scholarly journals Precision medicine: retrospective chart review and data analysis of 200 patients on dapsone combination therapy for chronic Lyme disease/post-treatment Lyme disease syndrome: part 1

2019 ◽  
Vol Volume 12 ◽  
pp. 101-119 ◽  
Author(s):  
Richard I Horowitz ◽  
Phyllis R Freeman
Keyword(s):  
Data Analysis ◽  
Lyme Disease ◽  
Combination Therapy ◽  
Precision Medicine ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Post Treatment ◽  
Chronic Lyme Disease

scholarly journals Efficacy of Double-Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases and Retrospective Chart Review

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 725
Author(s):  
Richard I. Horowitz ◽  
Phyllis R. Freeman
Keyword(s):  
Lyme Disease ◽  
Combination Therapy ◽  
Antibiotic Therapy ◽  
Chart Review ◽  
Controlled Trial ◽  
Retrospective Chart Review ◽  
Post Treatment ◽  
Double Dose ◽  
Chronic Lyme Disease

Three patients with multi-year histories of relapsing and remitting Lyme disease and associated co-infections despite extended antibiotic therapy were each given double-dose dapsone combination therapy (DDD CT) for a total of 7–8 weeks. At the completion of therapy, all three patients’ major Lyme symptoms remained in remission for a period of 25–30 months. A retrospective chart review of 37 additional patients undergoing DDD CT therapy (40 patients in total) was also performed, which demonstrated tick-borne symptom improvements in 98% of patients, with 45% remaining in remission for 1 year or longer. In conclusion, double-dose dapsone therapy could represent a novel and effective anti-infective strategy in chronic Lyme disease/post-treatment Lyme disease syndrome (PTLDS), especially in those individuals who have failed regular dose dapsone combination therapy (DDS CT) or standard antibiotic protocols. A randomized, blinded, placebo-controlled trial is warranted to evaluate the efficacy of DDD CT in those individuals with chronic Lyme disease/PTLDS.

scholarly journals Efficacy of Double Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases

2020 ◽  
Author(s):  
Richard Horowitz ◽  
Phyllis R. Freeman
Keyword(s):  
Lyme Disease ◽  
Combination Therapy ◽  
Antibiotic Therapy ◽  
Controlled Trial ◽  
Post Treatment ◽  
Double Dose ◽  
Chronic Lyme Disease

Three patients with multi-year histories of relapsing and remitting Lyme disease and associated co-infections despite extended antibiotic therapy were each given double dose dapsone combination therapy (DDD CT) for a total of 7-8 weeks. At the completion of therapy, all three patients major Lyme symptoms remained in remission for a period of 25-30 months. In conclusion, Double dose dapsone therapy could represent a novel and effective anti-infective strategy in chronic Lyme disease/PTLDS, especially in those individuals who have failed regular dose dapsone combination therapy (DDS CT) or standard antibiotic protocols. A randomized, blinded, placebo-controlled trial is warranted to evaluate the efficacy of DDD CT in those individuals with chronic Lyme disease/PTLDS.

447 EFFICACY OF CLARITHROMYCIN/CEFDINIR COMBINATION THERAPY IN PATIENTS WITH CHRONIC LYME DISEASE

2005 ◽  
Vol 53 (1) ◽  
pp. S156.4-S156 ◽  
Author(s):  
R. B. Stricker ◽  
S. L. Thomas ◽  
D. H. Moore ◽  
E. E. Winger
Keyword(s):  
Lyme Disease ◽  
Combination Therapy ◽  
Chronic Lyme Disease

scholarly journals 599. Patient Beliefs Regarding Lyme Disease and Need for Antimicrobial Treatment when Referred for Lyme Evaluation

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S403-S403
Author(s):  
Kalpana D Shere-Wolfe ◽  
Rachel Silk ◽  
Carla Alexander
Keyword(s):  
Lyme Disease ◽  
Infectious Diseases ◽  
Antimicrobial Treatment ◽  
Post Treatment ◽  
Patient Records ◽  
University Of Maryland ◽  
Patient Beliefs ◽  
Persistent Symptoms ◽  
Chronic Lyme Disease ◽  
The University

Abstract Background Controversy and confusion surround the terminology for patients who have persistent symptoms after treatment for Lyme disease (LD) or may have been misdiagnosed with Lyme disease. While Infectious Diseases (ID) use the term Post treatment Lyme disease syndrome (PTLDS), patients tend to use the term Chronic Lyme disease (CLD) to describe the syndrome associated with persistent symptoms post treatment of LD. Many ID physicians are reluctant to see patients who identify themselves as having “Chronic Lyme” disease in some part due to reluctance to prescribe repeated courses of antibiotics. The purpose of this inquiry was to assess belief regarding Lyme disease and treatment. Methods Patients at the Integrated Lyme Program at the University of Maryland completed clinical intake forms which included questions on their familiarity and beliefs surrounding Lyme disease. Results We evaluated 146 patient records from our Lyme Program Registry which began in December 2018. There were 57 (34.5%) males and 108 (65.5%)females with mean age of 51 years. Forty seven percentage of patients were referred by a physician and 53 % were self-referred. Approximately 50% (71/146) were treated with less 30 days of antibiotics, 37% (54/146) were treated with 1-6 months of antibiotics and 11.6% (17/146) were treated with >6months of antibiotics prior to their initial evaluation in our Lyme program. Sixty eight percentage of patients were familiar with the term CLD but only 44% percentage were familiar with term PTLDS. Approximately half of the patients ( 52%) believed that they currently had Lyme disease and 63% believed that their current symptoms were due to Lyme disease. Despite this only 18% believed that they needed antibiotics for Lyme disease at the time completing the form. Conclusion Patient referred to our Lyme center were more familiar with term CLD vs PTLDS. Many of them believed that they currently had LD and their symptoms were due to Lyme disease. Despite this, the majority did not feel that they needed antibiotics for Lyme Disease at the time of their clinical visit. More research is needed to better understand patient beliefs and understanding regarding Lyme disease. Disclosures All Authors: No reported disclosures

scholarly journals The Persistent Lyme Disease: “True Chronic Lyme Disease” rather than “Post-treatment Lyme Disease Syndrome”

2018 ◽  
Vol 10 (3) ◽  
pp. 170 ◽  
Author(s):  
Alexis Lacout ◽  
Mostafa El Hajjam ◽  
Pierre-Yves Marcy ◽  
Christian Perronne
Keyword(s):  
Lyme Disease ◽  
Post Treatment ◽  
Chronic Lyme Disease

scholarly journals Real world experience of the treatment outcome between photodynamic therapy combined with ranibizumab and aflibercept monotherapy in polypoidal choroidal vasculopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
I-Hsin Ma ◽  
Yun Hsia ◽  
Yi-Ting Hsieh ◽  
Tzyy-Chang Ho ◽  
Tso-Ting Lai ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Intravitreal Injection ◽  
Real World ◽  
Polypoidal Choroidal Vasculopathy ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Post Treatment ◽  
Tertiary Referral Center ◽  
Endothelial Growth Factor ◽  
Choroidal Vasculopathy

AbstractTo provide real-world experiences of treating polypoidal choroidal vasculopathy (PCV) patients with photodynamic therapy (PDT) plus intravitreal injection of ranibizumab or intravitreal injection of aflibercept alone. Retrospective chart review of patients with PCV in a single tertiary referral center in Taiwan. Chart review of PCV patients treated with PDT and injection of ranibizumab or injection of aflibercept. A total of 101 eyes of 101 patients (38 females and 63 males) were reviewed. Of those, 48 and 53 eyes received primary/adjunctive PDT along with injections of ranibizumab or intravitreal injections of aflibercept only, respectively. Initial visual acuity (VA) and central subfield choroidal thickness were similar between the two groups (p > 0.05). In addition, changes in VA at 3, 6, and 12 months post treatment were similar. The central retinal thickness decreased with either treatment (p < 0.01); however, this change did not translate into VA performance (p > 0.05). In the subgroup analysis of pachychoroid and non-pachychoroid patients, better initial VA and post-treatment VA at 3 months and 6 months was noted in the latter group of patients treated with anti-vascular endothelial growth factor monotherapy (p < 0.05). Aflibercept monotherapy is comparable with PDT plus ranibizumab in PCV patients with PCV (pachychoroid and non-pachychoroid patients). In addition, better prognosis regarding VA was observed in non-pachychoroid patients treated with aflibercept monotherapy.

scholarly journals Precision Medicine: The Role of the MSIDS Model in Defining, Diagnosing, and Treating Chronic Lyme Disease/Post Treatment Lyme Disease Syndrome and Other Chronic Illness: Part 2

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 129 ◽  
Author(s):  
Richard I. Horowitz ◽  
Phyllis R. Freeman
Keyword(s):  
Chronic Disease ◽  
Lyme Disease ◽  
Erythema Migrans ◽  
Functional Decline ◽  
Post Treatment ◽  
Food Allergies ◽  
Small Subset ◽  
Multiple Sources ◽  
Chronic Lyme Disease ◽  
Downstream Effects

We present a precision medical perspective to assist in the definition, diagnosis, and management of Post Treatment Lyme Disease Syndrome (PTLDS)/chronic Lyme disease. PTLDS represents a small subset of patients treated for an erythema migrans (EM) rash with persistent or recurrent symptoms and functional decline. The larger population with chronic Lyme disease is less understood and well defined. Multiple Systemic Infectious Disease Syndrome (MSIDS) is a multifactorial model for treating chronic disease(s), which identifies up to 16 overlapping sources of inflammation and their downstream effects. A patient symptom survey and a retrospective chart review of 200 patients was therefore performed on those patients with chronic Lyme disease/PTLDS to identify those variables on the MSIDS model with the greatest potential effect on regaining health. Results indicate that dapsone combination therapy decreased the severity of eight major Lyme symptoms, and multiple sources of inflammation (other infections, immune dysfunction, autoimmunity, food allergies/sensitivities, leaky gut, mineral deficiencies, environmental toxins with detoxification problems, and sleep disorders) along with downstream effects of inflammation may all affect chronic symptomatology. In part two of our observational study and review paper, we postulate that the use of this model can represent an important and needed paradigm shift in the diagnosis and treatment of chronic disease.

scholarly journals CORTICAL INTEGRATIVE THERAPY FOR THE TREATMENT OF MIGRAINES AND HEADACHES

2021 ◽  
Vol 57 (2) ◽  
pp. 168-176
Author(s):  
Nicole C. Lim ◽  
◽  
Victor M. Pedro ◽  
Elena Oggero ◽  
◽  
...  
Keyword(s):  
Linear Model ◽  
Repeated Measures ◽  
Postural Stability ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
General Linear Model ◽  
Post Treatment ◽  
General Linear ◽  
Integrative Therapy ◽  
Headache Disability

Migraine is a common neurological disorder that is characterized by a host of symptoms including severe throbbing headaches. In this retrospective chart review, the effectiveness of Cortical Integrative Therapy (PedroCIT®) was examined in adults with migraines. Multivariate General Linear Model (M-GLM) was utilized to determine if the emotional, functional, and overall difficulties, as well as the intensity of pain experienced with headaches decreased from before to after PedroCIT® treatment in individuals with mild to complete disability resulting from headaches. Repeated Measures General Linear Model (RM-GLM) was also used to investigate if postural stability increased from pre- to post-treatment. The results of the M-GLM showed that PedroCIT® was effective in reducing emotional, functional, overall disability, and intensity of pain resulting from headaches. Furthermore, RM-GLM indicated that patients who underwent PedroCIT® improved their postural stability from pre- to post-treatment. Finally, the findings also showed that the duration of the treatment did not have any effect among patients with varied degrees of headache disability. This study illustrates the effectiveness of PedroCIT® in the treatment of headaches and postural instability in migraine patients.

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