This book written by two physicians is excellent. However, upon reading the chapter on borrelia, I found it wanting. It had "some" new data but little. The authors seem very receptive to feedback and so I sent them a note. The book is read by thousands of medical students, and may be a good way to promote the newest research.
Here was what I said:
Hello Dr. Gladwin, I've read your book Microbiology MRS, 2010 print. I found it to be excellent and helpful. I have one suggestion you may find valuable for future updates. It may be prudent to include the latest data on borrelia burdorferi, B. azfeli, B. garinii and the two standards of care for treating Lyme Disease. The latest data appears contradictory, including unreliable testing - (PCR, ELISA & Western Blot, CSF) -- sero-negative testing in both early and late stages, immunosuppressive activity, pleomorphic behavior of the bacterium, biofilms, as well as duration of therapy which some data suggest can exceed 3-6 months in some "Chronic cases". Since the science remains unsettled, students may be well served with a brief note in your book to be aware of the controversy and competing theories presented by the Infectious Disease Society Of America and the International Lyme And Associated Disease Society. Relying on the clinical picture and history, absent objective evidence, may sometimes be necessary for these future physicians who encounter this illness, unfortunately.
For your convenience, a brief three page document supporting long term therapy in some patients is presented below. 80 additional pages are merely abstracts supporting the first 3. While larger DBPCT have been performed, including with NIH support, many questions remain in many areas involving this infectious disease and I think that warrants a students attention.
We are working on a new addition and will consider this carefully. One challenge with such a book is to keep it simple and not overwhelming, as it is intended to form a backbone of knowledge and not serve as a reference text.
I wrote this as a student and it hit a nerve among med students, it is always a challenge to keep it “pure”,
-------------------- I am not a physician, so do your own research to confirm any ideas given and then speak with a health care provider you trust.
E-mail: firstname.lastname@example.org Posts: 4155 | From Western Massachusetts | Registered: Dec 2004
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