1: Am J Med. 2008 Jul;121(7):562-4. Links Perspectives on "chronic Lyme disease".Baker PJ. American Lyme Disease Foundation, Lyme, Connecticut, USA. [email protected]
"There is much controversy about the treatment of Lyme disease with respect to 2 poorly defined entities: "chronic Lyme disease" and "posttreatment Lyme disease syndrome. In the absence of direct evidence that these conditions are the result of a persistent infection, some mistakenly advocate extended antibiotic therapy (>/=6 months), which can do great harm and has resulted in at least 1 death. The purpose of this brief report is to review what is known from clinical research about these conditions to assist both practicing physicians and lawmakers in making sound and safe decisions with respect to treatment". (my emphasis)
-------------------- Neil Posts: 697 | From Tucson, AZ USA | Registered: Apr 2002
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Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
Hey Neil....
Nice to see you! I am on my last leg tonight.. but have a couple thoughts.
Try the Hopkins blood test study.
Two-Year Evaluation of Borrelia burgdorferi Culture and Supplemental Tests for Definitive Diagnosis of Lyme Disease
Peggy Coulter,1 Clara Lema,1 Diane Flayhart,1 Amy S. Linhardt,1 John N. Aucott,2 Paul G. Auwaerter,2 and J. Stephen Dumler1* Division of Medical Microbiology, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland,1 and Divisions of General Internal Medicine and Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Maryland2 Received 14 April 2005/Returned for modification 22 April 2005/Accepted 13 July 2005
They state such things as ...
" Although culture is definitive and has a relatively high sensitivity, the results required a mean of 3.5 weeks to recovery."
And look under their "discussion" section for "gold standard".
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Also a Google or Pub Med search on "gold standard Lyme" test.
Tincup
Honored Contributor (10K+ posts)
Member # 5829
posted
OK...
Uh oh!
Looks like I read your question as a riddle... it appears? I can't do the double negatives or whatever... so may have your request backwards? Not the brightest bulb o the tree... but you already know that.
Seems you are looking for the opposite.. which is also in the Hopkins study.
They say only one or two patients had a positive culture out of a gaggle of patients... and how many cases were missed.
So use it as needed... and ignore this ding dong wizard-want-a-be behind the curtain.
northstar
Frequent Contributor (1K+ posts)
Member # 7911
posted
Baker, as a rep for the ALDF, used the term "lawmakers"........
scuse me? Are they looking to legislate IDSA lyme treatment now? Are they going to criminalize extended treatment which has been successful?
Edit: This also may be a pre-emptive strike to fight against future attempts at state legislation that would protect llmd's. As if this approach is not sound and not safe. This would be supported by the IDSA communications to the state governors.
And for crying out loud, how many times do they have to bring up a single case of mishandled iv infection, only one of the thousands and thousands that have used iv's .....again and again and again ad nauseum.
And they misapply one mishandled iv case to condemn extended oral abx
Maybe they should let the "lawmakers" outlaw iv's across the board.
Baker makes the standard judgmement call that symptoms after 6 weeks are incapable of being found as infectious, therefore, no treatment should be given.
He uses the phrase "absence of direct evidence" of infection. That would point to saying that culture of the organism would be the only direct evidence acceptable. But the studies show that culture is rarely successful.
My guess is he ends up quoting Klempner and all, and forgets to mention any of the numerous studies showing viability of the spirochete after treatment.
It would be helpful to read the full article, but knowing the source, and from the summary, one can guess where they are going with this. Same old same old....
A response to this article would cover 2 areas:
testing inadequacies (to determine if active infection)
IDSA Fool's Gold Klempner study, and the other 2 that have been mentioned.
lymecryme.com in the left column, there are a series of links involving testing. These will go to lists of studies.
there are other resources, such as (the LDA website) ilads.org canlyme.com jemsekspecialty.com wildernetwork.com
that would also have studies and reviews
Northstar
[ 17. July 2008, 08:53 AM: Message edited by: northstar ]
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