Patty Duke died of sepsis yesterday

March 30, 2016 

This is extra sad for me, because Patty Duke was my first celebrity crush. I was 10 years old at the time of her first season of The Patty Duke Show, in 1963. I was crazy for her, and her 'identical cousin', in every way! It was a brilliant and clever ruse that she played both main characters in the show. They were teen-aged cousins one of which was raised in England and the other in the US. The English one came to the States to live with her aunt and uncle's family. The two looked uncannily like twins but coming from different cultures they dressed differently, had different accents, and different mannerisms. It was one of the first TV shows (possibly the first) to use a split screen editing technique to have both characters be on a virtual stage so they could interact and appear to be talking to one another in real time. 

Well, I was crazy about her and she turned out to be a little crazy herself, but god bless her, she did good public service about her mental illness which was diagnosed as bipolar disorder. (Which, at the time was called "manic depression". She starred in a movie made for TV about her condition and she wrote a book with co-author Gloria Hochman called A Brilliant Madness, which broke down the complex nuances and everyday plights of dealing with a mood disorder. She also lobbied Congress for mental health research. [credit to Wikipedia for the last two sentences.] She also hit the big time in film as a child, playing Helen Keller in The Miracle Worker, along with Anne Bancroft. Patty received an Oscar for her performance, at the age of only 16.  See photo above. 

http://www.huffingtonpost.com/entry/patty-duke-mental-health_us_56fbfb62e4b0daf53aee3f5e

Patty Duke Died Of The Most Common Condition You've Never Heard Of

Sepsis, a reaction to infection that leads to systemic organ failure, kills more than 258,000 Americans every year, according to the U.S. Centers for Disease Control and Prevention, making it the ninth-leading cause of disease-related deaths in the country. While most people can fully recover from sepsis, some survivors are left with permanent organ damage or missing limbs due to amputation. 

Despite these alarming facts, less than half of Americans have even heard of sepsis, according to polls conducted by the Sepsis Alliance in partnership with official polling companies. In a 2015 online survey of 2,000 participants, only 47 percent of Americans were aware of sepsis. Meanwhile, 86 percent knew about Ebola and 76 percent knew about malaria -- two diseases that are much rarer in the United States.

People who have sepsis experience organ dysfunction caused by their body's overreaction to an initial infection, whether viral, bacterial or fungal. This overreaction is overwhelming for the body, and can lead to death. It's most common in people with compromised immune systems, like the very young, the very old and those with chronic diseases like AIDS, cancer, or diabetes. But people can also develop sepsis from a simple scrape, wound or burn that was not properly cleaned.

More about sepsis, what to look out for, and some more about Patty Duke.

http://www.cnn.com/2016/03/30/health/sepsis-causes-symptoms-treatment/index.html?eref=rss_topstories

It's VERY important information for anyone who is treating their Lyme disease (or cancer) by having a central line (Port, PICC, Hickman or other style) implanted in their body. I have had sepsis twice, and I know Lyme friends who have, too. I thought I was going to die the second time. A local LLMD (Lyme-literate MD) had sepsis recently and died from it because she didn't go the hospital soon enough.  

-Bob

Video: Steven Phillips on Lyme Disease

Dr. Steven Phillips on Lyme Disease

NY area Fox TV affiliate 

Good short interview 

http://www.fox5ny.com/news/104740644-video

Increasing evidence points to inflammation as source of nervous system manifestations of Lyme disease

From ScienceDaily

Summary:

About 15 percent of patients with Lyme disease develop peripheral and central nervous system involvement, often accompanied by debilitating and painful symptoms. New research indicates that inflammation plays a causal role in the array of neurologic changes associated with Lyme disease. The investigators also showed that the anti-inflammatory drug dexamethasone prevents many of these reactions.

Read the full article:
https://www.sciencedaily.com/releases/2015/04/150416084338.htm

Papers about cardiac issues and Lyme disease

Here is a bit of correspondence I bumped in to today between a couple of researchers and Lyme  disease specialists on the topic of cardiac problems that can result from Lyme infection.  -- Bob

Dear Dr. X,

I was looking up the paper you asked about and hit a gold mine of papers on the same subject which I have listed below.  I pulled these in 10 minutes and will search more thoroughly once I go through these papers with our think tank to see the etiology and supportive data.
So important for physicians to know regarding manifestations of lyme.
We are onto something !  Of course, I am going to zero in right into the membrane 
and see it from that perspective.

Warm regards,
PC Kane

PAPER 1
Pediatr Emerg Care. 2016 Mar 3. [Epub ahead of print]

Lyme Myocarditis Presenting as Chest Pain in an Adolescent Girl.

Fishe JN1, Marchese RF, Callahan JM.

PAPER 2
Clin Res Cardiol. 2010 Aug;99(8):519-26. doi: 10.1007/s00392-010-0152-8. Epub 2010 May 13.

Complete AV block in Lyme carditis: an important differential diagnosis.

Semmler D1, Blank R, Rupprecht H.

PAPER 3
Infect Dis Clin North Am. 2015 Jun;29(2):255-68. doi: 10.1016/j.idc.2015.02.003.

Lyme carditis.

Robinson ML1, Kobayashi T2, Higgins Y2, Calkins H3, Melia MT4.

PAPER 4
J R Coll Physicians Edinb. 2010 Jun;40(2):121-2. doi: 10.4997/JRCPE.2010.207.

Lyme carditis: a reversible cause of complete atrioventricular block.

Bhattacharya IS1, Dweck M, Francis M.

PAPER 5
Ann Intern Med. 1989 Mar 1;110(5):339-45.

Lyme carditis: an important cause of reversible heart block.

McAlister HF1, Klementowicz PT, Andrews C, Fisher JD, Feld M, Furman S.

PAPER 6
Hellenic J Cardiol. 2006 Sep-Oct;47(5):313-6.

Lyme carditis: complete atrioventricular dissociation with need for temporary pacing.

Xanthos T1, Lelovas P, Kantsos H, Dontas I, Perrea D, Kouskouni E.

PAPER 7
J Emerg Med. 1999 Jul-Aug;17(4):661-4.

Lyme carditis: complete AV dissociation with episodic asystole presenting as syncope in the emergency department.

Rosenfeld ME1, Beckerman B, Ward MF, Sama A.

PAPER 8
Scott Med J. 2013 May;58(2):e13-7. doi: 10.1177/0036933013482661.

A young healthy male with syncope and complete heart block.

Chauhan V1, Chauhan N, Chauhan CG, Vaid M.

PAPER 9
Cardiology. 1996 Jan-Feb;87(1):76-8.

Common form of Lyme borreliosis carditis--complete heart block with syncope: report on 3 cases.

Vasiljević Z1, Dmitrović R, Naumović Z, Ostojić M, Radosavljević M, Karadzić A, Prostran M, Colić M.

PAPER 10
Int J Cardiol. 2009 Oct 2;137(2):167-71. doi: 10.1016/j.ijcard.2008.05.028. Epub 2008 Aug 5.

Lyme carditis: sequential electrocardiographic changes in response to antibiotic therapy.

Manzoor K, Aftab W, Choksi S, Khan IA.

PAPER 11
Can J Cardiol. 1996 May;12(5):503-6.

Cardiac manifestations of Lyme disease: a review.

Nagi KS1, Joshi R, Thakur RK.

PAPER 12
Int J Cardiol. 2008 Sep 16;129(1):15-21. doi: 10.1016/j.ijcard.2008.01.044. Epub 2008 May 27.

Cardiac implications of Lyme disease, diagnosis and therapeutic approach.

Lelovas P1, Dontas I, Bassiakou E, Xanthos T.

Lyme Study - American Academy of Dermatology 74th Annual Meeting

Study: Early Lyme disease diagnosis difficult, treatment improvements needed

An early diagnosis of Lyme disease can help prevent systemic disease involvement, but currently available diagnostic tests are not sensitive, according to recently presented research. The findings also noted treatment regimens may not prevent long-term complications for many patients, and insurance coverage for treatment may be hindered by diagnostic and treatment shortcomings.

According to research from investigators at Drexel University College of Medicine, patients may present with erythema migrans in 60% to 80% of cases, and CDC-recommended ELISA and immunoblot staining may only confirm the presence of Lyme disease in 29% to 40% of cases. Long-term sequelae for 6 years may be present in 34% of patients, despite following a recommended course of treatment. Furthermore, Borrelial spirochetes may comprise up to 25% of the organisms in brains of patients with Alzheimer's disease, and the presence of DNA of the organisms has been confirmed in the synovial tissues of patients with Lyme disease-associated arthritis. Skin cultures have a 49% sensitivity, while investigators noted polymerase chain reaction DNA tests for Borrelial and immunoglobulins have variable reliability.

Treatment with doxycycline has resulted in the persistence of organisms in some individuals, and the development of vaccines has been limited due to false signaling produced by the organisms. The persistence of the organisms may be related to biofilms present in arthritic joints. Long-term complications may affect the heart, skin, joints, nervous system and eyes. – by Shirley Pulawski

Reference:

Allen Herbert, et al. Paper #3273. Presented at: American Academy of Dermatology 74th Annual Meeting; March 4-8, 2016; Washington, D.C.

____________________________________________

Eradication of Biofilm-like Microcolony Structures of Bb by Daunomycin and Daptomycin

Eradication of Biofilm-like Microcolony Structures of Borrelia burgdorferi by Daunomycin and Daptomycin but not Mitomycin C in Combination with Doxycycline and Cefuroxime
Feng Jie, Weitner Megan, Shi Wanliang, Zhang Shuo, Zhang Ying
Frontiers in Microbiology, online first, February 10, 2016.

http://doi.org/10.3389/fmicb.2016.00062


Abstract

Lyme disease, caused by Borrelia burgdorferi, is the most common vector-borne disease in the United States and Europe. While the majority of Lyme disease patients can resolve their symptoms if treated promptly, 10–20% of patients suffer from prolonged symptoms called post-treatment Lyme disease syndrome (PTLDS). 

Although the cause for PTLDS is unclear, one possibility is the presence of bacterial persisters not effectively cleared by the current Lyme antibiotics. Recent studies identified several drug candidates including daptomycin, daunomycin, doxorubicin, and mitomycin C that had good activity against B. burgdorferi persisters. However, their relative activities against B. burgdorferi persisters have not been evaluated under the same conditions. In this study, we tested the anti-persister activities of these drugs against both 7-day and 15-day old stationary phase cultures of B. burgdorferi individually as well as in combination with Lyme antibiotics doxycycline and cefuroxime (Ceftin). 

Our findings demonstrate daunomycin and daptomycin were more active than mitomycin C in single drug comparison at 10 and 20 μM, as well as in drug combinations with doxycycline and cefuroxime. In addition, daunomycin was more active than doxorubicin which correlated with their ability to stain and accumulate in B. burgdorferi. The two drug combination of doxycycline and cefuroxime was unable to eradicate biofilm-like microcolonies of B. burgdorferi persisters. However, the addition of either daunomycin or daptomycin to the doxycycline + cefuroxime combination completely eradicated the biofilm-like structures and produced no visible bacterial regrowth after 7 and 21 days, while the addition of doxorubicin was unable to prevent regrowth at either 7 or 21 day subculture. 

Mitomycin C in combination with doxycycline and cefuroxime caused no regrowth at 7 days but visible spirochetal regrowth occurred after 21 day subculture. Furthermore, we found that cefuroxime (Ceftin), the third commonly used and most active antibiotic to treat Lyme disease, could replace cefoperazone (a drug no longer available in the US) in the daptomycin + doxycycline combination with complete eradication of the biofilm-like structures as shown by lack of any regrowth in subcultures. 

Our findings may have implications for improved treatment of Lyme disease.

Free, full text: http://doi.org/10.3389/fmicb.2016.00062

Borrelia found in dogs before people

Found by Dr. Lynn Shepler: There was a veterinarian publishing on Borrelia in dogs before Allen Steere/Burgdorfer's report. (See p. 19 of the document linked below) At "CDC Stacks" you will find documents that you will find in no other place (http://stacks.cdc.gov/).

STEELE BORRELIA DOGS PRE STEERE CDC.pdf