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Literaturverzeichnis: Hinweise zur wissenschaftlichen Basis der Lyme Borreliose Quelle: Diagnostik und Therapie der Lyme-Borreliose - Leitlinien der Deutschen Borreliose Gesellschaft http://www.borreliose-gesellschaft.de/Texte/Leitlinien.pdf Auflage: Mai 2011 „Die wissenschaftliche Basis für die antibiotische Behandlung der LB ist mit Ausnahme des lokalisierten Frühstadiums (EM) immer noch unzureichend. Die erheblichen Defizite der wissenschaftlich-klinischen Analyse spiegeln sich in therapeutischen Leitlinien wider, deren Empfehlungsstärke und Evidenzbasis deutlich begrenzt sind (159) und den Anforderungen unter medizinischen und gesundheitspolitischen Aspekten nicht genügen. Eine erfolgreiche antibiotische Behandlung ist nur bei einem effizienten Immunsystem möglich. Im Hinblick auf die Antibiose ergeben sich zudem bei den Borrelien Probleme durch natürliche oder erworbene Resistenzen. Dem Immunsystem kann sich der Erreger der LymeBorreliose durch sogenannte Escape-Mechanismen entziehen (7/74). Im Frühstadium, d. h. in den ersten 4 Wochen nach Infektionsbeginn, ist bei der AntibiotikaBehandlung mit einer Versagerquote von 10% zu rechnen (121/135). Bei den chronischen Verlaufsformen liegt sie mit bis zu 50% wesentlich höher (30/31/52/55/74/99/121). Bereits frühere Arbeiten hatten auf das Problemfeld der chronischen Lyme-Borreliose und deren begrenzter therapeutischer Beeinflussbarkeit hingewiesen (31/55/59/61/62/65/92/94/121/ 138). In all diesen Studien war die Behandlungsdauer i. d. R. auf höchstens vier Wochen begrenzt. Auch bei wiederholten Behandlungszyklen zeigten sich unter derartigen Bedingungen erhebliche therapeutische Versagerquoten (78/82/90). Die Behandlungsdauer ist für den Erfolg der antibiotischen Behandlung von entscheidender Bedeutung. Inzwischen liegen einige Studien vor, die den positiven Effekt und die Sicherheit einer antibiotischen Langzeittherapie belegen (25/26/27/30/36/44/46/51/52/81/144). Die begrenzte Wirkung der antibiotischen Behandlung ist in zahlreichen Studien belegt: Selbst nach vermeintlich hoch wirksamer antibiotischer Therapie wurden Erreger angezüchtet (63/74/81/96/119/120/122/139/147). Beispielsweise konnten nach mehrfacher antibiotischer Behandlung (Ceftriaxon, Doxycyclin, Cefotaxim) Borrelien aus der Haut isoliert werden.(40/61/76/81/122/147) Auch wurde eine Diskrepanz zwischen der AntibiotikaEmpfindlichkeit der Borrelien in vitro versus in vivo nachgewiesen (74). Zudem kommen in vivo noch andere Faktoren hinzu, die in der Eigenschaft der Borrelien liegen, sich dem Immunsystem speziell unter dem Einfluss verschiedener Antibiotika (80) zu entziehen (60/83/85/86/120). Hypothetisch wird die Persistenz von Borrelien unter anderem auf deren intrazellulären Aufenthalt und auf die Entwicklung biologisch wenig aktiver Dauerformen (Sphäroplasten, Zystenbildung) zurückgeführt (19/85/86/94/120). Zudem wurde auch bei Borrelien die Ausbildung von Biofilmen mit dem Effekt einer Komplementresistenz und typischem Shedding (Abstreifen von Antikörpern von der Oberfläche des Bakteriums) nachgewiesen.(83/85/86) Auch andere Mechanismen, z. B. die Diversifizierung, d. h. Änderung membranständiger Proteinantigene, Verlust von Plasmiden und Vorgängen zur Inaktivierung von Komplement, (85/86/120) begünstigen den auch bei anderen Bakterien nachgewiesenen „escape-Mechanismus“, d. h. die Befähigung des Erregers, sich dem Immunsystem zu entziehen. Auch die Fähigkeit des Erregers zur down-Regulation von Proteinen (pore-forming protein) könnte die antibiotische Wirkung beeinträchtigen (34/74/84).“ Quelle: Berghoff W. Diagnostik und Therapie der Lyme-Borreliose http://www.praxis-berghoff.de/dokumente/diagnostik_und_therapie_der_lb.pdf „Die chronische Lyme-Borreliose beruht auf einer persistierenden Infektion mit vitalen Erregern. Sie ist nicht etwa Folge einer durchgemachten Infektion oder ein Zustand nach vermeintlich erzielter antibiotischer Eradikation des Erregers. Entsprechend belegen zahlreiche Studien, dass selbst nach hoch wirksamer antibiotischer Therapie Erreger angezüchtet wurden [11, 15, 24, 43, 50, 53, 57, 60, 62, 112, 121, 122, 125, 128, 139, 140, 141, 143, 150, 152, 156, 157, 225, 226, 227, 228, 229, 230, 231, 232, 233, 234, 235, 236, 237, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 255, 256]. Der Begriff „Seronarbe“ bezeichnet das Fortbestehen von Antikörpern nach vermeintlicher Abheilung der LB; dieser Begriff ist daher nur vertretbar, wenn keinerlei Symptome einer Lyme-Borreliose vorliegen. Auch ist möglich, dass der serologische Befund in ein beschwerdefreies Intervall fällt, so dass bei Wiederauftreten der Symptomatik (Schub) der Begriff Seronarbe zu revidieren ist“. Wikipedia http://de.wikipedia.org/wiki/Antik%C3%B6rper „Die in-vivo Halbwertszeit von IgG Antikörpern bei Patienten mit primärem Antikörpermangelsyndrom beträgt 35 Tage. Die Halbwertszeit von IgG kann jedoch von Patient zu Patient variieren, vor allem bei Patienten mit primären Immunmangelsyndromen. Immunglobuline und IgG-Komplexe werden in den Zellen des mononukleären phagozytischen Systems abgebaut“. Wikipedia http://www.ncbi.nlm.nih.gov/pubmed/10834975 „Die in-vivo Halbwertszeit für Borrelien DNA beträgt 3 Monate“ Infektion mit Borrelien ohne oder mit Krankheitszeichen: „Diese hohe Rate von Seropositiven hat die Annahme begründet, dass der Nachweisvon Immunglobulin-G-Antikörpern (IgG-Antikörpern) in vielen Fällen lediglich auf eine früher durchgemachte Infektion zu interpretieren wäre. Diese Ansicht wird noch heute vielfach publiziert. In einer Langzeit-Untersuchung des genannten Kollektivs konnten wir dann aber zeigen, dass alle seropositiven Probanden irgendwann auch klinisch symptomatisch werden. Die maximale Latenzzeit bis zum Auftreten von Krankheitssymptomen betrug acht Jahre [21]. In der einzigen ähnlichen Langzeitstudie, die bisher weltweit durchgeführt wurde, fanden Petersen et al. Bei 1849 Probanden ganz ähnliche Ergebnisse und ebenfalls eine maximale freie Latenzzeit von acht Jahren [36]. In der jetzt fast zwanzig Jahre laufenden Nachbeobachtung des Kraichtaler Kollektivs konnten keine Spontanheilungen bei Borrelien-Infektionen beobachtet werden. Hinzu kommt ein mikrobiologisches Argument: Bei allen Krankheitsstadien konnten Borrelien kulturell angezüchtet werden [24, 40, 41, 44, 46, 47]. Beim Erythema migrans gelingt die Anzucht regelhaft, aus Liquorproben relativ häufig, bei Synoviabioptaten zumindest in Einzelfällen und bei der Acrodermatitis chronica atrophicans (ACA) wieder sehr regelmäßig. Daher kann heute als geklärt gelten, dass die Lyme-Borreliose eine primär chronisch verlaufende Infektionskrankheit ist, bei der es in Analogie zur Syphilis keine Spontanheilung gibt. Die These eines „Durchseuchungstiters" im Sinne einer durchgemachten, spontan überstandenen Infektion konnte nie belegt werden und sollte heute obsolet sein“. Quelle: http://www.dieterhassler.de/fileadmin/PDF/CTJ806.pdf LYME DISEASE - USA (02): (NEW YORK), INCREASED INCIDENCE. Sat 5 May 2012 http://www.cdc.gov/lyme/stats/maps/interactiveMaps.html è CDC Centers of Disease Control and prevention http://www.cdc.gov/lyme/ BDH, Mai 2012, www.Huismans.de.vu History: Http://lymerick.net/Bb-history.ppt Chronische Borreliose Die chronische Borreliose ist als Krankheit definiert und in der Literatur präzise dargestellt. Berghoff W. Klinische Grundlagen der antibiotischen Behandlung der Lyme-Borreliose. umwelt-medizin-gesellschaft (22), 104-111, 2/2009 Müller KE. Erkrankung der elastischen und kollagenen Fasern von Haut, Sehnen und Bändern bei Lyme-Borreliose. umwelt-medizin-gesellschaft (22), 112-118, 2/2009 Berghoff W. Antibiotische Behandlung der Lyme-Borreliose (LB) umwelt-medizin-gesellschaft (22), 125-131, 2/2009 Berghoff W. Antbiotische Behandlung der Lyme-Borreliose (LB) http://www.praxis-berghoff.de/dokumente/Antibiotische_Behandlung_ der_LB.pdf v. Baehr R. Grundlagen zur Lyme-Borreliose umwelt-medizin.gesellschaft (22) 99-103 2/2009 1.) Neurologische Krankheitsmanifestation Burrascano J. Zukunftsweisende Themen der Lyme Krankheit (2008) Seite 36 http://www.borreliose.me/mediapool/77/776837/data/Burrascano_Leitfaden_Lyme_08.pdf Singleton K.B. The Lyme Disease Solution Brown Books Dallas Texas (2008) ISBN-13: 978-1-934812-00-6 Hopf-Seidel P. Krank nach Zeckenstich. Borreliose erkennen und wirksam behandeln. Knaus MensSana(2008) ISBN: 978-3-426-87392-2 Deutsche Borreliose-Gesellschaft http://www.borreliose-gesellschaft.de/Text und Empfehlungen/Empfehlungen.pdf ILADS international Lame and Associates Deseases Society. http://www.ilads.org Berhoff W. Klinische Symptomatik der Lyme-Borreliose (LB) und der Lyme-Neuroborreliose (LNB) umwelt-medinzin-gesellschaft (22) 2/2009 2.) „Post Lyme Syndrom“, Seite 7 (zweiter Absatz) bis Seite 8 (erster Absatz) Bujak et al.Clinical and neurocognitive features of the post Lyme syndrome. J.Rheumatol 23, 1392-1397 (1996) Berghoff W. Problemfelder und Meinungsdifferenzen bei Diagnostik und Therapie der Lyme Borreliose. http://www.praxis-berghoff.de/dokumente/problemfelder_und_meinungsdifferenzen_bei diagnostik_und_therapie_der_lb.pdf 3.) Borrelien Elisa, Borrelien Immunoblot Serologische Untersuchungen auf Antikörper, Borrelien ELISA-Test und Borrelien Immunoblot, liefern bei positivem Befund den Beweis für eine stattgehabte Infektion und mit mindestens drei monatiger Verzögerung (nur langsamer Abbau der Anitkörper nach dem Verschwinden des Krankheitserregers aus dem Wirtsorganismus) auch den Hinweis auf die Anwesenheit des Erregers. Positive (d.h. pathologische) serologische Befunde (Seropositivität) sind ein Indiz für eine Lyme-Borreliose. v. Baehr V. Die Labordiagnostik der Borrelieninfektion. umwelt-medizin-gesellschaft (22) 119-124- 2/2009 Berghoff W. http://www.praxis-berghoff.de/dokumente/Lyme_Borreliose_im_Ueberblick.pdf 1.) Langzeittherapie Langzeittherapien von 4 bis 6 Monaten und intermittierend verlaufsadaptierte Behandlungszeiten von 3 bis 5 Jahren sind praxisrelevant. Burrascano J Zukunftsweisende Themen der Lyme Krnakheit (2008) Seie 11 http://www.borreliose.me/mediapool/77/776837/data/ Burrascano_Leitfaden_Lyme_08.pdf KlemannW. Huismans B.D. Patienten mit Erreger-Direktnachweis bei chronischer LymeBorreliose; Klinik, Labordiagnostik, Antibiotika-Therapie und Krankheitsverlauf, Eine retrospektive Studie. umwelt-medizin-gesellschaft (22) 132-138, 2/2009. http://www.umg-verlag.de/umwelt-medizin-gesellschaft/209_kh_z.pdf Huismans B.D., Klemann W. Langzeitbehandlung mit Antiinfektiva bei persistierender Borreliose mit Borrelien-DNA-Nachweis durch PCR. Mit Hinweisen auf AntiinfektivaKombinationen im Anhang. Grin Verlag (2008) ISBN 978-3-604-19384-4 Stricker R, Counterpoint: leong-therm antibiotic therapy improves persistent symptoms associated with lyme disease. Clin Infect Dis 2007; 45: 149-47. Stricker RB, McNeil EL. Duration of antibiotic therapy for Lyme disease. Ann Intern Med 2004; 140:W6 Donta ST Tetracycline therapy for chronic Lyme desease. Clin Infect Dis. 25 Suppl I 52-60 (1997) Barthold et al. Treatment of late Lyme borreliosis. J Infect 29 (3) 225-261 (1994) Berghoff W. Antbiotische Behandlung der Lyme-Borreliose (LB) http://www.praxis-berghoff.de/dokumente/Antibiotische_Behandlung_ der_LB.pdf Berghoff W. Klinische Grundlagen der antibiotischen Behandlung bei Borreliose. Kullberg BJ, Berende A, van der Meer JW. The challenge of Lyme disease: tired of the Lyme wars. Neth J Med 2011;69:98-100. Stricker RB, Green CL, Savely VR, Chamallas SN, Johnson L. Benefit of intravenous antibiotic therapy in patients referred for treatment of neurologic Lyme disease. Int J Gen Med 2011;4:639-46. DeLong AK, Blossom B, Maloney E, Phillips SE. Antibiotic retreatment of Lyme disease in patients with persistent symptoms: A biostatistical review of randomized, placebo-controlled, clinical trials. Contemp Clin Trials 2012;epub ahead of print. http://dx.doi.org/10.1016/j.cct.2012.08.009 2.) Pulstherapie Die Pulstherapie ist ein Behandlungsschema, bei dem die Antibiotika an zwei bis 4 Tagen pro Woche (in der Regel parenteral) gegeben werden. Die Pulstherapie bietet nach J. Burrascano folgende Vorteile: 1. Verdoppelung der Dosen und dadurch bessere Wirksamkeit, 2. Toxische Medikamente können mit größerer Sicherheit gegeben werden. 3. Evtl. Effektivität, wenn konventionelle Methoden versagen. 4. Ein i.v. Zugang kann leichter zu tolerieren sein. 5. In der Regel kostengünstiger als Therapieschemata mit Tagesrhythmus. Burrascano J. Zukunftsweisende Themen der Lyme Krnakheit (2008) Seite 29 http://ww.borriliose.me/mediapool/77///6837/data/Burrascano_Leitfaden:Lyme_08.pdf Huismans B.D., Klemann W. Langzeitbehandlung mit Antiinfektiva bei persistierender Borrliose mit Borrelien-DNA-Nachweis durch PCR. Mit Hinweisen auf AntiinfektivaKombinationen im Anhang. Grin-Verlag (2008) ISBN 978-3-604-19384-4 3.) Therapiebegleitung Hopf-Seidel P. Krank nach Zeckenstich. Borreliose erkennen und wirksam behandeln. Knaus MensSana(2008) ISBN: 978-3-426-87392-2 Berghoff W. Antbiotische Behandlung der Lyme-Borreliose (LB) http://www.praxis-berghoff.de/dokumente/Antibiotische_Behandlung_ der_LB.pdf Therapie: Azithromycin Indikationen: Herstellerangaben: „Infektionen der unteren und oberen Atemwege; Bronchitis, leichte bis mittelschwere ambulant erworbene Pneumonie; Sinusitis, Pharyngitis/Tonsillitis. Akute Otitis media. Leichte bis mittelschwere Infektionen der Haut und des Weichteilgewebes; Folliculitis, Zellulitis, Erysipelas. Unkomplizierte, durch Chlamydia trachomatis verursachte Urethritis und Zervicitis“. Wikipedia: „Weiterhin wird Azithromycin bei akuten Mittelohrentzündungen, Hautund Wundinfektionen, Lyme-Borreliose, bakterieller Konjunktivitis, bei Urethritis durch Chlamydien und zur Prophylaxe sogenannter MAK-Infektion (MycobacteriumaviumintrazellulareKomplex-Infektion) bei immungeschwächten Patienten verwendet“. http://de.wikipedia.org/wiki/Azithromycin Azithromyzin (Azalid) / Makrolide Preac-Mursic V, Wilske B, Schierz G, Süss E, Gross B. (1989) Comparative antimicrobial activity of the new macrolides against Borrelia burgdorferi. Eur J Clin Microbiol Infect Dis. 8(7):651–653. [PubMed] Foulders G., Shepard RM et al. (1990) The pharmacokinetics of azithromycin in human serum and tissues. J Antimicrob Chemother25, Suppl A:73-82 Peters HD, Friedel HA et al. (1992) Azithromycin. A review of its antimicrobial activity, pharmacokinetic, properties and clinical efficacy. Drugs 44(5), 790-799 Dever LL, Jorgensen JH, Barbour AG (1993) Comparative in vitro activities of clarithromycin, azithromycin, and erythromycin against Borrelia burgdorferi. Antimicrob. Agents Chemother. 37(8) 1704-6 Strle F, Preac-Mursic V, Cimperman J, Ruzic E, Maraspin V, Jereb M (1993) Azithromycin versus doxycycline for treatment of erythema migrans: clinical and microbiological findings. Infection 21(2) 83-8 Alder J, Mitten M, Jarvis K, Gupta P, Clement J. (1993) Efficacy of clarithromycin for treatment of experimental Lyme disease in vivo. Antimicrob Agents Chemother. 37(6):1329–1333. [PMC free article] [PubMed] Luke DR, Foulds G. et al. (1996) Safety, toleration and pharmacokinetics of intravenous azithromycin. Antimicrob Agents Chemother. 40(11) 2577-2581 Luft BJ, Dattwyler RJ, Johnson RC, Luger SW, Bosler EM, Rahn DW, Masters EJ, Grunwaldt E, Ggdil SD (1996) Azithromycin compared with Amoxicillin in the treatment of erythema migrans. A doble blind, randomized, controlled trial. Ann Intern Med 124 785-91 DattwylerRJ, E Grunwaldt, and B J Luft (1996) Clarithromycin in Treatment of early Lyme disease: a pilot study. Antimicrob Agents Chemother. 40(2), 468–469. Donta ST. (2003) Macrolide therapy of chronic Lyme Disease. Med Sci Monit. 9(11), PI136-42. http://www.ncbi.nlm.nih.gov/pubmed/14586290 Vossen MG, Haque R, Starzengruber P, et al. (2007) [In vitro interaction studies of azithromycin and dihydroartemisinin in Plasmodium falciparum isolates from Bangladesh]. Wien Klin Wochenschr 119 (19-20 Suppl 3) 71-75. Aires FT, Soares RP, Bernardo WM (2010) Efficacy of azithromycin on the treatment of syphilis. Rev Assoc Med Bras 56(5), 496. Luntamo M, Kulmala T, Mbewe B, et al. (2010) Effect of repeated treatment of pregnant women with sulfadoxine-pyrimethamine and azithromycin on preterm delivery in Malawi: a randomized controlled trial. Am J Trop Med Hyg 83(6), 121220. Abstract | Full Citation | Find Related Articles Adriaenssens N, Coenen S, Versporten A, et al. (2011) European Surveillance of Antimicrobial Consumption (ESAC): outpatient macrolide, lincosamide and streptogramin (MLS) use in Europe (1997-2009). J Antimicrob Chemother vi37-45. Manhart LE, Broad JM, Golden MR (2011) Mycoplasma genitalium: should we treat and how? Clin Infect Dis S129-42. Ghanem KG, Workowski KA (2011) Management of adult syphilis. Clin Infect Dis S110-28 Fitzmaurice E, Keller E, Trebbin J, et al. (2011) Strategies for partner management when treating sexually transmitted infection. J Midwifery Womens Health 56(6), 608-14 Handsfield HH (2011) Questioning azithromycin for chlamydial infection. Sex Transm Dis 38(11), 1028-9. Coles CL, Seidman JC, Levens J, et al. (2011) Association of mass treatment with azithromycin in trachoma-endemic communities with short-term reduced risk of diarrhea in young children. Am J Trop Med Hyg 85(4), 691-6. Maezono H, Noiri Y, Asahi Y, et al. (2011) Antibiofilm effects of azithromycin and erythromycin on Porphyromonas gingivalis. Antimicrob Agents Chemother 55(12), 5887-92. Bala A, Kumar R, Harjai K (2011) Inhibition of quorum sensing in Pseudomonas aeruginosa by azithromycin and its effectiveness in urinary tract infections. J Med Microbiol 60(Pt 3), 300-6. Abstract | Full Citation | Find Related Articles Shperling NV, Vengerovskiĭ AI, Shperling IA, et al. (2011) [Treatment of chlamydial infection in chronic prostatitis]. Urologiia (4), 45, 47-9. Franco PS, Gomes AO, Barbosa BF, et al. (2011) Azithromycin and spiramycin induce anti-inflammatory response in human trophoblastic (BeWo) cells infected by Toxoplasma gondii but are able to control infection. Placenta 32(11), 838-44. Toti US, Guru BR, Hali M, et al. (2011) Targeted delivery of antibiotics to intracellular chlamydial infections using PLGA nanoparticles. Biomaterials 32(27), 6606-13. Schmidt E, Kaciroti N, Loesche W (2011) Benefits of additional courses of systemic azithromycin in periodontal therapy. Gen Dent 59(3), 180-7; quiz 188-9. Ayele B, Gebre T, House JI, et al. (2011) Adverse events after mass azithromycin treatments for trachoma in Ethiopia. [Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't] Am J Trop Med Hyg 85(2), 291-4. Srivastava P, Vardhan H, Bhengraj AR, et al. (2011) Azithromycin treatment modulates the extracellular signal-regulated kinase mediated pathway and inhibits inflammatory cytokines and chemokines in epithelial cells from infertile women with recurrent Chlamydia trachomatis infection. DNA Cell Biol 30(8), 545-54. Abstract | Full Citation | Find Related Articles Chico RM, Chandramohan D (2011) Azithromycin plus chloroquine: combination therapy for protection against malaria and sexually transmitted infections in pregnancy. Expert Opin Drug Metab Toxicol 7(9), 1153-67. Mishra MK, Kotta K, Hali M, et al. (2011) PAMAM dendrimer-azithromycin conjugate nanodevices for the treatment of Chlamydia trachomatis infections. Nanomedicine 7(6), 935-44. El-Bahnasawy MM, Khalil HH, Morsy TA (2011) Babesiosis in an Egyptian boy aquired from pet dog, and a general review. J Egypt Soc Parasitol 41(1), 99-108. Abstract | Full Citation | Find Related Articles Levine A, Turner D (2011) Combined azithromycin and metronidazole therapy is effective in inducing remission in pediatric Crohn's disease. J Crohns Colitis 5(3), 222-6. van Eijk AM, Terlouw DJ (2011) Azithromycin for treating uncomplicated malaria. Cochrane Database Syst Rev (2), CD006688. Abstract | Full Citation | Find Related Articles Samra Z, Rosenberg S, Dan M (2011) Susceptibility of Ureaplasma urealyticum to tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin. J Chemother 23(2):77-9. West SK, Munoz B, Mkocha H, et al. (2011) Number of years of annual mass treatment with azithromycin needed to control trachoma in hyper-endemic communities in Tanzania. J Infect Dis 204(2), 268-73. Bhengraj AR, Srivastava P, Mittal A (2011) Lack of mutation in macrolide resistance genes in Chlamydia trachomatis clinical isolates with decreased susceptibility to azithromycin. Int J Antimicrob Agents 38(2), 178-9. Evans JR, Solomon AW (2011) Antibiotics for trachoma. [Journal Article, MetaAnalysis, Review] Cochrane Database Syst Rev (3):CD001860. Bébéar C, Pereyre S, Peuchant O (2011) Mycoplasma pneumoniae: susceptibility and resistance to antibiotics. [Journal Article, Review] Future Microbiol 6(4), 423431. Abstract | Full Citation | Find Related Articles Sampaio E, Rocha M, Figueiredo LC, et al. (2011) Clinical and microbiological effects of azithromycin in the treatment of generalized chronic periodontitis: a randomized placebo-controlled clinical trial. J Clin Periodontol 38(9), 838-846. Renna M, Schaffner C, Brown K, et al. (2012) Azithromycin blocks autophagy and may predispose cystic fibrosis patients to mycobacterial infection. J Clin Invest 121(9):3554-3563. Gebre T, Ayele B, Zerihun M, et al. (2012) Comparison of annual versus twice-yearly mass azithromycin treatment for hyperendemic trachoma in Ethiopia: a clusterrandomised trial. Lancet 379(9811), 143-151. Keenan JD, See CW, Moncada J, et al. (2012) Diagnostic characteristics of tests for ocular Chlamydia after mass azithromycin distributions. Invest Ophthalmol Vis Sci 53(1), 235-240. Pernsteiner J (2012) Topical antibiotic stops tick disease. Gel gives hope for simplified prevention of Lyme borreliosis. Kinderkrankenschwester 31(3), 122. Full Citation | Find Related Articles Horner PJ (2012) Azithromycin antimicrobial resistance and genital Chlamydia trachomatis infection: duration of therapy may be the key to improving efficacy. Sex Transm Infect 2012 Apr; 88(3), 154-6. Full Citation Ray WA, Murray KT, Hall K, et al. (2012) Azithromycin and the risk of cardiovascular death. N Engl J Med 366(20), 1881-90. Abstract http://www.ncbi.nlm.nih.gov/pubmed/22591294 http://www.medscape.com/viewarticle/763994_print Beachte: Long QT syndrome http://en.wikipedia.org/wiki/Long_QT_syndrome QTc-Zeit (BAZETT): http://www.dr-gawlitza.de/qtc.htm HAVERKAMP W., HAVERKAMP F., BREITHARDT G.(2002) Medikamentenbedingte QT-Verlängerung und Torsade de pointes: Ein multidisziplinäres Problem. Dtsch Ärztebl 99, 1972–1979 Azithromycin nie mit Fluconazol oder Chinolonen (z.B. Ciprofloxazin, Levofloxazin) oder Psychopharmaka oder Antikoagulantien oder Sartanen oder anderen Makroliden (z.B. Chlarithromycin) kombinieren! Unbound MEDLINE results for: Azithromycin AND human Refine this search 3872 journal articles in the PubMed database http://www.unboundmedicine.com/medline/ebm/classic?in=kw|azithromycin&in=jn|&in=au| BDH, 22.06.2012 http://www.Huismans.de.vu Minocyclin, Doxycyclin, Tetrazyklin Cellerin L, Canfrere I, Ordronneau J, et al. (1994) Acute eosinophilic pneumopathy induced by minocycline. Rev Pneumol Clin 50(6), 325-8. Abstract Karlsson M, Hammers S, Nilsson-Ehle I, et al. (1996) Concentrations of doxycycline and penicillin G in sera and cerebrospinal fluid of patients treated for neuroborreliosis. Antimicrob Agents Chemother 40(5), 1104-7. Abstract Ziska MH, Donta ST, Demarest FC (1996) Physician preferences in the diagnosis and treatment of Lyme disease in the United States. Infection 24(2), 182-6. Abstract Donta ST (1997) Tetracycline therapy for chronic Lyme disease. Clin Infect Dis S52-6. Abstract Steere AC (1997) Diagnosis and treatment of Lyme arthritis. Med Clin North Am 81(1),17994. Abstract Horowitz HW, Wormser GP (1998) Doxycycline revisited: an old medicine for emerging diseases. Arch Intern Med 158(2), 192-3. Full Citation | Publisher Full Text Aberer E, Kehldorfer M, Binder B, et al. (1999) The outcome of Lyme borreliosis in children. Wien Klin Wochenschr 111(22-23), 941-4. Abstract | Find Related Articles De Maria A, Primavera A (2000) Possibility of the use of oral long-acting tetracyclines in the treatment of Lyme neuroborreliosis. Clin Infect Dis 31(3), 848-9. Full Citation | Publisher Full Text Bentas W, Karch H, Huppertz HI (2000) Lyme arthritis in children and adolescents: outcome 12 months after initiation of antibiotic therapy. J Rheumatol 27(8), 2025-30. Abstract Dotevall L, Hagberg L (2000) Adverse effects of minocycline versus doxycycline in the treatment of Lyme neuroborreliosis. Clin Infect Dis 30(2), 410-1. Full Citation | Publisher Full Text Cunha BA (2000) Minocycline versus doxycycline in the treatment of Lyme neuroborreliosis. Clin Infect Dis 30(1), 237-8. Full Citation | Publisher Full Text Donta ST (2001) Treatment of patients with persistent symptoms and a history of Lyme disease. N Engl J Med 345(19), 1424; author reply 1425. Full Citation Bernier C, Dréno B (2001) Minocycline. Ann Dermatol Venereol 128(5), 627-37. Abstract | Publisher Full Text Karkkonen K, Stiernstedt SH, Karlsson M (2001) Follow-up of patients treated with oral doxycycline for Lyme neuroborreliosis. Scand J Infect Dis 33(4), 59-62. Abstract Bell CD, Kovacs K, Horvath E, et al. (2001) Histologic, immunohistochemical, and ultrastructural findings in a case of minocycline-associated "black thyroid". Endocr Pathol 12(4), 443-51. Abstract Bonnetblanc JM (2002) Doxycycline. Ann Dermatol Venereol 129(6-7), 874-82. Abstract | Publisher Full Text Stricker RB, Lautin A (2003) The Lyme Wars: time to listen. Expert Opin Investig Drugs 12(10), 1609-14. Abstract van Steensel MA (2004) Why minocycline can cause systemic lupus - a hypothesis and suggestions for therapeutic interventions based on it. Med Hypotheses 63(1), 31-4. Abstract Fritzsche M (2005) Chronic Lyme borreliosis at the root of multiple sclerosis--is a cure with antibiotics attainable? Med Hypotheses 64(3), 438-48. Abstract Ogrinc K, Logar M, Lotric-Furlan S, et al. (2006) Doxycycline versus ceftriaxone for the treatment of patients with chronic Lyme borreliosis. Wien Klin Wochenschr 118(21-22), 696701. Abstract | Publisher Full Text Meer-Scherrer L, Chang Loa C, Adelson ME, et al. (2006) Lyme disease associated with Alzheimer's disease. Curr Microbiol 52(4), 330-2. Abstract Donta ST (2007) Lyme disease guidelines--it's time to move forward. Clin Infect Dis 44(8), 1134-5; author reply 1137-9. Full Citation | Publisher Full Text Larkin JM (2008) Lyme disease in children and pregnant women. Med Health R I 91(7), 212. Full Citation Wormser GP, Halperin JJ (2008) Oral doxycycline for neuroborreliosis. Lancet Neurol 7(8), 665-6. Full Citation Ljøstad U, Skogvoll E, Eikeland R, et al. (2008) Oral doxycycline versus intravenous ceftriaxone for European Lyme neuroborreliosis: a multicentre, non-inferiority, double-blind, randomised trial. Lancet Neurol 7(8), 690-5. Abstract | Publisher Full Text Aupee O, Almeras D, Le Garlantezec P, et al. (2009) Doxycycline. Med Trop (Mars) 69(6), 556-8. Abstract | Find Related Articles Schröder J, Kirch W (2009) Lyme borreliosis: How should erythema migrans be treated in pregnant women?. Dtsch Med Wochenschr 134(46), 2354. Full Citation | Publisher Full Text Gulati RK (2010) Doxycycline in children?--the unanswered question. Pediatr Dermatol 27(4), 419. Full Citation Unbound MEDLINE results for: Minocyclin and Borreliosis, human Refine this search 1 journal articles in the PubMed database Unbound MEDLINE results for: Minocyclin and tetracyclines, human Refine this search 27 journal articles in the PubMed database Unbound MEDLINE results for: tetracyclines and borreliosis, human Refine this search 432 journal articles in the PubMed database BDH, Mai 2012 www.Huismans.de.vu Rifampicin Herstellerangaben, Indikation Rifampicin: Behandlung der Tuberkulose in allen Formen und Stadien (…). Infektionen durch Tuberkulosebakterien oder durch „atypische“ Mykobakterien, sofern die Erreger gegen Rifampicin empfindlich sind (…). Zur Kombinationsbehandlung bei Lepra und Buruli ulcus (…). Vorbeugende Behandlung von Meningokokkenträgern. „Rifampicin wird vorwiegend bei Infektionen mit Mykobakterien, insbesondere bei Tuberkulose und Lepra, eingesetzt. Auch bei der Therapie von Methicillin-resistenten Staphylokokken wird es angewandt. Außerdem wird es prophylaktisch bei Kontaktpersonen von Erkrankten an Meningokokken-Meningitis empfohlen. Es wirkt zudem gegen Enterokokken und Legionella pneumophila und ist gut liquorgängig“. Quelle: http://de.wikipedia.org/wiki/Rifampicin Vasilos LV, Rumel' NB, Shchuka SS (1995) [Chemotherapeutic effectiveness of erythromycin, rifampicin and tetracyclines in chlamydiosis and mycoplasmosis in children]. [Clinical Trial, English Abstract, Journal Article] Antibiot Khimioter 40(6):40-2. Abstract | Full Citation | Find Related Articles Brunner S, Frey-Rindova P, Altwegg M, et al. (2000) Retroperitoneal abscess and bacteremia due to Mycoplasma hominis in a polytraumatized man. [Case Reports, Journal Article] Infection 28(1):46-8. Abstract | Full Citation | Publisher Full Text | Find Related Articles Lin HP, Lu HX (2007) [Analysis of detection and antimicrobial resistance of pathogens in prostatic secretion from 1186 infertile men with chronic prostatitis]. [English Abstract, Journal Article] Zhonghua Nan Ke Xue; 13(7):628-31. Abstract | Full Citation | Find Related Articles Carter JD, Espinoza LR, Inman RD, et al. (2010) Combination antibiotics as a treatment for chronic Chlamydia-induced reactive arthritis: a double-blind, placebo-controlled, prospective trial. [Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural] Arthritis Rheum 62(5):1298-307. Abstract | Full Citation | Publisher Full Text | Find Related Article Minematsu A, Sawai T, Matsutake T, et al. (2011) [A case of Mycobacterium intracellulare pulmonary infection with vertebral osteomyelitis]. [Case Reports, English Abstract, Journal Article] Kansenshogaku Zasshi 85(5):527-31. Abstract | Full Citation | Find Related Articles Patil MY, Antin SM, Gupta A (2011) Skeletal brucellosis. [Journal Article] J Indian Med Assoc 109(3):171-3. Abstract | Full Citation | Find Related Articles Dacso MM, Jacobson RR, Scollard DM, et al. (2011) Evaluation of multi-drug therapy for leprosy in the United States using daily rifampin. [Journal Article] South Med J 104(10):689-94. Abstract | Full Citation | Publisher Full Text | Find Related Articles Czekaj J, Dinh A, Moldovan A, et al. (2011) Efficacy of a combined oral clindamycin?rifampicin regimen for therapy of staphylococcal osteoarticular infections. [Journal Article] Scand J Infect Dis 43(11-12):962-7. Abstract | Full Citation | Publisher Full Text | Find Related Article Nelson RL, Kelsey P, Leeman H, et al. (2011) Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. [Journal Article, Meta-Analysis, Review] Cochrane Database Syst Rev CD004610. Abstract | Full Citation | Publisher Full Text | Find Related Articles Jean SS, Hsueh PR (2011) Current review of antimicrobial treatment of nosocomial pneumonia caused by multidrug-resistant pathogens. [Editorial, Review] Expert Opin Pharmacother 12(14):2145-8. Abstract | Full Citation | Publisher Full Text | Find Related Article Yesilyurt M, Kiliç S, Celebi B, et al. (2011) Antimicrobial susceptibilities of Francisella tularensis subsp. holarctica strains isolated from humans in the Central Anatolia region of Turkey. [Journal Article, Research Support, Non-U.S. Gov't] J Antimicrob Chemother 66(11):2588-92. Abstract | Full Citation | Publisher Full Text | Find Related Articles Varner TR, Bookstaver PB, Rudisill CN, et al. (2011) Role of rifampin-based combination therapy for severe community-acquired Legionella pneumophila pneumonia. [Journal Article, Research Support, Non-U.S. Gov't, Review] Ann Pharmacother 45(7-8):967-76. Abstract | Full Citation | Publisher Full Text | Find Related Articles Leite B, Gomes F, Teixeira P, et al. (2011) In vitro activity of daptomycin, linezolid and rifampicin on Staphylococcus epidermidis biofilms. [Journal Article, Research Support, Non-U.S. Gov't] Curr Microbiol 63(3):313-7. Abstract | Full Citation | Publisher Full Text | Find Related Articles Toti US, Guru BR, Hali M, et al. (2011) Targeted delivery of antibiotics to intracellular chlamydial infections using PLGA nanoparticles. [Journal Article, Research Support, N.I.H., Extramural] Biomaterials 32(27):6606-13. Abstract | Full Citation | Publisher Full Text | Find Related Articles Girdhar A, Kumar A, Girdhar BK (2011) A randomised controlled trial assessing the effect of adding clarithromycin to rifampicin, ofloxacin and minocycline in the treatment of single lesion paucibacillary leprosy in Agra District, India. [Journal Article, Randomized Controlled Trial] Lepr Rev 82(1):46-54. Abstract | Full Citation | Find Related Articles van Ingen J, Aarnoutse RE, Donald PR, et al. (2011) Why Do We Use 600 mg of Rifampicin in Tuberculosis Treatment? [Journal Article, Research Support, NonU.S. Gov't, Review] Clin Infect Dis 52(9):e194-9. Abstract | Full Citation | Publisher Full Text | Find Related Articles Donald PR, Maritz JS, Diacon AH (2011) The pharmacokinetics and pharmacodynamics of rifampicin in adults and children in relation to the dosage recommended for children. [Journal Article, Research Support, Non-U.S. Gov't, Review] Tuberculosis (Edinb) 91(3):196-207. Abstract | Full Citation | Publisher Full Text | Find Related Articles Aus: Unbound MEDLINE results for: Rifampicin, Chlamydia or Mycoplasma etc. AND human Refine this search http://www.unboundmedicine.com/medline/ebm/classic?in=kw|rifampicin,%20chlamydia&in=jn|&in=au http://www.unboundmedicine.com/medline/ebm/search?start=10&next=true&additional=rifampicin,%20mycoplasma%2 0AND%20human[MH] BDH, 06.04.2012 www.Huismans.de.vu Metronidazole Indikation (Metronidazol, Fa. Braun): „Behandlung und Vorbeugung von Infektionen, hervorgerufen durch Metronidazol-empfindliche Keime. Die Behandlung ist wirksam bei Infektionen des zentralen Nervensystems, Infektionen des Respirationstraktes, Endocarditis, Infektionen des Gastrointestinal-Traktes, bei gynäkologischen Infektionen, Infektionen im HNO- und Zahn-Mund-Kiefer-Bereich, Infektionen an Knochen und Gelenken, Gasbrand, Septikämie bei Thrombophlebitis. Hinweis: Bei Mischinfektionen mit aeroben und anaeroben Erregern zur Bekämpfung aerober Infektionen geeignete Antibiotika zusätzlich zu Metronidazol verabreichen.“ Wikipedia, Metronidazol http://de.wikipedia.org/wiki/Metronidazol http://en.wikipedia.org/wiki/Metronidazole Denner Brown LG, Drucker DB. (1969) COMBINATION OF PENICILLIN AND METRONIDAZOLE The Lancet, Volume 294, Issue 7623, Page 746 Hartley-Asp B. (1979) MUTAGENICITY OF METRONIDAZOLE The Lancet, Volume 313, Issue 8110, Page 275 E.J. Baines, J.A. McFadzean (1981) The Action of Metronidazole on Anaerobic Bacilli and Similar Organisms Advances in Pharmacology, Volume 18, Pages 223-272 Pylkkänen, Jaana Lähdetie (1984) Sperm abnormality assay of metronidazole and tinidazole Mutation Research Letters, Volume 140, Issues 2–3, Pages 137-140 Liisa Lubomír Dobiáš, Milena Černá, Pavel Rössner, Radim Šrám (1994) Genotoxicity and carcinogenicity of metronidazole Mutation Research/Reviews in Genetic Toxicology, Volume 317, Issue 3, Pages 177-194 Judith S. Simms-Cendan (1996) Metronidazole Primary Care Update for OB/GYNS, Volume 3, Issue 5, Pages 153-156 Mary Jo Kasten (1999) Clindamycin, Metronidazole, and Chloramphenicol Mayo Clinic Proceedings, Volume 74, Issue 8, Pages 825-833 Woodruff BK , Wijdicks EFM, Marshall WF (2002) Reversible Metronidazole-Induced Lesions of the Cerebellar Dentate Nuclei N Engl J Med 346:68-69 Takase K, Santa Y, Ohta S, Yoshimura T. (2005) MRI and SPECT findings in a case of metronidazole-induced reversible acute cerebellar ataxia. Rinsho Shinkeigaku 45(5):386– 389 Kevin T. Fitzgerald (2006) Chapter 60 - Metronidazole Small Animal Toxicology (Second Edition), Pages 853-859 Metronidazole (2006) Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions (Fifteenth Edition),Pages 2323-2328 Patel K., Green-Hopkins I., Lu S. Tunkel AR. (2008) Cerebellar ataxia following prolonged use of metronidazole: case report and literature review. International Journal of Infectious Diseases 12 (6), e111–e114 PDF (283 K) Gian Mario Tiboni, Francesca Marotta, Anna Pia Castigliego (2008) Teratogenic effects in mouse fetuses subjected to the concurrent in utero exposure to miconazole and metronidazole Reproductive Toxicology, Volume 26, Issues 3–4, Pages 254-261 Graves TD, Condon M, Loucaidou M, Perry RJ. (2009) Reversible metronidazole-induced cerebellar toxicity in a multiple transplant recipient. J. Neurol. Sci. 285(1-2):238–240] Ferroir J-P, Corpechot C, Freudenreich A, Khalil A. (2009) [Metronidazole-related polyneuritis, convulsive seizures, and cerebellar syndrome. Contribution of MRI]. Rev. Neurol. (Paris) 165(10):828–830 Moosa ANV, Perkins D. (2010) Neurological picture. MRI of metronidazole induced cerebellar ataxia. J. Neurol. Neurosurg. Psychiatr. 81(7):754–755 Park K-I, Chung J-M, Kim J-Y. (2011) Metronidazole neurotoxicity: sequential neuroaxis involvement. Neurol India 59(1):104–107 Kierzkowska M, Majewska A, Kqdzielska J, et al. (2011) Participation of gram-negative anaerobes in infections in hospitalized patients. Med Dosw Mikrobiol 63(3):235-40.Abstract Drekonja DM, Butler M, MacDonald R, et al.(2011) Comparative effectiveness of Clostridium difficile treatments: a systematic review. Ann Intern Med 155(12):839-47. Abstract Kim SM, Shin HW, Han HJ, et al. (2011) Serially changing metronidazole-induced encephalopathy. Can J Neurol Sci 38(6):921-4. Full Citation Chacko J, Pramod K, Sinha S, et al. (2011) Clinical, neuroimaging and pathological features of 5-nitroimidazole-induced encephalo-neuropathy in two patients: Insights into possible pathogenesis. Neurol India 59(5):743-7. Abstract Gardner E, Meghani N, Mancuso P, et al. (2011) Recognizing metronidazole resistant C. difficile. Nurse Pract 36(11):8-11. Full Citation Bohbot JM (2011) Chlamydia trachomatis: The enemy of the Fallopian tube. Gynecol Obstet Fertil 39(11):636-9. Abstract Léoni S, Mesplié N, Aitali F, et al. (2011) Metronidazole: alternative treatment for ocular and cutaneous rosacea in the pediatric population. J Fr Ophtalmol 34(10):703-10. Abstract Metronidazole. (2011) Rep Carcinog 269-70. Full Citation Unbound MEDLINE results for: Metronidazole AND human[MH]| Refine this search http://www.unboundmedicine.com/medline/ebm/classic?in=kw|Metronidazole%20AND%20human[MH]&in=jn|&in=au| 11184 journal articles in the PubMed database BDH, April 2012 www.Huismans.de.vu Artemisinin (internistisch - umweltmedizinische Auswahl) Neill US (2011) From branch to bedside: Youyou Tu is awarded the 2011 Lasker~DeBakey Clinical Medical Research Award for discovering artemisinin as a treatment for malaria. J Clin Invest 121(10), 3768-73. Full Citation Xie L, Zhai X, Liu C, et al. (2011) Anti-tumor activity of new artemisinin-chalcone hybrids. Arch Pharm (Weinheim) 344(10), 639-47. Abstract Faurant C (2011) From bark to weed: the history of artemisinin. Parasite 18(3), 215-8. Abstract Cui W (2011) WHO urges the phasing out of artemisinin based monotherapy for malaria to reduce resistance. BMJ, d2793. Full Citation Chou S, Marousek G, Auerochs S, et al. (2011) The unique antiviral activity of artesunate is broadly effective against human cytomegaloviruses including therapy-resistant mutants. Antiviral Res 92(2), 364-8. Abstract Dickerson F, Stallings C, Vaughan C, et al. (2011) Artemisinin reduces the level of antibodies to gliadin in schizophrenia. Schizophr Res 129(2-3), 196-200. Abstract Mercer AE, Copple IM, Maggs JL, et al. (2011) The role of heme and the mitochondrion in the chemical and molecular mechanisms of mammalian cell death induced by the artemisinin antimalarials. J Biol Chem 286(2):987-96. Abstract Wang Y, Huang ZQ, Wang CQ, et al. (2011) Artemisinin inhibits extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinase-9 expression via a protein kinase Cδ/p38/extracellular signal-regulated kinase pathway in phorbol myristate acetate-induced THP-1 macrophages. Clin Exp Pharmacol Physiol 38(1), 11-8. Abstract Goo YK, Terkawi MA, Jia H, et al. (2010) Artesunate, a potential drug for treatment of Babesia infection. Parasitol Int 59(3), 481-6. Abstract | Full Citation | Publisher Full Text | Chadwick J, Jones M, Mercer AE, et al. (2010) Design, synthesis and antimalarial/anticancer evaluation of spermidine linked artemisinin conjugates designed to exploit polyamine transporters in Plasmodium falciparum and HL-60 cancer cell lines. Bioorg Med Chem 18(7), 2586-97. Abstract Liu Y, Lok CN, Ko BC, et al. (2010) Subcellular localization of a fluorescent artemisinin derivative to endoplasmic reticulum. [Journal Article, Research Support, Non-U.S. Gov't] Org Lett 12(7), 1420-3. Abstract Firestone GL, Sundar SN (2009) Anticancer activities of artemisinin and its bioactive derivatives. Expert Rev Mol Med e32. Abstract Zhang S, Gerhard GS (2009) Heme mediates cytotoxicity from artemisinin and serves as a general anti-proliferation target. PLoS One 4(10), e7472. Abstract Medhi B, Patyar S, Rao RS, et al. (2009) Pharmacokinetic and toxicological profile of artemisinin compounds: an update. Pharmacology 84(6), 323-32. Abstract Randrianarivelojosia M, Randriasamimanana JR, Martin C (2009) Artemisinin-based combination therapies (ACTs) and herbal drugs crosstalk: facts and perspectives. Parasite 16(3), 243-4. Full Citation Stockwin LH, Han B, Yu SX, et al. (2009) Artemisinin dimer anticancer activity correlates with hemecatalyzed reactive oxygen species generation and endoplasmic reticulum stress induction. Int J Cancer 125(6), 1266-75. Abstract Willoughby JA, Sundar SN, Cheung M, et al. (2009) Artemisinin blocks prostate cancer growth and cell cycle progression by disrupting Sp1 interactions with the cyclin-dependent kinase-4 (CDK4) promoter and inhibiting CDK4 gene expression. J Biol Chem 284(4), 2203-13. Abstract Buommino E, Baroni A, Canozo N, et al. (2009) Artemisinin reduces human melanoma cell migration by down-regulating alpha V beta 3 integrin and reducing metalloproteinase 2 production. Invest New Drugs 27(5), 412-8. Abstract Sundar SN, Marconett CN, Doan VB, et al. (2008) Artemisinin selectively decreases functional levels of estrogen receptor-alpha and ablates estrogen-induced proliferation in human breast cancer cells. Carcinogenesis 29(12), 2252-8. Abstract Efferth T, Romero MR, Wolf DG, et al. (2008) The antiviral activities of artemisinin and artesunate. Clin Infect Dis 47(6), 804-11. Abstract Jefford CW (2007) New developments in synthetic peroxidic drugs as artemisinin mimics. Drug Discov Today 12(11-12), 487-95. Abstract Efferth T (2007) Willmar Schwabe Award 2006: antiplasmodial and antitumor activity of artemisinin--from bench to bedside. Planta Med 73(4), 299-309. Abstract Dellicour S, Hall S, Chandramohan D, et al. (2007) The safety of artemisinins during pregnancy: a pressing question. Malar J 15. Abstract Adjei GO, Goka BQ, Kurtzhals JA (2006) Neurotoxicity of artemisinin derivatives. Clin Infect Dis 43(12), 1618. Full Citation Paeshuyse J, Coelmont L, Vliegen I, et al. (2006) Hemin potentiates the anti-hepatitis C virus activity of the antimalarial drug artemisinin. Biochem Biophys Res Commun 348(1), 139-44. Abstract Efferth T (2006) Molecular pharmacology and pharmacogenomics of artemisinin and its derivatives in cancer cells. Curr Drug Targets 7(4), 407-21. Abstract Nandakumar DN et al. (2006) Curcumin-Artemisin in combination therapy for malaria. Antimicrobial Agents and Chemotherapy. 50, 1859-1860 Bray PG, Ward SA, O'Neill PM (2005) Quinolines and artemisinin: chemistry, biology and history. Curr Top Microbiol Immunol 3-38. Abstract Holzgrabe U (2005) Artemisinin and successors. Pharm Unserer Zeit 34(2), 95. Full Citation Singh NP, Lai HC (2004) Artemisinin induces apoptosis in human cancer cells. Anticancer Res 24(4), 2277-80. 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Multiple sclerosis Asthma Cardiac disease Interstitial cystitis i Additionally: chronic obstructive pulmonary disease, uveitis, optic neuritis, radiculitis, nerve deafness, transverse myelitis, sarcoid, myocarditis, pericarditis, culture-negative endocarditis, atheromatous arterial disease, aneurysm, giant-cell (temporal) arteritis, polyarteritis nodosa, Wegener's granuloma, primary sclerosing cholangitis, reactive arthritis, Reiter's syndrome, Behcet's disease, cutaneous vasculitides including pyoderma gangrenosa. Wheldon adds: "Conditions which may suggest the possibility of flare-ups of chronic Chlamydia pneumoniae infection deserving serological investigation include the following — a multiplicity being more strongly suggestive: recurrent sinusitis, recurrent chest infectionsi, chronic fatigue (especially if following a respiratory infection), focal neurological deficits, myalgia, muscle fasciculation's, recurrent episodes of bronchospasm, unexplained pleuritic pain, angina, recurrent arthralgia, unexplained recurrent abdominal pain, unexplained menorrhagia, recurrent fistula-in-ano, recurrent cutaneous vasculitides, achalasia, intestinal dysmotility. Treatment 1. Two protein synthase inhibitors continuously (such as 200mg doxycycline daily plus 250mg azithromycin 3x per week) 2. Alternately, daily Rifampin and/or Isoniazid 3. 2400mg NAC daily or amoxicillin 4. 5-day pulses of 1000-1500mg Flagyl or Tinidazole every 2-4 weeks. 5. A regimen of supplementsi to enhance body function, detoxification, counter oxidation and inflammation, and enhance cell replacement. Treatment can take months to years to completely eradicate Cpn from the body”. Stratton C. Chlamydiphila pneumonia. Respiratory tract syndrome. http://www.cpnhelp.org/twar/twar-syndrome.htm Supplements to Protect Cells and Foster Regeneration Specific to Cpn Infection (2005) http://www.cpnhelp.org/publicimages/allsupplementschart.html N-acetyl-Cysteine, Acetyl L-Carnitin, Selenium, Ubichinone (coenzyme Q), Alpha-lipoic azid, Magnesium, Omega 3 fish oil, Vitamin B12 i.v, i.m., Vitamins B, folic acid, L-Tryptophan, SAMe, Probiotics, Quercetin; cabbages, Garlic etc. Wheldon D. (2011) Empirical antibacterial treatment of infection with Chlamydophila pneumoniae in Multiple Sclerosis http://www.davidwheldon.co.uk/ms-treatment.html Rifampin (2012) http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/rifampicin.pdf Osler, W. (1908). 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Advanced PubMed MEDLINE Search Biofilms in human subjects (mehr als 4922 Veröffentlichungen): http://www.unboundmedicine.com/medline/ebm/classic?in=kw|biofilms&in=jn|&in=au| Biofilms, Youtube http://www.youtube.com/watch?v=DzTaZJ5hURw&feature=relmfu http://www.youtube.com/watch?v=OK-6B2J-si0&feature=relmfu <- Biofilme allgemein http://www.youtube.com/watch?v=fQ68OW-dNIg&feature=relmfu <- Staphylokokken http://www.youtube.com/watch?v=3eQhNyX7DRQ&feature=relmfu <- Phagentherapie http://www.youtube.com/watch?v=68zYTzTlTlk&feature=relmfu <- General Biofilms + Borrelia http://www.youtube.com/watch?v=AmvgOfIN_8c&NR=1&feature=fvwp <- Sapi http://www.youtube.com/watch?v=a4uNDWdChM8 <- Borrelia Biofilm in vitro Mc. Donald BDH, 2012-03-30 http://www.Huismans.de.vu LTT-Tests Sigal LH et al, Cellular immune findings Lyme disease. Yale J Biol Med 1984, 57 : 595-8 Sigal LH et al, Proliferative responses of mononuclear cells in Lyme disease. 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Verbesserte Borrelien-Serologie durch Einsatz von rekombinanten Antigenen mit der luminex-Technologie. Borreliose Wissen Nr. 17, Februar 2008, S. 14-16 Berghoff 2009, http://www.praxis-berghoff.de/dokumente/LTT_bei_der_Lyme-Borreliose.pdf National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (2011) SPOT® TB test (T– Spot) http://www.cdc.gov/tb/publications/factsheets/testing/IGRA.pdf Advanced PubMed MEDLINE Search LTT-Tests (mehr als 128, Elispot LTT 5 Literaturangaben) http://www.unboundmedicine.com/medline/ebm/classic?in=kw|LTT-Tests&in=jn|&in=au| http://www.unboundmedicine.com/medline/ebm/classic?in=kw|Elispot%20LTT&in=jn|&in=au| BDH, 30.03.2012 http://www.Huismans.de.vu CD57 natürliche Killerzellen Oldham RK. (1983) Natural killer cells: artifact to reality: an odyssey in biology. Cancer Metastasis Rev. 2(4):323-36. McNerlan SE, Rea IM, Alexander HD, et al. (1998) Changes in natural killer cells, the CD57 CD8 subset, and related cytokines in healthy aging. 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PLOS ONE | www.plosone.org , 7( 8 ) e41321 Evtl. Ergänzende Marker Hirn SPECT Katz A, Zubal G, Westerweldt M et al. (2007) Neuropsychological Testing and SPECT/PET Ratio-Images in Patients with Lyme-Encephalopathy – Pre and Post Antibiotic Treatment Studies. JOI 17, 103 Donta ST (2012) SPECT Brain Imaging in Chronic Lyme Disease. Clinical Nuclear Medicine. 37(9) http://journals.lww.com/nuclearmed/Abstract/2012/09000/SPECT_Brain_Imaging_in_Chronic_Lyme_Disease.33.aspx 7 CD57 natürliche Killerzellen è http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/cd57%20nat.killerzellen.pdf CXCL13 è http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/cxcl%2013.pdf Zyklische Diguanylsäure Cho SJ, Sattar AK, Jeong EH, Satchi M, Cho JA, Dash S et al. (2002) Aquaporin-1 regulates GTPinduced rapid gating of water in secretory vesicles. Proc Natl Acad Sci U S A 99, 4720–4 (Synaptic vesicles, GTP, water channels http://www.ncbi.nlm.nih.gov/sites/entrez ) Ryjenkov DA, Tarutina M, Moskvin OV, Gomelsky M. (2005) Cyclic diguanylate is a ubiquitous signaling molecule in bacteria: insights into biochemistry of the GGDEF protein domain. J Bacteriol 187, 1792-8. Cotter PA, Stibitz S. (2007) c-di-GMP-mediated regulation of virulence and biofilm formation. Curr Opin Microbiol 10, 7-23. Rogers EA, Terekhova D, Zhang HM, Hovis KM, Schwartz I, Marconi RT. (2009) Rrp1, a cyclic-diGMP-producing response regulator, is an important regulator of Borrelia burgdorferi core cellular functions. Mol Microbiol 71, 1551-73. Freedman JC, Rogers EA, Kostick JL, Zhang H, Iyer R, Schwartz I, Marconi RT.(2010) Identification and molecular characterization of a cyclic-di-GMP effector protein, PlzA (BB0733): additional evidence for the existence of a functional cyclic-di-GMP regulatory network in the Lyme disease spirochete, Borrelia burgdorferi. FEMS Immunol Med Microbiol 58, 285-94. Spermin-Titer, Neopterin è http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/biogene%20amine%20und%20peptide.pdf Komplement C3a,C4a (bei ANA-Nachweis) è http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/info%20immunologie.pdf è http://www.wwwarchiv.de/wwwarchiv/anfang/texte/lit/complement.pdf VCS-Test [Viren (Singular: das Virus … ; von lat. virus, -i, n. „Gift, Saft, Schleim“) = Toxin (griechisch τοξίνη, … „die giftige [Substanz]“)], Quelle: Wikipedia Burrascano JJ. (2012) Lyme Disease and Biotoxins. http://www.youtube.com/watch?v=DFwHXy99M2o&feature=related Schoemaker R. (2012) VCS-Test Demonstation http://www.youtube.com/watch?v=snHNH7Dpd1U BDH, Juli 2012, letzte Revision September 2012, www.Huismans.de.vu Serologie Lyme-Borreliose Stadium III In verschiedenen Meinungspublikationen wird behauptet, dass bei der LymeBorreliose im Stadium III (Spätstadium) grundsätzlich Antikörper nachweisbar seien, d.h. bei einer Lyme-Borreliose III bestünde stets Seropositivität. Andererseits belegen zahlreiche Publikationen und Fallstudien, dass bei der LymeBorreliose im Stadium III bis zu 50% der Patienten keine Antikörper aufweisen, es besteht also bei der Hälfte der Patienten Seronegativität (1-18). Repräsentativ für die Behauptung, dass bei der Lyme-Borreliose im Spätstadium stets Seropositivität vorläge, ist die Arbeit von Wilske et al aus 2007 (19). In dieser Publikation heißt es: „In der Spätphase der Lyme-Borreliose (Akrodermatitis, Arthritis) sind AK bei allen Patienten nachweisbar (Hansen und Asbrink, 1989, Wilske et al, 1993). Diese beiden Publikationen werden zunächst epikritisch dargestellt. Hansen K, Asbrink E 1989 (20) Die Publikation aus 1989 vergleicht die Sensivität von zwei ELISA-Tests: - sonic extract ELISA - flagellum ELISA Der flagellum ELISA ist sensitiver als der sonic extract ELISA. Bei Erythema migrans (EM) liegt die Sensivität des flagellum ELISA bei 36%, für IgM bei 45%. Bei Dauer des EM von einem Monat oder länger beträgt die IgG Sensivität 50%. Bei Patienten mit ACA waren in allen Fällen IgG AK nachweisbar. IgM AK stellt einen unspezifischen Befund bei Patienten mit ACA dar. Flagellum ELISA ist von Bedeutung bei der wachsenden Routineserologie bei LB. Kommentierung Im Hinblick auf den Aspekt Serologie bei Lyme-Borreliose Stadium III ist also zu beachten, dass eine positive Serologie nur bei Patienten mit ACA regelmäßig nachweisbar war, während ohne diese Hautmanifestation Seronegativität häufig beschrieben wird. Es kann also nicht ausgeschlossen werden, dass Patienten mit ACA immunologisch anders reagieren, als Patienten mit Lyme-Borreliose Stadium III ohne ACA. In den oben genannten Publikationen über Seronegativität bei LymeBorreliose Stadium III wurde häufig der Krankheitserreger nachgewiesen. Da sowohl ACA als auch Erregernachweis als Beweis für die Lyme-Borreliose im Stadium III gelten, können folglich nur zwei Schlussfolgerungen resultieren: - Bei ACA Seropositivität - Bei Lyme-Borreliose Stadium III ohne ACA häufig Seronegativität Die Gleichsetzung von ACA und Lyme-Borreliose Stadium III ohne ACA lässt sich literarisch nicht belegen. In diesem Zusammenhang ist auch das Verhältnis eines länger dauernden Erythema migrans / Serologie von Bedeutung. Auch das Erythema migrans gilt als krankheitsbeweisend. In der Arbeit von Hansen und Asbrink (1989) war das EM von einem Monat oder länger jedoch nur in 50% der Fälle mit einem pathologischen Befund für IgG AK verbunden. Wilske B et al, 1993 (21) Die Publikation vergleicht Immunoblot / IFA bzw. ELISA. Immunoblot: Antigene: p100, Flagellin, internes Flagellin, OspA, OspC. Vergleich mit folgenden Suchtests: IFA-ABS Flagellin ELISA ELISA (OGP-ELISA) Die Publikation schließt 24 Patienten mit Lyme-Arthritis (Arthritis im Spätstadium) und 19 Patienten mit ACA ein. Bei all diesen Patienten waren IgG-ELISA und p100 (Immunoblot) positiv (vgl. Tab. 1). Tab. 1 Serologie bei ACA bzw. Lyme-Arthritis ACA: IgG ELISA 100% p100 100% OspA 11% OspC 21% 41/i 46% Arthritis: ELISA IgG 100% p100 100% p41 100% OspA 4% OspC 13% P31/i 46% Blutspener: IgG ELISA 5% p100 9% 24 Patienten mit Lyme-Arthritis, 19 Patienten mit ACA. Kommentierung Neben der Arbeit von Hansen, K, Asbrink, E (1989) (20) und Wilske et al (1993) (21) enthält die Literatur auch einige andere Publikationen, die eine Beurteilung der Serologie bei Lyme-Borreliose im Stadium III erlauben. In der Arbeit von Asch et al (22) waren die 4 Patienten mit intermittierender Arthritis alle seropositiv, dagegen bestand bei den übrigen 119 Patienten mit Lyme-Borreliose im Spätstadium Seronegativität in 69% der Fälle. In der Arbeit von TylewskaWierzbanowska und Chmielewski (4) wurden bei 11 Patienten mit Lyme-Arthritis nur in etwa 30% der Fälle spezifische Banden im Immunoblot IgG nachgewiesen. Hassler (23) fand bei der Lyme-Arthritis Seronegativität, allerdings war die Seropositivität bei Vorliegen einer Lyme-Arthritis achtmal größer (23). – Andererseits berichtet Hassler über 166 Patienten, die im Laufe von drei Jahren mindestens einmal eine Episode einer Lyme-Arthritis aufwiesen. Von diesen Patienten waren 95 seronegativ und 71 seropositiv. Dies entspricht 55% seronegativ und 45% seropositiv (vgl. 23). Fazit: Die Behauptung von Wilske et al (19), dass bei einer Lyme-Borreliose im Stadium III stets Seropositivität vorläge, stützt sich also ausschließlich auf die Arbeit von Hansen und Asbrink (20) und Wilske et al (21). 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