What has Allen Steere said in published articles regarding Lyme disease? ************************************************************************ as of 28 October 1999 As sole author: 13 citations, 6 have "NO ABSTRACT AVAILABLE". TITLE: Diagnosis and treatment of Lyme arthritis. AUTHORS: Steere AC AUTHOR AFFILIATION: GRANT/CONTRACT ID: AR-20358/AR/NIAMS U50/CCU 11291 ABSTRACT: Lyme arthritis typically causes intermittent attacks of oligoarticular arthritis in a few large joints, especially the knee. A small percentage of patients may develop chronic arthritis, again affecting primarily the knee. The diagnosis is usually based on the presence of this characteristic clinical picture, exposure in an endemic area, and a positive IgG antibody response to B. burgdorferi determined by ELISA and Western blotting. In addition, spirochetal DNA can often be detected in joint fluid by PCR. Joint involvement in this infection can usually be treated successfully with a 1- or 2-month course of oral doxycycline or amoxicillin, but patients with certain genetic and immune markers may have persistent arthritis despite treatment with oral or intravenous antibiotics. If patients have persistent arthritis despite a second course of antibiotics and if the results of PCR testing are negative, the author treats such patients with anti- inflammatory agents or arthroscopic synovectomy. NLM PUBMED CIT. ID: 9012760 NLM CIT. ID: 97164998 SOURCE: Med Clin North Am 1997 Jan;81(1):179-94 Department of Medicine, Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, USA. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9012760&form=6&db=m&Dopt=b TITLE: Treatment of chronic Lyme disease [letter; comment] AUTHORS: Steere AC COMMENTS: Comment on: Science 1995 Oct 13;270(5234):228-9 Comment on: Science 1995 Dec 1;270(5241):1419 NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 8638094 NLM CIT. ID: 96239613 SOURCE: Science 1996 Mar 1;271(5253):1216-8 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8638094&form=6&db=m&Dopt=b TITLE: Musculoskeletal manifestations of Lyme disease. AUTHORS: Steere AC AUTHOR AFFILIATION: Division of Rheumatology/Immunology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111, USA. GRANT/CONTRACT ID: AR-20358/AR/NIAMS ABSTRACT: Musculoskeletal involvement, particularly arthritis, is a common feature of Lyme disease. Early in the illness, patients may experience migratory musculoskeletal pain in joints, bursae, tendons, muscle, or bone in one or a few locations at a time, frequently lasting only hours or days in a given location. Weeks to months later, after the development of a marked cellular and humoral immune response to the spirochete, untreated patients often have intermittent or chronic monoarticular or oligoarticular arthritis-primarily in large joints, especially the knee-during a period of several years. The diagnosis of Lyme arthritis is usually based on the presence of this characteristic clinical picture, exposure in an endemic area, and an elevated immunoglobulin G antibody response to Borrelia burgdorferi. In addition, spirochetal DNA can often be detected in joint fluid by polymerase chain reaction. Lyme arthritis can usually be treated successfully with 1-month courses of oral doxycycline or amoxicillin or with 2- to 4-week courses of intravenous ceftriaxone. However, patients with certain genetic and immune markers may have persistent arthritis, despite treatment with oral or intravenous antibiotics. B. burgdorferi may occasionally trigger fibromyalgia, a chronic pain syndrome with diffuse joint and muscle symptoms. This syndrome does not appear to respond to antibiotic therapy. NLM PUBMED CIT. ID: 7726191 NLM CIT. ID: 95243253 SOURCE: Am J Med 1995 Apr 24;98(4A):44S-48S; discussion 48S-51S http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=7726191&form=6&db=m&Dopt=b TITLE: [Lyme arthritis: the joint lesions in Lyme borreliosis in the USA] VERNACULAR TITLE: Laim-artrit: porazheniia sustavov pri Laim-borrelioze v SShA. AUTHORS: Steere AC ABSTRACT: Of 55 untreated patients with erythema migrans only 20% were free of follow-up manifestations of Lyme's disease. The rest exhibited episodes of articular, periarticular or musculoskeletal pains (18%), one or more episodes of arthritis (51%) or chronic arthritis (11%). Lyme's arthritis arises due to invasion of Borrelia burgdorferi into articular tissues. This became evident after detection of borrelian DNA in the synovia. The study of different cytokine concentrations in the synovial fluid in 83 patients with Lyme's arthritis showed that chronicity of arthritis depends on IL-1b and IL-1ra balance. As indicated by examination of 80 patients with Lyme's arthritis chronic persistence of articular syndrome in 57% was associated with HLA-DR4, in 43% with HLA- DR2. Lyme's arthritis requires long-term treatment. In its failure arthroscopic synovectomy is indicated. NLM PUBMED CIT. ID: 8571250 NLM CIT. ID: 96151294 SOURCE: Ter Arkh 1995;67(11):43-5 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8571250&form=6&db=m&Dopt=b TITLE: Lyme disease: a growing threat to urban populations. AUTHORS: Steere AC AUTHOR AFFILIATION: Division of Rheumatology/Immunology, Tufts University School of Medicine, New England Medical Center, Boston, MA 02111. GRANT/CONTRACT ID: AR-20358/AR/NIAMS ABSTRACT: Lyme disease or Lyme borreliosis, which is caused by three groups of the spirochete Borrelia burgdorferi, is transmitted in North America, Europe, and Asia by ticks of the Ixodes ricinus complex. The primary areas around the world that are now affected by Lyme disease are near the terminal moraine of the glaciers 15,000 years ago. The emergence of Lyme disease in the United States in this century is thought to have occurred because of ecological conditions favorable for deer. From 1982 through 1991, 40,195 cases occurring in 47 states were reported to the Centers for Disease Control, but enzootic cycles of B. burgdorferi have been identified in only 19 states. During the last several decades, the disease has spread to new areas and has caused focal outbreaks, including locations near Boston, New York, and Philadelphia. Lyme disease is like syphilis in its multisystem involvement, occurrence in stages, and mimicry of other diseases. Diagnosis of late neurologic abnormalities of the disorder has created the most difficulty. A recent phenomenon is that a number of poorly understood conditions, such as chronic fatigue syndrome or fibromyalgia, are misdiagnosed as "chronic Lyme disease." Part of the reason for misdiagnosis is due to problems associated with diagnostic tests. The various manifestations of Lyme disease can usually be treated successfully with oral doxycycline or amoxicillin, except for objective neurologic manifestations, which seem to require intravenous therapy. Vector control of thick-borne diseases has been difficult and, therefore, reduction of the risk of infection has been limited primarily to personal protection measures. NLM PUBMED CIT. ID: 8146126 NLM CIT. ID: 94195749 SOURCE: Proc Natl Acad Sci U S A 1994 Mar 29;91(7):2378-83 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8146126&form=6&db=m&Dopt=b TITLE: Lyme disease--1993. AUTHORS: Steere AC AUTHOR AFFILIATION: Division of Rheumatology/Immunology, New England Medical Center, Tufts University School of Medicine, Boston, MA. NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 8004219 NLM CIT. ID: 94272623 SOURCE: Bull Rheum Dis 1993 Oct;42(6):4-7 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8004219&form=6&db=m&Dopt=b TITLE: Seronegative Lyme disease. AUTHORS: Steere AC AUTHOR AFFILIATION: New England Medical Center, Tufts University School of Medicine, Boston. NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 8360974 NLM CIT. ID: 93367890 SOURCE: JAMA 1993 Sep 15;270(11):1369 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8360974&form=6&db=m&Dopt=b TITLE: Current understanding of Lyme disease. AUTHORS: Steere AC AUTHOR AFFILIATION: Tufts University School of Medicine, Boston. PUBLICATION TYPES: ABSTRACT: It is now the most common vector-borne disease in the United States. But because of misdiagnosis, the spread of this disease may also be more apparent than real. Lack of standardized serologic tests and varying clinical presentations do create confusion. Nevertheless, it is possible to distinguish Lyme disease from look-alike disorders, such as chronic fatigue syndrome and fibromyalgia. NLM PUBMED CIT. ID: 8463365 NLM CIT. ID: 93216872 SOURCE: Hosp Pract (Off Ed) 1993 Apr 15;28(4):37-44 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8463365&form=6&db=m&Dopt=b TITLE: Lyme disease. AUTHORS: Steere AC AUTHOR AFFILIATION: Tufts University School of Medicine. NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 8337773 NLM CIT. ID: 93331638 SOURCE: Trans Am Acad Insur Med Annu Meet 1993;76:73-81 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=8337773&form=6&db=m&Dopt=b TITLE: Clinical definitions and differential diagnosis of Lyme arthritis. AUTHORS: Steere AC AUTHOR AFFILIATION: Department of Rheumatology/Immunology, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111. GRANT/CONTRACT ID: AR-20358/AR/NIAMS AR-40576/AR/NIAMS ABSTRACT: Joint symptoms associated with B. burgdorferi infection range from arthralgias, to brief attacks of arthritis, to chronic erosive synovitis. From 2 weeks to 2 years after the onset of disease, commonly following migratory arthralgias, about 60% of untreated patients with Lyme disease in the United States develop brief attacks of oligoarticular arthritis, primarily in large joints, especially the knee. Episodes of arthritis often become longer during the second or third years of illness, lasting months rather than weeks, and in about 10% of patients, chronic arthritis begins during this period. Chronic Lyme arthritis appears to have an immunogentic basis. Of 28 patients with chronic arthritis, 25 (89%) had the HLA-DR4 or -DR2 specificities compared with only 6 of 22 patients (27%) with arthritis of short duration (P = 0.00006). In adults, Lyme arthritis is most like Reiter's syndrome or reactive arthritis, and in children, it is most similar to the pauciarticular form of juvenile rheumatoid arthritis. NLM PUBMED CIT. ID: 1947812 NLM CIT. ID: 92054275 SOURCE: Scand J Infect Dis Suppl 1991;77:51-4 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=1947812&form=6&db=m&Dopt=b TITLE: Lyme disease [see comments] AUTHORS: Steere AC AUTHOR AFFILIATION: Division of Rheumatology/Immunology, Tufts University School of Medicine, New England Medical Center, Boston, MA 02111. COMMENTS: Comment in: N Engl J Med 1990 Feb 15;322(7):474-5 GRANT/CONTRACT ID: AM-20358/AM/NIADDK ABSTRACT: Within the last decade, Lyme borreliosis has emerged as a complex new infection whose distribution is worldwide. The disorder is caused by a recently recognized spirochete, B. burgdorferi, transmitted by ticks of the I. ricinus complex. Certain species of mice are critical in the life cycle of the spirochete, and deer appear to be crucial to the tick. Although the disorder's basic outlines are similar everywhere, there are regional variations in the causative spirochete, animal hosts, and clinical manifestations of the illness. In the United States, Lyme disease commonly begins in summer with a characteristic skin lesion, erythema migrans, accompanied by flu-like or meningitis- like symptoms. Weeks or months later, the patients may have neurologic or cardiac abnormalities, migratory musculoskeletal pain, or arthritis, and more than a year after onset, some patients have chronic joint, skin, or neurologic abnormalities. After the first several weeks of infection, almost all patients have a positive antibody response to the spirochete, and serologic determinations are currently the most practical laboratory aid in diagnosis. Treatment with appropriate antibiotics is usually curative, but longer courses of therapy are often needed later in the illness, and some patients may not respond. NLM PUBMED CIT. ID: 2668764 NLM CIT. ID: 89344179 SOURCE: N Engl J Med 1989 Aug 31;321(9):586-96 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=2668764&form=6&db=m&Dopt=b TITLE: Pathogenesis of Lyme arthritis. Implications for rheumatic disease. AUTHORS: Steere AC AUTHOR AFFILIATION: Division of Rheumatology/Immunology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts 02111. GRANT/CONTRACT ID: AR-20358/AR/NIAMS NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 3056205 NLM CIT. ID: 89048816 SOURCE: Ann N Y Acad Sci 1988;539:87-92 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3056205&form=6&db=m&Dopt=b TITLE: [Lyme disease--a tick-transmitted spirochete infection] VERNACULAR TITLE: Laimovskaia bolezn'--spirokhetoznaia infektsiia, perenosimaia kleshchami. AUTHORS: Steere AC NO ABSTRACT AVAILABLE. NLM PUBMED CIT. ID: 3590002 NLM CIT. ID: 87235038 SOURCE: Ter Arkh 1987;59(4):32-4 http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=3590002&form=6&db=m&Dopt=b ----- Compiled by Art Doherty Lompoc, California doherty@utech.net