Lyme treatment guidelines

The Center for Disease Control (http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_treatment.htm) links to this article for the lyme treatment guidelines of the Infections Disease Society of America:
http://www.journals.uchicago.edu/doi/full/10.1086/508667

In response to some ongoing discussion about antibiotic regimes for Lyme, I thought I'd pull up a few quotes from the above document:
From section on Early Lyme Disease (not directly relevant):
( Read more... )

From section on Late Lyme Disease (that's me!):

Lyme arthritis. Lyme arthritis can usually be treated successfully
with antimicrobial agents administered orally. Doxycycline
(100 mg twice per day) (B-I), amoxicillin (500 mg 3
times per day) (B-I), or cefuroxime axetil (500 mg twice per
day) (B-III) for 28 days is recommended for adult patients
without clinical evidence of neurologic disease. For children,
amoxicillin (50 mg/kg per day in 3 divided doses [maximum
of 500 mg per dose]) (B-I), cefuroxime axetil (30 mg/kg per
day in 2 divided doses [maximum of 500 mg per dose]) (BIII),
or, if the patient is >=8 years of age, doxycycline (4 mg/
kg per day in 2 divided doses [maximum of 100 mg per dose])
(B-I) is recommended. Oral antibiotics are easier to administer
than intravenous antibiotics, are associated with fewer serious
complications, and are considerably less expensive. However,
it is important to recognize that a small number of patients
treated with oral agents have subsequently manifested overt
neuroborreliosis, which may require intravenous therapy with
a b-lactam antibiotic (see the paragraph below) for successful
resolution. Further controlled trials are needed to compare the
safety and efficacy of oral versus intravenous therapy for Lyme
arthritis.

...

For patients who have persistent or recurrent joint swelling
after a recommended course of oral antibiotic therapy, we recommend
re-treatment with another 4-week course of oral antibiotics
or with a 2–4-week course of ceftriaxone IV (B-III)
(for dosages of oral agents, see the recommendations above for
treatment of erythema migrans, and for dosages of parenteral
agents, see the recommendations above for treatment of Lyme
meningitis). A second 4-week course of oral antibiotic therapy
is favored by panel members for the patient whose arthritis has
substantively improved but has not yet completely resolved,
reserving intravenous antibiotic therapy for those patients
whose arthritis failed to improve at all or worsened. Clinicians
should consider waiting several months before initiating retreatment
with antimicrobial agents because of the anticipated
slow resolution of inflammation after treatment. If patients
have no resolution of arthritis despite intravenous therapy and
if PCR results for a sample of synovial fluid (and synovial tissue
if available) are negative, symptomatic treatment is recommended
(B-III). Symptomatic therapy might consist of nonsteroidal
anti-inflammatory agents, intra-articular injections of
corticosteroids, or disease-modifying antirheumatic drugs
(DMARDs), such as hydroxychloroquine; expert consultation
with a rheumatologist is recommended. If persistent synovitis
is associated with significant pain or limitation of function,
arthroscopic synovectomy may reduce the duration of joint
inflammation (B-II). [Bold face emphasis added.]

oh... academia

http://proflikesubstance.blogspot.com/2010/07/job-data-in-ecology-and-evolution.html (thanks to JK for the link)

Quote:

The Morris paper, entitled "Life History and Multi-level Selection in Academe" is at least worth a read for such gems as:

Euphemisms called “labs” coexist in structured universal aggregations where they compete with one another for scarce resources. Labs cooperate to produce copious numbers of zygotes, most of which disperse synchronously each year. The strongest find their way into the protective brood pouches of crusty adults who shed soft-shelled offspring at regular intervals (slowly developing zygotes die by the incompletely understood process of academic apoptosis). Juveniles develop a hard external carapace by intermittently joining and extracting themselves from other labs. The hardened but vulnerable sub-adults then join a common pool where they compete for space and position on rapidly eroding substrate in the universal aggregation. Many become dormant and fail to contribute to the gene (meme) pool. Some return to the lab as brood-rearing helpers. Few survive the rampant competition and frenzied cannibalism in the pool. Not all of the survivors are safe on the fragile substrate. A second apoptosis-like event eliminates the weak and meek. Only the most persistent or aggressive remain.