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Lyme Borreliosis In Europe And North America
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Book Synopsis Lyme Borreliosis in Europe and North America by : Sunil K. Sood
Download or read book Lyme Borreliosis in Europe and North America written by Sunil K. Sood and published by . This book was released on 2011 with total page 344 pages. Available in PDF, EPUB and Kindle. Book excerpt: The facts about Lyme disease, from epidemiology to treatment to control Lyme borreliosis, popularly known as Lyme disease, remains the most commonly reported tick-transmitted infection in North America and Europe. A growing body of scientific and clinical evidence has facilitated early diagnosis and effective treatment. Nonetheless, there are a number of misconceptions about this infectious disease that have given rise to unproven, potentially dangerous alternative therapies. In Lyme Borreliosis in Europe and North America, a team of authors whose expertise spans basic research, epidemiology,
Book Synopsis Lyme Borreliosis in Europe and North America by : Sunil K. Sood
Download or read book Lyme Borreliosis in Europe and North America written by Sunil K. Sood and published by John Wiley & Sons. This book was released on 2011-04-18 with total page 280 pages. Available in PDF, EPUB and Kindle. Book excerpt: The facts about Lyme disease, from epidemiology to treatment to control Lyme borreliosis, popularly known as Lyme disease, remains the most commonly reported tick-transmitted infection in North America and Europe. A growing body of scientific and clinical evidence has facilitated early diagnosis and effective treatment. Nonetheless, there are a number of misconceptions about this infectious disease that have given rise to unproven, potentially dangerous alternative therapies. In Lyme Borreliosis in Europe and North America, a team of authors whose expertise spans basic research, epidemiology, and clinical practice has compiled evidence-based information on Lyme borreliosis. Presents all the latest evidence needed to diagnose, treat, and prevent Lyme disease Lyme Borreliosis in Europe and North America begins with a review of the disease's epidemiology, the causative Borrelia genospecies, and tick vectors. It then explores pathogenesis, diagnosis, and treatment. Next, the book examines the role of serologic, culture, and molecular diagnostic methods. The book also features a chapter on prognosis, offering an evidence-based review of outcome studies, as well as practical advice to physicians to help them manage the challenging clinical scenario of chronic symptoms attributed to Borrelia infection. The final chapter is a guide to prevention strategies, including the management of tick bites. Examines similarities and differences in Europe and North America Because differences in Borrelia genospecies are responsible for differences in the clinical presentation of Lyme borreliosis between North America and Europe, this book provides descriptions of the disease as it presents on each continent. Most of the chapters have been cowritten by experts on each continent, in order to provide a balanced perspective that combines European and North American findings, practices, and experiences. Helps everyone better understand, treat, and control Lyme disease Lyme Borreliosis in Europe and North America is a comprehensive reference, ideal for clinicians, researchers, and public health officials who seek to treat and control Lyme borreliosis. It will help them better understand the facts and make sense of the misconceptions and myths that surround this infectious disease.
Download or read book Lyme Borreliosis written by J. Gray and published by CABI. This book was released on 2002-10-04 with total page 364 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lyme borreliosis commonly known as lyme disease is now acknowledged as the most highly prevalent arthropod-borne human disease in northern temperate regions of the world. This book describes the basic characteristics of the disease, the biology of the pathogens in their vectors and vertebrate hosts, their ecology in different regions of the world and the global epidemiology of the disease. The final chapters address the prevention and control measures that have resulted from this knowledge.
Book Synopsis The Biomedical Evolutionary History of Lyme Disease in North America and Europe by : John Martin Darcy
Download or read book The Biomedical Evolutionary History of Lyme Disease in North America and Europe written by John Martin Darcy and published by . This book was released on 2010 with total page 328 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Book Synopsis Health Information for International Travel 2005-2006 by : Paul Arguin
Download or read book Health Information for International Travel 2005-2006 written by Paul Arguin and published by . This book was released on 2005 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Lyme Disease written by Alan G. Barbour and published by JHU Press. This book was released on 2015-04-15 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: A world-renowned Lyme disease expert explains everything you need to know if you live, work, or play in areas with the ticks that carry disease. Once restricted to small forested areas in the northeast and north-central United States, Lyme disease is now a common infection in North America and Europe. The Centers for Disease Control and Prevention estimate that more than 300,000 new cases occur each year in the United States. Misunderstandings over symptoms and treatment increase the public's concerns about the disease—which, if not properly treated, can become chronic and debilitating. An expert on tick-borne diseases, Alan G. Barbour explains the course of illness that results from infection, diagnosis and treatment options, and steps that can be taken to avoid a tick bite in the first place. The ticks that transmit Lyme disease may also transmit other disease-causing pathogens, and these other infections are considered as well. Drawing on real case histories of individuals with Lyme disease—or illnesses that may be mistaken for Lyme disease—Barbour explains: The biology of the spirochete, Borrelia burgdorferi, that causes Lyme disease The role of animals such as mice that carry the infection The life cycle of the ticks that transmit the infection The importance of deer in perpetuating the cycle The basics of diagnostic laboratory tests and how test results are interpreted How antibiotics are used in treating Lyme disease Infected ticks are abundant in the woods, in walking trails, and in the shrubs and tall grass where suburban lawns meet wooded areas. Barbour stresses preventing disease through community-wide ecology projects and individual and household protection. While it may be difficult to escape infection, understanding the danger, the symptoms, and the treatment goes a long way toward preventing long-term health consequences. Featuring a list of reliable web sites and a glossary of terms, Lyme Disease is an invaluable resource for everyone who is at risk of the disease or is involved in preventing and treating it.
Book Synopsis Aspects of Lyme Borreliosis by : G. Schierz
Download or read book Aspects of Lyme Borreliosis written by G. Schierz and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 667 pages. Available in PDF, EPUB and Kindle. Book excerpt: Aspects of Lyme Borreliosis is a comprehensive scientific presentation of virtually all aspects of lyme borreliosis. It starts with a concise history of lyme borreliosis and its causative agent, Borrelia burgdorferi. The morphological and biological characteristics of B. burgdorferi are presented, followed by outlines on the ecology and histopathology of LB.The various aspects of the clinical manifestations of LB are systematically dealt with, starting with a clinical overview. A special chapter covers the microbiological diagnosis. After a presentation on the susceptibility of B. burgdorferi in vitro and in animals against a great variety of antibiotics, a thorough discussion on the treatment of LB including criticalremarks follows. The book closes with a chapter on the epidemiology of LB.
Book Synopsis Lyme Borreliosis by : John S. Axford
Download or read book Lyme Borreliosis written by John S. Axford and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 316 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lyme Borreliosis is a worldwide infectious disease causing a multisystem illness with considerable morbidity, particularly in North America and Europe. The causative agent is the spirochaete Borrelia burgdorferi, which is usually transmitted by the ixodid tick from animal reservoirs. This book is formed by contributions from the Second European Symposium on Lyme Borreliosis, held at St George's Hospital Medical School, London in 1993, which reviewed the current state of knowledge of the condition with regard to clinical manifestations, diagnosis, treatment, ecology, epidemiology, biology and immunopathogenesis. In this book, important data is reviewed concerning the clinical manifestations of Lyme Borreliosis. It seems that strain variation of the spirochaete is the main cause of regional differences seen in the clinical presentation of patients. One striking example of this, is the relatively high incidence of Lyme arthritis in the USA and apparent rarity of this manifestion in some areas of Europe. These important studies open the way for exciting new research that focuses on the immunological and molecular mechanisms that result in disease. A full insight into the ecology of Borrelia burgdorferi is essential to a balanced understanding of the disease and a number of excellent reviews on this subject are included. Significant advances with regard to the biology of Borrelia burgdorjeri and the immunopathogenic mechanisms that result in disease have been made, enabling the role of the Band T lymphocytes in disease to be established and the development of sophisticated phenotyping methods, improved diagnostic tests and effective vaccines.
Book Synopsis Vector- and Rodent-Borne Diseases in Europe and North America by : Norman Gratz
Download or read book Vector- and Rodent-Borne Diseases in Europe and North America written by Norman Gratz and published by Cambridge University Press. This book was released on 2006-11-02 with total page 424 pages. Available in PDF, EPUB and Kindle. Book excerpt: A significant number of diseases are carried by insects, ticks, mites and rodents, and these diseases are far more common than is often realised. New diseases are regularly discovered and are becoming increasingly widespread, in part due to increased global travel and possibly even climate change. In this exciting new volume Norman Gratz, former Director, Division of Vector Biology and Control, World Health Organisation, reviews the distribution of all currently identified vector and rodent-borne diseases in Europe, the USA and Canada. Each type of infection is presented by group, covering incidence and prevalence, costs and public health burdens. Basic vector biology and control is described in detail and an extensive bibliography is provided to aid readers seeking further information. With its comprehensive coverage and detail, this book is set to become the standard reference for anyone working on vector- and rodent-borne diseases in medical entomology, zoology, epidemiology and public health.
Download or read book Lyme written by Mary Beth Pfeiffer and published by Island Press. This book was released on 2018-04-17 with total page 306 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Superbly written and researched." --Booklist "Builds a strong case." --Kirkus Lyme disease is spreading rapidly around the globe as ticks move into places they could not survive before. Mary Beth Pfeiffer argues it is the first epidemic to emerge in the era of climate change, infecting millions around the globe. She tells the heart-rending stories of its victims, families whose lives have been destroyed by a single, often unseen, tick bite. Pfeiffer also warns of the emergence of other tick-borne illnesses that make Lyme more difficult to treat and pose their own grave risks. Lyme is an impeccably researched account of an enigmatic disease, making a powerful case for action to fight ticks, heal patients, and recognize humanity's role in a modern scourge.
Book Synopsis Lyme Disease and the Expanded Spectrum of Blacklegged Tick-Borne Infections, An Issue of Infectious Disease Clinics of North America, E-Book by : Robert P. Smith
Download or read book Lyme Disease and the Expanded Spectrum of Blacklegged Tick-Borne Infections, An Issue of Infectious Disease Clinics of North America, E-Book written by Robert P. Smith and published by Elsevier Health Sciences. This book was released on 2022-09-20 with total page 241 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this issue of Infectious Disease Clinics of North America, guest editor Dr. Robert P. Smith brings his considerable expertise to the topic of Lyme Disease and the Expanding Spectrum of Associated Tick-Borne Illness. With a primary focus on Lyme disease and its complications, the thorough reviews in this issue will also discuss the epidemiology, clinical presentations, diagnosis, treatment and outcomes of other infections transmitted by the black-legged tick in North America. The complexity of the public narrative of these diseases will also be addressed with an eye toward providing the clinician with a context for response. - Contains 14 practice-oriented topics including early Lyme disease: erythema migrans and Its mimics; Lyme arthritis; neurologic Lyme disease: four common fallacies and three diagnostic requirements; persistent symptoms in patients with treated Lyme disease; ID specialists approach to consultation in patients referred for refractory illness attributed to tick-borne disease; and more. - Provides in-depth clinical reviews on Lyme disease and the expanding spectrum of associated tick-borne illness, offering actionable insights for clinical practice. - Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Download or read book Lyme Disease written by Richard Ostfeld and published by Oxford University Press. This book was released on 2010-11-04 with total page 231 pages. Available in PDF, EPUB and Kindle. Book excerpt: Most human diseases come from nature, from pathogens that live and breed in non-human animals and are "accidentally" transmitted to us. Human illness is only the culmination of a complex series of interactions among species in their natural habitats. To avoid exposure to these pathogens, we must understand which species are involved, what regulates their abundance, and how they interact. Lyme disease affects the lives of millions of people in the US, Europe, and Asia. It is the most frequently reported vector-borne disease in the United States; About 20,000 cases have been reported each year over the past five years, and tens of thousands more go unrecognized and unreported. Despite the epidemiological importance of understanding variable LD risk, such pursuit has been slow, indirect, and only partially successful, due in part to an overemphasis on identifying the small subset of 'key players' that contribute to Lyme disease risk, as well as a general misunderstanding of effective treatment options. This controversial book is a comprehensive, synthetic review of research on the ecology of Lyme disease in North America. It describes how humans get sick, why some years and places are so risky and others not. It challenges dogma - for instance, that risk is closely tied to the abundance of deer - and replaces it with a new understanding that embraces the complexity of species and their interactions. It describes why the place where Lyme disease emerged - coastal New England - set researchers on mistaken pathways. It shows how tiny acorns have enormous impacts on our probability of getting sick, why biodiversity is good for our health, why living next to a small woodlot is dangerous, and why Lyme disease is an excellent model system for understanding many other human and animal diseases. Intended for an audience of professional and student ecologists, epidemiologists, and other health scientists, it is written in an informal style accessible also to non-scientists interested in human health and conservation.
Book Synopsis Lyme Borreliosis in Europe and North America by : Sunil K. Sood
Download or read book Lyme Borreliosis in Europe and North America written by Sunil K. Sood and published by Wiley-Blackwell. This book was released on 2011-07-13 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: The facts about Lyme disease, from epidemiology to treatment to control Lyme borreliosis, popularly known as Lyme disease, remains the most commonly reported tick-transmitted infection in North America and Europe. A growing body of scientific and clinical evidence has facilitated early diagnosis and effective treatment. Nonetheless, there are a number of misconceptions about this infectious disease that have given rise to unproven, potentially dangerous alternative therapies. In Lyme Borreliosis in Europe and North America, a team of authors whose expertise spans basic research, epidemiology, and clinical practice has compiled evidence-based information on Lyme borreliosis. Presents all the latest evidence needed to diagnose, treat, and prevent Lyme disease Lyme Borreliosis in Europe and North America begins with a review of the disease's epidemiology, the causative Borrelia genospecies, and tick vectors. It then explores pathogenesis, diagnosis, and treatment. Next, the book examines the role of serologic, culture, and molecular diagnostic methods. The book also features a chapter on prognosis, offering an evidence-based review of outcome studies, as well as practical advice to physicians to help them manage the challenging clinical scenario of chronic symptoms attributed to Borrelia infection. The final chapter is a guide to prevention strategies, including the management of tick bites. Examines similarities and differences in Europe and North America Because differences in Borrelia genospecies are responsible for differences in the clinical presentation of Lyme borreliosis between North America and Europe, this book provides descriptions of the disease as it presents on each continent. Most of the chapters have been cowritten by experts on each continent, in order to provide a balanced perspective that combines European and North American findings, practices, and experiences. Helps everyone better understand, treat, and control Lyme disease Lyme Borreliosis in Europe and North America is a comprehensive reference, ideal for clinicians, researchers, and public health officials who seek to treat and control Lyme borreliosis. It will help them better understand the facts and make sense of the misconceptions and myths that surround this infectious disease.
Book Synopsis Molecular Biology of Spirochetes by : Felipe C. Cabello
Download or read book Molecular Biology of Spirochetes written by Felipe C. Cabello and published by . This book was released on 1912 with total page 86 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diseases produced by spirochetes, including Lyme borreliosis, syphilis and leptospirosis, are on the rise worldwide. This volume focuses on a series of state-of-the-art presentations of the research taking place in the laboratories of the contributors, and serves as an introduction to those individuals entering in the field of spirochete research.
Book Synopsis Lyme Disease and Relapsing Fever Spirochetes by : Justin D Radolf
Download or read book Lyme Disease and Relapsing Fever Spirochetes written by Justin D Radolf and published by . This book was released on 2021 with total page 770 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lyme disease (Lyme borreliosis) is the most prevalent vector-borne illness in the United States and Europe and a growing threat to global health. In addition Lyme disease is considered a model system of emerging infectious diseases. The book Borrelia: Molecular Biology, Host Interaction and Pathogenesis published in 2010 was the first state-of-the-art reference work covering the myriad, interlaced facets of the enzootic disorders caused by pathogenic Borrelia. This current volume, by the same editors, builds on the previous work and contains a vast amount of new information, a wider scope, and increased coverage of genomics, genetics, evolutionary biology, vector biology, physiology, pathogenicity, immune response, and immune evasion. Written by renowned scientists who have made seminal contributions to the field, this book contains an expansive treatment of the options to track live spirochetes and evaluate gene expression in ticks and mice, provides insights into the workings of the flagellar motor, presents up-to-date research on the modulation of gene expression, and reviews recent studies on the Lyme disease spirochete's networks of regulatory pathways. The volume highlights and describes in detail the tremendous advances in understanding of the Borrelia genus at the molecular and cellular levels as well as the pathogenesis of Lyme disease and relapsing fever. This comprehensive volume is indispensable for anyone involved in Borrelia and Lyme disease research and is highly recommended for microbiologists, immunologists, and physicians with an interest in spirochetes, vector-borne illness, or emerging infectious diseases. The book is a recommended reference volume for all microbiology libraries.
Book Synopsis Lyme Disease and Other Infections Transmitted by Ixodes scapularis, An Issue of Infectious Disease Clinics of North America by : Paul G. Auwaerter
Download or read book Lyme Disease and Other Infections Transmitted by Ixodes scapularis, An Issue of Infectious Disease Clinics of North America written by Paul G. Auwaerter and published by Elsevier Health Sciences. This book was released on 2015-06-14 with total page 225 pages. Available in PDF, EPUB and Kindle. Book excerpt: This issue of Infectious Disease Clinics of North America, Guest Edited by Paul Auwaerter, MD, is devoted to Lyme Disease. Dr. Auwaerter has assembled a group of expert authors to review the following topics: Epidemiology of Lyme Disease; Early Lyme disease: Erythema Migrans; Neuroborreliosis; Lyme Carditis; Lyme Arthritis; Pediatric Lyme Disease; Diagnostics of Lyme Disease; Post-treatment Lyme Disease Syndrome; Chronic Lyme Disease; Co-infection: Human Granulocytic Ehrlichiosis; Co-infection: Babesiosis; and Emerging Tick-borne infections: Borrelia miyamotoi, Powassan/Deer Tick virus, Heartland virus, Bartonella.
Book Synopsis Molecular and serological tools for clinical diagnostics of Lyme borreliosis - can the laboratory analysis be improved? by : Malin Lager
Download or read book Molecular and serological tools for clinical diagnostics of Lyme borreliosis - can the laboratory analysis be improved? written by Malin Lager and published by Linköping University Electronic Press. This book was released on 2020-10-20 with total page 114 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lyme borreliosis (LB) is caused by spirochetes within the Borrelia burgdorferi sensu lato complex and is the most common tick-transmitted disease in the northern hemisphere. The transmission of the spirochetes to humans in Europe is done by the Ixodes ricinus ticks, which can also transmit the relapsing fever species Borrelia miyamotoi. LB may cause clinical manifestations in the skin, in the central nervous system, in joints, and in the heart. Diagnosis of LB is mainly based on the patient´s medical history, self-described symptoms, and clinical signs in combination with the detection of Borrelia-specific antibodies (serological methods). In some cases/issues, detection of Borrelia-specific deoxyribonucleic acid (molecular methods) may be used as a complement to serology. All diagnosed LB infections are treated with antibiotics to prevent disease progression, and most patients fully recover without further sequelae. The overall aims of this thesis were to evaluate molecular and serological tools for laboratory diagnosis of LB, with a special focus on Lyme neuroborreliosis (LNB), and to identify potential improvements. The results presented in this thesis showed that the immunoglobulin (Ig) G assays, currently in use in northern Europe for detection of antibodies in serum, had high diagnostic sensitivity (88 %) together with comparable results both between and within assays. For the IgM assays, the diagnostic sensitivity was lower (59 %) with more heterogeneous results. Small variations in diagnostic performance for IgM and IgG were mainly presented for samples within the borderline zone. These results support the theory that separate testing of IgM antibodies in serum has low diagnostic value. However, simultaneous detection in serum and cerebrospinal fluid (CSF) for both IgM and IgG antibodies was essential for the diagnosis of LNB, at least for certain assays. So far (to our knowledge), no systematic evaluation and optimisation of the pre-analytical handling of CSF samples before molecular testing has been performed. By use of the precipitate concentrated by moderate centrifugation, extraction of total nucleic acid followed by reversetranscription to complementary deoxyribonucleic acid, in combination with the absence of polymerase chain reaction (PCR) inhibitors, detection of Borrelia garinii, Borrelia afzelii, Borrelia burgdorferi sensu stricto, and B. miyamotoi was possible. These four species are all known to be pathogenic to humans. The results revealed a high analytical sensitivity and specificity for the optimised pre-analytical conditions. The thesis also presents results showing that the real-time PCR protocols currently used in Scandinavia have high analytical sensitivity, specificity, and concordance. This indicates that the low diagnostic sensitivity for detection of Borrelia in CSF was not a result of poorly designed and evaluated PCR protocols, but was possibly due to the low number of spirochetes in the samples. However, to further evaluate the diagnostic performance for detection of Borrelia in CSF by PCR, clinical samples need to be evaluated based on our new recommendations for the pre-analytical handling of CSF samples. In conclusion, this thesis presents results revealing that both molecular and serological tools for detection of Borrelia have, in general high sensitivity and specificity with results comparable between different protocols and different laboratories. It also presents recommendations for pre-analytical handling of CSF samples before PCR-analysis, and shows the benefits in diagnostic performance by simultaneous detection of IgM and IgG antibodies in serum and CSF for accurate diagnosis of LNB. Even though the techniques mentioned above have high analytical performance, the ability to discriminate an active infection from a previous one is limited and further studies need to be carried out. These studies need to focus on finding diagnostic tools that can help physicians to determine ongoing infection to ensure adequate treatment. It is also desirable to improve the standardisation of the diagnostic tools and to find methods that can discriminate between different Borrelia species. Borrelios är den vanligaste fästingöverförda sjukdomen på norra halvklotet och orsakas av bakterier inom Borrelia burgdorferi sensu lato gruppen. Överföringen av bakterier till människa i Europa sker via Ixodes ricinus fästingar, vilka även överför bakterien Borrelia miyamotoi som ger återfallsfeber. Borreliainfektioner uppvisar kliniska uttryck i huden, i det centrala nervsystemet och i leder. En borrelia-diagnos baseras främst på patientens medicinska historia i kombination med kliniska tecken, egenbeskrivna symptom samt påvisning av Borrelia-specifika antikroppar (serologiska metoder). Vid vissa frågeställningar kan påvisning av Borrelia-bakteriens arvsmassa (molekylärbiologiska metoder) användas som komplement till antikroppstester. Alla diagnostiserade borreliainfektioner behandlas med antibiotika för att förhindra utveckling av sjukdomen och merparten av patienterna blir fullt återställda. Det övergripande syftet med avhandlingen var att utvärdera metoder för påvisning av Borrelia-specifika antikroppar samt Borrelia-specifik arvsmassa, men fokus på neuroborrelios, samt identifiera potentiella förbättringar. De metoder som används för påvisning av immunoglobulin (IgG)-antikroppar (uppträder sent i en infektion) i serum i norra Europa uppvisar hög känslighet (88 %) med jämförbara resultat både mellan och inom en analysmetod. Vid påvisning av IgM-antikroppar (uppträder tidigt i en infektion) i serum uppvisas lägre känslighet (59 %) och mer olikartade resultat. Små variationer i den diagnostiska förmågan att påvisa IgM och IgG-antikroppar beror till stor del på att flera prover erhållit gränsvärden d v s ett värde som inte kan anses som positivt men inte heller som negativt. Resultaten från denna studie indikerar att påvisning av IgM-antikroppar i serum har lågt värde vid diagnostik av Borrelia. Dock bör parallell analys av både IgM och IgG-antikroppar i serum och ryggmärgsvätska utföras vid påvisning av neuroborrelios. I dagsläget (till vår kännedom) har ingen systematisk utvärdering och optimering av det preanalytiska tillvägagångssättet vid påvisning av Borrelia-specifik arvsmassa i ryggmärgsvätska genomförts. Genom att använda pelleten (bottensatsen som erhålls genom måttlig centrifugering), framrening av total nukleinsyra i kombination med frånvaro av material som kan påverka PCR-reaktionen på ett negativt sätt (inhibitorer), kan påvisning av Borreliaarterna Borrelia garinii, Borrelia afzelii, Borrelia burgdorferi sensu stricto och B. miyamotoi ske. Dessa Borrelia-arter är alla patogena för människa. De realtids-PCR protokoll som i dagsläget används i Skandinavien har hög analytisk känslighet, tillförlitlighet och överensstämmelse. Detta tyder på att den låga känslighet som uppvisas vid påvisning av Borrelia-specifik arvsmassa i ryggmärgsvätska inte beror på dåligt utvärderade och designade PCR-protokoll, utan är troligtvis orsakad av låg bakteriemängd i proverna. För vidare utvärdering av den diagnostiska förmågan att påvisa Borrelia-specifik arvsmassa i ryggmärgsvätska med PCR, bör kliniska prover samlas in och analyseras utifrån de nya rekommendationerna för pre-analytiskt tillvägagångssätt vid analys av ryggmärgsprover. Sammanfattningsvis visar resultaten i denna avhandling på generellt hög känslighet och tillförlitlighet samt överensstämmelse mellan olika protokoll/test vid påvisningar av Borreliaspecifika antikroppar och Borrelia-specifik arvsmassa. I avhandlingen presenteras även rekommendationer för pre-analytiskt tillvägagångssätt vid omhändertagande och transport av ryggmärgsvätska till laboratoriet. Resultaten visar även på nyttan i att analysera ryggmärgsvätska och serum parallellt för både IgM och IgG-antikroppar för att erhålla rätt diagnos vid frågeställningen neuroborrelios. Ovan nämnda metoder har trots god prestanda svårt att i alla lägen särskilja en aktiv infektion från en tidigare genomgången, varpå vidare studier krävs. Framtida studier bör fokusera på att finna diagnostiska verktyg som hjälper läkarna att urskilja en pågående infektion så att patienten erhåller passande behandling. Det är också mycket viktigt att arbeta vidare mot en standardisering av de diagnostiska metoderna samt finna metoder som har möjlighet att särskilja mellan olika Borrelia-arter.
