Archive for the ‘research’ Category

Management of Tick Bites & Lyme Disease During Pregnancy

https://pubmed.ncbi.nlm.nih.gov/32414479/

Practice Guideline
J Obstet Gynaecol Can

. 2020 May;42(5):644-653.

doi: 10.1016/j.jogc.2020.01.001.

Committee Opinion No. 399: Management of Tick Bites and Lyme Disease During Pregnancy

Graeme N Smith 1, Kieran M Moore 1, Todd F Hatchette 2, Jennifer Nicholson 3, William Bowie 4, Joanne M Langley 2

Abstract

Objective: Lyme disease is an emerging infection in Canada caused by the bacterium belonging to the Borrelia burgdorferi sensu lato species complex, which is transmitted via the bite of an infected blacklegged tick. Populations of blacklegged ticks continue to expand and are now established in different regions in Canada. It usually takes more than 24 hours of tick attachment to transfer B. burgdorferi to a human. The diagnosis of early localized Lyme disease is made by clinical assessment, as laboratory tests are not reliable at this stage. Most patients with early localized Lyme disease will present with a skin lesion (i.e., erythema migrans) expanding from the tick bite site and/or non-specific “influenza-like” symptoms (e.g., arthralgia, myalgia, and fever). Signs and symptoms may occur from between 3 and 30 days following the tick bite. The care of pregnant patients with a tick bite or suspected Lyme disease should be managed similarly to non-pregnant adults, including the consideration of antibiotics for prophylaxis and treatment. The primary objective of this committee opinion is to inform practitioners about Lyme disease and provide an approach to managing the care of pregnant women who may have been infected via a blacklegged tick bite.

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**Comment**

Payment is required to see the full article.

A few points:

  • I’m glad they acknowledge that ticks are expanding everywhere – and that goes for ALL ticks.
  • In my opinion, as these ticks expand, biting animals/people outside of their typical range, more transmission studies need to be done to determine if they are also picking up new pathogens not common to them previously.  This would help explain the expansion of pathogens as well as ticks. Unfortunately, researchers are content with 35+ year old studies with an inch of dust on them.
  • It DOES NOT take 24 hours to become infected and a minimum time has never been established:  https://madisonarealymesupportgroup.com/2017/04/14/transmission-time-for-lymemsids-infection/
  • I’m glad they acknowledge that Lyme/MSIDS is a clinical assessment.  Unfortunately, due to top down education from the CDC/IDSA, doctors are woefully unprepared to make this assessment.  There needs to be an overhaul on this aspect of medical training and they should listen to Lyme literate doctors with decades of experience rather than vilify them:  https://madisonarealymesupportgroup.com/2020/11/25/what-makes-a-doctor-lyme-literate/
  • Most patients will NOT present with a skin lesion:  https://madisonarealymesupportgroup.com/2019/02/22/why-mainstream-lyme-msids-research-remains-in-the-dark-ages/
  • I’m extremely grateful they recommend considering prophylactic treatment.  Unfortunately, again due to top down education from the CDC/IDSA, doctors are scared to death to use antibiotics for this, further revealing the need for education on the severe nature of this disease(s) and the potential for congenital transmission affecting the life of the newborn forever. This detail makes it clear any risk is worth the benefit, but only if you are knowledgable about the severity of the disease(s).
  • No mention of coinfections is given, and this is another important issue mainstream medicine is clueless about. Patients that are coinfected are sicker for longer and require far more than the typical mono treatment.

For more:  

Category:

Lyme, Pregnancy, research, Treatment

Antiviral Defense From the Gut

https://hms.harvard.edu/news/antiviral-defense-gut

Antiviral Defense from the Gut

Study looks at gut bacteria role in resistance to viral infections
By EKATERINA PESHEVA Research
digital xray image of the gut

Image: ChrisChrisW/iStock/Getty Images Plus

The role of the gut microbiome in disease and health has been well established. Yet, how the bacteria residing in our guts protect us from viral infections is not well understood.

Now, for the first time, Harvard Medical School researchers have described how this happens in mice and have identified the specific population of gut microbes that modulates both localized and systemic immune response to ward off viral invaders.

The work, published Nov. 18 in Cell, pinpoints a group of gut microbes, and a specific species within it, that causes immune cells to release virus-repelling chemicals known as type 1 interferons.

The researchers further identified the precise molecule—shared by many gut bacteria within that group—that unlocks the immune-protective cascade. That molecule, the researchers noted, is not difficult to isolate and could become the basis for drugs that boost antiviral immunity in humans. (See link for article)

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For more:  

Category:

Activism, Gut Health, research, Viruses

Evaluation of Disulfiram Drug Combinations & Identification of Other More Effective Combinations against Stationary Phase Borrelia burgdorferi

https://www.mdpi.com/2079-6382/9/9/542

Evaluation of Disulfiram Drug Combinations and Identification of Other More Effective Combinations against Stationary Phase Borrelia burgdorferi

by Hector S. Alvarez-Manzo, Yumin Zhang, Wanliang Shi and Ying Zhang 

Antibiotics2020, 9(9), 542; https://doi.org/10.3390/antibiotics9090542 (registering DOI)Received: 7 August 2020 / Revised: 21 August 2020 / Accepted: 25 August 2020 / Published: 26 August 2020View Full-TextDownload PDFBrowse Figures

Abstract

Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne disease in USA, and 10–20% of patients will develop persistent symptoms despite treatment (“post-treatment Lyme disease syndrome”). B. burgdorferi persisters, which are not killed by the current antibiotics for Lyme disease, are considered one possible cause. Disulfiram has shown to be active against B. burgdorferi, but its activity against persistent forms is not well characterized. We assessed disulfiram as single drug and in combinations against stationary-phase B. burgdorferi culture enriched with persisters.

  • Disulfiram was not very effective in the drug exposure experiment (survival rate (SR) 46.3%) or in combinations.
  • Clarithromycin (SR 41.1%) and nitroxoline (SR 37.5%) were equally effective when compared to the current Lyme antibiotic cefuroxime (SR 36.8%) and more active than disulfiram.
  • Cefuroxime + clarithromycin (SR 25.9%) and cefuroxime + nitroxoline (SR 27.5%) were significantly more active than cefuroxime + disulfiram (SR 41.7%).
  • When replacing disulfiram with clarithromycin or nitroxoline in three-drug combinations, bacterial viability decreased significantly and subculture studies showed that combinations with these two drugs (cefuroxime + clarithromycin/nitroxoline + furazolidone/nitazoxanide) inhibited the regrowth, while disulfiram combinations did not (cefuroxime + disulfiram + furazolidone/nitazoxanide).

Thus, clarithromycin and nitroxoline should be further assessed to determine their role as potential treatment alternatives in the future.View Full-Text

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For more:

https://madisonarealymesupportgroup.com/2020/12/07/repurposing-disulfiram-in-the-treatment-of-lyme-disease-and-babesiosis-retrospective-review-of-first-3-years-experience-in-one-medical-practice/

https://madisonarealymesupportgroup.com/2020/11/30/patients-can-respond-very-differently-to-disulfiram-be-cautious/

https://madisonarealymesupportgroup.com/2020/10/01/study-shows-dsm-works-for-lyme-reduces-inflammatory-markers-antibody-titers/

https://madisonarealymesupportgroup.com/2019/11/19/if-disulfiram-is-the-cure-for-lyme-disease-should-it-be-prescribed-to-all-lyme-disease-patients/

https://madisonarealymesupportgroup.com/2020/06/26/new-treatments-for-lyme-disease-on-the-horizon/

https://madisonarealymesupportgroup.com/2016/02/13/lyme-disease-treatment/

Category:

Lyme, research, Treatment

Symptomatic High-Grade AV Block & Phase 4 Right Bundle Branch Block – A Previously Unreported Manifestation in Lyme Carditis

https://www.heartrhythmcasereports.com/article/S2214-0271(20)30263-3/fulltext#secsectitle0020

Phase 4 Block of the Right Bundle Branch Suggesting His-Purkinje System Involvement in Lyme Carditis

Open AccessPublished: December 01, 2020DOI:https://doi.org/10.1016/j.hrcr.2020.11.017
We describe an adolescent with symptomatic high-grade AV block and evidence of phase 4 right bundle branch block, a previously unreported manifestation of infra-nodal conduction system involvement in LC.

A previously healthy 14-year-old boy presented via emergency medical services in mid-summer because of syncope (fainting).

Interesting findings:

  • Patient frequently hunts and fishes in wooded, Lyme-endemic region 
  • Didn’t remember tick bites or EM rash
  • Two weeks prior to ER visit patient had a runny nose, cough, abdominal pain, followed by headache and nausea.
  • In the ER he had bradycardia, altered mental status, headache, and vomiting.
  • Initial ECG showed complete heart block
  • He was given 2,000mg of IV Ceftriaxone every 24 hours
  • Testing supported clinical suspicion of Lyme
  • He was given a temporary pace-maker which was removed after 5 days of IV antibiotics and he was switched to oral doxycycline to complete a total of 21 days of antibiotics
  • After being monitored in hospital for 7 days, he was discharged with an auto-detecting wireless monitor until a follow-up appointment and stress test
  • Follow-up appointment patient was well with normal ECG

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**Comment*

Case study states: 

Significant AV block due to LC occurs in about 1% of LD cases.

I believe this statistic is premature considering many do not test positive and therefore are undiagnosed. I’ve posted numerous articles where patients are sent packing even when they present with positive test results three times in a row! We will never know how many patients with AV block have an underlying tick-borne illness due to abysmal testing and the lack of training and experience of most doctors with tick-borne illness.

And then there’s that nagging concern about long-term effects and if 21 days of antibiotics were enough for his patient. It often isn’t.

Please see:

https://madisonarealymesupportgroup.com/2020/11/25/what-makes-a-doctor-lyme-literate/

Category:

Heart Issues, Lyme, research, Testing, Treatment

Dogs Are Testing Positive For New Tick-Borne Bacteria

https://thebark.com/content/dogs-are-testing-positive-new-tick-borne-bacteria

Dogs Are Testing Positive For New Tick-Borne Bacteria

New species of bacteria identified that may cause disease in dogs and humans.
By Tracey Peake, November 2020

Researchers have identified a new species of Rickettsia bacteria that may cause significant disease in dogs and humans.

This new, yet-unnamed species, initially identified in three dogs, is part of the spotted-fever group Rickettsia which includes Rickettsia rickettsii, the bacteria that cause Rocky Mountain Spotted Fever (RMSF).

(See link for article)

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**Comment**

These poor dogs suffered from loss of appetite, lethargy, lameness, painful elbows, fever, dehydration, thrombocytopenia, and abdominal tenderness among other symptoms.  While I appreciate the authors’ desire to determine tick species and geography, these details have often been used against patients by hampering diagnosis and treatment.  We must stop trying to put this into a four-cornered box.  

Ticks and animals, including birds travel everywhere taking ticks with them.  You can get infected anytime, anywhere.

Study here:  https://madisonarealymesupportgroup.com/2020/11/17/novel-rickettsia-species-infecting-dogs-united-states/

Importantly, https://madisonarealymesupportgroup.com/2019/11/14/study-shows-ticks-can-transmit-rickettsia-immediately/ ..ticks can transmit infectious Rickettsia virtually as soon as they attach to the host.

Category:

Activism, research, Rickettsia, Ticks