% CI: 97.0-100). At IgG levels of 200 IU/ml and higher, the PPV was 99.3% (95% CI: 97.4-99.8). In conclusion, at IgG levels of 200 IU/ml and higher, an ELISA was sufficient to detect antibodies to Borrelia burgdorferi s.l. At those IgG levels, a confirmatory immunoblot may be omitted in patients referred to a tertiary Lyme centre. Before these results can be implemented in routine diagnosis of Lyme borreliosis, confirmation of the results is necessary in other patient populations and using other quantitative ELISAs and immunoblots. Copyright © 2017 Elsevier GmbH. All rights reserved.

Incidence du cancer au Canada : tendances et projections (1983-2032)

OpenAIRE

Lin Xie; Robert Semenciw; Les Mery

2015-01-01

Dans cette monographie, nous présentons, pour 1983 à 2032, un historique et des projections du nombre de nouveaux cas et des taux d'incidence du cancer pour le Canada, à l'exception des cancers de la peau autres que le mélanome (c.-à -d. les carcinomes basocellulaire et spinocellulaire). Ces renseignements visent à faciliter la planification stratégique et l'affectation de ressources et d'infrastructures pour assurer la prestation future de soins de santé et de mesures de lutte contre le canc...

Cerebrospinal Fluid B-lymphocyte Chemoattractant CXCL13 in the Diagnosis of Acute Lyme Neuroborreliosis in Children.

Science.gov (United States)

Barstad, Bjørn; Tveitnes, Dag; Noraas, Sølvi; Selvik Ask, Ingvild; Saeed, Maryam; Bosse, Franziskus; Vigemyr, Grete; Huber, Ilka; Øymar, Knut

2017-12-01

Current markers of Lyme neuroborreliosis (LNB) in children have insufficient sensitivity in the early stage of disease. The B-lymphocyte chemoattractant CXCL13 in the cerebrospinal fluid (CSF) may be useful in diagnosing LNB, but its specificity has not been evaluated in studies including children with clinically relevant differential diagnoses. The aim of this study was to elucidate the diagnostic value of CSF CXCL13 in children with symptoms suggestive of LNB. Children with symptoms suggestive of LNB were included prospectively into predefined groups with a high or low likelihood of LNB based on CSF pleocytosis and the detection of Borrelia antibodies or other causative agents. CSF CXCL13 levels were compared between the groups, and receiver-operating characteristic analyses were performed to indicate optimal cutoff levels to discriminate LNB from non-LNB conditions. Two hundred and ten children were included. Children with confirmed LNB (n=59) and probable LNB (n=18) had higher CSF CXCL13 levels than children with possible LNB (n=7), possible peripheral LNB (n=7), non-Lyme aseptic meningitis (n=12), non-meningitis (n=91) and negative controls (n=16). Using 18 pg/mL as a cutoff level, both the sensitivity and specificity of CSF CXCL13 for LNB (confirmed and probable) were 97%. Comparing only children with LNB and non-Lyme aseptic meningitis, the sensitivity and specificity with the same cutoff level were 97% and 83%, respectively. CSF CXCL13 is a sensitive marker of LNB in children. The specificity to discriminate LNB from non-Lyme aseptic meningitis may be more moderate, suggesting that CSF CXCL13 should be used together with other variables in diagnosing LNB in children.

Meteorological Influences on the Seasonality of Lyme Disease in the United States

Science.gov (United States)

Moore, Sean M.; Eisen, Rebecca J.; Monaghan, Andrew; Mead, Paul

2014-01-01

Lyme disease (Borrelia burgdorferi infection) is the most common vector-transmitted disease in the United States. The majority of human Lyme disease (LD) cases occur in the summer months, but the timing of the peak occurrence varies geographically and from year to year. We calculated the beginning, peak, end, and duration of the main LD season in 12 highly endemic states from 1992 to 2007 and then examined the association between the timing of these seasonal variables and several meteorological variables. An earlier beginning to the LD season was positively associated with higher cumulative growing degree days through Week 20, lower cumulative precipitation, a lower saturation deficit, and proximity to the Atlantic coast. The timing of the peak and duration of the LD season were also associated with cumulative growing degree days, saturation deficit, and cumulative precipitation, but no meteorological predictors adequately explained the timing of the end of the LD season. PMID:24470565

Spirochete della malattia di Lyme nelle zecche raccolte in uno studio di campo nell’Italia centrale (Regione Marche

Directory of Open Access Journals (Sweden)

Ilaria Pascucci

2010-06-01

Full Text Available La malattia di Lyme è la più diffusa malattia trasmessa da zecche in Italia. La provincia di Pesaro ed Urbino per le sue caratteristiche ecologiche può essere considerata area rischio per la patologia. Ciò nonostante, non sono ancora disponibili dati di campo per questa area, sebbene la malattia sia presente nei territori limitrofi. Al fine di indagare la presenza del ciclo della borreliosi di Lyme, è stato condotto, nell’area di interesse, uno studio di un anno durante il quale sono state raccolte zecche da cervidi selvatici, uomo e dall’ambiente, successivamente identificate e analizzate mediante PCR. Le zecche appartenenti alla specie Ixodes ricinus (la specie più frequente in tutte le raccolte sono state testate mediante tre diverse PCR per la ricerca di Borrelia burgdorferi s.l. Inoltre, per identificare le genospecie di Borrelia burgdorferi s.lcoinvolte, è stato amplificato e sequenziato un frammento della regione intergenica spaziatrice 5S-23S dell’ RNA ribosomiale. Il sequenziamento ha permesso di identificare due differenti genospecie: B. burgdorferi s.s. e B. lusitaniae, precedentemente coinvolte in casi umani di malattia di Lyme. Le informazioni riguardo le relazioni tra ospite, zecca e genospecie di B. burgdorferi s.l., confermando le notizie già presenti in letteratura per il bacino del Mediterraneo, mostrano come nell’area di interesse siano presenti le condizioni favorevoli allo sviluppo del ciclo della borreliosi di Lyme.

Detection of IFN-γ Secretion by T Cells Collected Before and After Successful Treatment of Early Lyme Disease.

Science.gov (United States)

Callister, Steven M; Jobe, Dean A; Stuparic-Stancic, Aleksandra; Miyamasu, Misato; Boyle, Jeff; Dattwyler, Raymond J; Arnaboldi, Paul M

2016-05-15

Current serodiagnostics for Lyme disease lack sensitivity during early disease, and cannot determine treatment response. We evaluated an assay based on QuantiFERON technology utilizing peptide antigens derived from Borrelia burgdorferi to stimulate interferon-gamma (IFN-γ) release as an alternative to serodiagnosis for the laboratory detection of Lyme disease. Blood was obtained from patients with erythema migrans before (n = 29) and 2 months after (n = 27) antibiotic therapy. IFN-γ release was measured by enzyme-linked immunosorbent assay (ELISA) following overnight stimulation of whole blood with the peptide antigens, and compared to the results of standard serological assays (C6, ELISA, and Western blot). IFN-γ release was observed in pretreatment blood of 20 of 29 (69%) patients with Lyme disease. Following antibiotic treatment, IFN-γ was significantly reduced (P = .0002), and was detectable in only 4 of 20 (20%) initially positive patients. By contrast, anti-C6 antibodies were detected in pretreatment sera from 17 of 29 (59%) subjects, whereas only 5 of 29 (17%) patients had positive Western blot seroreactivity. Antibody responses persisted and expanded following treatment. Our findings suggest that measurement of IFN-γ after incubating blood with Borrelia antigens could be useful in the laboratory diagnosis of early Lyme disease. Also, after antibiotic treatment, this response appears to be short lived. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

Lyme Disease: A Sourcebook for Teaching about a Major Environmental Problem.

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Anderson, Norman D.; Stubbs, Harriett S.

This book and others in the Changes in the Environment Series were produced as part of the GLOBE-NET Project, a partnership of science teachers and research scientists working on various aspects of global change. This book contains up-to-date information about Lyme disease, activities for the classroom, and other resources useful in teaching about…

Magnetic susceptibilities of liquid Cr-Au, Mn-Au and Fe-Au alloys

Energy Technology Data Exchange (ETDEWEB)

Ohno, S.; Shimakura, H. [Niigata University of Pharmacy and Applied Life Sciences, Higashijima, Akiha-ku, Niigata 956-8603 (Japan); Tahara, S. [Faculty of Science, University of the Ryukyus, Nishihara-cho, Okinawa 903-0213 (Japan); Okada, T. [Niigata College of Technology, Kamishin’eicho, Nishi-ku, Niigata 950-2076 (Japan)

2015-08-17

The magnetic susceptibility of liquid Cr-Au, Mn-Au, Fe-Au and Cu-Au alloys was investigated as a function of temperature and composition. Liquid Cr{sub 1-c}Au{sub c} with 0.5 ≤ c and Mn{sub 1-c}Au{sub c} with 0.3≤c obeyed the Curie-Weiss law with regard to their dependence of χ on temperature. The magnetic susceptibilities of liquid Fe-Au alloys also exhibited Curie-Weiss behavior with a reasonable value for the effective number of Bohr magneton. On the Au-rich side, the composition dependence of χ for liquid TM-Au (TM=Cr, Mn, Fe) alloys increased rapidly with increasing TM content, respectively. Additionally, the composition dependences of χ for liquid Cr-Au, Mn-Au, and Fe-Au alloys had maxima at compositions of 50 at% Cr, 70 at% Mn, and 85 at% Fe, respectively. We compared the composition dependences of χ{sub 3d} due to 3d electrons for liquid binary TM-M (M=Au, Al, Si, Sb), and investigated the relationship between χ{sub 3d} and E{sub F} in liquid binary TM-M alloys at a composition of 50 at% TM.

Change in Reported Lyme Disease Incidence in the Northeast and Upper Midwest, 1991-2014

Data.gov (United States)

U.S. Environmental Protection Agency — This indicator shows how reported Lyme disease incidence has changed by state since 1991, based on the number of new cases per 100,000 people. The total change has...

A COMPARISON OF ANALYSIS UNITS FOR ASSOCIATING LYME DISEASE WITH FOREST-EDGE HABITAT

Science.gov (United States)

This study assessed the relationship between land-cover pattern and Lyme disease incidence rate when modeled under three designs for data aggregation. Incidence rates were calculated from passive surveillance data reported in 12 Maryland counties during 1996 – 2000. A design usin...

Interactions of phagocytes with the Lyme disease spirochete: role of the Fc receptor

International Nuclear Information System (INIS)

Benach, J.L.; Fleit, H.B.; Habicht, G.S.; Coleman, J.L.; Bosler, E.M.; Lane, B.P.

1984-01-01

The phagocytic capacity of murine and human mononuclear and polymorphonuclear phagocytes (including peripheral blood monocytes and neutrophils), rabbit and murine peritoneal exudate cells, and the murine macrophage cell line P388D1 against the Lyme disease spirochete was studied. All of these cells were capable of phagocytosing the spirochete; phagocytosis was measured by the uptake of radiolabeled spirochetes, the appearance of immunofluorescent bodies in phagocytic cells, and electron microscopy. Both opsonized and nonopsonized organisms were phagocytosed. The uptake of opsonized organisms by neutrophils was blocked by a monoclonal antibody specific for the Fc receptor and by immune complexes; these findings suggested that most phagocytosis is mediated by the Fc receptor. Similarly, the uptake of opsonized organisms by human monocytes was inhibited by human monomeric IgG1 and by immune complexes. These results illustrate the role of immune phagocytosis of spirochetes in host defense against Lyme disease

Pratiques de publicité au point de vente dans l'industrie du tabac ...

International Development Research Centre (IDRC) Digital Library (Canada)

Des études menées dans des pays comme le Canada démontrent que la publicité au point de vente exerce une influence importante sur les écoliers et peut les prédisposer à devenir fumeurs. De plus, les ... Articles de revue. Tobacco point-of-sale advertising in Guatemala city, Guatemala and Buenos Aires, Argentina.

The effectiveness of permethrin-treated deer stations for control of the Lyme disease vector Ixodes scapularis on Cape Cod and the islands: a five year experiment

Science.gov (United States)

The use of animal host-targeted pesticide application to control blacklegged ticks, which transmit the Lyme disease bacterium between wildlife hosts and humans, is receiving increased attention as an approach to Lyme disease risk management. Included among the attractive features...

Enquête sur les personnes ayant une maladie chronique au Canada – Composante des troubles de l’humeur et d’anxiété, 2014 : aperçu de la méthodologie

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S. O’Donnell

2016-01-01

Full Text Available Introduction : Il existe peu de données à propos des répercussions des troubles de l’humeur et d’anxiété sur les Canadiens et sur la gestion de ces troubles. L’Enquête sur les personnes ayant une maladie chronique au Canada – Composante des troubles de l’humeur et d’anxiété (EPMCC-THA de 2014 a été élaborée pour combler les lacunes à ce chapitre. Le but du présent article est de décrire la méthodologie de l’EPMCC-THA de 2014 et de présenter les caractéristiques sociodémographiques de l’échantillon final. Méthodologie : L’EPMCC-THA de 2014 est une enquête transversale de suivi menée auprès de Canadiens des 10 provinces âgés de 18 ans et plus qui souffrent d’un trouble de l’humeur ou d’anxiété diagnostiqué par un professionnel de la santé et dont on s'attend à ce qu'il dure (ou durant depuis déjà six mois ou plus. L’enquête a été élaborée par l’Agence de la santé publique du Canada (ASPC au moyen d’un processus itératif et consultatif avec Statistique Canada et des experts externes. Statistique Canada a mis à l’essai le contenu, a conçu la base et les stratégies d’échantillonnage et a recueilli et traité les données. L’ASPC a procédé à des analyses descriptives pour déterminer les caractéristiques sociodémographiques des répondants, a produit des estimations représentatives à l’échelle nationale à l’aide des coefficients de pondération fournis par Statistique Canada et a produit des estimations de la variance à l’aide de la méthode bootstrap. Résultats : L’échantillon final de l’EPMCC-THA de 2014 était constitué de 3 361 répondants (taux de réponse de 68,9 %. Parmi ceux qui vivaient avec un trouble de l'humeur ou d'anxiété, près des deux tiers (64 % étaient des femmes, plus de la moitié (56 % étaient mariés ou vivaient en union libre et 60 % avaient obtenu un diplôme d’études postsecondaires. La plupart étaient jeunes ou d�

Faire la chose « la plus sensée » pour le Canada et pour le monde ...

International Development Research Centre (IDRC) Digital Library (Canada)

18 déc. 2014 ... Je faisais partie de la délégation qui a accompagné dernièrement le gouverneur général du Canada, Son Excellence le très honorable David Johnston, et Son Excellence Sharon Johnston au ... Il avait ensuite a déclaré que ce que le CRDI a fait au Chili, c'est qu'il a permis aux idées de continuer de vivre.

Time trend of clinical cases of Lyme disease in two hospitals in Belgium, 2000-2013.

Science.gov (United States)

De Keukeleire, Mathilde; Vanwambeke, Sophie O; Kabamba, Benoît; Belkhir, Leila; Pierre, Philippe; Luyasu, Victor; Robert, Annie

2017-12-05

As several studies indicated an increase in Lyme disease (LD), notably in neighbouring countries, concerns have arisen regarding the evolution of Lyme disease in Belgium. In order to confirm or infirm the increase of LD in Belgium, we focused on hospital admissions of patients diagnosed with LD between 2000 and 2013 based on hospital admission databases from two hospitals in Belgium. Hospital databases are a stable recording system. We did a retrospective analysis of the medical files of patients hospitalized with Lyme disease in two Belgian hospitals between 2000 and 2013. The annual number of cases of LD for the two studied Belgian hospitals remained stable between 2000 and 2013, ranging from 1 for the Cliniques universitaires Saint-Luc to 15 for the the Clinique Saint-Pierre. No increasing trend were noted in the estimated annual incidence rate but the average estimated annual incidence rate was higher for the hospital Saint-Pierre (8.1 ± 3.7 per 100,000 inhabitants) than Saint-Luc (2.2 ± 1.5 per 100,000 inhabitants). The number of hospital cases of LD peaked between June and November. Based on hospital admissions with LD, no increasing trend was observed for the period 2000-2013 in the two studied Belgian hospitals. This is in line with other studies carried out in Belgium.

Investigating Alternatives to Broad-Scale Pesticide Spraying for Control of Lyme Disease Risk

Science.gov (United States)

More than 20,000 cases of Lyme disease are reported annually in the US. Here in the Northeast, the geographic range of the disease and infection rates continue to increase. Beginning this summer, scientists from EPA Region 1 (Robert Koethe, Bart Hoskins) and ORD (Jason Grear) w...

Celebrity over science? An analysis of Lyme disease video content on YouTube.

Science.gov (United States)

Yiannakoulias, N; Tooby, R; Sturrock, S L

2017-10-01

Lyme disease has been a subject of medical controversy for several decades. In this study we looked at the availability and type of content represented in a (n = 700) selection of YouTube videos on the subject of Lyme disease. We classified video content into a small number of content areas, and studied the relationship between these content areas and 1) video views and 2) video likeability. We found very little content uploaded by government or academic institutions; the vast majority of content was uploaded by independent users. The most viewed videos tend to contain celebrity content and personal stories; videos with prevention information tend to be of less interest, and videos with science and medical information tend to be less liked. Our results suggest that important public health information on YouTube is very likely to be ignored unless it is made more appealing to modern consumers of online video content. Copyright © 2017 Elsevier Ltd. All rights reserved.

A case of chronic progressive Lyme encephalitis as a manifestation of late Lyme neuroborreliosis

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Vivek Verma

2014-12-01

Full Text Available A 54-year-old female living in Europe presented with gait ataxia, dizziness, and bilateral hearing loss. Magnetic resonance imaging (MRI revealed non-specific white matter changes. The patient’s condition gradually deteriorated over two years without diagnosis. The patient continued to decline cognitively and neurologically with worsening ataxia and upper motor neuron signs. Repeat MRI showed worsening white matter changes. Lumbar puncture, not previously done, showed positive Lyme testing. Treatment with intravenous ceftriaxone resulted in marked neurological improvement. Four years after symptom, the patient has short-term memory deficits and chronic fatigue, but is otherwise neurologically, cognitively, and functionally intact. Follow up MRI findings remain largely unchanged. Because cases of intraparenchymal or encephalopathic neuroborreliosis in America are lacking, so are treatment options. We present a rare case and discuss our experience with antibiotic treatment. This case lends evidence to define optimal treatment of this disease, imperative for hastening neurological recovery.

Population dynamics of Borrelia burgdorferi in Lyme disease

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Sebastian Christoph Binder

2012-03-01

Full Text Available Many chronic inflammatory diseases are known to be caused by persistent bacterial or viral infections. A well-studied example is the tick-borne infection by the gram-negative Spirochaetes of the genus Borrelia in humans and other mammals, causing severe symptoms of chronic inflammation and subsequent tissue damage (Lyme Disease, particularly in large joints and the central nervous system, but also in the heart and other tissues of untreated patients. Although killed efficiently by human phagocytic cells in vitro, Borrelia exhibits a remarkably high infectivity in mice and men. In experimentally infected mice, the first immune response almost clears the infection. However, approximately one week post infection, the bacterial population recovers and reaches an even larger size before entering the chronic phase. We developed a mathematical model describing the bacterial growth and the immune response against Borrelia burgdorferi in the C3H mouse strain that has been established as an experimental model for Lyme disease. The peculiar dynamics of the infection exclude two possible mechanistic explanations for the regrowth of the almost cleared bacteria. Neither the hypothesis of bacterial dissemination to different tissue nor a limitation of phagocytic capacity were compatible with experiment. The mathematical model predicts that Borrelia recovers from the strong initial immune response by the regrowth of an immune-resistant sub-population of the bacteria. The chronic phase appears as an equilibration of bacterial growth and adaptive immunity. This result has major implications for the development of the chronic phase of Borrelia infections as well as on potential protective clinical interventions.

A nonlocal spatial model for Lyme disease

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Yu, Xiao; Zhao, Xiao-Qiang

2016-07-01

This paper is devoted to the study of a nonlocal and time-delayed reaction-diffusion model for Lyme disease with a spatially heterogeneous structure. In the case of a bounded domain, we first prove the existence of the positive steady state and a threshold type result for the disease-free system, and then establish the global dynamics for the model system in terms of the basic reproduction number. In the case of an unbound domain, we obtain the existence of the disease spreading speed and its coincidence with the minimal wave speed. At last, we use numerical simulations to verify our analytic results and investigate the influence of model parameters and spatial heterogeneity on the disease infection risk.

Critical Evaluation of the Linkage Between Tick-Based Risk Measures and the Occurrence of Lyme Disease Cases

Science.gov (United States)

Eisen, Lars; Eisen, Rebecca J.

2018-01-01

The nymphal stage of the blacklegged tick, Ixodes scapularis Say, is considered the primary vector to humans in the eastern United States of the Lyme disease spirochete Borrelia burgdorferi sensu stricto. The abundance of infected host-seeking nymphs is commonly used to estimate the fundamental risk of human exposure to B. burgdorferi, for the purpose of environmental risk assessment and as an outcome measure when evaluating environmentally based tick or pathogen control methods. However, as this tick-based risk measure does not consider the likelihoods of either human encounters with infected ticks or tick bites resulting in pathogen transmission, its linkage to the occurrence of Lyme disease cases is worth evaluating. In this Forum article, we describe different tick-based risk measures, discuss their strengths and weaknesses, and review the evidence for their capacity to predict the occurrence of Lyme disease cases. We conclude that: 1) the linkage between abundance of host-seeking B. burgdorferi-infected nymphs and Lyme disease occurrence is strong at community or county scales but weak at the fine spatial scale of residential properties where most human exposures to infected nymphs occur in Northeast, 2) the combined use of risk measures based on infected nymphs collected from the environment and ticks collected from humans is preferable to either one of these risk measures used singly when assessing the efficacy of environmentally based tick or pathogen control methods aiming to reduce the risk of human exposure to B. burgdorferi, 3) there is a need for improved risk assessment methodology for residential properties that accounts for both the abundance of infected nymphs and the likelihood of human–tick contact, and 4) we need to better understand how specific human activities conducted in defined residential microhabitats relate to risk for nymphal exposures and bites. PMID:27330093

L'intermédialité au Portugal: bilan des rencontres scientifiques à l'ISMAI

OpenAIRE

Vieira, Célia; Rio Novo, Isabel

2015-01-01

Dans cet article nous nous proposons de dresser un bilan des apports critiques sur l’intermédialité issus des rencontres scientifiques que nous avons organisées, à l’Institut Universitaire de Maia (ISMAI), au Portugal. Lors de la première édition du Colloque International en Études d’Intermédialité, en 2009, le concept d’intermédialité avait déjà fait l’objet d’une réflexion systématique au Canada, surtout dans le contexte du CRI (Centre de Recherche sur l’Intermédialité), alors qu’il était, ...

Collection and Characterization of Samples for Establishment of a Serum Repository for Lyme Disease Diagnostic Test Development and Evaluation

Science.gov (United States)

Molins, Claudia R.; Sexton, Christopher; Young, John W.; Ashton, Laura V.; Pappert, Ryan; Beard, Charles B.

2014-01-01

Serological assays and a two-tiered test algorithm are recommended for laboratory confirmation of Lyme disease. In the United States, the sensitivity of two-tiered testing using commercially available serology-based assays is dependent on the stage of infection and ranges from 30% in the early localized disease stage to near 100% in late-stage disease. Other variables, including subjectivity in reading Western blots, compliance with two-tiered recommendations, use of different first- and second-tier test combinations, and use of different test samples, all contribute to variation in two-tiered test performance. The availability and use of sample sets from well-characterized Lyme disease patients and controls are needed to better assess the performance of existing tests and for development of improved assays. To address this need, the Centers for Disease Control and Prevention and the National Institutes of Health prospectively collected sera from patients at all stages of Lyme disease, as well as healthy donors and patients with look-alike diseases. Patients and healthy controls were recruited using strict inclusion and exclusion criteria. Samples from all included patients were retrospectively characterized by two-tiered testing. The results from two-tiered testing corroborated the need for novel and improved diagnostics, particularly for laboratory diagnosis of earlier stages of infection. Furthermore, the two-tiered results provide a baseline with samples from well-characterized patients that can be used in comparing the sensitivity and specificity of novel diagnostics. Panels of sera and accompanying clinical and laboratory testing results are now available to Lyme disease serological test users and researchers developing novel tests. PMID:25122862

Home leaving trajectories in Canada: exploring cultural and gendered dimensions

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Mitchell, Barbara A.

2003-01-01

Full Text Available EnglishIn this exploratory study, we profile variations in home leaving, homereturning,and home staying behaviour among four ethnocultural groups in Canada -British, Chinese, Indian, and South European. Data collected in a 1999-2000survey of 1,907 young adults (ages 19-35 residing in the Vancouver area areused. Our principal foci are ethnocultural and gendered aspects of home leavingtrajectories, specifically: ages at home leaving and returning, and reasons forhome leaving, home returning and home staying. Special attention is paid toreturners/boomerangers, given an increasing overall trend in home returning inCanada. We find that: (a both ethnocultural origin and gender are importantdeterminants of home leaving trajectory, (b there is a distinct (but far from tidydifference between European-origin and Asian-origin groups in home leavingtrajectory, (c British-Canadians leave home at the youngest ages and Indo-Canadians at the oldest ages, (d the main reason for home leaving isindependence for British-Canadians; schooling for Chinese-Canadians, andmarriage for Indo-Canadians, (e among all four groups, home returners leavehome initially at younger ages and, with the exception of Indo-Canadian youngmen, who typically leave home for school, and (f gender differences in homeleaving trajectory are larger among the Chinese and Indo-Canadians than amongpersons of European origins. Overall, we conclude that the theorized trend of theindividualized family life course holds for only some ethnocultural groups inCanada. We conclude with suggestions for future research directions on thetopic of ethnicity and the home leaving life course transitions.FrenchDans cette étude préliminaire, nous donnons le profil de plusieurscomportements relatifs au fait de quitter la maison, d’y retourner et d’y rester dequatre groupes ethnoculturels au Canada, notamment les Britanniques, lesChinois, les Indiens et les ressortissants du sud de l’Europe. On s’est servi

Improving national surveillance of Lyme neuroborreliosis in Denmark through electronic reporting of specific antibody index testing from 2010 to 2012

DEFF Research Database (Denmark)

Dessau, Ram Benny; Espenhain, L; Mølbak, K

2015-01-01

Our aim was to evaluate the results of automated surveillance of Lyme neuroborreliosis (LNB) in Denmark using the national microbiology database (MiBa), and to describe the epidemiology of laboratory-confirmed LNB at a national level. MiBa-based surveillance includes electronic transfer of labora......Our aim was to evaluate the results of automated surveillance of Lyme neuroborreliosis (LNB) in Denmark using the national microbiology database (MiBa), and to describe the epidemiology of laboratory-confirmed LNB at a national level. MiBa-based surveillance includes electronic transfer...

Emerging vector-borne diseases and environmental change : The rise of Lyme borreliosis in Western-Europe

NARCIS (Netherlands)

Huitema, Tim

2013-01-01

SUMMARY During the last decade several infectious diseases started to emerge in Western-Europe. At the same time numerous environmental factors were changing. One of the diseases that apparently emerged is Lyme borreliosis (LB). This thesis aims to incre

La guerrière colombienne à l'ordinateur portatif : la connectivité au ...

International Development Research Centre (IDRC) Digital Library (Canada)

3 févr. 2011 ... Dwight Dorey, chef miíkmaq de la Nouvelle-Écosse (Canada), considère qu'une meilleure connectivité ne menace pas l'identité culturelle, mais qu'elle représente au contraire une source d'avantages économiques, sociaux et spirituels. Le chef national du Congrès des peuples autochtones, qui défend les ...

Adaptation, mise à l'épreuve et évaluation d'interventions complexes en santé publique : leçons tirées du Nurse-Family Partnership dans le secteur de la santé publique au Canada

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S. M. Jack

2015-01-01

Full Text Available Introduction : Le Nurse-Family Partnership (NFP est un programme de visites à domicile destiné aux nouvelles jeunes mères défavorisées sur le plan socioéconomique. Les données issues de trois essais contrôlés randomisés (ECR américains ont solidement démontré l'efficacité des interventions quant à l'amélioration de l'issue de la grossesse, de la santé et du développement des enfants ainsi que de l'autonomie économique des mères. Cependant, l'efficacité du NFP dans le contexte canadien des services de santé et des services sociaux, qui diffère de celui des États-Unis, reste à déterminer. Cet article vise à décrire le processus complexe suivi pour adapter la recherche sur le NFP et mettre ainsi en œuvre ce programme au Canada. Méthodologie : L'évaluation menée au Canada se divise en trois étapes : 1 adaptation de l'intervention, 2 mise à l'épreuve de l'intervention dans des études de faisabilité et d'acceptabilité à petite échelle et 3 réalisation d'un ECR et d'une évaluation du processus dans le cadre de l'étude intitulée British Columbia Healthy Connections Project (BCHCP. Cette évaluation à grande échelle permettra d'enrichir la base de données probantes du NFP par la tenue d'une étude supplémentaire sur les mécanismes biologiques susceptibles de témoigner de la relation entre l'intervention et les effets sur le comportement des enfants. Résultats : L'adaptation de la documentation du NFP pour les visites à domicile est un processus continu. Un projet pilote a montré la faisabilité du recrutement des femmes admissibles au NFP. Il a aussi révélé qu'il était préférable au Canada que le NFP soit mis en œuvre par les organismes de santé publique et que les infirmières et infirmiers en santé publique (ISP s'occupent des interventions. Enfin, il a montré que ce programme intensif de visites à domicile a bénéficié d'une réception positive de la part des clientes, des membres de

Swimming Dynamics of the Lyme Disease Spirochete

Science.gov (United States)

Vig, Dhruv K.; Wolgemuth, Charles W.

2012-11-01

The Lyme disease spirochete, Borrelia burgdorferi, swims by undulating its cell body in the form of a traveling flat wave, a process driven by rotating internal flagella. We study B. burgdorferi’s swimming by treating the cell body and flagella as linearly elastic filaments. The dynamics of the cell are then determined from the balance between elastic and resistive forces and moments. We find that planar, traveling waves only exist when the flagella are effectively anchored at both ends of the bacterium and that these traveling flat waves rotate as they undulate. The model predicts how the undulation frequency is related to the torque from the flagellar motors and how the stiffness of the cell body and flagella affect the undulations and morphology.

The first case of imported Borrelia miyamotoi disease concurrent with Lyme disease.

Science.gov (United States)

Oda, Rentaro; Kutsuna, Satoshi; Sekikawa, Yoshiyuki; Hongo, Igen; Sato, Kozue; Ohnishi, Makoto; Kawabata, Hiroki

2017-05-01

Borrelia miyamotoi disease (BMD) is an emerging infectious disease caused by B. miyamotoi. Although BMD has been reported in the United States, Europe, and Japan, no case of imported BMD has been described in the world. Here, we report a 63-year-old American man living in Japan who presented with malaise, headache, myalgia, and arthralgia. We suspected Lyme disease because of his travel history to Minnesota and presence of erythema migrans. Serologic analysis supported our diagnosis, and doxycycline was administered for 14 days. However, we also suspected coinfection with BMD because of his fever, elevated liver function test results and his travel history. The patient was seropositive for the immunoglobulin M antibody to recombinant glycerophosphodiester phosphodiesterase, and was diagnosed with coinfection with BMD. This case suggests that BMD should be considered in febrile travelers returning from the Northeastern and Midwestern regions of the United States, and that BMD and Lyme disease coinfection should be considered to detect cases of imported BMD. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Direct Molecular Detection and Genotyping of Borrelia burgdorferi from Whole Blood of Patients with Early Lyme Disease

Science.gov (United States)

Eshoo, Mark W.; Crowder, Christopher C.; Rebman, Alison W.; Rounds, Megan A.; Matthews, Heather E.; Picuri, John M.; Soloski, Mark J.; Ecker, David J.; Schutzer, Steven E.; Aucott, John N.

2012-01-01

Direct molecular tests in blood for early Lyme disease can be insensitive due to low amount of circulating Borrelia burgdorferi DNA. To address this challenge, we have developed a sensitive strategy to both detect and genotype B. burgdorferi directly from whole blood collected during the initial patient visit. This strategy improved sensitivity by employing 1.25 mL of whole blood, a novel pre-enrichment of the entire specimen extract for Borrelia DNA prior to a multi-locus PCR and electrospray ionization mass spectrometry detection assay. We evaluated the assay on blood collected at the initial presentation from 21 endemic area patients who had both physician-diagnosed erythema migrans (EM) and positive two-tiered serology either at the initial visit or at a follow-up visit after three weeks of antibiotic therapy. Results of this DNA analysis showed detection of B. burgdorferi in 13 of 21 patients (62%). In most cases the new assay also provided the B. burgdorferi genotype. The combined results of our direct detection assay with initial physician visit serology resulted in the detection of early Lyme disease in 19 of 21 (90%) of patients at the initial visit. In 5 of 21 cases we demonstrate the ability to detect B. burgdorferi in early Lyme disease directly from whole blood specimens prior to seroconversion. PMID:22590620

Glycophospholipid Formulation with NADH and CoQ10 Significantly Reduces Intractable Fatigue in Western Blot-Positive ‘Chronic Lyme Disease’ Patients: Preliminary Report

Directory of Open Access Journals (Sweden)

Garth L. Nicolson

2012-03-01

Full Text Available Background: An open label 8-week preliminary study was conducted in a small number of patients to determine if a combination oral supplement containing a mixture of phosphoglycolipids, coenzyme Q10 and microencapsulated NADH and other nutrients could affect fatigue levels in long-term, Western blot-positive, multi-symptom ‘chronic Lyme disease’ patients (also called ‘post-treatment Lyme disease’ or ‘post Lyme syndrome’ with intractable fatigue. Methods: The subjects in this study were 6 males (mean age = 45.1 ± 12.4 years and 10 females (mean age = 54.6 ± 7.4 years with ‘chronic Lyme disease’ (determined by multiple symptoms and positive Western blot analysis that had been symptomatic with chronic fatigue for an average of 12.7 ± 6.6 years. They had been seen by multiple physicians (13.3 ± 7.6 and had used many other remedies, supplements and drugs (14.4 ± 7.4 without fatigue relief. Fatigue was monitored at 0, 7, 30 and 60 days using a validated instrument, the Piper Fatigue Scale.Results: Patients in this preliminary study responded to the combination test supplement, showing a 26% reduction in overall fatigue by the end of the 8-week trial (p< 0.0003. Analysis of subcategories of fatigue indicated that there were significant improvements in the ability to complete tasks and activities as well as significant improvements in mood and cognitive abilities. Regression analysis of the data indicated that reductions in fatigue were consistent and occurred with a high degree of confidence (R2= 0.998. Functional Foods in Health and Disease 2012, 2(3:35-47 Conclusions: The combination supplement was a safe and effective method to significantly reduce intractable fatigue in long-term patients with Western blot-positive ‘chronic Lyme disease.’

Risk of Lyme disease development after a tick bite

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Mladenović Jovan

2010-01-01

Full Text Available Background/Aim. Despite numerous research of Lyme disease (LD, there are still many concerns about environmental of infectious agent of LD, as well as its prophylaxis, diagnosis and treatment. The aim of this work was to determine the risk of LD in relation to the way of removing ticks and duration of tick attachment. Methods. In the period from 2000 to 2007 a prospective study was conducted including persons with tick bite referred to the Institute of Epidemiology, Military Medical Academy, and followed for the occurrence of early Lyme disease up to six months after a tick bite. Epidemiological questionnaire was used to collect relevant information about the place and time of tick bites, the way of a removing tick, duration of tick attachment, remnants of a tick left in the skin (parts of the mouth device and the signs of clinical manifestations of LD. Duration of tick attachment was determined on the basis of size of engorged tick and epidemiological data. Removed ticks were determined by the key of Pomerancev. Professional removing of attached tick was considered to be removing of tick with mechanical means by healthcare personnel. Fisher's exact test, Chi squares test and calculation of the relative risk (RR were used for data analysis. Results. Of 3 126 patients with tick bite, clinical manifestations of LD were demonstrated in 19 (0.61%. In the group of subjects (n = 829 in which a tick was not removed professionally there were 17 (2.05% cases with LD, while in the group of respondents (n=2 297 in who a tick was removed professionally there were 2 (0.09% cases with LD after tick bite (RR, 23.55; p < 0.0001. The disease was most frequent in the group of respondents with incompletely and unprofessionally removed ticks (2.46%. In the groups of patients with unprofessionally but completely removed ticks LD occurred in 0.89%, while in the group of subjects with a tick removed by an expert, but incompletely in 0.78% cases. The disease occurred

Health Information-Seeking Patterns of the General Public and Indications for Disease Surveillance: Register-Based Study Using Lyme Disease.

Science.gov (United States)

Pesälä, Samuli; Virtanen, Mikko J; Sane, Jussi; Mustonen, Pekka; Kaila, Minna; Helve, Otto

2017-11-06

People using the Internet to find information on health issues, such as specific diseases, usually start their search from a general search engine, for example, Google. Internet searches such as these may yield results and data of questionable quality and reliability. Health Library is a free-of-charge medical portal on the Internet providing medical information for the general public. Physician's Databases, an Internet evidence-based medicine source, provides medical information for health care professionals (HCPs) to support their clinical practice. Both databases are available throughout Finland, but the latter is used only by health professionals and pharmacies. Little is known about how the general public seeks medical information from medical sources on the Internet, how this behavior differs from HCPs' queries, and what causes possible differences in behavior. The aim of our study was to evaluate how the general public's and HCPs' information-seeking trends from Internet medical databases differ seasonally and temporally. In addition, we aimed to evaluate whether the general public's information-seeking trends could be utilized for disease surveillance and whether media coverage could affect these seeking trends. Lyme disease, serving as a well-defined disease model with distinct seasonal variation, was chosen as a case study. Two Internet medical databases, Health Library and Physician's Databases, were used. We compared the general public's article openings on Lyme disease from Health Library to HCPs' article openings on Lyme disease from Physician's Databases seasonally across Finland from 2011 to 2015. Additionally, media publications related to Lyme disease were searched from the largest and most popular media websites in Finland. Both databases, Health Library and Physician's Databases, show visually similar patterns in temporal variations of article openings on Lyme disease in Finland from 2011 to 2015. However, Health Library openings show not only

La violence sexuelle envers les enfants est-elle en baisse au Canada? Résultats d’enquêtes rétrospectives représentatives à l’échelle nationale

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M. Shields

2016-01-01

Full Text Available Introduction : Selon de nombreuses sources de données, la violence sexuelle envers les enfants (VSE est en baisse aux États-Unis depuis le début des années 1990. Il semble par ailleurs qu’elle ait connu une hausse après la Seconde Guerre mondiale. Cette étude a pour but de faire l’examen des estimations de prévalence des cas de violence sexuelle durant l’enfance (VSdE signalés rétrospectivement dans le cadre de deux enquêtes nationales représentatives menées auprès de la population canadienne. Méthodologie : Les données proviennent de 13 931 répondants de 18 à 76 ans interrogés dans le cadre de l’enquête GENACIS (Gender, Alcohol and Culture: An International Study – Canada de 2004-2005 et de 22 169 résidents âgés de 18 ans et plus ayant participé à l’Enquête sur la santé dans les collectivités canadiennes – Santé mentale (ESCC – Santé mentale de 2012. Nous présentons des comparaisons de la prévalence de la VSdE par sexe et par groupe d’âge à la fois entre ces deux enquêtes et au sein de chacune. Résultats : Les résultats des deux enquêtes indiquent une baisse de la VSE depuis 1993, qui va de pair avec la baisse observée aux États-Unis. Il ressort également des résultats que le risque de VSE était plus élevé entre 1946 et 1992 qu’avant 1946. Les données sont plus solides pour les femmes. Conclusion : Constater une baisse de la VSE au Canada depuis le début des années 1990 est encourageant, étant donné les effets débilitants à long terme qui sont associés à la VSE. Une surveillance continue est essentielle. Ces effets négatifs à long terme sont la preuve de l’importance de poursuivre sur cette lancée, pour passer d’un risque faible à un risque nul.

Cluster-to-cluster transformation among Au6, Au8 and Au11 nanoclusters.

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Ren, Xiuqing; Fu, Junhong; Lin, Xinzhang; Fu, Xuemei; Yan, Jinghui; Wu, Ren'an; Liu, Chao; Huang, Jiahui

2018-05-22

We present the cluster-to-cluster transformations among three gold nanoclusters, [Au6(dppp)4]2+ (Au6), [Au8(dppp)4Cl2]2+ (Au8) and [Au11(dppp)5]3+ (Au11). The conversion process follows a rule that states that the transformation of a small cluster to a large cluster is achieved through an oxidation process with an oxidizing agent (H2O2) or with heating, while the conversion of a large cluster to a small one occurs through a reduction process with a reducing agent (NaBH4). All the reactions were monitored using UV-Vis spectroscopy and ESI-MS. This work may provide an alternative approach to the synthesis of novel gold nanoclusters and a further understanding of the structural transformation relationship of gold nanoclusters.

Les coûts du diabète sur 10 ans au Canada : intégration des coûts en soins de santé imputables au diabète à un modèle de prédiction de son incidence

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Anja Bilandzic

2017-01-01

Full Text Available Introduction : Notre objectif était d’estimer les coûts de santé directs liés au traitement du diabète au Canada sur 10 ans, à l’aide de données de sondages nationaux et d’un outil de prévision du risque de diabète, ainsi que les coûts par personne. Méthodologie : Nous avons utilisé le Diabetes Population Risk Tool pour estimer le nombre de nouveaux cas de diabète chez les personnes âgées de 20 ans et plus sur 10 ans (jusqu'en 2022 à l’aide des données de 2011 et de 2012 de l’Enquête sur la santé dans les collectivités canadiennes. Nous avons évalué les coûts liés au diabète à partir d’une étude de cohorte faisant appel à l’appariement par score de propension, en utilisant la base de données sur le diabète de l’Ontario ainsi que d’autres données administratives. Nous avons calculé les coûts totaux en utilisant les coûts associés aux nouveaux cas, en tenant compte du sexe, de l’année du diagnostic et des taux de mortalité annuels dus à la maladie. Résultats : D'après nos calculs, le risque de développer le diabète sur 10 ans s’élevait pour la population canadienne en 2011-2012 à 9,98 %, soit 2,16 millions de nouveaux cas. Les coûts totaux en soins de santé imputables au diabète pendant cette période sont de 15,36 milliards (7,55 milliards pour les femmes et 7,81 milliards pour les hommes. Ce sont les hospitalisations de courte durée qui constituent la majeure partie de ces coûts (43,2 %. Des interventions menées au sein de la population entraînant une perte de poids de 5 % au sein de la population permettraient de réduire les coûts des soins de santé de 2,03 milliards de dollars. Une réduction du risque de 30 % obtenue grâce à des interventions auprès des personnes à plus haut risque de développer le diabète (c.-à-d. les 10 % au sommet du groupe à risque le plus élevé entraînerait des économies de l’ordrede 1,48 million de dollars. Conclusion : D'ici 2022

RACIALIZED IN JUSTICE: THE LEGAL AND EXTRA-LEGAL STRUGGLES OF MIGRANT AGRICULTURAL WORKERS IN CANADA

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Adrian A Smith

2013-10-01

Une attention considérable a été accordée à la décision de la Cour suprême du Canada rendue en 2011 dans l’arrêt Fraser, qui portait sur le droit constitutionnel à la liberté d’association des travailleurs agricoles en Ontario. Bien que les interventions tendent à juste titre à critiquer la décision de la Cour rejetant des droits d’association significatifs, il existe une indifférence marquée à l’égard des dimensions racialisées de la décision et de la production de la main-d’œuvre agricole au Canada d’une façon générale. Cependant, bien qu’elle soit nécessaire pour aborder les limites de l’analyse juridique savante et jurisprudentielle contemporaine, l’application des idées de la théorie raciale critique ne tient pas suffisamment compte des particularités de l’exploitation de la main-d’œuvre qui fait partie intégrante du régime canadien de migration temporaire de la main-d’œuvre. Dans le but d’approfondir l’étude de la racialisation, de la main-d’œuvre et du droit au Canada, je place les luttes judiciaires et extrajudiciaires des travailleurs agricoles migrants au sein d’une analyse antiraciste du droit qui tient compte des diverses façons dont la racialisation et le racisme influencent la migration de la main-d’œuvre. La construction du travail migrant fondée sur une catégorie racialisée -- une « nécessité structurelle » dans le cadre de la production agricole -- se fait par l’imposition d’obstacles politico-juridiques organisés par le capitalisme mondial et le système des États nationaux. L’analyse se termine en préconisant l’abandon des approches actuelles relatives à l’étude et à l’exercice du droit du travail, au profit d’un programme transgressif visant à contester ouvertement l’exploitation capitaliste sous toutes ses formes, y compris la réglementation racialisée de la main-d’œuvre agricole migrante.

Taxing Consumption or Income: Du Pareil Au Même?

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Sijbren Cnossen

2012-03-01

Full Text Available Income and consumption comprise the two main tax bases in most countries, leaving many governments with the perennial dilemma of deciding which ought to be the focus of fiscal policy. However, in Canada the situation is much less ambiguous; the existing Canadian tax regime disproportionately favours direct, income-based taxation, deriving over two-thirds [this includes property tax revenue] of tax revenues from this stream. This paper argues that Canada’s narrow focus on direct taxation leads governments to miss out on the revenuestabilizing effects that a greater emphasis on consumption taxes would bring. Tilting the balance toward indirect consumption taxes like the GST would benefit public revenues because: i demand fluctuates less than income; ii consumption is largely local, reducing tax avoidance; and iii the GST is less amenable to being co-opted for market-distorting political purposes. As income and consumption taxes are broadly similar in their effects, a shift from the former to the latter would have few consequences for Canadian employment, investment and saving. The author provides a summary of income and consumption tax structures in several Western countries with consumption-oriented tax structures to contend that it’s time Canadian governments embraced meaningful tax reform. L’impôt sur le revenu et les taxes à la consommation constituent les deux principales assiettes fiscales dans la plupart des pays, si bien que de nombreux gouvernements sont confrontés en permanence au dilemme de déterminer sur laquelle de ces deux solutions concentrer leurs politiques fiscales. Toutefois, au Canada, la situation est beaucoup moins floue; le régime fiscal canadien favorise de façon disproportionnée l’impôt direct sur le revenu et tire de cette source plus des deux tiers de ses recettes fiscales (cela comprend les impôts fonciers. On soutient ici que le Canada fonde une trop grande part de ces recettes sur l’impôt direct et

Development of a foundation for a case definition of post-treatment Lyme disease syndrome.

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Aucott, John N; Crowder, Lauren A; Kortte, Kathleen B

2013-06-01

The study objective is to demonstrate the clinical and research utility of an operationalized definition of post-treatment Lyme disease syndrome (PTLDS), as proposed by the Infectious Diseases Society of America. Seventy-four patients with confirmed erythema migrans and 14 controls were enrolled. Patient-reported symptoms and health function (SF-36) were collected pre-treatment and at follow-up visits over 6 months post-treatment. Eight (11%) patients met our operationalized definition of PTLDS, which included self-reported symptoms of fatigue, widespread musculoskeletal pain or cognitive complaints, and functional impact as measured by a T score of definition of PTLDS allows for identification of those patients who are treated for early Lyme disease and have significant post-treatment illness, as they have both residual symptoms and impact on daily life functioning. With further refinement and improvement of this operationalized definition, the true incidence of PTLDS can be determined and future studies can be designed to examine its pathophysiology and treatment. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Fédéralisme et droits des LGBT aux États-Unis et au Canada : analyse comparatives des politiques

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Miriam Smith

2014-12-01

Full Text Available L’article examine le militantisme LGBT et les résultats des politiques en matière de droit pénal et du mariage entre personnes de même sexe de 1969 à aujourd’hui, dans le cadre d’une analyse comparée du fédéralisme aux États-Unis et au Canada. Nous soutiendrons que le fédéralisme a grandement façonné les politiques publiques relatives aux droits des LGBT. Dans le régime américain, le potentiel d’expansion du fédéralisme a favorisé les changements graduels de politiques dans les États et, parallèlement, les multiples points de véto créés par le système de séparation des pouvoirs conjugués aux compétences conférés aux États dans d’importants domaines de politiques ont entravé ces changements de politiques. Dans le régime canadien, la centralisation des mécanismes de protection des droits de la personne dans la Charte de même que la dynamique descendante de l’exercice du pouvoir dans le régime parlementaire de type Westminster ont facilité les changements de politiques. Le fédéralisme est souvent perçu comme un obstacle à l’adoption de politiques progressistes. La répartition des pouvoirs entrave l’élaboration de politiques cohérentes et prête le flanc à la prolifération de vétos dont peuvent se prévaloir des groupes influents pour freiner le changement. Les critiques de cette perspective arguent depuis longtemps que, même si le fédéralisme multiplie les points de véto, il présente aussi de nombreuses possibilités d’innovation. Ils font valoir que les groupes ont plus de poids dans les régimes fédéraux puisqu’ils peuvent exercer leur influence à deux paliers de gouvernement plutôt qu’à un. Ainsi, un groupe qui ne réussit pas à se faire entendre à l’un des paliers pourra tenter sa chance au second et pourra même dresser un palier contre l’autre pour atteindre ses objectifs stratégiques.

BB0347, from the lyme disease spirochete Borrelia burgdorferi, is surface exposed and interacts with the CS1 heparin-binding domain of human fibronectin.

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Robert A Gaultney

Full Text Available The causative agent of Lyme disease, Borrelia burgdorferi, codes for several known fibronectin-binding proteins. Fibronectin a common the target of diverse bacterial pathogens, and has been shown to be essential in allowing for the development of certain disease states. Another borrelial protein, BB0347, has sequence similarity with these other known fibronectin-binding proteins, and may be important in Lyme disease pathogenesis. Herein, we perform an initial characterization of BB0347 via the use of molecular and biochemical techniques. We found that BB0347 is expressed, produced, and presented on the outer surface of intact B. burgdorferi. We also demonstrate that BB0347 has the potential to be important in Lyme disease progression, and have begun to characterize the nature of the interaction between human fibronectin and this bacterial protein. Further work is needed to define the role of this protein in the borrelial infection process.

Coinfection with Borrelia burgdorferi sensu stricto and Borrelia garinii alters the course of murine Lyme borreliosis

NARCIS (Netherlands)

Hovius, Joppe W. R.; Li, Xin; Ramamoorthi, Nandhini; van Dam, Alje P.; Barthold, Stephen W.; van der Poll, Tom; Speelman, Peter; Fikrig, Erol

2007-01-01

Ixodes ricinus ticks and mice can be infected with both Borrelia burgdorferi sensu stricto and Borrelia garinii. The effect of coinfection with these two Borrelia species on the development of murine Lyme borreliosis is unknown. Therefore, we investigated whether coinfection with the

Réduction des pertes de fruits en Inde et au Sri Lanka grâce à la ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ce projet réunit des partenaires de recherche du Canada et de l'Asie du Sud dans le but de mettre au point d'un nouveau mode d'emballage basé sur la ... Association, in close collaboration with IDRC, is holding a webinar titled “Climate change and adaptive water management: Innovative solutions from the Global South”.

Preliminary Bedrock Geologic Map of the Old Lyme Quadrangle, New London and Middlesex Counties, Connecticut

Science.gov (United States)

Walsh, Gregory J.; Scott, Robert B.; Aleinikoff, John N.; Armstrong, Thomas R.

2006-01-01

This report presents a preliminary map of the bedrock geology of the Old Lyme quadrangle, New London and Middlesex Counties, Connecticut. The map depicts contacts of bedrock geologic units, faults, outcrops, and structural geologic information. The map was published as part of a study of fractured bedrock aquifers and regional tectonics.

Spatial and Temporal Distribution of Lyme Disease Infected Ticks in the Texas-Mexico Border Region

Science.gov (United States)

Lyme disease (LD) is the most prevalent arthropod-borne infection in the United States, with 33,097 cases of LD reported to the Centers for Disease Control and Prevention (CDC) in 2011. The disease is transmitted to a mammalian host by Ixodes ticks infected with Borrelia burgdorferi. Efforts to unde...

Histopathology of Lyme arthritis in LSH hamsters

International Nuclear Information System (INIS)

Hejka, A.; Schmitz, J.L.; England, D.M.; Callister, S.M.; Schell, R.F.

1989-01-01

The authors studied the histopathologic evolution of arthritis in nonirradiated and irradiated hamsters infected with Borrelia burgdorferi. Nonirradiated hamsters injected in the hind paws with B. burgdorferi developed an acute inflammatory reaction involving the synovium, periarticular soft tissues, and dermis. This acute inflammatory reaction was short-lived and was replaced by a mild chronic synovitis as the number of detectable spirochetes in the synovium, periarticular soft tissues, and perineurovascular areas diminished. Exposing hamsters to radiation before inoculation with B. burgdorferi exacerbated and prolonged the acute inflammatory phase. Spirochetes also persisted longer in the periarticular soft tissues. A major histopathologic finding was destructive and erosive bone changes of the hind paws, which resulted in deformation of the joints. These studies should be helpful in defining the immune mechanism participating in the onset, progression, and resolution of Lyme arthritis

T-Helper 17 Cell Cytokine Responses in Lyme Disease Correlate With Borrelia burgdorferi Antibodies During Early Infection and With Autoantibodies Late in the Illness in Patients With Antibiotic-Refractory Lyme Arthritis.

Science.gov (United States)

Strle, Klemen; Sulka, Katherine B; Pianta, Annalisa; Crowley, Jameson T; Arvikar, Sheila L; Anselmo, Anthony; Sadreyev, Ruslan; Steere, Allen C

2017-04-01

Control of Lyme disease is attributed predominantly to innate and adaptive T-helper 1 cell (TH1) immune responses, whereas the role of T-helper 17 cell (TH17) responses is less clear. Here we characterized these inflammatory responses in patients with erythema migrans (EM) or Lyme arthritis (LA) to elucidate their role early and late in the infection. Levels of 21 cytokines and chemokines, representative of innate, TH1, and TH17 immune responses, were assessed by Luminex in acute and convalescent sera from 91 EM patients, in serum and synovial fluid from 141 LA patients, and in serum from 57 healthy subjects. Antibodies to Borrelia burgdorferi or autoantigens were measured by enzyme-linked immunosorbent assay. Compared with healthy subjects, EM patients had significantly higher levels of innate, TH1, and TH17-associated mediators (P ≤ .05) in serum. In these patients, the levels of inflammatory mediators, particularly TH17-associated cytokines, correlated directly with B. burgdorferi immunoglobulin G antibodies (P ≤ .02), suggesting a beneficial role for these responses in control of early infection. Late in the disease, in patients with LA, innate and TH1-associated mediators were often >10-fold higher in synovial fluid than serum. In contrast, the levels of TH17-associated mediators were more variable, but correlated strongly with autoantibodies to endothelial cell growth factor, matrix metalloproteinase 10, and apolipoprotein B-100 in joints of patients with antibiotic-refractory LA, implying a shift in TH17 responses toward an autoimmune phenotype. Patients with Lyme disease often develop pronounced TH17 immune responses that may help control early infection. However, late in the disease, excessive TH17 responses may be disadvantageous by contributing to autoimmune responses associated with antibiotic-refractory LA. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions

Infection history of the blood-meal host dictates pathogenic potential of the Lyme disease spirochete within the feeding tick vector.

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Bharti Bhatia

2018-04-01

Full Text Available Lyme disease in humans is caused by several genospecies of the Borrelia burgdorferi sensu lato (s.l. complex of spirochetal bacteria, including B. burgdorferi, B. afzelii and B. garinii. These bacteria exist in nature as obligate parasites in an enzootic cycle between small vertebrate hosts and Ixodid tick vectors, with humans representing incidental hosts. During the natural enzootic cycle, infected ticks in endemic areas feed not only upon naïve hosts, but also upon seropositive infected hosts. In the current study, we considered this environmental parameter and assessed the impact of the immune status of the blood-meal host on the phenotype of the Lyme disease spirochete within the tick vector. We found that blood from a seropositive host profoundly attenuates the infectivity (>104 fold of homologous spirochetes within the tick vector without killing them. This dramatic neutralization of vector-borne spirochetes was not observed, however, when ticks and blood-meal hosts carried heterologous B. burgdorferi s.l. strains, or when mice lacking humoral immunity replaced wild-type mice as blood-meal hosts in similar experiments. Mechanistically, serum-mediated neutralization does not block induction of host-adapted OspC+ spirochetes during tick feeding, nor require tick midgut components. Significantly, this study demonstrates that strain-specific antibodies elicited by B. burgdorferi s.l. infection neutralize homologous bacteria within feeding ticks, before the Lyme disease spirochetes enter a host. The blood meal ingested from an infected host thereby prevents super-infection by homologous spirochetes, while facilitating transmission of heterologous B. burgdorferi s.l. strains. This finding suggests that Lyme disease spirochete diversity is stably maintained within endemic populations in local geographic regions through frequency-dependent selection of rare alleles of dominant polymorphic surface antigens.

[FR] Le developpment du Travail Social et le pluralisme au Québec

Directory of Open Access Journals (Sweden)

André Jacob

2011-06-01

Full Text Available Normal 0 21 false false false ES X-NONE X-NONE MicrosoftInternetExplorer4 Au Canada et au Québec, traiter des questions liées à la diversité culturelle et au racisme a été un défi pour les gouvernements depuis les années soixante. Auparavant et jusqu'à présent, une grande partie des responsabilités en termes de développement ethnoculturel sensible des services publics (services sociaux, des programmes de formation en travail social, etc. ont été laissés aux mains d’organismes de charité non-lucratifs. Cependant, peu à peu, depuis les années soixante, le gouvernement fédéral et le gouvernement provincial, ont dû développer des politiques et des programmes d'action. Au Québec, le travail social a fait partie du débat face à deux grands courants politiques, l’un canadien basé sur le multiculturalisme, et l’autre québécois basé sur l'interculturalisme. L'article vise à donner une perspective historique

Des idées novatrices et vivifiantes : le Canada prend les devants en ...

International Development Research Centre (IDRC) Digital Library (Canada)

25 janv. 2011 ... Des chercheurs de l'Université du Québec à Montréal ont été parmi les premiers à innover dans ce domaine en réalisant des études qui ont fait date sur la contamination par le mercure au Brésil, ainsi que dans des collectivités des Premières nations dans le nord du Canada et dans les milieux humides du ...

Un projet écosanté au Pérou fait parler de lui à la radio | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

25 janv. 2013 ... L'Année internationale de la coopération dans le domaine de l'eau vient de commencer. Pour souligner l'occasion, Chantal Srivastava, de l'émission Les années lumière, diffusée à la radio de Radio‑Canada, s'entretient avec des administrateurs de programme du CRDI au sujet de travaux de recherche ...

Radars routiers, étranges retombées technologiques de la recherche au CERN... - French version only

CERN Multimedia

Association du personnel

2007-01-01

Les lecteurs de la presse locale, les « cernois » en particulier, ont apprécié très modérément les titres des journaux locaux de la semaine dernière, relayés par les informations sur les radios publiques francophones en Suisse, France, Belgique et même… au Canada : « Des radars sur les routes du CERN !... »

Chiral magnetic effect search in p+Au, d+Au and Au+Au collisions at RHIC

Science.gov (United States)

Zhao, Jie

2018-01-01

Metastable domains of fluctuating topological charges can change the chirality of quarks and induce local parity violation in quantum chromodynamics. This can lead to observable charge separation along the direction of the strong magnetic field produced by spectator protons in relativistic heavy-ion collisions, a phenomenon called the chiral magnetic effect (CME). A major background source for CME measurements using the charge-dependent azimuthal correlator (Δϒ) is the intrinsic particle correlations (such as resonance decays) coupled with the azimuthal elliptical anisotropy (v2). In heavy-ion collisions, the magnetic field direction and event plane angle are correlated, thus the CME and the v2-induced background are entangled. In this report, we present two studies from STAR to shed further lights on the background issue. (1) The Δϒ should be all background in small system p+Au and d+Au collisions, because the event plane angles are dominated by geometry fluctuations uncorrelated to the magnetic field direction. However, significant Δϒ is observed, comparable to the peripheral Au+Au data, suggesting a background dominance in the latter, and likely also in the mid-central Au+Au collisions where the multiplicity and v2 scaled correlator is similar. (2) A new approach is devised to study Δϒ as a function of the particle pair invariant mass (minv) to identify the resonance backgrounds and hence to extract the possible CME signal. Signal is consistent with zero within uncertainties at high minv. Signal at low minv, extracted from a two-component model assuming smooth mass dependence, is consistent with zero within uncertainties.

Prevalence and spectrum of residual symptoms in Lyme neuroborreliosis after pharmacological treatment: a systematic review.

Science.gov (United States)

Dersch, R; Sommer, H; Rauer, S; Meerpohl, J J

2016-01-01

Controversy exists about residual symptoms after pharmacological treatment of Lyme neuroborreliosis. Reports of disabling long-term sequels lead to concerns in patients and health care providers. We systematically reviewed the available evidence from studies reporting treatment of Lyme neuroborreliosis to assess the prevalence and spectrum of residual symptoms after treatment. A literature search was performed in three databases and three clinical trial registers to find eligible studies reporting on residual symptoms in patients after pharmacological treatment of LNB. Diagnosis must have been performed according to consensus-derived case definitions. No restrictions regarding study design or language were set. Symptom prevalence was pooled using a random-effects model. Forty-four eligible clinical trials and studies were found: 8 RCTs, 17 cohort studies, 2 case-control studies, and 17 case series. The follow-up period in the eligible studies ranged from 7 days to 20 years. The weighted mean proportion of residual symptoms was 28 % (95 % CI 23-34 %, n = 34 studies) for the latest reported time point. Prevalence of residual symptoms was statistically significantly higher in studies using the "possible" case definition (p = 0.0048). Cranial neuropathy, pain, paresis, cognitive disturbances, headache, and fatigue were statistically significantly lower in studies using the "probable/definite" case definition. LNB patients may experience residual symptoms after treatment with a prevalence of approximately 28 %. The prevalence and spectrum of residual symptoms differ according to the applied case definition. Symptoms like fatigue are not reported in studies using the "probable/definite" case definition. As the "possible" case definition is more unspecific, patients with other conditions may be included. Reports of debilitating fatigue and cognitive impairment after LNB, a "post-Lyme syndrome", could therefore be an artifact of unspecific case definitions in single

Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey

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Lorraine Johnson

2014-03-01

Full Text Available Overview. The Centers for Disease Control and Prevention (CDC health-related quality of life (HRQoL indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD and compares the severity of CLD to other chronic conditions.Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods.Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs.Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed

Severity of chronic Lyme disease compared to other chronic conditions: a quality of life survey

Science.gov (United States)

Johnson, Lorraine; Wilcox, Spencer; Mankoff, Jennifer

2014-01-01

Overview. The Centers for Disease Control and Prevention (CDC) health-related quality of life (HRQoL) indicators are widely used in the general population to determine the burden of disease, identify health needs, and direct public health policy. These indicators also allow the burden of illness to be compared across different diseases. Although Lyme disease has recently been acknowledged as a major health threat in the USA with more than 300,000 new cases per year, no comprehensive assessment of the health burden of this tickborne disease is available. This study assesses the HRQoL of patients with chronic Lyme disease (CLD) and compares the severity of CLD to other chronic conditions. Methods. Of 5,357 subjects who responded to an online survey, 3,090 were selected for the study. Respondents were characterized as having CLD if they were clinically diagnosed with Lyme disease and had persisting symptoms lasting more than 6 months following antibiotic treatment. HRQoL of CLD patients was assessed using the CDC 9-item metric. The HRQoL analysis for CLD was compared to published analyses for the general population and other chronic illnesses using standard statistical methods. Results. Compared to the general population and patients with other chronic diseases reviewed here, patients with CLD reported significantly lower health quality status, more bad mental and physical health days, a significant symptom disease burden, and greater activity limitations. They also reported impairment in their ability to work, increased utilization of healthcare services, and greater out of pocket medical costs. Conclusions. CLD patients have significantly impaired HRQoL and greater healthcare utilization compared to the general population and patients with other chronic diseases. The heavy burden of illness associated with CLD highlights the need for earlier diagnosis and innovative treatment approaches that may reduce the burden of illness and concomitant costs posed by this

Disruption of bbe02 by Insertion of a Luciferase Gene Increases Transformation Efficiency of Borrelia burgdorferi and Allows Live Imaging in Lyme Disease Susceptible C3H Mice.

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Kamfai Chan

Full Text Available Lyme disease is the most prevalent tick-borne disease in North America and Europe. The causative agent, Borrelia burgdorferi persists in the white-footed mouse. Infection with B. burgdorferi can cause acute to persistent multisystemic Lyme disease in humans. Some disease manifestations are also exhibited in the mouse model of Lyme disease. Genetic manipulation of B. burgdorferi remains difficult. First, B. burgdorferi contains a large number of endogenous plasmids with unique sequences encoding unknown functions. The presence of these plasmids needs to be confirmed after each genetic manipulation. Second, the restriction modification defense systems, including that encoded by bbe02 gene lead to low transformation efficiency in B. burgdorferi. Therefore, studying the molecular basis of Lyme pathogenesis is a challenge. Furthermore, investigation of the role of a specific B. burgdorferi protein throughout infection requires a large number of mice, making it labor intensive and expensive. To overcome the problems associated with low transformation efficiency and to reduce the number of mice needed for experiments, we disrupted the bbe02 gene of a highly infectious and pathogenic B. burgdorferi strain, N40 D10/E9 through insertion of a firefly luciferase gene. The bbe02 mutant shows higher transformation efficiency and maintains luciferase activity throughout infection as detected by live imaging of mice. Infectivity and pathogenesis of this mutant were comparable to the wild-type N40 strain. This mutant will serve as an ideal parental strain to examine the roles of various B. burgdorferi proteins in Lyme pathogenesis in the mouse model in the future.

Attorney General forces Infectious Diseases Society of America to redo Lyme guidelines due to flawed development process.

Science.gov (United States)

Johnson, L; Stricker, R B

2009-05-01

Lyme disease is one of the most controversial illnesses in the history of medicine. In 2006 the Connecticut Attorney General launched an antitrust investigation into the Lyme guidelines development process of the Infectious Diseases Society of America (IDSA). In a recent settlement with IDSA, the Attorney General noted important commercial conflicts of interest and suppression of scientific evidence that had tainted the guidelines process. This paper explores two broad ethical themes that influenced the IDSA investigation. The first is the growing problem of conflicts of interest among guidelines developers, and the second is the increasing centralisation of medical decisions by insurance companies, which use treatment guidelines as a means of controlling the practices of individual doctors and denying treatment for patients. The implications of the first-ever antitrust investigation of medical guidelines and the proposed model to remediate the tainted IDSA guidelines process are also discussed.

Western blot banding pattern in early Lyme borreliosis among patients from an endemic region of north-eastern Poland.

Science.gov (United States)

Flisiak, R; Wierzbicka, I; Prokopowicz, D

1998-01-01

Aim of this study was evaluation of Western blot banding patterns in different clinical forms of early Lyme borreliosis diagnosed in patients from north-eastern Poland, recognized as endemic for tick-borne diseases. Study was performed on serum samples of 48 patients with Lyme borreliosis and 26 healthy volunteers, as controls. Samples tested routinely for total antibody with enzyme immunoassay were subsequently analysed for specific antibodies with Western blot based on antigen extract of European strain of Borrelia burgdorferi. In patients, IgM antibodies were the most frequently directed against 41 kDa and 58 kDa antigens, whereas in control group only antibodies against 45 kDa and 58 kDa were present. Similar response was observed in respect to IgG antibodies. Evaluation of banding pattern in respect to clinical form of the disease revealed the highest prevalence of IgM and IgG anti-41 kDa antibodies in patients with erythema migrans and Lyme arthritis, and anti-58 kDa in neuroborreliosis patients, who had no anti-21 kDa antibodies. Relatively high frequency of IgG antibodies against 21, 30 and 93 kDa antigens was typical for neuroborreliosis. Bands count was significantly higher in different clinical forms of the disease than in controls, and it was the highest in neuroborreliosis. Combined analysis of Western blot results (IgM/IgG) enabled to achieve higher sensitivity (84%) and specificity (100%) than available with the most recommended EIA kits.

Zoonotic occupational diseases in forestry workers – Lyme borreliosis, tularemia and leptospirosis in Europe

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Stéphanie Richard

2015-02-01

Full Text Available [b]Introduction[/b]. Forestry workers and other people who come into close contact with wild animals, such as hunters, natural science researchers, game managers or mushroom/berry pickers, are at risk of contracting bacterial, parasitological or viral zoonotic diseases. Synthetic data on the incidence and prevalence of zoonotic diseases in both animals and humans in European forests do not exist. It is therefore difficult to promote appropriate preventive measures among workers or people who come into direct or indirect contact with forest animals. [b]Objectives.[/b] The objectives of this review are to synthesise existing knowledge on the prevalence of the three predominant bacterial zoonotic diseases in Europe, i.e. Lyme borreliosis, tularemia and leptospirosis, in order to draw up recommendations for occupational or public health. [b]Methods[/b]. 88 papers published between 1995–2013 (33 on Lyme borreliosis, 30 on tularemia and 25 on leptospirosis were analyzed. [b]Conclusions[/b]. The prevalences of these three zoonotic diseases are not negligible and information targeting the public is needed. Moreover, the results highlight the lack of standardised surveys among different European countries. It was also noted that epidemiological data on leptospirosis are very scarce

Low seroprevalence of human Lyme disease near a focus of high entomologic risk.

Science.gov (United States)

Rand, P W; Lacombe, E H; Smith, R P; Gensheimer, K; Dennis, D T

1996-08-01

To investigate a low rate of reported human Lyme disease adjacent to an area where the vector tick had become well established, we performed human and canine serosurveys and gathered data on environmental factors related to the risk of transmission. In March 1993, we obtained serum samples and conducted questionnaires that included information on outdoor activities, lot size, and frequency of deer sightings from 272 individuals living within a 5-km strip extending 12 km inland from a study site in south coastal Maine where collections revealed an abundant population of deer ticks. Serologic analysis was done using a flagellin-based enzyme-linked immunosorbent assay (ELISA) followed by Western immunoblot of positive and equivocal samples. Sera from 71 unvaccinated dogs within the study area were also analyzed for anti-Borrelia antibodies by ELISA. Human seropositivity was limited to two individuals living within 1.2 km of the coast. The frequency of daily deer sightings decreased sharply outside this area. Canine seropositivity, 100% within the first 0.8 km, decreased to 2% beyond 1.5 km. Canine serology appears to correlate with the entomologic indicators of the risk of Lyme disease transmission. Possible explanations for the low human seroprevalence are offered.

Utilization of serology for the diagnosis of suspected Lyme borreliosis in Denmark: Survey of patients seen in general practice

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Skarphedinsson Sigurdur

2010-11-01

Full Text Available Abstract Background Serological testing for Lyme borreliosis (LB is frequently requested by general practitioners for patients with a wide variety of symptoms. Methods A survey was performed in order to characterize test utilization and clinical features of patients investigated for serum antibodies to Borrelia burgdorferi sensu lato. During one calendar year a questionnaire was sent to the general practitioners who had ordered LB serology from patients in three Danish counties (population 1.5 million inhabitants. Testing was done with a commercial ELISA assay with purified flagella antigen from a Danish strain of B. afzelii. Results A total of 4,664 patients were tested. The IgM and IgG seropositivity rates were 9.2% and 3.3%, respectively. Questionnaires from 2,643 (57% patients were available for analysis. Erythema migrans (EM was suspected in 38% of patients, Lyme arthritis/disseminated disease in 23% and early neuroborreliosis in 13%. Age 0-15 years and suspected EM were significant predictors of IgM seropositivity, whereas suspected acrodermatitis was a predictor of IgG seropositivity. LB was suspected in 646 patients with arthritis, but only 2.3% were IgG seropositive. This is comparable to the level of seropositivity in the background population indicating that Lyme arthritis is a rare entity in Denmark, and the low pretest probability should alert general practitioners to the possibility of false positive LB serology. Significant predictors for treating the patient were a reported tick bite and suspected EM. Conclusions A detailed description of the utilization of serology for Lyme borreliosis with rates of seropositivity according to clinical symptoms is presented. Low rates of seropositivity in certain patient groups indicate a low pretest probability and there is a notable risk of false positive results. 38% of all patients tested were suspected of EM, although this is not a recommended indication due to a low sensitivity of

Evidence for frequent OspC gene transfer between Borrelia valaisiana sp. nov. and other Lyme disease spirochetes

NARCIS (Netherlands)

Wang, G.; van Dam, A. P.; Dankert, J.

1999-01-01

Molecular polymorphism of the ospC gene has been reported in Borrelia burgdorferi sensu stricto, Borrelia garinii and Borrelia afzelii, the spirochetes causing human Lyme borreliosis. To assess the genetic relationship between ospC genes from the recently described Borrelia valaisiana sp. nov. and

La participation des personnes utilisatrices aux exercices de planification et d'organisation des services de santé mentale au Québec

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Michèle Clément

2013-10-01

Full Text Available Cet article documente la manière dont s'est renouvelé et s'est transformé au fil du temps le projet de faire participer les usagers aux exercices de planification et d'organisation des services de santé mentale au Québec (Canada. Pour ce faire, les auteurs reviennent sur l'ensemble des documents ministériels qui ont traité de cette question et dégage, pour les principaux moment-clés, les principales modalités de participation des usagers.

The ecology of Lyme borreliosis risk : interactions between lxodes ricinus, rodents and Borrelia burgdorferi sensu lato

NARCIS (Netherlands)

Duijvendijk, van Gilian

2016-01-01

The sheep tick (Ixodes ricinus) is widespread throughout Europe and can transmit Borrelia burgdorferi sensu lato (s.l.), which can cause Lyme borreliosis and B. miyamotoi, the agent of Borrelia miyamotoi disease in humans.

THE INTERNATIONAL HUMAN RIGHT TO HOUSING & THE CANADIAN CHARTER: A CASE COMMENT ON TANUDJAJA V. CANADA (ATTORNEY GENERAL

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David DesBaillets

2015-02-01

écialistes en droit du Canada d’examiner le droit à un logement adéquat dans le contexte des droits de la personne protégés au Canada. Il s’agit du seul litige dans lequel le droit au logement en droit canadien est abordé directement sous l’angle de deux dispositions clés de la Charte canadienne des droits et libertés : les articles 7 et 15. De plus, dans cette même affaire, les demandeurs ont tenté d’étoffer leur allégation fondée sur la Charte en invoquant les droits au logement reconnus dans le droit international sur les droits de la personne. Pour les spécialistes en matière de droits au logement au Canada, malgré les conclusions plutôt négatives qui y sont tirées, cette décision illustre la nécessité de mieux comprendre l’interaction entre les normes juridiques internationales sur les droits de la personne, d’une part, et la Charte, d’autre part. Cependant, elle ne décrit pas adéquatement l’ampleur de l’influence des premières sur la seconde, puisque le juge Lederer, de la Cour supérieure de justice de l’Ontario, n’a pas abordé l’importance de la doctrine juridique internationale relative à l’interprétation des droits sociaux et humains positifs dans le contexte juridique canadien. Plus précisément, il a ignoré le nombre croissant de décisions canadiennes liées à la Charte qui ont mis en lumière la relation complexe entre les droits humains fondamentaux garantis dans différents documents juridiques internationaux et les obligations positives reconnues que ces textes imposent au gouvernement du Canada en ce qui a trait à la mise en œuvre de ces droits en conformité avec des traités d’aussi longue date que le Pacte international relatif aux droits économiques, sociaux et culturels. Dans ce commentaire, l’auteur critique l’analyse que le juge Lederer a menée au sujet de la pertinence des normes internationales à l’égard des droits de la personne dans le contexte de l’affaire Tanudaja, en

Critical Evaluation of Urine-Based PCR Assay for Diagnosis of Lyme Borreliosis

OpenAIRE

Rauter, Carolin; Mueller, Markus; Diterich, Isabel; Zeller, Sabine; Hassler, Dieter; Meergans, Thomas; Hartung, Thomas

2005-01-01

Many approaches were made in recent years to establish urine PCR as a diagnostic tool for Lyme borreliosis, but results are contradictory. In the present study, a standardized protocol spiking urine from healthy donors with a defined amount of whole Borrelia or Borrelia DNA was established. The development of a nested real-time PCR targeting ospA enabled a highly sensitive and quantitative analysis of these samples. We show the following. (i) Storage of spiked urine samples for up to 6 months...

Transplantation of Human Embryonic Stem Cells in Patients with Multiple Sclerosis and Lyme Disease

OpenAIRE

Shroff, Geeta

2016-01-01

Case series Patient: Male, 42 ? Female, 30 Final Diagnosis: Human embryonic stem cells showed good therapeutic potential for treatment of multiple sclerosis with lyme disease Symptoms: Fatigue ? weakness in limbs Medication: ? Clinical Procedure: Human embryonic stem cells transplantation Specialty: Transplantology Objective: Rare disease Background: Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease in which the myelin sheath of nerve cells is damaged. It can cause dela...

Health Consequences to Immigrant Family Caregivers in Canada

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Suwal, Juhee Varacharya

2010-01-01

Full Text Available AbstractThis study revisited the “double jeopardy” hypothesis in terms of the health ofimmigrant family caregivers. It also investigated the effect of “reciprocity”(feeling of giving back something on the health of family caregivers. TheGeneral Social Survey 2002 Cycle 16 data were analyzed using χ2-test andLogistic regressions. About 16% of immigrants and 13.6% of non-immigrantssaid that their health was negatively affected as a result of caregiving.Immigrant family caregivers were three times more likely than non-immigrantsto report a health consequence. Reciprocity played a big role in this outcome.Given the fact that an increasing number of culturally diverse immigrants enterCanada every year and that the immigrant population is aging, more caregiverswill be in demand. Policy makers need to find ways to keep immigrantcaregivers healthy so that quality care can be given to immigrant older adultsand also for maintaining an overall healthy Canada.RésuméCette étude réexamine l'hypothèse de «non bis in idem» dans le contexte de lasanté des aidantes et aidants membres de familles immigrantes. Elle étudie aussil'effet de «réciprocité» (le sentiment de rendre quelque chose sur la santé desaidantes et aidants membres de la famille. Les données de l'Enquête socialegénérale 2002, cycle 16 ont été analysées à l'aide du test du χ² et de régressionslogistiques. À peu près 16% des immigrants et 13.6% des non-immigrantes ontreporté que leur santé avait été négativement affectée par leur dispensation desoins. Les aidantes et aidants membres de familles immigrantes avaient troisfois plus de chance de reporter une conséquence sur leur santé que ceux desfamilles non-immigrantes. La réciprocité jouait un rôle important dans cerésultat. Quand on considère qu'un nombre croissant d'immigrants issus decultures diverses entre au Canada chaque année et que la populationimmigrante vieillit, il est clair que plus en plus

Successful synthesis and thermal stability of immiscible metal Au-Rh, Au-Ir andAu-Ir-Rh nanoalloys

Science.gov (United States)

Shubin, Yury; Plyusnin, Pavel; Sharafutdinov, Marat; Makotchenko, Evgenia; Korenev, Sergey

2017-05-01

We successfully prepared face-centred cubic nanoalloys in systems of Au-Ir, Au-Rh and Au-Ir-Rh, with large bulk miscibility gaps, in one-run reactions under thermal decomposition of specially synthesised single-source precursors, namely, [AuEn2][Ir(NO2)6], [AuEn2][Ir(NO2)6] х [Rh(NO2)6]1-х and [AuEn2][Rh(NO2)6]. The precursors employed contain all desired metals ‘mixed’ at the atomic level, thus providing significant advantages for obtaining alloys. The observations using high-resolution transmission electron microscopy show that the nanoalloy structures are composed of well-dispersed aggregates of crystalline domains with a mean size of 5 ± 3 nm. Еnergy dispersive x-ray spectroscopy and x-ray powder diffraction (XRD) measurements confirm the formation of AuIr, AuRh, AuIr0.75Rh0.25, AuIr0.50Rh0.50 and AuIr0.25Rh0.75 metastable solid solutions. In situ high-temperature synchrotron XRD (HTXRD) was used to study the formation mechanism of nanoalloys. The observed transformations are described by the ‘conversion chemistry’ mechanism characterised by the primary development of particles comprising atoms of only one type, followed by a chemical reaction resulting in the final formation of a nanoalloy. The obtained metastable nanoalloys exhibit essential thermal stability. Exposure to 180 °C for 30 h does not cause any dealloying process.

Synthesis of ultrathin face-centered-cubic Au@Pt and Au@Pd core-shell nanoplates from hexagonal-close-packed Au square sheets

KAUST Repository

Fan, Zhanxi

2015-03-17

The synthesis of ultrathin face-centered-cubic (fcc) Au@Pt rhombic nanoplates is reported through the epitaxial growth of Pt on hexagonal-close-packed (hcp) Au square sheets (AuSSs). The Pt-layer growth results in a hcp-to-fcc phase transformation of the AuSSs under ambient conditions. Interestingly, the obtained fcc Au@Pt rhombic nanoplates demonstrate a unique (101)f orientation with the same atomic arrangement extending from the Au core to the Pt shell. Importantly, this method can be extended to the epitaxial growth of Pd on hcp AuSSs, resulting in the unprecedented formation of fcc Au@Pd rhombic nanoplates with (101)f orientation. Additionally, a small amount of fcc (100)f-oriented Au@Pt and Au@Pd square nanoplates are obtained with the Au@Pt and Au@Pd rhombic nanoplates, respectively. We believe that these findings will shed new light on the synthesis of novel noble bimetallic nanostructures. Phase change: Ultrathin Au@Pt and Au@Pd core-shell nanoplates were prepared from Au square sheets. A phase transformation from hexagonal close-packed (hcp) to face-centered cubic (fcc) is observed upon coating the hcp Au square sheets with Pt or Pd under ambient conditions. The prepared fcc Au@Pt and Au@Pd rhombic nanoplates demonstrate unique (101)f orientation (picture shows a typical fcc Au@Pt rhombic nanoplate). © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The clinical spectrum of early Lyme borreliosis in patients with culture-confirmed erythema migrans.

Science.gov (United States)

Nadelman, R B; Nowakowski, J; Forseter, G; Goldberg, N S; Bittker, S; Cooper, D; Aguero-Rosenfeld, M; Wormser, G P

1996-05-01

The diagnosis of erythema migrans (EM), the characteristic rash of early Lyme borreliosis, is based primarily on its clinical appearance since it often occurs prior to the development of a specific antibody response. Other skin disorders, however, may be confused with EM. Between June 1991 and September 1993, a prospective study was conducted at the Lyme Disease Diagnostic Center of the Westchester County Medical Center to isolate Borrelia burgdorferi systematically from patients with Em, and to characterize the clinical manifestations of patients with culture-documented infection. Skin biopsies and/or needle aspirates of the advancing margin of primary lesions, and blood specimens from adult patients were cultured for B burgdorferi in modified Barbour-Stoenner-Kelly medium at 33 degrees C. B burgdorferi was recovered from 79 patients (49 [62%] males) ranging in age from 16 to 76 years old (mean, 43 +/- 14 years old). Maximum EM diameter (mean, 16 +/- 10 cm; range, 6-73 cm) was a function of EM duration (mean 6.7 +/- 6.4 days; range, 1-39 days) (correlation coefficient = 0.7; P lesion a mean of 10 days (range, 1-27 days) before onset. Multiple EM lesions (range, 2-70) were present in 14 (18%) patients. Systemic symptoms were present at the time of culture in 54 patients (68%) including fatigue (54%), arthralgia (44%), myalgia (44%), headache, (42%), fever and/or chills (39%), stiff neck (35%), and anorexia (26%). Thirty-three patients (42%) had at least one objective finding on physical examination in addition to EM, including 18 (23%) with localized lymphadenopathy, 13 (16%) with fever (t > or = 37.8 degrees C), seven (9%) with tender neck flexion, six (8%) with joint tenderness, and 1 each with joint swelling, nuchal rigidity, and facial nerve palsy. No patient had new electrocardiogram evidence of atrioventricular block. Liver function assays were abnormally elevated in 37% of patients. Thirty-four percent of patients were seropositive by enzyme

The Electronic Properties and L3 XANES of Au and Nano-Au

International Nuclear Information System (INIS)

Yiu, Y.M.; Zhang, P.; Sham, T.K.

2004-01-01

The electronic properties of Au crystal and nano Au have been investigated by theory and experiment. Molecularly capped nano-Au was synthesized using the two-phase method. Au nano-particles have been characterized by X-Ray Diffraction (XRD) and Transmission Electron Microscopy (TEM). They retain the fcc crystal structure. Their sizes have been determined to be in a range from 5.5 nm to 1.7 nm. The L3 X-ray Absorption Near Edge Structure (XANES) of nano-Au and Au foil have been recorded using synchrotron radiation, and examined by theoretical calculation based on the first principles. Both theory and experiment show that the nano-Au particles have essentially all the Au L3 XANES features of bulk Au in the near edge region with less pronounced resonance peaks. It is also shown that nano Au exhibits lower 4f binding energy than bulk Au in good agreement with quantum confined Au systems reported previously.

100-MeV proton beam intensity measurement by Au activation analysis using {sup 197}Au(p, pn){sup 196}Au and {sup 197}Au(p, p3n){sup 194}Au reactions

Energy Technology Data Exchange (ETDEWEB)

Mokhtari Oranj, Leila [Division of Advanced Nuclear Engineering, POSTECH, Pohang 37673 (Korea, Republic of); Jung, Nam-Suk; Oh, Joo-Hee [Pohang Accelerator Laboratory, POSTECH, Pohang 37673 (Korea, Republic of); Lee, Hee-Seock, E-mail: lee@postech.ac.kr [Pohang Accelerator Laboratory, POSTECH, Pohang 37673 (Korea, Republic of)

2016-05-15

The proton beam intensity of a 100-MeV proton linac at the Korea Multi-purpose Accelerator Complex (KOMAC) was measured by an Au activation analysis using {sup 197}Au(p, pn){sup 196}Au and {sup 197}Au(p, p3n){sup 194}Au reactions to determine the accuracy and precision of beam intensity measurement using Gafchromic film dosimetry method. The target, irradiated by 100-MeV protons, was arranged in a stack consisting of Au, Al foils and Pb plates. The yields of produced radio-nuclei in Au foils were obtained by gamma-ray spectroscopy. The FLUKA code was employed to calculate the energy spectrum of protons onto the front surface of Au foils located at three different depth points of the target and also to investigate the condition of incident beam on the target. A good agreement was found between the beam intensity measurements using the activation analysis method at three different depth points of the target. An excellent agreement was also observed between the beam intensity measurements using the Au activation analysis method and the dosimetry method using Gafchromic film.

Tungsten oxide-Au nanosized film composites for glucose oxidation and sensing in neutral medium

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Gougis M

2015-04-01

Full Text Available Maxime Gougis, Dongling Ma, Mohamed Mohamedi INRS-Énergie, Matériaux et Télécommunications, Varennes, Québec, Canada Abstract: In this work, we report for the first time the use of tungsten oxide (WOx as catalyst support for Au toward the direct electrooxidation of glucose. The nanostructured WOx/Au electrodes were synthesized by means of laser-ablation technique. Both micro-Raman spectroscopy and transmission electron microscopy showed that the produced WOx thin film is amorphous and made of ultrafine particles of subnanometer size. X-ray diffraction and X-ray photoelectron spectroscopy revealed that only metallic Au was present at the surface of the WOx/Au composite, suggesting that the WOx support did not alter the electronic structure of Au. The direct electrocatalytic oxidation of glucose in neutral medium such as phosphate buffered saline (pH 7.2 solution has been investigated with cyclic voltammetry, chronoamperometry, and square-wave voltammetry. Sensitivity as high as 65.7 µA cm-2 mM-1 up to 10 mM of glucose and a low detection limit of 10 µM were obtained with square-wave voltammetry. This interesting analytical performance makes the laser-fabricated WOx/Au electrode potentially promising for implantable glucose fuel cells and biomedical analysis as the evaluation of glucose concentration in biological fluids. Finally, owing to its unique capabilities proven in this work, it is anticipated that the laser-ablation technique will develop as a fabrication tool for chip miniature-sized sensors in the near future. Keywords: Au, tungsten oxide, nanostructures, pulsed laser deposition, glucose oxidation and sensing

Studies on Lyme disease incidence rates in selected groups of forestry workers in West Pomerania, 2005–2014

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Tomasz Stawicki

2017-04-01

Full Text Available Background: The data collected by sanitary-epidemiological stations in 2005–2014 were analyzed to determine the incidence rates of borreliosis Lyme disease in the West Pomerania group of workers exposed to tick bites. Material and Methods: It was assumed that an adequate comparison of official epidemiological data with the data concerning the number of exposed people, is an indispensable condition for assessing properly the trend in Lyme disease incidence rates, concerning at the same time a real scale of occupational exposure. The study covered a selected group of forestry workers, i.e., white-collar staff employed in different units of the State Forests National Forest Holding with their seats in West Pomerania. The aim of the research was to process and analyze the data on workers employed in the forest sector and their positions, requested from district sanitary-epidemiological stations. Results: In the years concerned 282 cases of the occupational disease were recorded mainly in the groups of forest rangers, junior foresters and forest service inspectors. The values of the incidence factor exhibit high variability with the major share of cases recorded in the years 2008–2010 that accounted for 61.8% of the total occurrences concerned. The incidence in the years 2008, 2009 and 2010 amounted to 2418, 2828 and 2646 cases per 100 000 employees, respectively. Conclusions: The results show that previously published information about the incidence of Lyme disease in the agriculture, forestry and hunting sector, did not fully illustrate a real scale of occupational risk. Med Pr 2017;68(2:211–220

Spitting Image: Tick Saliva Assists the Causative Agent of Lyme Disease in Evading Host Skin's Innate Immune Response

NARCIS (Netherlands)

Hovius, Joppe W. R.

2009-01-01

Lyme disease is caused by the spirochete Borrelia burgdorferi and is transmitted through ticks. Inhibition of host skin's innate immune response might be instrumental to both tick feeding and B. burgdorferi transmission. The article by Marchal et al. describes how tick saliva suppresses B.

Lyme disease ecology in a changing world: Consensus, uncertainty and critical gaps for improving control

Science.gov (United States)

Kilpatrick, A. Marm; Dobson, Andrew D.M.; Levi, Taal; Salkeld, Daniel J.; Swei, Andrea; Ginsberg, Howard; Kjemtrup, Anne; Padgett, Kerry A.; Jensen, Per A.; Fish, Durland; Ogden, Nick H.; Diuk-Wasser, Maria A.

2017-01-01

Lyme disease is the most common tick-borne disease in temperate regions of North America, Europe and Asia, and the number of reported cases has increased in many regions as landscapes have been altered. Although there has been extensive work on the ecology and epidemiology of this disease in both Europe and North America, substantial uncertainty exists about fundamental aspects that determine spatial and temporal variation in both disease risk and human incidence, which hamper effective and efficient prevention and control. Here we describe areas of consensus that can be built on, identify areas of uncertainty and outline research needed to fill these gaps to facilitate predictive models of disease risk and the development of novel disease control strategies. Key areas of uncertainty include: (i) the precise influence of deer abundance on tick abundance, (ii) how tick populations are regulated, (iii) assembly of host communities and tick-feeding patterns across different habitats, (iv) reservoir competence of host species, and (v) pathogenicity for humans of different genotypes of Borrelia burgdorferi. Filling these knowledge gaps will improve Lyme disease prevention and control and provide general insights into the drivers and dynamics of this emblematic multi-host–vector-borne zoonotic disease.

Ensembles de donnees nationales : sources d'information sur la garde des enfants au Canada

OpenAIRE

Forer, Barry; Hertzman, Clyde; Kohen, Dafna

2006-01-01

La presente etude fournit une description des differents ensembles de donnees canadiennes qui pourraient etre utilises pour examiner des questions relatives au recours aux services de garde. Les ensembles de donnees nationales qui traitent des tendances de l'emploi, de l'emploi du temps, des revenus familiaux, du soutien social ainsi que des mesures de la sante des enfants, des adolescents et des adultes ont ete inclus. On a conclu que de nombreuses questions demeurent sans reponse en ce qui ...

High-p$_{T}$ Tomography of d+Au and Au+Au at SPS, RHIC, and LHC

CERN Document Server

Vitev, I; Vitev, Ivan; Gyulassy, Miklos

2002-01-01

The interplay of nuclear effects on the p_T > 2 GeV inclusive hadron spectra in d+Au and Au+Au reactions at root(s) = 17, 200, 5500 GeV is compared to leading order perturbative QCD calculations for elementary p+p (p-bar+p) collisions. The competition between nuclear shadowing, Cronin effect, and jet energy loss due to medium-induced gluon radiation is predicted to lead to a striking energy dependence of the nuclear suppression/enhancement pattern in A+A reactions. We show that future d+Au data can used to disentangle the initial and final state effects.

Serum carnitine concentration is decreased in patients with Lyme borreliosis

Directory of Open Access Journals (Sweden)

Alina Kępka

2016-03-01

Full Text Available Background: Lyme borreliosis (LB is a serious infectious disease. Carnitine plays a crucial role in metabolism and inflammatory responses. Carnitine may be important in improving neuronal dysfunction and loss of neurons. Aim: To evaluate serum carnitine concentration in adult patients with various clinical types of LB. Material/Methods: Groups: 1 patients with erythema migrans (EM, n=16, 2 neuroborreliosis (NB, n=10, 3 post-Lyme disease (PLD, n=22 and healthy controls (HC, n=32. Total (TC and free (FC carnitine were determined with the spectrophotometric method. Results: TC levels (44.9±10.4, 28.0±8.4, 35.9±15.6 μmol/L in the EM, NB and PLD patients were lower than in HC (54.0±11.4 μmol/L, p < 0.001. FC levels (32.7±7.7, 23.6±6.8, 26.3±11.2 μmol/L in the EM, NB and PLD patients were lower than in HC (40.5±7.6 μmol/L, p < 0.001. AC levels (12.2±5.2, 4.4±2.6, 9.6±7.4 μmol/L in the EM, NB and PLD patients were lower in the NB and PLD patients than in HC (13.5±8.40 μmol/L, p <0.001. AC/FC ratio was 0.31±0.14, 0.18±0.09, 0.39±0.33 in the EM, NB and PLD patients. Conclusions: LB patients exhibit a significant decrease of their serum carnitine concentrations. The largest changes were in the NB and PLD patients. To prevent late complications of the disease a possibility of early supplementation with carnitine should be considered. Further studies are required to explain the pathophysiological significance of our findings.

Élaboration d’indicateurs pour l’évaluation des collectivités-amies des aînés au Canada : démarche et résultats

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H. Orpana

2016-01-01

Full Text Available Introduction : En 2006, l’Organisation mondiale de la Santé (OMS a lancé le projet mondial « Villes-amies des aînés » afin de favoriser un vieillissement actif. Si un grand nombre d’initiatives « amies des aînés » ont été mises en oeuvre au Canada, on dispose de peu d’information sur l’efficacité et les résultats des initiatives des collectivités-amies des aînés (CAA. En outre, les intervenants affirment qu’ils n’ont pas la capacité et les outils nécessaires pour élaborer et réaliser des évaluations relatives à leurs initiatives de CAA. Afin de pallier ces lacunes, l’Agence de la santé publique du Canada a mis au point des indicateurs pour l’évaluation des initiatives de CAA dans de nombreuses collectivités canadiennes. Ces indicateurs, destinés à répondre aux différents besoins des collectivités, ne sont pas conçus pour faire l’évaluation de répercussions collectives ou pour rendre possible une comparaison entre collectivités. Méthodologie : Une démarche de consultation itérative fondée sur des données probantes a été employée pour l’élaboration d’indicateurs relatifs aux CAA. Elle a nécessité une revue de la littérature et une analyse du contexte. Deux rondes de consultation auprès d’experts et d’intervenants clés ont été menées, ce qui a permis de classer les indicateurs potentiels en fonction de leur importance, de leur capacité à être mis en pratique et de leur faisabilité. Une liste définitive d’indicateurs et de mesures potentielles a ensuite été mise au point, en fonction des résultats de ces consultations et de considérations clés relatives aux politiques. Résultats : Trente-neuf indicateurs répartis en huit domaines relevant des CAA et quatre indicateurs relevant des résultats liés à la santé et aux conditions sociales à long terme ont été sélectionnés. Tous sont conformes à l’objectif énoncé, à savoir l’évaluation des

Antibodies against a tick protein, Salp15, protect mice from the Lyme disease agent

OpenAIRE

Dai, Jianfeng; Wang, Penghua; Adusumilli, Sarojini; Booth, Carmen J.; Narasimhan, Sukanya; Anguita, Juan; Fikrig, Erol

2009-01-01

Traditionally, vaccines directly target a pathogen or microbial toxin. Lyme disease, caused by Borrelia burgdorferi, is a tick-borne illness for which a human vaccine is not currently available. B. burgdorferi binds a tick salivary protein, Salp15, during transmission from the vector, and this interaction facilitates infection of mice. We now show that Salp15-antiserum significantly protected mice from B. burgdorferi infection. Salp15-antiserum also markedly enhanced the protective capacity o...

Local structure of disordered Au-Cu and Au-Ag alloys

International Nuclear Information System (INIS)

Frenkel, A. I.; Machavariani, V. Sh.; Rubshtein, A.; Rosenberg, Yu.; Voronel, A.; Stern, E. A.

2000-01-01

X-ray-absorption fine structure (XAFS) and x-ray-diffraction (XRD) measurements of disordered alloys Au x Cu 1-x and Au 0.5 Ag 0.5 prepared by melt spinning were performed. In the Au 0.5 Ag 0.5 alloy, no significant local deviations of the atoms from the average fcc lattice were detected while in Au x Cu 1-x alloys, significant deviations of atoms from the average fcc lattice were found. Mean-square vibrations of the Cu-Cu distances revealed by the XAFS in Au x Cu 1-x alloys indicate the weakening of contact between Cu atoms in the dilute limit. Our computer simulation for Au x Cu 1-x clusters of 10 5 atoms reproduces the main features of both the XAFS and XRD data

Nuclear spin of 185Au and hyperfine structure of 188Au

International Nuclear Information System (INIS)

Ekstroem, C.; Ingelman, S.; Wannberg, G.

1977-03-01

The nuclear spin of 185 Au, I = 5/2, and the hyperfine separation of 188 Au, Δγ = +- 2992(30) MHz, have been measured with the atomic-beam magnetic resonance method. The spin of 185 Au indicates a deformed nuclear shape in the ground state. The small magnetic moment of 188 Au is close in value to those of the heavier I = 1 gold isotopes 190 192 194 Au, being located in a typical transition region. (Auth.)

Diversity and convergence of population aging: evidence from China and Canada

Directory of Open Access Journals (Sweden)

Légaré, Jacques

2004-01-01

Full Text Available EnglishTaking the diversity and the convergence of demographic transitions intoconsideration, it is hypothesized that population aging that occurs in developed countries anddeveloping countries will reflect diversity, but will also show some convergence. In order to testthis hypothesis, the present study compares the population aging experiences of China (1971-2050 andCanada (1911-2050 and places them within the context of the demographic transition. In this paper welearn how, as population ages, these two countries will, through two distinct pathways, arrive atsimilar age structures by the middle of the 21st century. Both the diversity and the convergence ofpopulation aging are shown in this comparative study.FrenchEn constatant la diversité et la convergence des transitions démographiques,nous faisons l'hypothèse que le processus du vieillissement démographiquecomporte également une certaine diversité et montrera une convergence, enparticulier, entre les pays développés et les pays en développement. Afin devérifier cette hypothèse, la présente étude compare les vieillissementsdémographiques en Chine (1971-2050 et au Canada (1911-2050, en lesmettant dans le contexte de la transition démographique. Cet article montre qu’àmesure que vieillit la population, comment ces deux pays arriveront par deuxvoies distinctes à une structure par âge similaire au milieu du XXIème siècle. Ladiversité et la convergence du vieillissement sont toutes deux illustrées danscette étude comparative.

Evidence of final-state suppression of high-p{_ T} hadrons in Au + Au collisions using d + Au measurements at RHIC

Science.gov (United States)

Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Becker, B.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; Gburek, T.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Harrington, A. S.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Khan, N.; Kulinich, P.; Kuo, C. M.; Lee, J. W.; Lin, W. T.; Manly, S.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Roland, C.; Roland, G.; Sagerer, J.; Sarin, P.; Sedykh, I.; Skulski, W.; Smith, C. E.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tonjes, M. B.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Veres, G. I.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wysłouch, B.; Zhang, J.

Transverse momentum spectra of charged hadrons with pT 2 GeV/c). In contrast, the d + Au nuclear modification factor exhibits no suppression of the high-pT yields. These measurements suggest a large energy loss of the high-pT particles in the highly interacting medium created in the central Au + Au collisions. The lack of suppression in d + Au collisions suggests that it is unlikely that initial state effects can explain the suppression in the central Au + Au collisions. PACS: 25.75.-q

Lone-father families in Canada, 1971-1996

Directory of Open Access Journals (Sweden)

McQuillan, Kevin

2001-01-01

Full Text Available EnglishDemographers and sociologists have paid considerable attention to thesituation of lone-parent families. However, until recently, almost all of this work has focused onfamilies headed by a lone mother. This paper seeks to fill an important gap in our knowledge of familychange by examining the growth and characteristics of lone-father families in Canada. Using data fromthe public-use microfiles (PUMFs of the census, the paper shows that the number of lone-fatherfamilies has increased significantly in recent years, and that lone fathers are now younger and morelikely to have become lone fathers through marital breakdown. The results also suggest that while lone-father families are not as economically disadvantaged as lone-mother families, income levels lag wellbehind those of two-parent families and have, in relative terms, declined in recent years.FrenchLes démographes et sociologues se sont beaucoup attardés à la situation desfamilles monoparentales. Cependant, jusqu'à récemment, l'ensemble de cetravail ciblait surtout les mères seules. Cet article cherche à combler la brèchede notre connaissance des changements dans la famille en examinantl'augmentation du nombre de pères seuls au Canada et les caractéristiques de cesfamilles. Grâce aux données des microfilms à usage public du recensement,l'article illustre que le nombre de pères seuls a considérablement augmenté aucours des dernières années, que les pères seuls sont plus jeunes et que leursituation résulte vraisemblablement de la rupture de leur mariage. Les résultatsindiquent aussi que bien que les familles dont le père est monoparental ne soientpas aussi défavorisées que les familles dont la mère est monoparentale, lesniveaux de revenu accusent un certain retard par rapport aux famillesbiparentales et qu'ils ont relativement baissé au cours des dernières années.

Comparative efficiencies of photothermal destruction of malignant cells using antibody-coated silica-Au nanoshells, hollow Au/Ag nanospheres and Au nanorods

Energy Technology Data Exchange (ETDEWEB)

Cheng, Fong-Yu; Chen, Chen-Tai; Yeh, Chen-Sheng, E-mail: csyeh@mail.ncku.edu.t [Department of Chemistry, National Cheng Kung University, Tainan 701, Taiwan (China)

2009-10-21

Three Au-based nanomaterials (silica-Au nanoshells, hollow Au/Ag nanospheres and Au nanorods) were evaluated for their comparative photothermal efficiencies at killing three types of malignant cells (A549 lung cancer cells, HeLa cervix cancer cells and TCC bladder cancer cells) using a CW NIR laser. Photodestructive efficiency was evaluated as a function of the number of nanoparticles required to destroy the cancer cells under 808 nm laser wavelength at fixed laser power. Of the three nanomaterials, silica/Au nanoshells needed the minimum number of particles to produce effective photodestruction, whereas Au nanorods needed the largest number of particles. Together with the calculated photothermal conversion efficiency, the photothermal efficiency rankings are silica-Au nanoshells > hollow Au/Ag nanospheres > Au nanorods. Additionally, we found that HeLa cells seem to present better heat tolerance than the other two cancer cell lines.

CCL19 as a Chemokine Risk Factor for Posttreatment Lyme Disease Syndrome: a Prospective Clinical Cohort Study

Science.gov (United States)

Soloski, Mark J.; Rebman, Alison W.; Crowder, Lauren A.; Wagner, Catriona A.; Robinson, William H.; Bechtold, Kathleen T.

2016-01-01

Approximately 10% to 20% of patients optimally treated for early Lyme disease develop persistent symptoms of unknown pathophysiology termed posttreatment Lyme disease syndrome (PTLDS). The objective of this study was to investigate associations between PTLDS and immune mediator levels during acute illness and at several time points following treatment. Seventy-six participants with physician-documented erythema migrans and 26 healthy controls with no history of Lyme disease were enrolled. Sixty-four cytokines, chemokines, and inflammatory markers were measured at each visit for a total of 6 visits over 1 year. An operationalized definition of PTLDS incorporating symptoms and functional impact was applied at 6 months and 1 year following treatment completion, and clinical outcome groups were defined as the return-to-health, symptoms-only, and PTLDS groups. Significance analysis of microarrays identified 7 of the 64 immune mediators to be differentially regulated by group. Generalized logit regressions controlling for potential confounders identified posttreatment levels of the T-cell chemokine CCL19 to be independently associated with clinical outcome group. Receiver operating characteristic analysis identified a CCL19 cutoff of >111.67 pg/ml at 1 month following treatment completion to be 82% sensitive and 83% specific for later PTLDS. We speculate that persistently elevated CCL19 levels among participants with PTLDS may reflect ongoing, immune-driven reactions at sites distal to secondary lymphoid tissue. Our findings suggest the relevance of CCL19 both during acute infection and as an immunologic risk factor for PTLDS during the posttreatment phase. Identification of a potential biomarker predictor for PTLDS provides the opportunity to better understand its pathophysiology and to develop early interventions in the context of appropriate and specific clinical information. PMID:27358211

Mental Health and Service Issues Faced by Older Immigrants in Canada: A Scoping Review.

Science.gov (United States)

Guruge, Sepali; Thomson, Mary Susan; Seifi, Sadaf Grace

2015-12-01

RÉSUMÉ Une population vieillissante et la croissance de la population sur la base de l'immigration nécessitent que la recherche, la pratique et la politique doivent se concentrer sur la santé mentale des immigrants âgés, surtout parce que leur santé mentale semble se détériorer au fil du temps. Cette revue se concentre sur: Qu'est-ce que l'on sait sur les déterminants sociaux de la santé mentale chez les immigrants âgés, et quels sont les obstacles à l'accès aux services de santé mentale confrontés par les immigrants âgés? Les résultats révèlent que (1) les déterminants sociaux décisifs de la santé mentale sont la culture, le sexe et les services de santé; (2) que les immigrants plus âgés utilisent les services de santé mentale de moins que leurs homologues nés au Canada à cause des obstacles tels que, par exemple, les croyances et les valeurs culturelles, un manque de services culturellement et linguistiquement appropriées, des difficultés financières, et l'âgisme; et (3) quelles que soient les sous-catégories dans cette population, les immigrants âgés éprouvent des inégalités en matière de la santé mentale. La preuve des recherches disponibles indique que de combler les lacunes des service de santé mentale devrait devenir une priorité pour la politique et la pratique du système de soins de santé au Canada.

Synthesis of nir-sensitive Au-Au{sub 2}S nanocolloids for drug delivery

Energy Technology Data Exchange (ETDEWEB)

Ren, L.; Chow, G.M

2003-01-15

Near IR (NIR) sensitive Au-Au{sub 2}S nanocolloids were prepared by mixing HAuCl{sub 4} and Na{sub 2}S in aqueous solutions. An anti-tumor drug, cis-platin, was adsorbed onto Au-Au{sub 2}S nanoparticle surface via the 11-mercaptoundecanoic acid (MUA) layers. The results show that the degree of adsorption of cis-platin onto Au-Au{sub 2}S nanoparticles was controlled by the solution pH value, and the drug release was sensitive to near-infrared irradiation. The cis-platin-loaded Au-Au{sub 2}S nanocolloids can be potentially applied as NIR activated drug delivery carrier.

English for au pairs the au pair's guide to learning English

CERN Document Server

Curtis, Lucy

2014-01-01

English for Au Pairs has interlinked stories about a group of au pairs new to England. Marta, an 18-year-old from Poland arrives in the UK to work as an au pair. Throughout her year-long stay she has many different experiences - some bad, some good - but with the support of her host family she finds new friends and improves her English. English for Au Pairs offers insight into the joys and difficulties of being an au pair while at the same time reinforcing English language learning through grammar explanations and exercises.

A tick mannose-binding lectin inhibitor interferes with the vertebrate complement cascade to enhance transmission of the lyme disease agent

NARCIS (Netherlands)

Schuijt, Tim J.; Coumou, Jeroen; Narasimhan, Sukanya; Dai, Jianfeng; Deponte, Kathleen; Wouters, Diana; Brouwer, Mieke; Oei, Anneke; Roelofs, Joris J. T. H.; van Dam, Alje P.; van der Poll, Tom; van't Veer, Cornelis; Hovius, Joppe W.; Fikrig, Erol

2011-01-01

The Lyme disease agent Borrelia burgdorferi is primarily transmitted to vertebrates by Ixodes ticks. The classical and alternative complement pathways are important in Borrelia eradication by the vertebrate host. We recently identified a tick salivary protein, designated P8, which reduced

Cost-effectiveness of longer-term versus shorter-term provision of antibiotics in patients with persistent symptoms attributed to Lyme disease

NARCIS (Netherlands)

Berende, A.; Nieuwenhuis, L.; Hofstede, H.J.M. ter; Vos, F.J.; Vogelaar, M.L.; Tromp, M.A.; Middendorp, H. van; Donders, A.R.T.; Evers, A.W.M.; Kullberg, B.J.; Adang, E.M.M.

2018-01-01

BACKGROUND: The treatment of persistent symptoms attributed to Lyme disease remains controversial. Recently, the PLEASE study did not demonstrate any additional clinical benefit of longer-term versus shorter-term antibiotic treatment. However, the economic impact of the antibiotic strategies has not

Electron diffraction on amorphous and crystalline AuAl2 , AuGa2 and AuIn2 thin films

International Nuclear Information System (INIS)

Bohorquez, A.

1991-01-01

Experimental (in situ) measurements of electron diffraction and resistivity of amorphous and crystalline AuAl 2 , AuGa 2 and AuIn 2 thin films were performed. Thin films were produced by quench condensation. Interference and atomic distribution functions were analyzed assuming the same short range order for the three systems in the amorphous phase. The experimental results do not agree with this assumption, giving evidence that the short range order is not the same for the three amorphous systems. Further discussion of interference and atomic distribution functions shows a more evident tendency in amorphous AuIn 2 where short order of AuIn 2 and In can be inferred. (Author)

Complex Population Structure of Lyme Borreliosis Group Spirochete Borrelia garinii in Subarctic Eurasia

Science.gov (United States)

Comstedt, Pär; Asokliene, Loreta; Eliasson, Ingvar; Olsen, Björn; Wallensten, Anders; Bunikis, Jonas; Bergström, Sven

2009-01-01

Borrelia garinii, a causative agent of Lyme borreliosis in Europe and Asia, is naturally maintained in marine and terrestrial enzootic cycles, which primarily involve birds, including seabirds and migratory passerines. These bird groups associate with, correspondingly, Ixodes uriae and Ixodes ricinus ticks, of which the latter species may bite and transmit the infection to humans. Studies of the overlap between these two natural cycles of B. garinii have been limited, in part due to the absence of representative collections of this spirochete's samples, as well as of the lack of reliable measure of the genetic heterogeneity of its strains. As a prerequisite for understanding the epidemiological correlates of the complex maintenance of B. garinii, the present study sought to assess the diversity and phylogenetic relationships of this species' strains from its natural hosts and patients with Lyme borreliosis from subarctic Eurasia. We used sequence typing of the partial rrs-rrl intergenic spacer (IGS) of archived and prospective samples of B. garinii from I. uriae ticks collected predominantly on Commander Islands in North Pacific, as well as on the islands in northern Sweden and arctic Norway. We also typed B. garinii samples from patients with Lyme borreliosis and I. ricinus ticks infesting migratory birds in southern Sweden, or found questing in selected sites on the islands in the Baltic Sea and Lithuania. Fifty-two (68%) of 77 B. garinii samples representing wide geographical range and associated with I. ricinus and infection of humans contributed 12 (60%) of total 20 identified IGS variants. In contrast, the remaining 25 (32%) samples recovered from I. uriae ticks from a few islands accounted for as many as 10 (50%) IGS types, suggesting greater local diversity of B. garinii maintained by seabirds and their ticks. Two IGS variants of the spirochete in common for both tick species were found in I. ricinus larvae from migratory birds, an indication that B

The cyclic-di-GMP signaling pathway in the Lyme disease spirochete, Borrelia burgdorferi

Directory of Open Access Journals (Sweden)

Elizabeth A. Novak

2014-05-01

Full Text Available In nature, the Lyme disease spirochete Borrelia burgdorferi cycles between the unrelated environments of the Ixodes tick vector and mammalian host. In order to survive transmission between hosts, B. burgdorferi must be able to not only detect changes in its environment, but also rapidly and appropriately respond to these changes. One manner in which this obligate parasite regulates and adapts to its changing environment is through cyclic-di-GMP (c-di-GMP signaling. c-di-GMP has been shown to be instrumental in orchestrating the adaptation of B. burgdorferi to the tick environment. B. burgdorferi possesses only one set of c-di-GMP-metabolizing genes (one diguanylate cyclase and two distinct phosphodiesterases and one c-di-GMP-binding PilZ-domain protein designated as PlzA. While studies in the realm of c-di-GMP signaling in B. burgdorferi have exploded in the last few years, there are still many more questions than answers. Elucidation of the importance of c-di-GMP signaling to B. burgdorferi may lead to the identification of mechanisms that are critical for the survival of B. burgdorferi in the tick phase of the enzootic cycle as well as potentially delineate a role (if any c-di-GMP may play in the transmission and virulence of B. burgdorferi during the enzootic cycle, thereby enabling the development of effective drugs for the prevention and/or treatment of Lyme disease.

Design, construction and evaluation of multi-epitope antigens for diagnosis of Lyme disease.

Science.gov (United States)

Schreterova, Eva; Bhide, Mangesh; Potocnakova, Lenka; Borszekova Pulzova, Lucia

2017-12-23

Introduction and objective. Lyme disease (LD) is the most common vector-borne disease in the temperate zone of the Northern Hemisphere. Diagnosis of LD is mainly based on clinical symptoms supported with serology (detection of anti-Borrelia antibodies) and is often misdiagnosed in areas of endemicity. In this study, the chimeric proteins (A/C-2, A/C-4 and A/C-7.1) consisting of B-cell epitopes of outer surface proteins OspA and OspC from Borrelia genospecies prevalent in Eastern Slovakia, were designed, over-expressed in E. coli, and used to detect specific anti-Borrelia antibodies in serologically characterized sera from patients with Lyme-like symptoms to evaluate their diagnostic potential. Results showed that chimeras vary in their immuno-reactivity when tested with human sera. Compared with the results obtained from a two-tier test, the application of recombinant multi-epitope chimeric proteins as diagnosis antigens, produced fair agreement in the case of A/C-2 (0.20<κ<0.40) and good agreement (0.60<κ<0.80) when A/C-7.1 was used as capture antigen. Chimera A/C-4 were excluded from further study due to loss of reactivity with OspA-specific antibodies. The combination of specific B-cell epitopes from OspA and OspC proteins may improve the diagnostic accuracy of serologic assays, but further studies are required to address this hypothesis.

Di-hadron correlations with identified leading hadrons in 200 GeV Au + Au and d + Au collisions at STAR

Science.gov (United States)

Adamczyk, L.; Adkins, J. K.; Agakishiev, G.; Aggarwal, M. M.; Ahammed, Z.; Alekseev, I.; Aparin, A.; Arkhipkin, D.; Aschenauer, E. C.; Averichev, G. S.; Bai, X.; Bairathi, V.; Banerjee, A.; Bellwied, R.; Bhasin, A.; Bhati, A. K.; Bhattarai, P.; Bielcik, J.; Bielcikova, J.; Bland, L. C.; Bordyuzhin, I. G.; Bouchet, J.; Brandenburg, D.; Brandin, A. V.; Bunzarov, I.; Butterworth, J.; Caines, H.; Calderón de la Barca Sánchez, M.; Campbell, J. M.; Cebra, D.; Cervantes, M. C.; Chakaberia, I.; Chaloupka, P.; Chang, Z.; Chattopadhyay, S.; Chen, X.; Chen, J. H.; Cheng, J.; Cherney, M.; Christie, W.; Contin, G.; Crawford, H. J.; Das, S.; De Silva, L. C.; Debbe, R. R.; Dedovich, T. G.; Deng, J.; Derevschikov, A. A.; di Ruzza, B.; Didenko, L.; Dilks, C.; Dong, X.; Drachenberg, J. L.; Draper, J. E.; Du, C. M.; Dunkelberger, L. E.; Dunlop, J. C.; Efimov, L. G.; Engelage, J.; Eppley, G.; Esha, R.; Evdokimov, O.; Eyser, O.; Fatemi, R.; Fazio, S.; Federic, P.; Fedorisin, J.; Feng, Z.; Filip, P.; Fisyak, Y.; Flores, C. E.; Fulek, L.; Gagliardi, C. A.; Garand, D.; Geurts, F.; Gibson, A.; Girard, M.; Greiner, L.; Grosnick, D.; Gunarathne, D. S.; Guo, Y.; Gupta, S.; Gupta, A.; Guryn, W.; Hamad, A.; Hamed, A.; Haque, R.; Harris, J. W.; He, L.; Heppelmann, S.; Heppelmann, S.; Hirsch, A.; Hoffmann, G. W.; Hofman, D. J.; Horvat, S.; Huang, T.; Huang, B.; Huang, H. Z.; Huang, X.; Huck, P.; Humanic, T. J.; Igo, G.; Jacobs, W. W.; Jang, H.; Jia, J.; Jiang, K.; Judd, E. G.; Kabana, S.; Kalinkin, D.; Kang, K.; Kauder, K.; Ke, H. W.; Keane, D.; Kechechyan, A.; Khan, Z. H.; Kikoła, D. P.; Kisiel, A.; Kochenda, L.; Koetke, D. D.; Kosarzewski, L. K.; Kraishan, A. F.; Kravtsov, P.; Krueger, K.; Kumar, L.; Lamont, M. A. C.; Landgraf, J. M.; Landry, K. D.; Lauret, J.; Lebedev, A.; Lednicky, R.; Lee, J. H.; Li, X.; Li, W.; Li, Z. M.; Li, Y.; Li, C.; Li, X.; Lisa, M. A.; Liu, F.; Ljubicic, T.; Llope, W. J.; Lomnitz, M.; Longacre, R. S.; Luo, X.; Ma, G. L.; Ma, Y. G.; Ma, R.; Ma, L.; Magdy, N.; Majka, R.; Manion, A.; Margetis, S.; Markert, C.; Masui, H.; Matis, H. S.; McDonald, D.; Meehan, K.; Mei, J. C.; Minaev, N. G.; Mioduszewski, S.; Mishra, D.; Mohanty, B.; Mondal, M. M.; Morozov, D. A.; Mustafa, M. K.; Nandi, B. K.; Nasim, Md.; Nayak, T. K.; Nigmatkulov, G.; Niida, T.; Nogach, L. V.; Noh, S. Y.; Novak, J.; Nurushev, S. B.; Odyniec, G.; Ogawa, A.; Oh, K.; Okorokov, V.; Olvitt, D.; Page, B. S.; Pak, R.; Pan, Y. X.; Pandit, Y.; Panebratsev, Y.; Pawlik, B.; Pei, H.; Perkins, C.; Peterson, A.; Pile, P.; Pluta, J.; Poniatowska, K.; Porter, J.; Posik, M.; Poskanzer, A. M.; Pruthi, N. K.; Putschke, J.; Qiu, H.; Quintero, A.; Ramachandran, S.; Raniwala, R.; Raniwala, S.; Ray, R. L.; Ritter, H. G.; Roberts, J. B.; Rogachevskiy, O. V.; Romero, J. L.; Roy, A.; Ruan, L.; Rusnak, J.; Rusnakova, O.; Sahoo, N. R.; Sahu, P. K.; Sakrejda, I.; Salur, S.; Sandweiss, J.; Sarkar, A.; Schambach, J.; Scharenberg, R. P.; Schmah, A. M.; Schmidke, W. B.; Schmitz, N.; Seger, J.; Seyboth, P.; Shah, N.; Shahaliev, E.; Shanmuganathan, P. V.; Shao, M.; Sharma, B.; Sharma, M. K.; Shen, W. Q.; Shi, S. S.; Shou, Q. Y.; Sichtermann, E. P.; Sikora, R.; Simko, M.; Singha, S.; Skoby, M. J.; Smirnov, N.; Smirnov, D.; Song, L.; Sorensen, P.; Spinka, H. M.; Srivastava, B.; Stanislaus, T. D. S.; Stepanov, M.; Strikhanov, M.; Stringfellow, B.; Sumbera, M.; Summa, B.; Sun, Y.; Sun, Z.; Sun, X. M.; Sun, X.; Surrow, B.; Svirida, D. N.; Szelezniak, M. A.; Tang, A. H.; Tang, Z.; Tarnowsky, T.; Tawfik, A.; Thomas, J. H.; Timmins, A. R.; Tlusty, D.; Todoroki, T.; Tokarev, M.; Trentalange, S.; Tribble, R. E.; Tribedy, P.; Tripathy, S. K.; Tsai, O. D.; Ullrich, T.; Underwood, D. G.; Upsal, I.; Van Buren, G.; van Nieuwenhuizen, G.; Vandenbroucke, M.; Varma, R.; Vasiliev, A. N.; Vertesi, R.; Videbæk, F.; Viyogi, Y. P.; Vokal, S.; Voloshin, S. A.; Vossen, A.; Wang, J. S.; Wang, F.; Wang, H.; Wang, G.; Wang, Y.; Wang, Y.; Webb, G.; Webb, J. C.; Wen, L.; Westfall, G. D.; Wieman, H.; Wissink, S. W.; Witt, R.; Wu, Y. F.; Wu; Xiao, Z. G.; Xie, W.; Xin, K.; Xu, H.; Xu, Z.; Xu, Q. H.; Xu, Y. F.; Xu, N.; Yang, S.; Yang, Y.; Yang, Q.; Yang, Y.; Yang, C.; Yang, Y.; Ye, Z.; Ye, Z.; Yepes, P.; Yi, L.; Yip, K.; Yoo, I.-K.; Yu, N.; Zbroszczyk, H.; Zha, W.; Zhang, Y.; Zhang, Z.; Zhang, J. B.; Zhang, J.; Zhang, X. P.; Zhang, S.; Zhang, J.; Zhao, J.; Zhong, C.; Zhou, L.; Zhu, X.; Zoulkarneeva, Y.

2015-12-01

The STAR Collaboration presents for the first time two-dimensional di-hadron correlations with identified leading hadrons in 200 GeV central Au + Au and minimum-bias d + Au collisions to explore hadronization mechanisms in the quark gluon plasma. The enhancement of the jet-like yield for leading pions in Au + Au data with respect to the d + Au reference and the absence of such an enhancement for leading non-pions (protons and kaons) are discussed within the context of a quark recombination scenario. The correlated yield at large angles, specifically in the ridge region, is found to be significantly higher for leading non-pions than pions. The consistencies of the constituent quark scaling, azimuthal harmonic model and a mini-jet modification model description of the data are tested, providing further constraints on hadronization.

Catching Up or Falling Behind? Continuing Wealth Disparities for Immigrants to Canada by Region of Origin and Cohort.

Science.gov (United States)

Maroto, Michelle; Aylsworth, Laura

2016-11-01

This paper investigates wealth disparities among first-generation immigrants using data from the 2012 Survey of Financial Security. We apply logistic and linear regression models to estimate disparities in homeownership and household equivalent net worth by immigrant status, region of origin, and time since arrival. By focusing on immigrant families from different regions who entered Canada at different points in time, this research applies theories related to assimilation, human capital, and structural barriers to wealth. Our findings demonstrate that even though many immigrant families transition into homeownership and grow their wealth over time, certain first-generation immigrant groups continue to experience wealth disparities many years after their arrival to Canada. In particular, immigrant families from African, Asian, and Middle Eastern countries experienced the largest wealth gaps. Cet article examine les disparités de richesse entre les immigrants de première génération en utilisant les données de l'Enquête 2012 sur la sécurité financière. Nous appliquons des modèles de régression logistique et linéaire pour estimer les disparités dans la propriété et valeur nette des ménages équivalente par le statut d'immigrant, la région d'origine, et le temps écoulé depuis leur arrivée. En se concentrant sur les familles d'immigrants de différentes régions qui sont entrés au Canada à différents points dans le temps, cette recherche applique les théories liées à l'assimilation, le capital humain, et les obstacles structurels à la richesse. Nos résultats démontrent que même si de nombreuses familles d'immigrants transition vers la propriété et de croître leur richesse au fil du temps, certains groupes d'immigrants de première génération continuent d'éprouver des disparités de richesse de nombreuses années après leur arrivée au Canada. En particulier, les familles d'immigrants d'Afrique, d'Asie, et les pays du Moyen-Orient ont

A Novel Scoring System Approach to Assess Patients with Lyme Disease (Nutech Functional Score)

OpenAIRE

Geeta Shroff; Petra Hopf-Seidel

2018-01-01

Introduction: A bacterial infection by Borrelia burgdorferi referred to as Lyme disease (LD) or borreliosis is transmitted mostly by a bite of the tick Ixodes scapularis in the USA and Ixodes ricinus in Europe. Various tests are used for the diagnosis of LD, but their results are often unreliable. We compiled a list of clinically visible and patient-reported symptoms that are associated with LD. Based on this list, we developed a novel scoring system. Methodology: Nutech functional Score (NF...

Diagnostic Lumbar Puncture Among Children With Facial Palsy in a Lyme Disease Endemic Area.

Science.gov (United States)

Paydar-Darian, Niloufar; Kimia, Amir A; Lantos, Paul M; Fine, Andrew M; Gordon, Caroline D; Gordon, Catherine R; Landschaft, Assaf; Nigrovic, Lise E

2017-06-01

We identified 620 children with peripheral facial palsy of which 211 (34%) had Lyme disease. The 140 children who had a lumbar puncture performed were more likely to be hospitalized (73% LP performed vs 2% no LP) and to receive parenteral antibiotics (62% LP performed vs 6% no LP). © The Author 2016. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Di-hadron correlations with identified leading hadrons in 200 GeV Au+Au and d+Au collisions at STAR

Directory of Open Access Journals (Sweden)

L. Adamczyk

2015-12-01

Full Text Available The STAR Collaboration presents for the first time two-dimensional di-hadron correlations with identified leading hadrons in 200 GeV central Au+Au and minimum-bias d+Au collisions to explore hadronization mechanisms in the quark gluon plasma. The enhancement of the jet-like yield for leading pions in Au+Au data with respect to the d+Au reference and the absence of such an enhancement for leading non-pions (protons and kaons are discussed within the context of a quark recombination scenario. The correlated yield at large angles, specifically in the ridge region, is found to be significantly higher for leading non-pions than pions. The consistencies of the constituent quark scaling, azimuthal harmonic model and a mini-jet modification model description of the data are tested, providing further constraints on hadronization.

Di-hadron correlations with identified leading hadrons in 200 GeV Au + Au and d + Au collisions at STAR

Energy Technology Data Exchange (ETDEWEB)

Adamczyk, L; Adkins, JK; Agakishiev, G; Aggarwal, MM; Ahammed, Z; Alekseev, I; Aparin, A; Arkhipkin, D; Aschenauer, EC; Averichev, GS; Bai, X; Bairathi, V; Banerjee, A; Bellwied, R; Bhasin, A; Bhati, AK; Bhattarai, P; Bielcik, J; Bielcikova, J; Bland, LC; Bordyuzhin, IG; Bouchet, J; Brandenburg, D; Brandin, AV; Bunzarov, I; Butterworth, J; Caines, H; Calderón de la Barca Sánchez, M; Campbell, JM; Cebra, D; Cervantes, MC; Chakaberia, I; Chaloupka, P; Chang, Z; Chattopadhyay, S; Chen, X; Chen, JH; Cheng, J; Cherney, M; Christie, W; Contin, G; Crawford, HJ; Das, S; De Silva, LC; Debbe, RR; Dedovich, TG; Deng, J; Derevschikov, AA; di Ruzza, B; Didenko, L; Dilks, C; Dong, X; Drachenberg, JL; Draper, JE; Du, CM; Dunkelberger, LE; Dunlop, JC; Efimov, LG; Engelage, J; Eppley, G; Esha, R; Evdokimov, O; Eyser, O; Fatemi, R; Fazio, S; Federic, P; Fedorisin, J; Feng, Z; Filip, P; Fisyak, Y; Flores, CE; Fulek, L; Gagliardi, CA; Garand, D; Geurts, F; Gibson, A; Girard, M; Greiner, L; Grosnick, D; Gunarathne, DS; Guo, Y; Gupta, S; Gupta, A; Guryn, W; Hamad, A; Hamed, A; Haque, R; Harris, JW; He, L; Heppelmann, S; Heppelmann, S; Hirsch, A; Hoffmann, GW; Hofman, DJ; Horvat, S; Huang, T; Huang, B; Huang, HZ; Huang, X; Huck, P

2015-10-23

The STAR Collaboration presents for the first time two-dimensional di-hadron correlations with identified leading hadrons in 200 GeV central Au + Au and minimum-bias d + Au collisions to explore hadronization mechanisms in the quark gluon plasma. The enhancement of the jet-like yield for leading pions in Au + Au data with respect to the d + Au reference and the absence of such an enhancement for leading non-pions (protons and kaons) are discussed within the context of a quark recombination scenario. The correlated yield at large angles, specifically in the ridge region, is found to be significantly higher for leading non-pions than pions. The consistencies of the constituent quark scaling, azimuthal harmonic model and a mini-jet modification model description of the data are tested, providing further constraints on hadronization.

Development and Validation of a Serologic Test Panel for Detection of Powassan Virus Infection in U.S. Patients Residing in Regions Where Lyme Disease Is Endemic.

Science.gov (United States)

Thomm, Angela M; Schotthoefer, Anna M; Dupuis, Alan P; Kramer, Laura D; Frost, Holly M; Fritsche, Thomas R; Harrington, Yvette A; Knox, Konstance K; Kehl, Sue C

2018-01-01

Powassan virus (POWV) is an emerging tick-borne arbovirus presenting a public health threat in North America. POWV lineage II, also known as deer tick virus, is the strain of the virus most frequently found in Ixodes scapularis ticks and is implicated in most cases of POWV encephalitis in the United States. Currently, no commercial tests are available to detect POWV exposure in tick-borne disease (TBD) patients. We describe here the development and analytical validation of a serologic test panel to detect POWV infections. The panel uses an indirect enzyme immunoassay (EIA) to screen. EIA-positive samples reflex to a laboratory-developed, POWV-specific immunofluorescence assay (IFA). The analytical sensitivity of the test panel was 89%, and the limit of detection was a plaque reduction neutralization test (PRNT) titer of 1:20. The analytical specificity was 100% for the IgM assay and 65% for the IgG assay when heterologous-flavivirus-positive samples were tested. On samples collected from regions where Lyme disease is endemic, seroprevalence for POWV in TBD samples was 9.4% (10 of 106) versus 2% when tested with non-TBD samples (2 of 100, P = 0.034). No evidence of POWV infection was seen in samples collected from a region where Lyme disease was not endemic (0 of 22). This test panel provides a sensitive and specific platform for detecting a serologic response to POWV early in the course of infection when neutralizing antibodies may not be detectable. Combined with clinical history, the panel is an effective tool for identifying acute POWV infection. IMPORTANCE Approximately 100 cases of POWV disease were reported in the United States over the past 10 years. Most cases have occurred in the Northeast (52) and Great Lakes (45) regions (https://www.cdc.gov/powassan/statistics.html). The prevalence of POWV in ticks and mammals is increasing, and POWV poses an increasing threat in a greater geographical range. In areas of the Northeast and Midwest where Lyme disease is

Sensitivity of Lyme Borreliosis Spirochetes to Serum Complement of Regular Zoo Animals: Potential Reservoir Competence of Some Exotic Vertebrates

Czech Academy of Sciences Publication Activity Database

Tichá, L.; Golovchenko, Maryna; Oliver, J. H., Jr.; Grubhoffer, Libor; Rudenko, Natalia

2016-01-01

Roč. 16, č. 1 (2016), s. 13-19 ISSN 1530-3667 EU Projects: European Commission(XE) 278976 - ANTIGONE Institutional support: RVO:60077344 Keywords : Borrelia burgdorferi sensu lato * Lyme disease * serum complement * exotic animals * reservoir hosts * zoo Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 2.045, year: 2016

Diagnosis and management of Lyme neuroborreliosis.

Science.gov (United States)

Halperin, John J

2018-01-01

The nervous system is involved in 10-15% of patients infected with B. burgdorferi, B. afzelii and B. garinii. This review will address widespread misconceptions about the clinical phenomenology, diagnostic approach and response to treatment of neuroborreliosis. Areas covered: Improvements in diagnostic testing have allowed better definition of the clinical spectrum of neuroborreliosis, with lymphocytic meningitis and uni- or multifocal inflammation of peripheral/cranial nerves predominating. Despite widespread concern that post-treatment cognitive/behavioral symptoms might be attributable to persisting infection or aberrant inflammation within the central nervous system a large body of evidence indicates this is extremely improbable. Importantly, recent studies show most neuroborreliosis can be treated with fairly brief courses of oral antibiotics. All high-level evidence confirms that prolonged courses of antibiotics carry harm with no commensurate benefit. Expert commentary: Lyme disease in the US, and corresponding disorders in Europe, are well defined neuro-infectious diseases that are highly responsive to antibiotic therapy. Although the nervous system is slow to recover after insults (e.g. persistent facial weakness after appropriately treated facial nerve palsy) there is no evidence that prolonged post-treatment neurocognitive symptoms are related to nervous system infection - either as a triggering event or as a cause of ongoing symptoms.

Three-particle correlations from parton cascades in Au+Au collisions

International Nuclear Information System (INIS)

Ma, G.L.; Ma, Y.G.; Zhang, S.; Cai, X.Z.; Chen, J.H.; He, Z.J.; Huang, H.Z.; Long, J.L.; Shen, W.Q.; Shi, X.H.; Zhong, C.; Zuo, J.X.

2007-01-01

We present a study of three-particle correlations among a trigger particle and two associated particles in Au+Au collisions at s NN =200 GeV using a multi-phase transport model (AMPT) with both partonic and hadronic interactions. We found that three-particle correlation densities in different angular directions with respect to the triggered particle ('center', 'cone', 'deflected', 'near' and 'near-away') increase with the number of participants. The ratio of 'deflected' to 'cone' density approaches to 1.0 with the increasing of number of participants, which indicates that partonic Mach-like shock waves can be produced by strong parton cascades in central Au+Au collisions

Genomic characterisation of Leptospira inadai serogroup Lyme isolated from captured rat in Brazil and comparative analysis with human reference strain.

Science.gov (United States)

Moreno, Luisa Z; Miraglia, Fabiana; Loureiro, Ana P; Kremer, Frederico S; Eslabao, Marcus R; Dellagostin, Odir A; Lilenbaum, Walter; Vasconcellos, Silvio A; Heinemann, Marcos B; Moreno, Andrea M

2018-03-12

Leptospira inadai is classified as a species of the Leptospira intermediate group that has been poorly studied due to its apparent insignificance to human and animal health. Nevertheless, over the last two decades the species has been described in human cases in India and in carrier animals in Ecuador. Here, we present the first identification and genomic characterisation of L. inadai serogroup Lyme isolated from captured rodent in Brazil. Even though the M34/99 strain was not pathogenic for hamsters, it was able to establish renal colonisation. The M34/99 strain presented high similarity with L. inadai serogroup Lyme human reference indicating that animal strain could also infect humans, although it does not represent high risk of severe disease. An extrachromosomal sequence was also identified in M34/99 strain and presented high identity with previously described L. inadai phage LinZ_10, suggesting that phage-like extrachromosomal sequence may be another feature of this understudied species.

Genomic characterisation of Leptospira inadai serogroup Lyme isolated from captured rat in Brazil and comparative analysis with human reference strain

Science.gov (United States)

Moreno, Luisa Z; Miraglia, Fabiana; Loureiro, Ana P; Kremer, Frederico S; Eslabao, Marcus R; Dellagostin, Odir A; Lilenbaum, Walter; Vasconcellos, Silvio A; Heinemann, Marcos B; Moreno, Andrea M

2018-01-01

Leptospira inadai is classified as a species of the Leptospira intermediate group that has been poorly studied due to its apparent insignificance to human and animal health. Nevertheless, over the last two decades the species has been described in human cases in India and in carrier animals in Ecuador. Here, we present the first identification and genomic characterisation of L. inadai serogroup Lyme isolated from captured rodent in Brazil. Even though the M34/99 strain was not pathogenic for hamsters, it was able to establish renal colonisation. The M34/99 strain presented high similarity with L. inadai serogroup Lyme human reference indicating that animal strain could also infect humans, although it does not represent high risk of severe disease. An extrachromosomal sequence was also identified in M34/99 strain and presented high identity with previously described L. inadai phage LinZ_10, suggesting that phage-like extrachromosomal sequence may be another feature of this understudied species. PMID:29538491

Genomic characterisation of Leptospira inadai serogroup Lyme isolated from captured rat in Brazil and comparative analysis with human reference strain

Directory of Open Access Journals (Sweden)

Luisa Z Moreno

2018-03-01

Full Text Available Leptospira inadai is classified as a species of the Leptospira intermediate group that has been poorly studied due to its apparent insignificance to human and animal health. Nevertheless, over the last two decades the species has been described in human cases in India and in carrier animals in Ecuador. Here, we present the first identification and genomic characterisation of L. inadai serogroup Lyme isolated from captured rodent in Brazil. Even though the M34/99 strain was not pathogenic for hamsters, it was able to establish renal colonisation. The M34/99 strain presented high similarity with L. inadai serogroup Lyme human reference indicating that animal strain could also infect humans, although it does not represent high risk of severe disease. An extrachromosomal sequence was also identified in M34/99 strain and presented high identity with previously described L. inadai phage LinZ_10, suggesting that phage-like extrachromosomal sequence may be another feature of this understudied species.

Solvent extraction of Au(III) for preparation of a carrier-free multitracer and an Au tracer from an Au target

International Nuclear Information System (INIS)

Weginwar, R.G.; Kobayashi, Y.; Ambe, S.; Liu, B.; Enomoto, S.; Ambe, F.

1996-01-01

Separation of Au(III) and various carrier-free radionuclides by solvent extraction was investigated using an Au target irradiated by an energetic heavy-ion beam. Percentage extraction of Au(III) and coextraction of the radionuclides were determined with varying parameters such as kinds of solvent, molarity of HCl or pH, and Au concentration. Under the conditions where Au(III) was effectively extracted, namely extraction with ethyl acetate or isobutyl methyl ketone from 3 mol*dm -3 HCl, carrier-free radionuclides of many elements were found to be more or less coextracted. Coextraction of radionuclides of some elements was found to increase with an increase in the concentration of Au(III). This finding is ascribed to the formation of strong association of the complex of these elements with chloroauric acid. In order to avoid serious loss of these elements by the extraction, lowering of the Au(III) concentration or the use of a masking agent such as sodium citrate is necessary. Gold(III) was shown to be effectively back extracted with a 0.1 mol*dm -3 aqueous solution of 2-amino-2-hydroxymethyl-1,3-propanediol. Thus, a radiochemical procedure has been established for preparing a carrier-free multitracer and an Au tracer with carrier form from an Au target irradiated with a heavy-ion beam. Both tracers are now used individually for chemical and biological experiments. (author). 22 refs., 3 figs., 2 tabs

Fermi surfaces properties of AuAl2, AuGa2, and AuIn2 with the CaF2-type cubic structure

Science.gov (United States)

Nishimura, K.; Kakihana, M.; Suzuki, F.; Yara, T.; Hedo, M.; Nakama, T.; Ōnuki, Y.; Harima, H.

2018-05-01

We grew high-quality single crystals of AuAl2, AuGa2, and AuIn2 with the fluorite (CaF2)-type cubic structure and determined the Fermi surface properties by the de Haas-van Alphen (dHvA) experiments using full-potential LAPW bad calculations. The Fermi surface and optical properties for three compounds were once studied from an interest of colors because AuAl2 has a striking bright reddish-purple color, whereas AuGa2 and AuIn2 are, respectively, neutral and bluish. The detected dHvA frequencies in the present study are found to be in a wide range of (0.1-13)×107 Oe. The main dHvA branches for three compounds are in excellent agreement with the theoretical ones, but some dHvA branches with small dHvA frequencies are slightly deviated from the theoretical ones, especially in AuGa2 and AuIn2.

Seed-mediated growth and manipulation of Au nanorods via size-controlled synthesis of Au seeds

International Nuclear Information System (INIS)

Liu Juncheng; Duggan, Jennifer N.; Morgan, Joshua; Roberts, Christopher B.

2012-01-01

Seed-mediated growth of gold (Au) nanorods with highly controllable length, width, and aspect ratio was accomplished via carefully size-controlled synthesis of the original Au seeds. A slow dynamic growth of Au nanoparticle seeds was observed after reduction of the Au salt (i.e., hydrogen tetrachloroaurate (III) hydrate) by sodium borohydride (NaBH 4 ) in the presence of cetyltrimethyl ammonium bromide (CTAB). As such, the size of the Au nanoparticle seeds can therefore be manipulated through control over the duration of the reaction period (i.e., aging times of 2, 8, 48, 72, and 144 h were used in this study). These differently sized Au nanoparticles were subsequently used as seeds for the growth of Au nanorods, where the additions of Au salt, CTAB, AgNO 3 , and ascorbic acid were employed. Smaller Au nanoparticle seeds obtained via short growth/aging time resulted in Au nanorods with higher aspect ratio and thus longer longitudinal surface plasmon wavelength (LSPW). The larger Au nanoparticle seeds obtained via longer growth/aging time resulted in Au nanorods with lower aspect ratio and shorter LSPW.

Canada

International Nuclear Information System (INIS)

Thexton, H.E.

1987-01-01

The development of CANDU (Canada Deuterium Uranium) type reactors in Canada is traced. What is CANDU? and how does it differ from a pressurized water reactor? Whey did Canada adopt this design? What factors have led to its success? These questions are asked and answered. First the design itself is explained. Technical problems are considered and figures on operating reliability presented. The economic advantages of CANDU are shown by comparing electricity generating costs at CANDU stations with those at coal-fired stations. Future CANDU options are discussed and prospects for CANDU considered. (U.K.)

Controlled Synthesis of Au@AgAu Yolk-Shell Cuboctahedra with Well-Defined Facets.

Science.gov (United States)

Londono-Calderon, Alejandra; Bahena, Daniel; Yacaman, Miguel J

2016-08-02

The synthesis of Au@AgAu yolk-shell cuboctahedra nanoparticles formed by galvanic replacement in a seed-mediated method is described. Initially, single-crystal Au seeds are used for the formation of Au@Ag core-shell nanocubes, which serve as the template material for the deposition of an external Au layer. The well-controlled synthesis yields the formation of cuboctahedra nanoparticles with smooth inner and outer Au/Ag surfaces. The deposition/oxidation process is described to understand the formation of cuboctahedra and octahedra nanoparticles. The Au core maintains the initial morphology of the seed and remains static at the center of the yolk-shell because of residual Ag. Structural analysis of the shell indicates intrinsic stacking faults (SFs) near the surface. Energy dispersive X-ray spectroscopy (EDS) and X-ray photoelectron spectroscopy (XPS) compositional analysis show an Au-Ag nonordered alloy forming the shell. The three-dimensional structure of the nanoparticles presented open facets on the [111] as observed by electron tomography SIRT reconstruction over a stack of high-angle annular dark-field scanning transmission electron microscopy (HAADF-STEM) images. The geometrical model was validated by analyzing the direction of streaks in coherent nanobeam diffraction (NBD). The catalytic activity was evaluated using a model reaction based on the reduction of 4-nitrophenol (4-NTP) by NaBH4 in the presence of Au@AgAu yolk-shell nanoparticles.

Controlled synthesis of PbS-Au nanostar-nanoparticle heterodimers and cap-like Au nanoparticles

Science.gov (United States)

Zhao, Nana; Li, Lianshan; Huang, Teng; Qi, Limin

2010-11-01

Uniform PbS-Au nanostar-nanoparticle heterodimers consisting of one Au nanoparticle grown on one horn of a well-defined six-horn PbS nanostar were prepared using the PbS nanostars as growth substrates for the selective deposition of Au nanoparticles. The size of the Au nanoparticles on the horns of the PbS nanostars could be readily adjusted by changing the PbS concentration for the deposition of Au nanoparticles. An optimum cetyltrimethylammonium bromide concentration and temperature were essential for the selective deposition of uniform Au nanoparticles on single horns of the PbS nanostars. Unusual PbS-Au nanoframe-nanoparticle heterodimers were obtained by etching the PbS-Au nanostar-nanoparticle heterodimers with oxalic acid while novel cap-like Au nanoparticles were obtained by etching with hydrochloric acid. The obtained heterodimeric nanostructures and cap-like nanoparticles are promising candidates for anisotropic nanoscale building blocks for the controllable assembly of useful, complex architectures.

How Does Amino Acid Ligand Modulate Au Core Structure and Characteristics in Peptide Coated Au Nanocluster?

Science.gov (United States)

Li, Nan; Li, Xu; Zhao, Hongkang; Zhao, Lina

2018-03-01

The atomic structures and the corresponding physicochemical properties of peptide coated Au nanoclusters determine their distinctive biological targeting applications. To learn the modulation of amino acid ligand on the atomic structure and electronic characteristics of coated Au core is the fundamental knowledge for peptide coated Au nanocluster design and construction. Based on our recent coated Au nanocluster configuration study (Nanoscale, 2016, 8, 11454), we built the typically simplified Au13(Cys-Au-Cys) system to more clearly learn the basic modulation information of amino acid ligand on Au core by the density functional theory (DFT) calculations. There are two isomers as ligand adjacent bonding (Iso1) and diagonal bonding (Iso2) to Au13 cores. The geometry optimizations indicate the adjacent bonding Iso1 is more stable than Iso2. More important, the Au13 core of Iso1 distorts much more significantly than that of Iso2 by Cys-Au-Cys bonding through the root-mean-square deviation (RMSD) analysis, which modulate their electronic characteristics in different ways. In addition, the frontier molecular orbital results of Au13(Cys-Au-Cys) isomers confirm that the Au cores mainly determine the blue shifts of Au13(Cys-Au-Cys) systems versus the original Au13 core in their UV-visible absorption spectrum studies. The configuration of Au13 core performs deformation under Cys-Au-Cys ligand modulation to reach new stability with distinct atomic structure and electronic properties, which could be the theory basis for peptide coated AuNCs design and construction.

Lyme disease caused by Borrelia burgdorferi with two homeologous 16S rRNA genes: a case report

Directory of Open Access Journals (Sweden)

Lee SH

2016-04-01

Full Text Available Sin Hang Lee,1,21Pathology Department, Milford Hospital, Milford, CT, USA; 2Milford Molecular Diagnostics, Milford, CT, USA Abstract: Lyme disease (LD, the most common tick-borne disease in North America, is believed to be caused exclusively by Borrelia burgdorferi sensu stricto and is usually diagnosed by clinical evaluation and serologic assays. As reported previously in a peer-reviewed article, a 13-year-old boy living in the Northeast of the USA was initially diagnosed with LD based on evaluation of his clinical presentations and on serologic test results. The patient was treated with a course of oral doxycycline for 28 days, and the symptoms resolved. A year later, the boy developed a series of unusual symptoms and did not attend school for 1 year. A LD specialist reviewed the case and found the serologic test band patterns nondiagnostic of LD. The boy was admitted to a psychiatric hospital. After discharge from the psychiatric hospital, a polymerase chain reaction test performed in a winter month when the boy was 16 years old showed a low density of B. burgdorferi sensu lato in the blood of the patient, confirmed by partial 16S rRNA (ribosomal RNA gene sequencing. Subsequent DNA sequencing analysis presented in this report demonstrated that the spirochete isolate was a novel strain of B. burgdorferi with two homeologous 16S rRNA genes, which has never been reported in the world literature. This case report shows that direct DNA sequencing is a valuable tool for reliable molecular diagnosis of Lyme and related borrelioses, as well as for studies of the diversity of the causative agents of LD because LD patients infected by a rare or novel borrelial variant may produce an antibody pattern that can be different from the pattern characteristic of an infection caused by a typical B. burgdorferi sensu stricto strain. Keywords: Lyme disease, Borrelia burgdorferi, homeologous 16S rRNA genes, DNA sequencing

Au pair trajectories

DEFF Research Database (Denmark)

Dalgas, Karina Märcher

2015-01-01

pair-sending families in the Philippines, this dissertation examines the long-term trajectories of these young Filipinas. It shows how the au pairs’ local and transnational family relations develop over time and greatly influence their life trajectories. A focal point of the study is how au pairs...... that Filipina au pairs see their stay abroad as an avenue of personal development and social recognition, I examine how the au pairs re-position themselves within their families at home through migration, and how they navigate between the often conflicting expectations of participation in the sociality......Since 2000, thousands of young Filipino migrants have come to Denmark as au pairs. Officially, they are there to “broaden their cultural horizons” by living temporarily with a Danish host family, but they also conduct domestic labor in exchange for food and money, which allows them to send...

Social-cognitive determinants of the tick check: a cross-sectional study on self-protective behavior in combatting Lyme disease.

Science.gov (United States)

van der Heijden, Amy; Mulder, Bob C; Poortvliet, P Marijn; van Vliet, Arnold J H

2017-11-25

Performing a tick check after visiting nature is considered the most important preventive measure to avoid contracting Lyme disease. Checking the body for ticks after visiting nature is the only measure that can fully guarantee whether one has been bitten by a tick and provides the opportunity to remove the tick as soon as possible, thereby greatly reducing the chance of contracting Lyme disease. However, compliance to performing the tick check is low. In addition, most previous studies on determinants of preventive measures to avoid Lyme disease lack a clear definition and/or operationalization of the term "preventive measures". Those that do distinguish multiple behaviors including the tick check, fail to describe the systematic steps that should be followed in order to perform the tick check effectively. Hence, the purpose of this study was to identify determinants of systematically performing the tick check, based on social cognitive theory. A cross-sectional self-administered survey questionnaire was filled out online by 508 respondents (M age  = 51.7, SD = 16.0; 50.2% men; 86.4% daily or weekly nature visitors). Bivariate correlations and multivariate regression analyses were conducted to identify associations between socio-cognitive determinants (i.e. concepts related to humans' intrinsic and extrinsic motivation to perform certain behavior), and the tick check, and between socio-cognitive determinants and proximal goal to do the tick check. The full regression model explained 28% of the variance in doing the tick check. Results showed that performing the tick check was associated with proximal goal (β = .23, p theory to identify determinants. Based on the results, a number of practical recommendations can be made to promote the performance of the tick check.

Theoretical prediction of the noble gas complexes HeAuF and NeAuF

Institute of Scientific and Technical Information of China (English)

无

2009-01-01

Ab initio calculations were carried out to investigate the structures and the stability of the noble gas complexes HeAuF and NeAuF through MP2 and CCSD(T) methods.The HeAuF was predicted to have a linear structure with weak He-Au covalent bonding,the distance of which is closer to the covalent limit in comparison with the corresponding van der Waals limit.The dissociation energy with respect to He + AuF was found to be 24 and 26 kJ·mol-1 at the CCSD(T)/basis set B and B’ levels,respectively.However,similar calculations for NeAuF indicate that NeAuF is not a stable species.

Lyme disease with facial nerve palsy: rapid diagnosis using a nested polymerase chain reaction-restriction fragment length polymorphism analysis.

Science.gov (United States)

Hashimoto, Y; Takahashi, H; Kishiyama, K; Sato, Y; Nakao, M; Miyamoto, K; Iizuka, H

1998-02-01

A 64-year-old woman with Lyme disease and manifesting facial nerve palsy had been bitten by a tick on the left frontal scalp 4 weeks previously. Erythema migrans appeared on the left forehead, accompanied by left facial paralysis. Nested polymerase chain reaction-restriction fragment length polymorphism analysis (nested PCR-RFLP) was performed on DNA extracted from a skin biopsy of the erythema on the left forehead. Borrelia flagellin gene DNA was detected and its RFLP pattern indicated that the organism was B. garinii, Five weeks later, B. garinii was isolated by conventional culture from the erythematous skin lesion, but not from the cerebrospinal fluid. After treatment with ceftriaxone intravenously for 10 days and oral administration of minocycline for 7 days, both the erythema and facial nerve palsy improved significantly. Nested PCR and culture taken after the lesion subsided, using skin samples obtained from a site adjacent to the original biopsy, were both negative. We suggest that nested PCR-RFLP analysis might be useful for the rapid diagnosis of Lyme disease and for evaluating therapy.

La formation professionnelle en santé d'étudiantes issues des communautés d'immigrants francophones s'intégrant à la minorité francophone nationale au Canada

Directory of Open Access Journals (Sweden)

HÉLÈNE LAPERRIÈRE

2010-01-01

Full Text Available Au Canada, plus spécifiquement dans la capitale nationale, il y a une mise-en-oeuvre considérable de programmes pour offrir une formation en français à la minorité francophone nationale. Toutefois, les observations actuelles dans la formation professionnelle en santé, clairement présentes en sciences infirmières, démontrent que les étudiants et les étudiantes francophones sont de plus en plus issus d'un sous-groupe formé de communautés immigrantes plus ou moins récentes. La formation en santé dans les programmes universitaires canadiens doit aujourd'hui relever le défi contemporain de former avec des connaissances théoriques plus ou moins uniformisées pour répondre aux compétences nationales de la majorité anglophone et de la minorité nationale francophone, tout en essayant de mieux comprendre les cultures d'origine de ses nouveaux étudiants francophones. Cet article présente la prise de conscience de cette nouvelle problématique durant un stage clinique en santé communautaire.

Acaricidal Treatment of White-Tailed Deer to Control Ixodes Scapularis (Acari: Ixodidae) in a New York Lyme Disease-Endemic Community

Science.gov (United States)

The 4-Poster device for the topical treatment of white-tailed deer, Odocoileus virginianus (Zimmermann) against ticks using the acaricide amitraz was evaluated in a Lyme borreliosis endemic community in Connecticut. As part of a 5-year project from 1997 to 2002, 21–24 of the 4-Posters were distribut...

The extraction characteristic of Au-Ag from Au concentrate by thiourea solution

Science.gov (United States)

Kim, Bongju; Cho, Kanghee; On, Hyunsung; Choi, Nagchoul; Park, Cheonyoung

2013-04-01

The cyanidation process has been used commercially for the past 100 years, there are ores that are not amenable to treatment by cyanide. Interest in alternative lixiviants, such as thiourea, halogens, thiosulfate and malononitrile, has been revived as a result of a major increase in gold price, which has stimulated new developments in extraction technology, combined with environmental concern. The Au extraction process using the thiourea solvent has many advantages over the cyanidation process, including higher leaching rates, faster extraction time and less than toxicity. The purpose of this study was investigated to the extraction characteristic of Au-Ag from two different Au concentrate (sulfuric acid washing and roasting) under various experiment conditions (thiourea concentration, pH of solvent, temperature) by thiourea solvent. The result of extraction experiment showed that the Au-Ag extraction was a fast extraction process, reaching equilibrium (maximum extraction rate) within 30 min. The Au-Ag extraction rate was higher in the roasted concentrate than in the sulfuric acid washing. The higher the Au-Ag extraction rate (Au - 70.87%, Ag - 98.12%) from roasted concentrate was found when the more concentration of thiourea increased, pH decreased and extraction temperature increased. This study informs extraction method basic knowledge when thiourea was a possibility to eco-/economic resources of Au-Ag utilization studies including the hydrometallurgy.

Multifragmentation in Au + Au collisions studied with AMD-V

Energy Technology Data Exchange (ETDEWEB)

Ono, Akira [Tohoku Univ., Sendai (Japan). Faculty of Science

1998-07-01

AMD-V is an optimum model for calculation of multifragmentation in Au + Au collisions. AMD-V consider anti-symmetry of incident nucleus, target nucleus and fragments, furthermore, it treat the quantum effect to exist many channels in the intermediate and final state. 150 and 250 MeV/nucleon incident energy were used in the experiments. The data of multifragment atom in {sup 197}Au + {sup 197}Au collisions was reproduced by AMD-V calculation using Gognny force, corresponding to the imcompressibility of nuclear substance K = 228 MeV and its mean field depend on momentum. When other interaction (SKG 2 force, corresponding to K = 373 KeV) was used an mean field does not depend on momentum, the calculation results could not reproduce the experimental values, because nucleus and deuteron were estimated too large and {alpha}-particle and intermediate fragments estimated too small. (S.Y.)

Synthesis of ultrathin face-centered-cubic Au@Pt and Au@Pd core-shell nanoplates from hexagonal-close-packed Au square sheets

KAUST Repository

Fan, Zhanxi; Zhu, Yihan; Huang, Xiao; Han, Yu; Wang, Qingxiao; Liu, Qing; Huang, Ying; Gan, Chee Lip; Zhang, Hua

2015-01-01

@Pd rhombic nanoplates, respectively. We believe that these findings will shed new light on the synthesis of novel noble bimetallic nanostructures. Phase change: Ultrathin Au@Pt and Au@Pd core-shell nanoplates were prepared from Au square sheets. A phase

Genome Stability of Lyme Disease Spirochetes: Comparative Genomics of Borrelia burgdorferi Plasmids

Energy Technology Data Exchange (ETDEWEB)

Casjens S. R.; Dunn J.; Mongodin, E. F.; Qiu, W.-G.; Luft, B. J.; Schutzer, S. E.; Gilcrease, E. B.; Huang, W. M.; Vujadinovic, M.; Aron, J. K.; Vargas, L. C.; Freeman, S.; Radune, D.; Weidman, J. F.; Dimitrov, G. I.; Khouri, H. M.; Sosa, J. E.; Halpin, R. A.; Fraser, C. M.

2012-03-14

Lyme disease is the most common tick-borne human illness in North America. In order to understand the molecular pathogenesis, natural diversity, population structure and epizootic spread of the North American Lyme agent, Borrelia burgdorferi sensu stricto, a much better understanding of the natural diversity of its genome will be required. Towards this end we present a comparative analysis of the nucleotide sequences of the numerous plasmids of B. burgdorferi isolates B31, N40, JD1 and 297. These strains were chosen because they include the three most commonly studied laboratory strains, and because they represent different major genetic lineages and so are informative regarding the genetic diversity and evolution of this organism. A unique feature of Borrelia genomes is that they carry a large number of linear and circular plasmids, and this work shows that strains N40, JD1, 297 and B31 carry related but non-identical sets of 16, 20, 19 and 21 plasmids, respectively, that comprise 33-40% of their genomes. We deduce that there are at least 28 plasmid compatibility types among the four strains. The B. burgdorferi {approx}900 Kbp linear chromosomes are evolutionarily exceptionally stable, except for a short {le}20 Kbp plasmid-like section at the right end. A few of the plasmids, including the linear lp54 and circular cp26, are also very stable. We show here that the other plasmids, especially the linear ones, are considerably more variable. Nearly all of the linear plasmids have undergone one or more substantial inter-plasmid rearrangements since their last common ancestor. In spite of these rearrangements and differences in plasmid contents, the overall gene complement of the different isolates has remained relatively constant.

The Infectious Diseases Society of America Lyme guidelines: a cautionary tale about the development of clinical practice guidelines

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Johnson Lorraine

2010-06-01

Full Text Available Abstract Flawed clinical practice guidelines may compromise patient care. Commercial conflicts of interest on panels that write treatment guidelines are particularly problematic, because panelists may have conflicting agendas that influence guideline recommendations. Historically, there has been no legal remedy for conflicts of interest on guidelines panels. However, in May 2008, the Attorney General of Connecticut concluded a ground-breaking antitrust investigation into the development of Lyme disease treatment guidelines by one of the largest medical societies in the United States, the Infectious Diseases Society of America (IDSA. Although the investigation found significant flaws in the IDSA guidelines development process, the subsequent review of the guidelines mandated by the settlement was compromised by a lack of impartiality at various stages of the IDSA review process. This article will examine the interplay between the recent calls for guidelines reform, the ethical canons of medicine, and due process considerations under antitrust laws as they apply to the formulation of the IDSA Lyme disease treatment guidelines. The article will also discuss pitfalls in the implementation of the IDSA antitrust settlement that should be avoided in the future.

Charged hadron transverse momentum distributions in Au+Au collisions at S=200 GeV

Science.gov (United States)

Roland, Christof; PHOBOS Collaboration; Back, B. B.; Baker, M. D.; Barton, D. S.; Betts, R. R.; Ballintijn, M.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Michałowski, J.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steadman, S. G.; Steinberg, P.; Stephans, G. S. F.; Stodulski, M.; Sukhanov, A.; Tang, J.-L.; Teng, R.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wadsworth, B.; Wolfs, F. L. H.; Wosiek, B.; Woźniak, K.; Wuosmaa, A. H.; Wysłouch, B.

2003-03-01

We present transverse momentum distributions of charged hadrons produced in Au+Au collisions at sqrt(s_NN) = 200 GeV. The evolution of the spectra for transverse momenta p_T from 0.25 to 5GeV/c is studied as a function of collision centrality over a range from 65 to 344 participating nucleons. We find a significant change of the spectral shape between proton-antiproton and peripheral Au+Au collisions. Comparing peripheral to central Au+Au collisions, we find that the yields at the highest p_T exhibit approximate scaling with the number of participating nucleons, rather than scaling with the number of binary collisions.

New K-Ar ages of volcanic rocks and associated mineralization in Canada Honda district, San Luis, Argentina

International Nuclear Information System (INIS)

Urbina, N.E.; Oggier, F.P

2001-01-01

New K-Ar ages in the Late Tertiary gold-bearing volcanic belt of the Sierras Pampeanas of San Luis, Argentina are presented. At Canada Honda district, an age of 8.49±0.2 Ma yielded by Cerro del Valle andesite indicates that the dome emplacement postdates the Diente Verde eruptive event. An even younger age of 7.3±0.2 Ma was obtained for illite from hydrothermal alteration at La Reynela mineralization which is hosted by Cerro del Valle andesite (au)

Biodiversity and disease: a synthesis of ecological perspectives on Lyme disease transmission.

Science.gov (United States)

Wood, Chelsea L.; Lafferty, Kevin D.

2013-01-01

Recent reviews have argued that disease control is among the ecosystem services yielded by biodiversity. Lyme disease (LD) is commonly cited as the best example of the ‘diluting’ effect of biodiversity on disease transmission, but many studies document the opposite relationship, showing that human LD risk can increase with forestation. Here, we unify these divergent perspectives and find strong evidence for a positive link between biodiversity and LD at broad spatial scales (urban to suburban to rural) and equivocal evidence for a negative link between biodiversity and LD at varying levels of biodiversity within forests. This finding suggests that, across zoonotic disease agents, the biodiversity–disease relationship is scale dependent and complex.

Voluntary Participation in Community Economic Development in Canada: An Empirical Analysis

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Laura Lamb

2011-01-01

Full Text Available This article is an empirical analysis of an individual's decision to participate in community economic development (CED initiatives in Canada. The objective of the analysis is to better understand how individuals make decisions to volunteer time toward CED initiatives and to determine whether the determinants of participation in CED are unique when compared to those of participation in volunteer activities in general. The dataset employed is Statistics Canada's 2004 Canada Survey of Giving, Volunteering and Participating (CSGVP. To date, there has been no prior econometric analysis of the decision to participate in community economic development initiatives in Canada. Results suggest a role for both public policymakers and practitioners in influencing participation in CED. / Cet article constitue une analyse empirique du processus de prise de décision chez les individus en ce qui a trait à la participation aux initiatives canadiennes de développement économique communautaire (DÉC. Le but de l'analyse est de mieux comprendre la façon dont les individus prennent la décision de consacrer du temps au bénévolat dans les initiatives de DÉC. Elle sert aussi à trancher la question de savoir si les facteurs de participation aux initiatives de développement économique communautaire sont uniques ou communs à la participation à des activités bénévoles en général. Les données employées dans le cadre de cette analyse sont puisées de l'Enquête canadienne sur le don, le bénévolat et la participation effectuée par Statistique Canada en 2004. À ce jour, aucune analyse économétrique n'a été menée sur la décision de participer aux initiatives canadiennes de DÉC. Les résultats suggèrent que les responsables de l'élaboration des politiques ainsi que les praticiens influencent tous deux la participation aux initiatives de DÉC.

Possible role of glial cells in the onset and progression of Lyme neuroborreliosis

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Jacobs Mary B

2009-08-01

Full Text Available Abstract Background Lyme neuroborreliosis (LNB may present as meningitis, cranial neuropathy, acute radiculoneuropathy or, rarely, as encephalomyelitis. We hypothesized that glia, upon exposure to Borrelia burgdorferi, the Lyme disease agent, produce inflammatory mediators that promote the acute cellular infiltration of early LNB. This inflammatory context could potentiate glial and neuronal apoptosis. Methods We inoculated live B. burgdorferi into the cisterna magna of rhesus macaques and examined the inflammatory changes induced in the central nervous system (CNS, and dorsal root nerves and ganglia (DRG. Results ELISA of the cerebrospinal fluid (CSF showed elevated IL-6, IL-8, CCL2, and CXCL13 as early as one week post-inoculation, accompanied by primarily lymphocytic and monocytic pleocytosis. In contrast, onset of the acquired immune response, evidenced by anti-B. burgdorferi C6 serum antibodies, was first detectable after 3 weeks post-inoculation. CSF cell pellets and CNS tissues were culture-positive for B. burgdorferi. Histopathology revealed signs of acute LNB: severe multifocal leptomeningitis, radiculitis, and DRG inflammatory lesions. Immunofluorescence staining and confocal microscopy detected B. burgdorferi antigen in the CNS and DRG. IL-6 was observed in astrocytes and neurons in the spinal cord, and in neurons in the DRG of infected animals. CCL2 and CXCL13 were found in microglia as well as in endothelial cells, macrophages and T cells. Importantly, the DRG of infected animals showed significant satellite cell and neuronal apoptosis. Conclusion Our results support the notion that innate responses of glia to B. burgdorferi initiate/mediate the inflammation seen in acute LNB, and show that neuronal apoptosis occurs in this context.

Co-feeding transmission facilitates strain coexistence in Borrelia burgdorferi, the Lyme disease agent

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S.L. States

2017-06-01

Full Text Available Coexistence of multiple tick-borne pathogens or strains is common in natural hosts and can be facilitated by resource partitioning of the host species, within-host localization, or by different transmission pathways. Most vector-borne pathogens are transmitted horizontally via systemic host infection, but transmission may occur in the absence of systemic infection between two vectors feeding in close proximity, enabling pathogens to minimize competition and escape the host immune response. In a laboratory study, we demonstrated that co-feeding transmission can occur for a rapidly-cleared strain of Borrelia burgdorferi, the Lyme disease agent, between two stages of the tick vector Ixodes scapularis while feeding on their dominant host, Peromyscus leucopus. In contrast, infections rapidly became systemic for the persistently infecting strain. In a field study, we assessed opportunities for co-feeding transmission by measuring co-occurrence of two tick stages on ears of small mammals over two years at multiple sites. Finally, in a modeling study, we assessed the importance of co-feeding on R0, the basic reproductive number. The model indicated that co-feeding increases the fitness of rapidly-cleared strains in regions with synchronous immature tick feeding. Our results are consistent with increased diversity of B. burgdorferi in areas of higher synchrony in immature feeding – such as the midwestern United States. A higher relative proportion of rapidly-cleared strains, which are less human pathogenic, would also explain lower Lyme disease incidence in this region. Finally, if co-feeding transmission also occurs on refractory hosts, it may facilitate the emergence and persistence of new pathogens with a more limited host range.

Influence of Au Nanoparticle Shape on Au@Cu2O Heterostructures

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Jie Zhu

2015-01-01

Full Text Available Synthesis of metal-semiconductor heterostructures may allow the combination of function of the corresponding components and/or the enhanced performance resulting from the interactions between all the components. In this paper, Au@Cu2O core-shell heterostructures are prepared by a seed-growth method, using different-shaped Au nanocrystals as the seeds such as nanorods, octahedra, decahedra, dots, and nanocubes. The results revealed that the final structure of Au@Cu2O was greatly influenced by the shape of the seeds used. Exposure of Cu2O{111} and Cu2O{001} favored when the overgrowth happened on Au{111} and Au{001} surface, respectively. The size of the product can also be tuned by the amount of the seeds. The results reported here provide a thinking clue to modulate the shape and size of core-shell nanocrystals, which is useful in developing new materials with desired performance.

Au/ZnO nanoarchitectures with Au as both supporter and antenna of visible-light

Energy Technology Data Exchange (ETDEWEB)

Liu, Tianyu; Chen, Wei; Hua, Yuxiang; Liu, Xiaoheng, E-mail: xhliu@mail.njust.edu.cn

2017-01-15

Highlights: • An inversed Au/ZnO nanostructure was fabricated with ZnO loaded onto Au. • The Au/ZnO nanocomposites showed enhanced properties in visible-light photocatalysis. • The SPR effect of Au was considered important for visible-light photocatalysis. - Abstract: In this paper, we fabricate Au/ZnO nanostructure with smaller ZnO nanoparticles loaded onto bigger gold nanoparticles via combining seed-mediated method and sol-gel method. The obtained Au/ZnO nanocomposites exhibit excellent properties in photocatalysis process like methyl orange (MO) degradation and oxidative conversion of methanol into formaldehyde under visible light irradiation. The enhanced properties were ascribed to the surface plasmon resonance (SPR) effect of Au nanoparticles, which could contribute to the separation of photo-excited electrons and holes and facilitate the process of absorbing visible light. This paper contributes to the emergence of multi-functional nanocomposites with possible applications in visible-light driven photocatalysts and makes the Au/ZnO photocatalyst an exceptional choice for practical applications such as environmental purification of organic pollutants in aqueous solution and the synthesis of fine chemicals and intermediates.

Au/ZnO nanoarchitectures with Au as both supporter and antenna of visible-light

International Nuclear Information System (INIS)

Liu, Tianyu; Chen, Wei; Hua, Yuxiang; Liu, Xiaoheng

2017-01-01

Highlights: • An inversed Au/ZnO nanostructure was fabricated with ZnO loaded onto Au. • The Au/ZnO nanocomposites showed enhanced properties in visible-light photocatalysis. • The SPR effect of Au was considered important for visible-light photocatalysis. - Abstract: In this paper, we fabricate Au/ZnO nanostructure with smaller ZnO nanoparticles loaded onto bigger gold nanoparticles via combining seed-mediated method and sol-gel method. The obtained Au/ZnO nanocomposites exhibit excellent properties in photocatalysis process like methyl orange (MO) degradation and oxidative conversion of methanol into formaldehyde under visible light irradiation. The enhanced properties were ascribed to the surface plasmon resonance (SPR) effect of Au nanoparticles, which could contribute to the separation of photo-excited electrons and holes and facilitate the process of absorbing visible light. This paper contributes to the emergence of multi-functional nanocomposites with possible applications in visible-light driven photocatalysts and makes the Au/ZnO photocatalyst an exceptional choice for practical applications such as environmental purification of organic pollutants in aqueous solution and the synthesis of fine chemicals and intermediates.

Catalytic activity of Au nanoparticles

DEFF Research Database (Denmark)

Larsen, Britt Hvolbæk; Janssens, Ton V.W.; Clausen, Bjerne

2007-01-01

Au is usually viewed as an inert metal, but surprisingly it has been found that Au nanoparticles less than 3–5 nm in diameter are catalytically active for several chemical reactions. We discuss the origin of this effect, focusing on the way in which the chemical activity of Au may change with par......Au is usually viewed as an inert metal, but surprisingly it has been found that Au nanoparticles less than 3–5 nm in diameter are catalytically active for several chemical reactions. We discuss the origin of this effect, focusing on the way in which the chemical activity of Au may change...... with particle size. We find that the fraction of low-coordinated Au atoms scales approximately with the catalytic activity, suggesting that atoms on the corners and edges of Au nanoparticles are the active sites. This effect is explained using density functional calculations....

Fabricating a Homogeneously Alloyed AuAg Shell on Au Nanorods to Achieve Strong, Stable, and Tunable Surface Plasmon Resonances

KAUST Repository

Huang, Jianfeng

2015-08-13

Colloidal metal nanocrystals with strong, stable, and tunable localized surface plasmon resonances (SPRs) can be useful in a corrosive environment for many applications including field-enhanced spectroscopies, plasmon-mediated catalysis, etc. Here, a new synthetic strategy is reported that enables the epitaxial growth of a homogeneously alloyed AuAg shell on Au nanorod seeds, circumventing the phase segregation of Au and Ag encountered in conventional synthesis. The resulting core–shell structured bimetallic nanorods (AuNR@AuAg) have well-mixed Au and Ag atoms in their shell without discernible domains. This degree of mixing allows AuNR@AuAg to combine the high stability of Au with the superior plasmonic activity of Ag, thus outperforming seemingly similar nanostructures with monometallic shells (e.g., Ag-coated Au NRs (AuNR@Ag) and Au-coated Au NRs (AuNR@Au)). AuNR@AuAg is comparable to AuNR@Ag in plasmonic activity, but that it is markedly more stable toward oxidative treatment. Specifically, AuNR@AuAg and AuNR@Ag exhibit similarly strong signals in surface-enhanced Raman spectroscopy that are some 30-fold higher than that of AuNR@Au. When incubated with a H2O2 solution (0.5 m), the plasmonic activity of AuNR@Ag immediately and severely decayed, whereas AuNR@AuAg retained its activity intact. Moreover, the longitudinal SPR frequency of AuNR@AuAg can be tuned throughout the red wavelengths (≈620–690 nm) by controlling the thickness of the AuAg alloy shell. The synthetic strategy is versatile to fabricate AuAg alloyed shells on different shaped Au, with prospects for new possibilities in the synthesis and application of plasmonic nanocrystals.

STRUCTURILE DE DEFLECTORI, FACTORI DE ÎMBUNĂTĂŢIRE AI HABITATULUI PISCICOL- STUDIU DE CAZ, RÂUL NICOLET (QUEBEC-CANADA

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Marius DULGHERU

2010-06-01

Full Text Available Deflection structures factors for improve the fish habitat. Case study nicolet river (Quebec-Canada. Există câţiva factori care joacă un rol important în definirea calităţii habitatului fizic al râurilor, speciile de peşti manifestând preferinţe pentru anumite elemente hidraulice (viteză, adâncime, tipul sedimentelor etc. Un habitat sănătos este în mod normal caracterizat printr-o succesiune morfologică de vaduri şi adâncuri cu impact în oxigenarea apei, reproducerea şi hrănirea peştilor etc. Datorită importanţei recreaţionale a pescuitului, în Canada există un număr foarte mare de proiecte de îmbunătăţire a habitatului piscicol. In acest sens, deflectorii amplasaţi în albiile cursurilor de apă s-au dovedit a fi metoda cea mai de succes pentru habitatul păstrăvilor. Pe râul Nicolet (Quebec-Canada a fost monitorizată influenţa unor astfel de structuri inginereşti asupra menţinerii în timp a structurii de adânc. Din analiza evoluţiei morfologice şi morfometrice a adâncurilor (prin folosirea diferitelor ridicări topografice succesive din perioada 2000-2007, rezultă faptul că structurile inginereşti au un rol benefic în menţinerea unui habitat propice pentru peşti.

Charged particle density distributions in Au + Au collisions at ...

Indian Academy of Sciences (India)

Charged particle pseudorapidity distributions have been measured in Au + Au collisions using the BRAHMS detector at RHIC. The results are presented as a function of the collision centrality and the center of mass energy. They are compared to the predictions of different parton scattering models and the important role of ...

Canada's Fusion Program

International Nuclear Information System (INIS)

Jackson, D. P.

1990-01-01

Canada's fusion strategy is based on developing specialized technologies in well-defined areas and supplying these technologies to international fusion projects. Two areas are specially emphasized in Canada: engineered fusion system technologies, and specific magnetic confinement and materials studies. The Canadian Fusion Fuels Technology Project focuses on the first of these areas. It tritium and fusion reactor fuel systems, remote maintenance and related safety studies. In the second area, the Centre Canadian de fusion magnetique operates the Tokamak de Varennes, the main magnetic fusion device in Canada. Both projects are partnerships linking the Government of Canada, represented by Atomic Energy of Canada Limited, and provincial governments, electrical utilities, universities and industry. Canada's program has extensive international links, through which it collaborates with the major world fusion programs, including participation in the International Thermonuclear Experimental Reactor project

Refractoriness of the western fence lizard (Sceloporus occidentalis) to the Lyme disease group spirochete Borrelia bissettii.

Science.gov (United States)

Lane, R S; Mun, J; Eisen, L; Eisen, R J

2006-08-01

The western fence lizard, Sceloporus occidentalis, is refractory to experimental infection with Borrelia burgdorferi sensu stricto, one of several Lyme disease spirochetes pathogenic for humans. Another member of the Lyme disease spirochete complex, Borrelia bissettii, is distributed widely throughout North America and a similar, if not identical, spirochete has been implicated as a human pathogen in southern Europe. To determine the susceptibility of S. occidentalis to B. bissettii, 6 naïve lizards were exposed to the feeding activities of Ixodes pacificus nymphs experimentally infected with this spirochete. None of the lizards developed spirochetemias detectable by polymerase chain reaction for up to 8 wk post-tick feeding, infected nymphs apparently lost their B. bissettii infections within 1-2 wk after engorgement, and xenodiagnostic L. pacificus larvae that co-fed alongside infected nymphs did not acquire and maintain spirochetes. In contrast, 3 of 4 naïve deer mice (Peromyscus maniculatus) exposed similarly to feeding by 1 or more B. bissettii-infected nymphs developed patent infections within 4 wk. These and previous findings suggest that the complement system of S. occidentalis typically destroys B. burgdorferi sensu lato spirochetes present in tissues of attached and feeding I. pacificus nymphs, thereby potentially reducing the probability of transmission of these bacteria to humans or other animals by the resultant adult ticks.

[Usefulness of serological studies for the early diagnosis of Lyme disease in Primary Health Care Centres].

Science.gov (United States)

Vázquez-López, María Esther; Fernández, Gonzalo; Díaz, Pablo; Díez-Morrondo, Carolina; Pego-Reigosa, Robustiano; Coira-Nieto, Amparo

2018-01-01

The main aim of this study was to determine the usefulness of an early diagnosis of Lyme disease (LD) in Primary Health Care Centres (PHCC) using the ELISA test as serological screening technique. A retrospective study (2006-2013) was performed in order to determine the anti-Borrelia seropositivity in 2,842 people at risk of having LD. The possible relationship between the environment and the area of residence with anti-Borrelia seropositivity was also studied according to the origin of the specimens (PHCC/Hospital). Overall, 15.2% of samples were positive to Borrelia spp. Seropositivity was significantly higher in samples sent by PHCC doctors than those sent by Hospital doctors. Seropositivity was significantly higher in rural than in urban populations and in those who live in mountainous or flat areas. The percentage of seropositivity has increased over the years. The role of the PHCC doctor is essential for achieving an early diagnosis of Lyme disease, as a higher percentage of seropositives was detected in samples submitted from PHCC. Furthermore, most early localised LD patients were diagnosed in PHCC, avoiding the appearance of sequelae. Therefore, detection of Borrelia specific antibodies using an ELISA assay is a useful screening test for patients at risk of LD. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Association of Lyme Disease and Schizoaffective Disorder, Bipolar Type: Is it Inflammation Mediated?

Science.gov (United States)

Mattingley, David William; Koola, Maju Mathew

2015-01-01

Lyme disease has been reported to be associated with various psychiatric presentations. Borreliaburgdorferi (Bb) can present with symptoms similar to schizophrenia and bipolar disorder. It has been suggested that inflammation incurred during the Bb infection leads to neurodegenerative changes that result in schizophrenia-like presentations. We report a case of a 41-year-old male with a past history of Bb infection who presents with psychosis. Later in the course of his hospitalization, he developed mood symptoms and was diagnosed with schizoaffective disorder, bipolar type. This case highlights the diagnosis and treatment of a patient with the unique presentation of schizoaffective disorder, bipolar type in the setting of previous Bb infection.

Amélioration de la nutrition au Cambodge au moyen de l ...

International Development Research Centre (IDRC) Digital Library (Canada)

Amélioration de la nutrition au Cambodge au moyen de l'aquaculture et des jardins potagers domestiques (FCRSAI). Si l'on produit au Cambodge suffisamment de riz pour nourrir la population, la sous-alimentation maternelle et infantile y demeure quand même élevée en raison de la faible diversification des cultures et du ...

[Hyp-Au-Sn9(Hyp)3-Au-Sn9(Hyp)3-Au-Hyp]-: the longest intermetalloid chain compound of tin.

Science.gov (United States)

Binder, Mareike; Schrenk, Claudio; Block, Theresa; Pöttgen, Rainer; Schnepf, Andreas

2017-10-12

The reaction of the metalloid tin cluster [Sn 10 (Hyp) 4 ] 2- with (Ph 3 P)Au-SHyp (Hyp = Si(SiMe 3 ) 3 ) gave an intermetalloid cluster [Au 3 Sn 18 (Hyp) 8 ] - 1, which is the longest intermetalloid chain compound of tin to date. 1 shows a structural resemblance to binary AuSn phases, which is expected for intermetalloid clusters.

Hollow Au@Pd and Au@Pt core-shell nanoparticles as electrocatalysts for ethanol oxidation reactions

KAUST Repository

Song, Hyon Min

2012-09-27

Hybrid alloys among gold, palladium and platinum become a new category of catalysts primarily due to their enhanced catalytic effects. Enhancement means not only their effectiveness, but also their uniqueness as catalysts for the reactions that individual metals may not catalyze. Here, preparation of hollow Au@Pd and Au@Pt core-shell nanoparticles (NPs) and their use as electrocatalysts are reported. Galvanic displacement with Ag NPs is used to obtain hollow NPs, and higher reduction potential of Au compared to Ag, Pd, and Pt helps to produce hollow Au cores first, followed by Pd or Pt shell growth. Continuous and highly crystalline shell growth was observed in Au@Pd core-shell NPs, but the sporadic and porous-like structure was observed in Au@Pt core-shell NPs. Along with hollow core-shell NPs, hollow porous Pt and hollow Au NPs are also prepared from Ag seed NPs. Twin boundaries which are typically observed in large size (>20 nm) Au NPs were not observed in hollow Au NPs. This absence is believed to be due to the role of the hollows, which significantly reduce the strain energy of edges where the two lattice planes meet. In ethanol oxidation reactions in alkaline medium, hollow Au@Pd core-shell NPs show highest current density in forward scan. Hollow Au@Pt core-shell NPs maintain better catalytic activities than metallic Pt, which is thought to be due to the better crystallinity of Pt shells as well as the alloy effect of Au cores. © 2012 The Royal Society of Chemistry.

Using Risk Group Profiles as a Lightweight Qualitative Approach for Intervention Development: An Example of Prevention of Tick Bites and Lyme Disease

NARCIS (Netherlands)

Beaujean, Desirée; van Velsen, Lex Stefan; van Gemert-Pijnen, Julia E.W.C.; Maat, Angelique; van Steenbergen, Jim; Crutzen, Rik

2013-01-01

Background: Many public health campaigns use a one-size-fits-all strategy to achieve their desired effect. Public health campaigns for tick bites and Lyme disease (LD) in many countries convey all relevant preventive measures to all members of the public. Although preventing tick bites (eg, by

The Conundrum of Demographic Aging and Policy Challenges: A Comparative Case Study of Canada, Japan and Korea

Directory of Open Access Journals (Sweden)

McDaniel, Susan A.

2009-01-01

cet article, trois pays dont les marchés, les états et les familles contrastent et qui se trouvent à différents points dans le vieillissement des populationssont comparés et contrastés : le Canada, le Japon, et la Corée. Cet article a trois objectifs : 1 souligner les changements majeurs dans les populations, les familles, et la situation de l’emploidans chaque pays ; 2 évaluer comment les données au sujet de ces changements, leurs dynamiques et leurs rapports mutuels, sont cadrées par rapport aux possibilités d’action; et 3 comparer le Canada, le Japon et la Corée dans leur cadrage des défis aux politiques posés parle vieillissement des populations. Il se dégage de l’étude que le Canada est en train de joindre le modèle déjà bien établi au Japon et en Corée des départs tardifs des jeunes, ce qui représenteune plus courte période de temps au sein de la main d’oeuvre rémunérée. De petits mais profonds liens existent entre le vieillissement des populations et la productivité économique oules pénuries de main d’oeuvre. La participation différentielle des femmes à la main d’oeuvre affecte le vieillissement des populations.

Evidence from d+Au measurements for final-state suppression of high-p(T) hadrons in Au+Au collisions at RHIC.

Science.gov (United States)

Adams, J; Adler, C; Aggarwal, M M; Ahammed, Z; Amonett, J; Anderson, B D; Anderson, M; Arkhipkin, D; Averichev, G S; Badyal, S K; Balewski, J; Barannikova, O; Barnby, L S; Baudot, J; Bekele, S; Belaga, V V; Bellwied, R; Berger, J; Bezverkhny, B I; Bhardwaj, S; Bhaskar, P; Bhati, A K; Bichsel, H; Billmeier, A; Bland, L C; Blyth, C O; Bonner, B E; Botje, M; Boucham, A; Brandin, A; Bravar, A; Cadman, R V; Cai, X Z; Caines, H; Calderón de la Barca Sánchez, M; Carroll, J; Castillo, J; Castro, M; Cebra, D; Chaloupka, P; Chattopadhyay, S; Chen, H F; Chen, Y; Chernenko, S P; Cherney, M; Chikanian, A; Choi, B; Christie, W; Coffin, J P; Cormier, T M; Cramer, J G; Crawford, H J; Das, D; Das, S; Derevschikov, A A; Didenko, L; Dietel, T; Dong, X; Draper, J E; Du, F; Dubey, A K; Dunin, V B; Dunlop, J C; Dutta Majumdar, M R; Eckardt, V; Efimov, L G; Emelianov, V; Engelage, J; Eppley, G; Erazmus, B; Fachini, P; Faine, V; Faivre, J; Fatemi, R; Filimonov, K; Filip, P; Finch, E; Fisyak, Y; Flierl, D; Foley, K J; Fu, J; Gagliardi, C A; Ganti, M S; Gagunashvili, N; Gans, J; Gaudichet, L; Germain, M; Geurts, F; Ghazikhanian, V; Ghosh, P; Gonzalez, J E; Grachov, O; Grigoriev, V; Gronstal, S; Grosnick, D; Guedon, M; Guertin, S M; Gupta, A; Gushin, E; Gutierrez, T D; Hallman, T J; Hardtke, D; Harris, J W; Heinz, M; Henry, T W; Heppelmann, S; Herston, T; Hippolyte, B; Hirsch, A; Hjort, E; Hoffmann, G W; Horsley, M; Huang, H Z; Huang, S L; Humanic, T J; Igo, G; Ishihara, A; Jacobs, P; Jacobs, W W; Janik, M; Johnson, I; Jones, P G; Judd, E G; Kabana, S; Kaneta, M; Kaplan, M; Keane, D; Kiryluk, J; Kisiel, A; Klay, J; Klein, S R; Klyachko, A; Koetke, D D; Kollegger, T; Konstantinov, A S; Kopytine, M; Kotchenda, L; Kovalenko, A D; Kramer, M; Kravtsov, P; Krueger, K; Kuhn, C; Kulikov, A I; Kumar, A; Kunde, G J; Kunz, C L; Kutuev, R Kh; Kuznetsov, A A; Lamont, M A C; Landgraf, J M; Lange, S; Lansdell, C P; Lasiuk, B; Laue, F; Lauret, J; Lebedev, A; Lednický, R; Leontiev, V M; LeVine, M J; Li, C; Li, Q; Lindenbaum, S J; Lisa, M A; Liu, F; Liu, L; Liu, Z; Liu, Q J; Ljubicic, T; Llope, W J; Long, H; Longacre, R S; Lopez-Noriega, M; Love, W A; Ludlam, T; Lynn, D; Ma, J; Ma, Y G; Magestro, D; Mahajan, S; Mangotra, L K; Mahapatra, D P; Majka, R; Manweiler, R; Margetis, S; Markert, C; Martin, L; Marx, J; Matis, H S; Matulenko, Yu A; McShane, T S; Meissner, F; Melnick, Yu; Meschanin, A; Messer, M; Miller, M L; Milosevich, Z; Minaev, N G; Mironov, C; Mishra, D; Mitchell, J; Mohanty, B; Molnar, L; Moore, C F; Mora-Corral, M J; Morozov, V; de Moura, M M; Munhoz, M G; Nandi, B K; Nayak, S K; Nayak, T K; Nelson, J M; Nevski, P; Nikitin, V A; Nogach, L V; Norman, B; Nurushev, S B; Odyniec, G; Ogawa, A; Okorokov, V; Oldenburg, M; Olson, D; Paic, G; Pandey, S U; Pal, S K; Panebratsev, Y; Panitkin, S Y; Pavlinov, A I; Pawlak, T; Perevoztchikov, V; Peryt, W; Petrov, V A; Phatak, S C; Picha, R; Planinic, M; Pluta, J; Porile, N; Porter, J; Poskanzer, A M; Potekhin, M; Potrebenikova, E; Potukuchi, B V K S; Prindle, D; Pruneau, C; Putschke, J; Rai, G; Rakness, G; Raniwala, R; Raniwala, S; Ravel, O; Ray, R L; Razin, S V; Reichhold, D; Reid, J G; Renault, G; Retiere, F; Ridiger, A; Ritter, H G; Roberts, J B; Rogachevski, O V; Romero, J L; Rose, A; Roy, C; Ruan, L J; Rykov, V; Sahoo, R; Sakrejda, I; Salur, S; Sandweiss, J; Savin, I; Schambach, J; Scharenberg, R P; Schmitz, N; Schroeder, L S; Schweda, K; Seger, J; Seliverstov, D; Seyboth, P; Shahaliev, E; Shao, M; Sharma, M; Shestermanov, K E; Shimanskii, S S; Singaraju, R N; Simon, F; Skoro, G; Smirnov, N; Snellings, R; Sood, G; Sorensen, P; Sowinski, J; Spinka, H M; Srivastava, B; Stanislaus, S; Stock, R; Stolpovsky, A; Strikhanov, M; Stringfellow, B; Struck, C; Suaide, A A P; Sugarbaker, E; Suire, C; Sumbera, M; Surrow, B; Symons, T J M; Szanto de Toledo, A; Szarwas, P; Tai, A; Takahashi, J; Tang, A H; Thein, D; Thomas, J H; Tikhomirov, V; Tokarev, M; Tonjes, M B; Trainor, T A; Trentalange, S; Tribble, R E; Trivedi, M D; Trofimov, V; Tsai, O; Ullrich, T; Underwood, D G; Van Buren, G; VanderMolen, A M; Vasiliev, A N; Vasiliev, M; Vigdor, S E; Viyogi, Y P; Voloshin, S A; Waggoner, W; Wang, F; Wang, G; Wang, X L; Wang, Z M; Ward, H; Watson, J W; Wells, R; Westfall, G D; Whitten, C; Wieman, H; Willson, R; Wissink, S W; Witt, R; Wood, J; Wu, J; Xu, N; Xu, Z; Xu, Z Z; Yakutin, A E; Yamamoto, E; Yang, J; Yepes, P; Yurevich, V I; Zanevski, Y V; Zborovský, I; Zhang, H; Zhang, H Y; Zhang, W M; Zhang, Z P; Zołnierczuk, P A; Zoulkarneev, R; Zoulkarneeva, J; Zubarev, A N

2003-08-15

We report measurements of single-particle inclusive spectra and two-particle azimuthal distributions of charged hadrons at high transverse momentum (high p(T)) in minimum bias and central d+Au collisions at sqrt[s(NN)]=200 GeV. The inclusive yield is enhanced in d+Au collisions relative to binary-scaled p+p collisions, while the two-particle azimuthal distributions are very similar to those observed in p+p collisions. These results demonstrate that the strong suppression of the inclusive yield and back-to-back correlations at high p(T) previously observed in central Au+Au collisions are due to final-state interactions with the dense medium generated in such collisions.

Isolation of live Borrelia burgdorferi sensu lato spirochaetes from patients with undefined disorders and symptoms not typical for Lyme borreliosis

Czech Academy of Sciences Publication Activity Database

Rudenko, Natalia; Golovchenko, Maryna; Vancová, Marie; Clark, K.; Grubhoffer, Libor; Oliver, J. H., Jr.

2016-01-01

Roč. 22, č. 3 (2016), 267.e9-267.e15 ISSN 1198-743X EU Projects: European Commission(XE) 278976 - ANTIGONE Institutional support: RVO:60077344 Keywords : antibiotic treatment * live Borrelia burgdorferi * live Borrelia bissettii * Lyme borreliosis * recovery of live spirochaetes Subject RIV: FN - Epidemiology, Contagious Diseases ; Clinical Immunology Impact factor: 5.292, year: 2016

Influence of Au Nanoparticle Shape on Au@Cu2O Heterostructures

OpenAIRE

Zhu, Jie; Lu, Na; Chen, Wei; Kong, Lina; Yang, Yun; Ma, Dekun; Huang, Shaoming

2015-01-01

Synthesis of metal-semiconductor heterostructures may allow the combination of function of the corresponding components and/or the enhanced performance resulting from the interactions between all the components. In this paper, Au@Cu2O core-shell heterostructures are prepared by a seed-growth method, using different-shaped Au nanocrystals as the seeds such as nanorods, octahedra, decahedra, dots, and nanocubes. The results revealed that the final structure of Au@Cu2O was greatly influenced by ...

Flow in Au+Au collisions at RHIC

Science.gov (United States)

Belt Tonjes, Marguerite; the PHOBOS Collaboration; Back, B. B.; Baker, M. D.; Ballintijn, M.; Barton, D. S.; Betts, R. R.; Bickley, A. A.; Bindel, R.; Budzanowski, A.; Busza, W.; Carroll, A.; Decowski, M. P.; García, E.; George, N.; Gulbrandsen, K.; Gushue, S.; Halliwell, C.; Hamblen, J.; Heintzelman, G. A.; Henderson, C.; Hofman, D. J.; Hollis, R. S.; Hołyński, R.; Holzman, B.; Iordanova, A.; Johnson, E.; Kane, J. L.; Katzy, J.; Khan, N.; Kucewicz, W.; Kulinich, P.; Kuo, C. M.; Lin, W. T.; Manly, S.; McLeod, D.; Mignerey, A. C.; Nouicer, R.; Olszewski, A.; Pak, R.; Park, I. C.; Pernegger, H.; Reed, C.; Remsberg, L. P.; Reuter, M.; Roland, C.; Roland, G.; Rosenberg, L.; Sagerer, J.; Sarin, P.; Sawicki, P.; Skulski, W.; Steinberg, P.; Stephans, G. S. F.; Sukhanov, A.; Tang, J.-L.; Trzupek, A.; Vale, C.; van Nieuwenhuizen, G. J.; Verdier, R.; Wolfs, F. L. H.; Wosiek, B.; Wozniak, K.; Wuosmaa, A. H.; Wysłouch, B.

2004-08-01

The study of flow can provide information on the initial state dynamics and the degree of equilibration attained in heavy-ion collisions. This contribution presents results for both elliptic and directed flow as determined from data recorded by the PHOBOS experiment in Au+Au runs at RHIC at \\sqrt{sNN} = 19.6, 130 and 200 GeV. The PHOBOS detector provides a unique coverage in pseudorapidity for measuring flow at RHIC. The systematic dependence of flow on pseudorapidity, transverse momentum, centrality and energy is discussed.

A tick mannose-binding lectin inhibits the vertebrate complement cascade to enhance transmission of the Lyme disease agent

OpenAIRE

Schuijt, Tim J.; Coumou, Jeroen; Narasimhan, Sukanya; Dai, Jianfeng; DePonte, Kathleen; Wouters, Diana; Brouwer, Mieke; Oei, Anneke; Roelofs, Joris J.T.H.; van Dam, Alje P.; van der Poll, Tom; van ’t Veer, Cornelis; Hovius, Joppe W.; Fikrig, Erol

2011-01-01

The Lyme disease agent, Borrelia burgdorferi, is primarily transmitted to vertebrates by Ixodes ticks. The classical and alternative complement pathways are important in Borrelia eradication by the vertebrate host. We recently identified a tick salivary protein, designated P8 that reduced complement-mediated killing of Borrelia. We now discover that P8 interferes with the human lectin complement cascade resulting in impaired neutrophil phagocytosis and chemotaxis, and diminished Borrelia lysi...

Prédiction de la compacité des bétons compactés au rouleau à l'aide d'un modèle d'empilement granulaire