2 Video: Jorge Benach On Tickborne Disease At Stony Brook

I came across this video on Youtube which I haven't seen mentioned elsewhere. It is a presentation by Dr. Jorge Benach on tickborne diseases, mostly focused on cases in New York State and much of it on Lyme disease - but there is also discussion on tickborne diseases in a more general sense as well.

I watched the video and made a note on topics of discussion during various points of time during the presentation which may be of interest to others.

Note that it is a little over an hour long, but you can skip the first three minutes as they are only an introduction. The last fifteen minutes are dedicated to a question and answer session with the audience - including one person who walked out because she was not satisfied with Dr. Benach's response.

[Time: 1:06:41]




11:39 Benach discusses Lone Star tick as primary tick on Long Island and that the number of cases of Lyme disease are going down in Eastern Long Island - possibly due to this tick's expansion.

16:33 Lifestyle of Ixodes tick described.

23:17 Early Babesia microti case on Long Island identified in 1970's - opens discussion on Babesiosis. Risk categories: over 50, elderly, asplenic, immunosuppressed, and/or alcoholism history.

29:00 Beginning of Lyme disease discussion... history of discovery, use of dark field microscopy for detection; electromicroscopy.

36:12 60% of patients have EM rash that is noticed. 40% do not.

37:00 Disseminated Lyme - Neuroborreliosis -20%, Cardiac disease- 5-10%, Arthritis - 60%

37:20 Secondary Disseminated symptoms - refractory to treatment - Benach does not understand what happens with chronic Lyme disease patients. Audience member brings up infection-related damage, Benach agrees with him that this is a problem - then goes back to discussing acute Lyme disease.

39:40 A rash that enlargens is clearly an EM rash. This is key to early diagnosis with a rash.

40:20 Multiple EM rash is sign of disseminated Lyme disease and requires IV or parenteral antibiotics.

40:57 Discusses spirochetes affecting the CNS and how it is similar to syphilis, and that a dementia-like form of Lyme disease is controversial. Audience member mentions person who was completely messed up by neurological Lyme disease; had CSF that was positive for Lyme disease and improved with IV treatment.

43:00 Benach thinks neurologic involvement in Lyme disease is underreported.

43:10 Explanation of Bells palsy in a child, says it is very common but not malignant.

43:57 Mentions Lyme arthritis in the classic sense. Discusses symptoms as relapsing and remitting.

44:38 Benach is under impression that most people's cases of Lyme disease are caught early and treated early due to presence of EM rash.

44:50 Epidemiology of Lyme disease in New York State and counties in NY. Benach thinks doctors in some counties are treating Lyme disease and are not reporting their cases to the state any more - they are "Lyme tired". For other counties, there is active surveillance, and the numbers are going up as more cases are new to their area.

47:00 Quip that LD now threatens politicians in Albany.

47:48 Is Lonestar tick driving other ticks away? Maybe… someone needs to study it.

48:13 Audience member asks about birds. Catbirds and robins have ticks, but don't carry a lot because they like the rims near eyes (bare skin). Birds are dead ends for the spirochetes because of their high temperature, according to Benach…

49:30 Start of Q & A session

51:38 Do people have natural immunity to Lyme disease? Benach does not think so - there is universal susceptibility to LD.

53:00 Jury still out on whether or not people have genetic susceptibility to Lyme disease. Hard to know if you are bitten multiple times if you have new instance of disease or preexisting disease because Lyme disease can last for 30 (possibly more) years in the human body.

54:40 No known existence of antibiotic resistant Lyme disease. Does he rule it out completely? No. But he states Borrelia are genetically challenged and have so few genes they need them to do housekeeping; they have a very small genome. He says there is no presence of those genes and he is 90% sure there is no antibiotic resistance.

57:09 Vaccine discussion - brief.

58:00 Pesticide soaked cotton balls used to fight ticks locally. (Damminix)

1:00 Opinion on prolonged chronic Lyme IV treatment: If  my child or I myself had a very strong titer for Lyme disease, I would use antibiotics for as long as it did good. If I did not have a very strong titer, then I would be reluctant to use antibiotics due to side effects.

Recurring arthritis and neurological manifestations come with strong serology according to Benach.

Benach leaves the audience with a confusing opinion: On one hand, he states he would not take antibiotics long term. On the other, he states that if he continued to be sick in the presence of strong serology then he would take antibiotics.

1:05 IgM doesn't drop over time in Lyme disease. We cannot culture Lyme disease easily, doesn't grow well in vitro - it is very slow growing. Only mycobacteria divides more slowly. You need 5 weeks to culture Borrelia. Benach's implication is no one would wait for those results - test is too difficult; takes too long.

More info. on Dr. Benach's research:
http://www.mgm.stonybrook.edu/benach/index.shtml


Comments:

One of my main comments for now (I may add more later) is that I think Dr. Benach is wrong about the birds.

I found this article: http://news.discovery.com/animals/migrating-birds-lower-body-temperature.html

Migrating birds can easily carry Borrelia spirochetes because their average daytime temperature is around 42.5C and goes down to 33C at night - the birds temporarily have hypothermia. They do this to save energy during long trips.

While some strains of Borrelia are sensitive to the birds' higher temperature range, some birds are actually conducive of supporting Borrelia spirochetal infections. Catharus fuscescens is one example.

See: http://jmm.sgmjournals.org/content/47/10/929.full.pdf

B. garinii, at 41C has the highest growth temperature on record. However, just because Borrelia stop growing doesn't indicate it is not present. Under varying temperature conditions, some Borrelia may be able to survive.

Another comment is that Dr. Benach mentions that Borrelia burgdorferi does not show signs of antibiotic resistance or genes for antibiotic resistance mechanism.

However, there are some spirochetes which have been resistant to erythromycin, and there is now some evidence of an antibiotic resistance mechanism in Bb: http://www.plospathogens.org/article/info%3Adoi%2F10.1371%2Fjournal.ppat.1000009

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0 Babesiosis Fatality In Australia

Earlier this week, the Australian television show Today Tonight aired a story about a 56 year old man from New South Wales who died from Babesiosis. There is some concern by others that the man contracted the infection within Australia and not overseas, though more evidence is needed this is the case.

Babesiosis is a tickborne illness caused by a protozoan parasite, Babesia, which infects red blood cells and produces symptoms which are similar to those found in malaria. It can be subclinical and cause no to mild symptoms - but it can also lead to moderate and severe symptoms. And sadly, as we've seen - even kill people.

People who are most likely to have severe symptoms are the elderly, those with compromised immune systems, and those who do not have a spleen.

I know firsthand what Babesiosis is like because several months after I was bitten by a tick, new symptoms showed up in me which were indicative of an infection with Babesia. I also was fortunate to get a positive blood smear - not something which is easily accomplished in the lab.

The most obvious symptoms I experienced were an ongoing shortness of breath with the sensation of a vice-like grip around my ribs, breaking out into sweats at night, "flash" fevers, and anemia. There were other less known symptoms as well, but these are among the most common. Fortunately, I think (I hope) I have beat this coinfection, and it has not beat me.

As it stands, the United States has seen a number of its own deaths due to Babesia, and according to an article in the New York Times, in coastal Rhode Island, the number of cases of Babesia are around 25% less than those of Lyme disease - in an area which is highly endemic for Lyme disease. And not only is Babesia becoming quite common in northeastern states - it's spreading to the northern midwest as well and was already found on the west coast.

One important thing to be aware of is not only can Babesia be transmitted by ticks - it can be spread through the blood supply via donations and transfusions. Thus far, there are twelve people who have died from Babesia spread through blood transfusions in the US. It is unknown, though, how many people may have been infected with Babesia through the blood supply and currently carry a more subclinical infection that may become more evident later.

There is currently no blood screening test available for donations and transfusions, and research is underway to develop such a test to avoid spreading more Babesia through the blood supply. So I highly recommend that if you have to get surgery and know this in advance, that you blood bank your own blood in preparation in case you need a transfusion.

You can view the dramatic video of the Today Tonight story here [4:46 minutes, plus short ad]:

Read this link for a full transcript of the show:

http://au.news.yahoo.com/today-tonight/latest/article/-/13207421/tick-timebomb/

For more information about Babesia and Babesiosis, check out these links:

Specific to Australia: http://lymedisease.org.au/about-lyme-disease/babesiosis/

About the Lifecycle: http://www.stanford.edu/group/parasites/ParaSites2006/Babesiosis/lifecycle.html

About Treatment: http://emedicine.medscape.com/article/780914-treatment

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2 Обзор Для русских читателей Лайм боррелиоза

Given what I learned about Russian treatment guidelines for Lyme disease - as well as a particular treatment plan from Serbia - I have decided to offer Russian Lyme disease patients (former and current) a survey.  I plan to give a similar survey to readers from other countries after this one...

Дорогие русские читатели этого блога,Благодарим Вас за посещение и чтение других блогов лагерь.Недавно я узнал от читателя, который лечился боррелиоз Лайма в Сербии, что оба вида антибиотиков выбрали и продолжительность лечения была отличной от той, которую мы обычно получают в Соединенных Штатах.

В результате, мне было интересно, о том, что различные руководящие принципы для лечения боррелиоза Лайма в разных странах. Я посмотрел на принципы Сербии лечения, но не могли найти их в Интернете. Потом я посмотрел на принципы лечения России по боррелиозом Лайма, и я нашел их, и разделяет их.

В поисках русских руководящие принципы для лечения боррелиоза Лайма, я узнал немного о том, как Лайм боррелиоза рассматривается врачей и медицинских вузов России. Я знаю, что мое понимание пациентов ограничен, однако.

Поэтому я хотел бы спросить вас, если вы могли бы пожалуйста, ответьте на несколько вопросов для меня о боррелиозом Лайма. Вы можете ответить с именем пользователя блоггер или быть анонимными - либо все в порядке.

Единственным требованием является то, что вы ни были Лайм боррелиоза в прошлом, или у вас есть боррелиоз Лайма сейчас.

Пожалуйста, ответьте на вопросы ниже, используя следующие инструкции:


1) ответы на русском языке первый, так что поисковые системы будут забрать свой комментарий и больше россиян будут видеть и поощрять участие.


2) Далее ваш ответ России, пожалуйста, напишите английский копию ответа так английских читателей, здесь можно понять ваш ответ.(Используйте translate.google.com или иной русско-английский перевод программы вы считаете хорошим, чтобы перевести ваш ответ.)


3) Имейте в виду, что существует предел в 4000 символов для каждого ответа. Если у вас есть длинный ответ, вы можете сделать комментарий.


Пожалуйста, обратите внимание: Все комментарии модерируются, то есть я рассматриваю их, прежде чем отправлять их в Интернете. Там может бытьзадержка между временем, когда вы входите в комментарий, и он показывает на странице. Я делаю это, чтобы избежать случайного спама и маркетинговыхсообщений.



Ну, вот ваши вопросы:


1) Есть ли у вас Лайм боррелиоза в прошлом?


2) Есть ли у вас боррелиоз Лайма сейчас?


3) Какие этапы или шаги Лайм боррелиоза у вас было в прошлом?Сейчас?


4) Было ли у вас укуса клеща и "быки глаз" сыпь?


5) Как долго времени между укусом клеща и лечение антибиотиками?


6) Какие у вас были симптомы?


7) Как долго вы были или вы больны?


8) Какое лечение вы получили для боррелиоза Лайма?


9) Как долго вы используете антибиотики?


10) Какие еще лекарства и методы лечения вы получите за Лайм боррелиоза (не антибиотики)?


11) После лечения, как здорово ты? Есть ли у вас остальные симптомы?Если да, то каковы ваши оставшиеся симптомы?


12) Как вы думаете, боррелиоз Лайма может быть хронической инфекции - даже после лечения антибиотиками? Считаете ли вы, никаких симптомов после лечения антибиотиками, свидетельствуют о аутоиммунное заболевание?


Спасибо за ваши ответы.Я понимаю, это очень много вопросов, но важно знать, какие проблемы у пациентов с Лайм-боррелиозом лица по всему миру. После Лайм боррелиоза является хроническим, то становится труднее лечить, и зная, как другие люди справляются с этой болезнью может быть полезным.


PS: Если вы знаете другие русские, которые пострадали с боррелиозом Лайма, пожалуйста, присылайте их сюда и попросить их ответить на эти вопросы тоже.


PPS: Я прошу прощения за использование Google Translate - это лучшее, что я мог сделать.

Dear Russian readers of this blog,

Thank you for visiting and reading Camp Other blog.

Recently, I learned from a reader who was treated for Lyme Borreliosis in Serbia that both the kind of antibiotics chosen and length of treatment was different from that which we usually receive in the United States.

As a result, I was curious about what different guidelines are for the treatment of Lyme Borreliosis in different countries. I looked for Serbia's treatment guidelines, but could not find them on the internet. Then I looked for Russia's treatment guidelines for Lyme Borreliosis, and I did find them, and shared them.

While searching for the Russian treatment guidelines for Lyme Borreliosis, I learned a little about how Lyme Borreliosis is viewed by doctors and medical universities in Russia. I know that my understanding about patients is limited, though.

So I would like to ask you if you could please answer a few questions for me about Lyme Borreliosis. You may answer with a blogger user name or be anonymous - either is okay.

The only requirement is that you have either had Lyme Borreliosis in the past or you have Lyme Borreliosis now.

Please answer the questions below using these instructions:

1) Respond in Russian first, so that search engines will pick up your comment and more Russians will see it and be encouraged participate.

2) Below your Russian response, please post an English copy of your response so the English readers here can understand your response. (Use translate.google.com or another Russian-English translation program you think is a good one to translate your response.)

3)  Be aware that there is a 4,000 character limit for each response. If you have a long response, you may want to make a new comment.

Okay, here are your questions:

1) Have you had Lyme Borreliosis in the past?

2) Do you have Lyme Borreliosis now?

3) What stages or steps of Lyme Borreliosis did you have in the past? Now?

4) Did you have a tick bite and a "bulls eye" rash?

5) How long was the time between the tick bite and antibiotic treatment?

6) What were your symptoms?

7) How long were you or are you sick?

8) What treatment did you receive for Lyme Borreliosis?

9) How long did you use antibiotics?

10) What other medicines and treatments did you receive for Lyme Borreliosis (not antibiotics)?

11) After treatment, how healthy are you? Do you have any remaining symptoms? If so, what are your remaining symptoms?

12) Do you think Lyme Borreliosis can be a persistent infection - even after antibiotic treatment?  Do you think any symptoms after antibiotic treatment are evidence of an autoimmune disorder?

Thank you for your answers.

I realize these are a lot of questions, but it's important to know what problems patients with Lyme Borreliosis face around the world. Once Lyme Borreliosis is chronic, it becomes harder to treat and knowing how other people are managing this disease could be helpful.

PS: If you know of any other Russians who have suffered with Lyme Borreliosis, please send them here and ask them to respond to these questions, too.

PPS: I apologize for using google translate - it's the best I could do.

Image credit:

English: Tomsk I railway station, Russia

Русский: Вокзал станции Томск I, Россия

by Alexander V. Solomin from Wikimedia Commons

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10 2011 Guidelines For Treating Lyme Disease...

... from Russia are here. With love.

This past weekend I got into a lengthy discussion with "radicale" on the Embers et al Issues a Statement post, and somewhere along the line, amid over 50 comments there (I highly recommend reading them, too), radicale advised that I check out documentation and research on Lyme disease from Russia and the Balkans.

So I did, and I did in part because he's the one who told me that treatment for both acute and disseminated Lyme disease in Serbia - particularly at two hospitals in the country - is more aggressive by default than it is either in the US or in Canada. He also stated that this treatment is backed by clinical studies (two of which are mentioned in the comments on the above post) - and because it was his home country and had this scientific backing, he went there for treatment for Lyme disease rather than in Canada.

He shared what he said was the standard antibiotic treatment schedule for Lyme disease given to patients in a few hospitals in Serbia:

"It is interesting that in Serbia, where every third tick is infected, amoxicillin is the drug of choice and it is routinely given for 6 weeks for early Lyme Disease.

In addition, disseminated Lyme Disease is treated in the following manner:

1) 4 weeks of ceftriaxone 2g/day plus metronidazole 500 mg bid
or three weeks of amoxicillin 1g tid followed by three weeks doxycycline 200mg bid plus metronidazole 500 mg bid
2) in case of persisting symptoms therapy is extended using pulsed doses up to 6 months

There are open-label control studies to support this type of treatment (in Serbian)."

I found this difference in approach to treatment interesting and I wanted a confirmation with a reliable source - so I have requested more information from him in terms of a citation for official guidelines using this antibiotic treatment.

While awaiting his response, I decided to see if I could find guidelines for other countries in the region and translate them. So far, I have found the 2011 guidelines for treatment of tickborne Borreliosis (they call it SDS) for Russia and ran them through Google Translate.

They are - as you will see - pretty bare bones relative to the guidelines document written up by either the IDSA or ILADS... And oh, OPTIONS... We have OPTIONS... did I say we have options? Yes, only I don't know what all the options actually are yet - I would have to figure out what all the drugs are by name.

Far as I can tell, Azitroks = azithromycin. doksitsi-wedge is, I think, some form of liquid doxycycline that is highly absorbent. klaforan = Claforan. Instructions at the bottom "per os" means "by mouth" or "orally".

I can figure out what some of the other drugs are due to their spelling coming close to the English word - but other drugs are unknown to me by the name being used...

APPROVED
Head of the Department of Health
Tomsk Oblast
O.S. Kobyakov
2011
Lepekhin A.
MD, Professor, Head of
Infectious Diseases and Epidemiology, State Educational Institution SSMU Health Ministry of Russia

Lukashova L.
MD, Professor, Department of Infectious Diseases and Epidemiology
GOU VPO SSMU Health Ministry of Russia

Ilyinskikh EN
MD, Professor, Department of Infectious Diseases and Epidemiology
GOU VPO SSMU Health Ministry of Russia

Zhukov, N.
MD, Professor of Neurology and Neurosurgery
GOU VPO SSMU Health Ministry of Russia

Portnyagina EV
PhD, Assistant Professor of Epidemiology and Infectious Diseases
GOU VPO SSMU Health Ministry of Russia

Dobkin, MN
PhD, chief freelance specialist in infectious
Health Department of the Tomsk region

Guidelines for Physicians
(Third edition, revised and enlarged)

Tomsk - 2011

THERAPY PROGRAM SDS

Schemes of causal treatment for tickborne Lyme Borreliosis

During the acute, manifest form (mild)

(Schema therapy - individual choice of doctor)
A. Amoxicillin 0.5 g three times daily per os (0.375 g of amoxiclav three times daily
per os), 14 days.
 or
Two. Azitroks 0.5 1 g once a day per os, 6 days.
 or
Three. Doxycycline 0.1 g 2 times a day per os, 14 days.

During the acute, manifest form (medium severity)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 1.0 g 2 times a day by intravenous drip, and 7 days, then - Amoxil-
penicillin of 0.75 g 3 times daily per os (0.375 g of amoxiclav three times daily per os),
7 days.
  or
Two. Ceftriaxone 1.0 g 2 times a day by intravenous drip, and 7 days, then - doksitsi-
wedge of 0.2 g 2 times a day intravenous drip, and 7 days.
 or
Three. 0.75 g of amoxicillin three times daily per os (0.560 g of amoxiclav three times daily
per os), 7 days, then - Azitroks 0.5 g of 1 time per day per os, 6 days.
 or
4. Doxycycline 0.2 g 2 times a day intravenous drip, and 7 days, then - Azitroks
0.5 1 g once a day per os, 6 days.

During the acute, manifest form (severe severity)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 2.0 g 2 times a day intravenous drip, and 10 days later - Amoxil-
penicillin at 1.0 g three times daily per os (amoxiclav, 0.625 g 3 times daily per os),
10 days.
 or
Two. Ceftriaxone 2.0 g 2 times a day intravenous drip, and 10 days later - doksitsi-
wedge of 0.2 g 2 times a day intravenous drip, and 10 days.
 or
Three. Amoxicillin 1.0 g three times daily per os (amoxiclav, 0.625 g 3 times a day
per os), 7 days, then - Azitroks of 1.0 g of 1 time per day per os in a 1-day and 0.5 g of 1
once a day per os for the next 5 days.
 or
4. Doxycycline 0.2 g 2 times a day intravenous drip, and 7 days, then - Azitroks 1.0 g of 1 time per day per os in 1-day and 0.5 g of 1 time per day per os for at- the next 5 days.

8Podostroe for (mild)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 1.0 g of a once-daily intravenous infusion, and 10 days later - doksitsi-
wedge of 0.1 g 2 times a day intravenous drip, and 10 days.
 or
Two. Amoxicillin 0.5 g three times daily per os (amoxiclav, 0.625 g 3 times a day
per os), 10 days later - doxycycline 0.1 g 2 times daily intravenous-drip
10 days.

Subacute (medium severity)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 1.0 g of a once-daily intravenous infusion, and 10 days later - doksitsi-
wedge of 0.2 g 2 times a day intravenous drip, and 10 days.
 or
Two. Ceftriaxone 1.0 g of a once-daily intravenous infusion, and 10 days later - Amoxil-
penicillin of 0.75 g 3 times daily per os (0.375 g of amoxiclav three times daily per os),
10 days.

Subacute (severe severity)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - doksitsi-
wedge of 0.2 g 2 times a day intravenous drip, and 10 days.
 or
Two. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - Amoxil-
penicillin at 1.0 g three times daily per os (amoxiclav, 0.625 g 3 times daily per os),
10 days.

Chronic (phase compensation)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
amoxicillin 0.5 g three times daily per os (0.375 g of amoxiclav three times daily
per os), 7 days.
 or
Two. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
doxycycline 0.1 g 2 times a day by intravenous drip, and 10 days.

Chronic (Stage subcompensation)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
amoxicillin 0.5 g three times daily per os (0.375 g of amoxiclav three times daily
per os), 10 days.
 or
Two. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
doxycycline 0.2 g 2 times a day by intravenous drip, and 10 days.

9Hronicheskoe for (stage decompensation)

(Schema therapy - individual choice of doctor)
A. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
amoxicillin 0.5 g three times daily per os (0.375 g of amoxiclav three times daily
per os), 10 days.
 or
Two. Ceftriaxone 2.0 g of a once-daily intravenous infusion, and 10 days later - klaforan
2.0 g 2 times a day by intravenous infusion or intramuscular injection, and 10 days, then -
doxycycline 0.2 g 2 times a day by intravenous drip, and 10 days.

Scheme of pathogenetic and symptomatic therapy

Universal scheme of pathogenetic and symptomatic therapy
patients with SDS

(Drugs, marked with #, appoint, and the testimony of an individual selection, dosing regimen of drugs - depending on the severity of illness)

- Lineks 1-2 capsules three times daily per os, 30 days;
# 0.9% sodium chloride, 200 ml of intravenous-drip of 5% glucose solution
200-400 ml of intravenous-drip reopolyglukine 200-400 ml of intravenous-ka-
pelno;

# Immunomodulators (including data immunogram).

When neurological manifestations...

# Venotonicheskie tools
- 2.4% -10.0 aminophylline IV-drip, 10 days
or
- Cavinton (vinpocetine) 4-mL intravenous infusion, 10 days
# Neuroprotective drugs
- 10 ml Cerebrolysin intravenous-infusion, 10 days
or
- Actovegin 5-20 ml per day by intravenous drip, and 10 days later - on 0.2 g of 3
times a day per os, 30 days
or
- Cytoflavin 10 ml intravenous drip, in 100-200 ml of 5-10% solution of glucoside
goats, or 0.9% sodium chloride solution, 1 time per day, 10 days later - on 2
tablets 2 times daily per os, 25-30 days
or
- Nootropil 5 ml intravenous drip, and 10 days
or
- Lutset 10 ml intravenous bolus, and 10 days

# Metabolic means

- Mildronat 10% -5.0 (10.0) IV-bolus, 10 days
or
- Panangin 10-20 ml intravenous bolus, and 10 days, then - 1 tablet 3 times a
per day per os, 30 days

# Vitamin
- Milgamma 2 ml daily intramuscular injections of 10
or
1011
- Berokka plus 1 tablet daily per os, 30 days
or
- Benfolipen (combined multivitamin complex) 1 tablet 1.3
times daily after meals per os, 30 days

# Tranquilizers
- Nozepam of 0.01 g per os the night
or
- Grandaksin of 0.05 g 2 times a day per os
or
- Alprazolam 0,025 g per night per os, with a gradual increase in dose
0.025 g in 3-5 days
or
- Phenazepam of 0.005-0.01 g per night per os, 7-10 days
or
- Glycine, 0.1 g 4-6 times a day sublingually, long-term (period-rekonva
lestsentsii)
or
- Adaptol (mebikar) to 0.5 g 2-3 times a day per os, a few days to 2-3
months (the period of convalescence)

# Sedatives
- New-passive 1 tablet or 1 tsp. solution 3 times a day per os, 30 days
or
- Tincture of motherwort (peony, Valerian) or Corvalol (valokordin, valoser-
din)

otvornye tools
- Donormil to 0,015 g per night per os
or
- Radedorm to 0,005 g per night per os
or
- Ivadal of 0.010 g per os the night
or
- Imovan of 0.0075 g per night per os
or
- Sanval to 0,005 g per night per os

# antidepressants
- Amitriptyline to 0,025 g per night per os, with a gradual increase in dose
0.025 g, 30-40 days
or
- Luvox of 0.05-0.1 g per night per os, up to 3 months
or
- Agomelatine 0,025 g per night per os, up to 3 months
When arthrologic manifestations

# Non-steroidal anti-inflammatory drugs
- Diclofenac 3 ml intramuscular injections of 6 or 0.025-0.05 g 3 times
per day per os, up to 7 days
or
- Movalis 1.5 mL intramuscularly or 0.015 g of 1 time per day per os, up to 7 days
or 12
- Ksefokam of 0,008 g 1-2 times daily per os
or
- Celebrex to 0.2 g 2 times a day per os, up to 7 days
or
- Artrozan (meloxicam) to 0,015 g 1 a day per os

# Antispasmodics
- Midokalm of 0.05 g 2-3 times a day per os, with a gradual increase razo-
curve to the dose of 0.15 g (0.1 g 1-2 times a day intramuscularly or intravenously
slowly)
or
- Sirdalud 0,002 g 3 times a day

# With the express pain
- Diprospan 1 ml in 2-4 ml of 0.5% solution of novocaine or lidocaine 2%
an intramuscular injection once a week, 3-5 injections
or
- Combilipen (combined multivitamin complex in conjunction with the Do-
dokainom) 2 ml intramuscularly daily for 5-7 days, then - 2
ml 2-3 times a week for 2 weeks

# Massage, therapeutic exercise, physical therapy (in the period of convalescence)

When cardiac manifestations...

# Metabolic means
- 10% mildronat -5,0-10,0 intravenous bolus, and 10 days (myocarditis, myocardial-
odistrofiya, ECG signs of repolarization, disturbances of rate)
- Panangin 10-20 ml intravenous bolus, and 10 days, then - 1 tablet 3 times a
per day per os, 30 days (arrhythmias and conduction)

# Sedatives
- New-passive 1 tablet or 1 tsp. solution 3 times a day per os, 30 days
(Syndrome of vegetative dystonia)
or
- Tincture of motherwort (peony, Valerian) or Corvalol (valokordin, valoser-
din)

# Antihypertensives
- Atenolol to 0.05-0.1 g per day, 20-30 days (arterial hypertension syndrome-
sion, cardiac arrhythmias, the syndrome of vegetative dystonia, stenokardicheskie
syndrome)

---

Comments? Questions? Thoughts?

My first thought on these guidelines are that the first thing I notice is that they are broken down into certain stages and conditional stages of Lyme disease/Borreliosis that are not defined here - perhaps they are defined in another document I have yet to locate, but just at first glance, medical professionals in Russia seem to break the stages down into finer grades of distinction with treatments to match.

My second thought is it seems their approach is to vary the kind of antibiotic used, and use the most bactericidal antibiotic first, followed by progressively less bactericidal and more bacteriostatic antibiotics. I am wondering if this is done for any specific reason.

My third thought is that the IDSA would probably not like part of these guidelines because they recommend using vitamins, massage therapy, and a little alternative medicine. That tincture of motherwort would probably be troubling to them. (Personally, I found valerian root to be a useful sleep aid, but it smells like dirty socks so I don't use it.)

My fourth thought is that this is pretty thorough in terms of intensive treatment for patients with cardiac and neurological manifestations of disseminated and late stage Lyme disease/Borreliosis, and I like that it offers ideas for supportive treatment for not only pain, anxiety, and depression - but for irregular heart rhythms.

There are some things that didn't translate well and I'm wondering what they are. "8Podostroe" for one thing."9Hronicheskoe" for another... I don't know what that is, either. Readers are invited to guess.

One thing I have learned while looking at various Russian and Balkans regional web sites on Lyme disease: They take it seriously.

You are considered an early mild case only within the first few days of a bite. After that, there is concern the disease has moved to the disseminated phase and it is treated more intensively. They also believe in relapses, and will give additional antibiotics if the initial course fails. In a number of places, you are expected to visit an infectious disease doctor as an outpatient 1, 3, 6, and 12 months after treatment in order to get follow up testing, report any relapsing, ongoing, or new symptoms, and give doctors more data for them to collect to understand how Lyme disease affects people.

There's more I've learned, but I'll share it later. Right now I just wanted to put these out here for you to see what other countries are doing to treat Lyme disease.

This work by Camp Other is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 Unported License.

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6 ILADS 2011 Conference

I was kinda expecting that at some point, this sign would show up on my feed:

No Burrascano. Missed part of Maloney. Horowitz was also MIA. Only got to see part of Jones, as I'd already taken a coffee break.

Maybe tomorrow will be better if I can haul myself out of bed early on a Saturday... If.

More on this event in the future - especially if there is more to see.

This work by Camp Other is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 Unported License.

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0 Research And A Personal Story: Computer scientist researches own Lyme disease

Well, this has been posted elsewhere, but I just had to share it here, too:

Computer scientist researched her own condition, Lyme disease

Source link: http://www.post-gazette.com/pg/11101/1138165-114.stm

Read the above article, and see if you see yourself (or someone you care about) in this woman's shoes. (I know that I can relate to her own search for reliable medical information, that's for sure.)

After much research from many different medical sources, Ms. Mankoff decided to try long-term antibiotics. After 18 months of antibiotic use she could stop treatment and go on to write professional papers, work full time, and do research on how members of the Lyme patient community seek out information on Lyme disease diagnosis, treatment, and support.

There is mention in the Post-Gazette article above that the paper based on her research of the Lyme patient community will be presented at an upcoming conference on computer-human interaction, CHI 2011.

That paper is:

J. Mankoff, K. Kuksenok, J. A. Rode, S. Kiesler & K. Waldman, Competing online viewpoints and models of chronic illness. In Proceedings of CHI 2011. To Appear (Full Paper)

And here is a link to the FULL TEXT (no subscription required):

http://www.cs.cmu.edu/~assist/publications/11MankoffCHI.pdf

If anyone happens to be in the Vancouver area this May 6 and would like to attend the session, it will be from 4:00-5:20 pm. (A link to the conference appears at the bottom of this post.)

A description is as follows:

Session Chair: Julie Kientz (University of Washington)
Competing Online Viewpoints and Models of Chronic Illness - Paper

Session Chair: Julie Kientz (University of Washington)
Competing Online Viewpoints and Models of Chronic Illness - Paper
Jennifer Mankoff Carnegie Mellon University,
Kateryna Kuksenok University of Washington,
Sara Kiesler Carnegie Mellon,
Jennifer A. Rode Drexel University,
Kelly Waldman Duke

Abstract »

People with chronic health problems use online resources to understand and manage their condition, but many such resources can present competing and confusing viewpoints. We surveyed and interviewed with people experiencing prolonged symptoms after a Lyme disease diagnosis. We explore how competing viewpoints in online content affect participants’ understanding of their disease. Our results illustrate how chronically ill people search for information and support, and work to help others over time. Participant identity and beliefs about their illness evolved, and this led many to take on new roles, creating content and advising others who were sick. What we learned about online content creation suggests a need for designs that support this journey and engage with complex issues surrounding online health resources.


If you wish to attend CHI 2011 for only a day session on site, you must be warned that registration is steep:
http://chi2011.org/attending/registration.html

If you can't make it to Vancouver and pay for admission, consider sitting at home, reading the pdf of the paper above, and emailing Ms. Mankoff with comments and questions.

This work by Camp Other is licensed under a Creative Commons
Attribution-NonCommercial-ShareAlike 3.0 Unported License.

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0 Video: Immunology Lectures from The Einstein College of Medicine

Given the volume of questions I'm getting on the immune system lately, I thought I'd post this 14 part mini series on the immune system.

Others have reported that watching this makes learning about immunology less scary and overwhelming - I haven't seen the entire series yet, but how about watching an episode or two and letting me know what you think of them?

There are slides online which accompany the lectures - these are the first session's slides:

http://www.einstein.yu.edu/multimedia/videos/conferences/immunologycourseinsouthafrica/L-1-Goldstein-Componenets-of-immune-system.pdf

Below is episode 1 - from there you should be able to advance to the next video in the series.

Learning more about immunology, microbiology, genetics, and molecular biology will help in understanding the research that is out there as well as patents.

All this knowledge is within reach - but requires putting the time in, and patience with one's own brain fog. I know, because I've been there... and it's a slow learning process - but learning does happen.

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0 Administrivia: Notes & Future Topics

Just popping in here for a moment amid fighting off some strange viral infection to leave a few short notes for my readers:

• When I'm feeling particularly unwell above and beyond my usual unwell, posting frequency may slow down. I'll try to give advance notice in comments or in a post like this one.
  
• Here's your notice: My posting frequency is slowing down now because I'm unwell.
  
• In general, new posts are less likely to be made during the weekend. What do I mean by "weekend" given everyone reading is in different time zones? Refer to island time.
  
• If I'm near a computer, I will check comments in the moderation queue during the weekend and post them.
  
• I may or may not respond to comments during weekends.
  
• Friday Four posts are sometimes posted as late as midnight Friday, Honolulu time (-10 h UTC/GMT).
  
• Reader comment & mailbag has included the following requests for further discussion: the immune system and how to build it, alternative medicine, XMRV, Morgellons, and the effectiveness of canine Borrelia blood tests.
  
• I plan to write an entry or two on each of these topics in the future. There is no guarantee on how soon each will be addressed. The timeline for each is dependent on my health, availability, other preexisting or newsworthy posts already in the pipeline, and the amount of time needed for additional reading and research to address each issue.
  
• Lymenet Europe has some interesting threads on Lyme disease organizations throughout Europe. I recommend viewing some of them, as well as guidelines different countries use. Tip: If you use the Chrome browser, you can translate web sites in other languages into English with a click of a button.

And now your moment of patient experience zen... This is something I think about when I get sick or am more symptomatic than usual - maybe some of you reading along will see yourself in it, too:

All I have to add for now. I'm going to lie down.

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0 Free Video Lectures & Podcasts: UC Berkeley Molecular and Cell Biology

For those of you who use iTunes to download podcasts and have the ability to learn by listening - or hope to absorb information through repetition and osmosis - there are FREE audio podcasts on Molecular and Cell Biology from UC Berkeley you can download from iTunes.

There are also some video podcasts of the classes available on iTunes and both audio and video podcasts can be found on UC Berkeley's webcast site.

If you're new to studying biology, I highly recommend starting with a basic biology course first, - such as this Biology 1A lecture at Berkeley and/or these Biology video podcasts from MIT - then this class:

Molecular and Cell Biology 110, 001|Fall 2009|UC Berkeley
by Qiang ZHOU, qing zhong, Thomas C. ALBER
Download up to 41 classes (start with session 1 at bottom of podcast list!)
http://itunes.apple.com/itunes-u/molecular-cell-biology-110/id354820350


Followed by its more advanced class:

Molecular and Cell Biology 130, 001|Spring 2009|UC Berkeley
by Randy W SCHEKMAN, Kunxin LUO, David G. DRUBIN
Download up to 42 classes (start with session 1 at bottom of podcast list!)
http://itunes.apple.com/us/itunes-u/molecular-cell-biology-130/id354820424

If you do not have iTunes, you can also go directly to UC Berkeley's webcast site and WATCH and listen to these classroom lectures for free, on a variety of topics.


I realize this may be challenging for many Lyme patients dealing with cognitive issues and "brain fog", but I put the information out there because it can be useful to learn to decipher the studies and research you may come across from the IDSA, ILADS, and other groups. Knowledge is power, and the great things about these videocasts and podcasts are:

• You can play and replay each podcast as often as you like.
• You can learn at your own pace.
• You can share these links with others and talk about what they learned at their pace.
• You can watch some and listen to others - work with your best learning style.
• They are absolutely FREE - do you have any idea how much each unit at UC Berkeley costs?

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