Quality of life: the same all around

Medical topics with questions, information and discussion related to Lyme disease and other tick-borne diseases.
duncan
Posts: 1370
Joined: Wed 5 Sep 2012 18:48

Re: Quality of life: the same all around

Post by duncan » Wed 30 Sep 2015 22:00

As far as I can tell, none of these LNB patients was ever diagnosed with chronic Lyme - regardless of whose definition - or PTLDS, or even registered complaints of persistent symptoms.

From what I can discern, these were LNB patients who received treatment, and were cured. X-member may be correct that most were likely treated in early stage, but I'm not sure we can state that with any level of confidence.

So, the authors seem to be comparing cured individuals, ie. healthy individuals that were once sick with Borrelia, with healthy controls.

One question I have is, What's the point, especially when the selection of the sample was not random, and after the fact?

Here's a study that would interest me: Take newly discovered cases of late stage NB, treat with recommended therapy, then follow-up with patients upon treatment completion, six months out, one year out, two years out, then annually thereafter. What percentage develop persistent symptoms, and to what degree?

Or do similarly with acute LNB cases, but expect a lower incidence of unsuccessful treatment. Perhaps more in line with that 10-20 failure rate so often cited? Higher?

X-member
Posts: 7650
Joined: Mon 30 Jul 2007 18:18

Re: Quality of life: the same all around

Post by X-member » Wed 30 Sep 2015 22:42

Martian wrote earlier:
The term "chronic Lyme disease" does not have one universal definition. So everyone using it, should define what they mean with it. Even better is avoiding the term and replacing it with a less ambiguous term.
Those people that don't use it in the same meaning as chronic Lyme borreliosis should use some other term.

X-member
Posts: 7650
Joined: Mon 30 Jul 2007 18:18

Re: Quality of life: the same all around

Post by X-member » Thu 1 Oct 2015 0:25

Duncan, if we only talk about neuroborreliosis, there is (of course) more cases than 10-20 % that still have symptoms after treatment. So, you are right, it is something "peculiar" with the study in the first post.

Edit to add:

I have now activated the thread/topic below:

European LNB - Long-term follow-up (Norway)

http://www.lymeneteurope.org/forum/view ... f=7&t=3980

Lorima
Posts: 914
Joined: Mon 29 Oct 2007 20:47

Re: Quality of life: the same all around

Post by Lorima » Thu 1 Oct 2015 2:49

Yes, everyone, check out that thread linked above titled European LNB - Long-term follow-up (Norway). It features European LD research heavies admitting that LNB is often not cured by standard treatment. Including even Strle, one of the European IDSA collaborators (though one who does better science than most).
"I have to understand the world, you see."
Richard Feynman

X-member
Posts: 7650
Joined: Mon 30 Jul 2007 18:18

Re: Quality of life: the same all around

Post by X-member » Thu 1 Oct 2015 19:08

Maybe this also belong in this thread?

Europeisk nevroborreliose - hvordan går det etter behandling? (Eikeland, Norway)

http://www.lyme.no/index.php/component/ ... behandling

A translated quote:
Most recover after treatment of neuroborreliosis, but a subgroup gets reduced quality of life and fatigue, and impaired cognition such as decreased attention, memory and cognitive tempo. It appears that symptoms over six weeks, more serious illness before treatment and lack of recovery after four months are risk factors for long-term ailments. We found no signs of active infection after 30 months.

duncan
Posts: 1370
Joined: Wed 5 Sep 2012 18:48

Re: Quality of life: the same all around

Post by duncan » Thu 1 Oct 2015 19:21

I wonder how they defined "active infection".

Do they distinguish between acute presentation and late stage NB? Between acute and treatment-refractory NB?

Are signs of "active infection" a one-size-fits-all kind of thing?

X-member
Posts: 7650
Joined: Mon 30 Jul 2007 18:18

Re: Quality of life: the same all around

Post by X-member » Thu 1 Oct 2015 19:39

Late (stage 3) active neuroborreliosis is called sen (= late) neuroborreliose or kronisk (= late) neuroborreliose in Norway.

Most cases (over 95% of the cases) with neuroborreliosis in Norway (and Sweden) have an acute (early, stage 2) neuroborreliosis when they are diagnosed.

About 225 of the 5 000 estimated Norwegian borreliosis cases/year are diagnosed with neuroborreliosis.

Edit to add:

So Norwegian studies on cases with neuroborreliosis are (most likely) done only on cases with early (stage 2) neuroborrelios. And I think that Dr Eikeland is right, it wasn't any case that had a relapse after treatment in that study.

X-member
Posts: 7650
Joined: Mon 30 Jul 2007 18:18

Re: Quality of life: the same all around

Post by X-member » Fri 2 Oct 2015 19:55

I wrote earlier:
Norwegian studies on cases with neuroborreliosis are (most likely) done only on cases with early (stage 2) neuroborrelios
What do Dr Ying Zhang say about this?

Interview with Prof. Ying Zhang at the NorVect Conference 2015

https://www.youtube.com/watch?v=krXSFmk ... e=youtu.be

A quote (NorVect):
The two views – ILADS and IDSA are two different ways of seeing the same disease. Prof. Zhang thinks they are both right. When it comes to acute Lyme disease, IDSA is right. Then you only need shorter courses of treatment. When the disease turns chronic, longer courses of treatment with the right drug combinations are needed (ILADS view).
He did not actually say that everyone with late Lyme disease need longer courses of treatment, but this text was (most likely) written by someone that perhaps have missed (or not understood?) what Dr Ying Zhang said.

Post Reply