Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HOSPITALS, CONVALESCENT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,567 records · Page 87Linked to original sources
PubMed2004

[A case of Q fever infection causing acute exacerbation of chronic respiratory failure].

The authors report a case of Q fever infection that caused acute exacerbation of chronic respiratory failure, which had developed as a sequela of pulmonary tuberculosis. This case was found on wide-ranging serological screening for respiratory infection performed in order to investigate the prevalence of Q fever in Japan. A 73-year-old man who had been treated for hypertension and sequelae of pulmonary tuberculosis was admitted to our hospital because of fever, productive cough, and dyspnea on effort. Hypoxia and right heart failure were detected on arterial blood analysis and ultrasonography. The acute exacerbation was triggered by respiratory infection and although the infection improved on azithromycin treatment after admission, respiratory failure continued for the period of admission. Home oxygen therapy was required for the management of chronic respiratory failure on discharge. Paired serum samples were tested for antibodies against Coxiella burnetii by indirect immunofluorescence, showing an elevated antibody titer in the convalescent phase. We believe that Q fever infection caused acute exacerbation of chronic respiratory failure, and that C. burnetii is an agent that might influence the clinical course of chronic respiratory failure.

Acute Disease↗
PubMed2006

[Human anaplasmosis (ehrlichiosis)].

OBJECTIVE: The north part of Croatia, especially the Koprivnica-Krizevci County is a well known endemic area of several tick-transmitted diseases including tick-borne encephalitis, Lyme borreliosis and tularemia. Each summer numerous patients develop a nonspecific febrile illness after tick bite, etiology of which is sometimes never established. PURPOSE OF WORK: The aim of this prospective study was to determine whether the infection with Anaplasma phagocytophilum was associated with febrile illnesses occurring after tick bite. The epidemiological, clinical and laboratory characteristics, and diagnostic procedures in patients suffering from confirmed and probable anaplasmosis are presented. PATIENTS AND METHODS: A prospective study to assess the potential ehrlichial etiology of febrile illnesses after tick bite was conducted at the Department of Infectious Disease, General Hospital, Koprivnica, Croatia, during the period from January 1998 to August 2004. The study included patients of all age groups with acute febrile illness (temperature higher than 38 degrees C) manifesting within 30 days of a tick bite, in whom a recent infection with Anaplasma phagocytophilum was established serologically by seroconversion or at least 4-fold increase in antibody titer to anaplasma antigen (defined as confirmed cases of anaplasmosis), or by the presence of positive IFA titer > or = 1: 256 in acute and convalescent phase serum samples without demonstrating a 4-fold titer change (defined as probable cases of anaplasmosis), and with no alternative explanation for the acute febrile illness. Thorough medical histories were collected, physical examinations performed, and several laboratory tests carried out. Giemsa-stained peripheral blood smears were examined by high microscopy for the presence of ehrlichial morulae within leukocytes. Acute and convalescent phase serum samples were tested by use of an indirect immunofluorescence assay (IFA) for the presence of specific IgG antibodies to Anaplasma phagocytophilum antigen. At the same time all serum samples were tested for other tick borne agents including tick-borne encephalitis virus, Borrelia burgdorferi sensu lato and Ehrlichia chaffeensis. Serological tests were performed at the Institute of Microbiology and Immunology, School of Medicine, University of Ljubljana, Ljubljana, Slovenia. Oral consent was obtained from all patients enrolled in the study. RESULTS: Of 132 patients included in the study during the 7-year period, eight (6%) patients were diagnosed with anaplasmosis, without any additional diagnosis, and were included in the analysis. Three patients fulfilled the case definition criteria for confirmed anaplasmosis, while five had probable anaplasmosis (three men and five women aged 17-43). Clinically, the disease presented as a nonspecific, flu-like febrile illness with leukopenia, thrombocytopenia and moderately elevated aminotransferases. Intracytoplasmic morulae were not seen in leukocytes in blood smears. Specific antimicrobial therapy was administered in four patients. All patients recovered rapidly and no long-term consequences were found during the one-year follow-up. CONCLUSION: We report on the first patients meeting the case definition criteria for confirmed and probable anaplasmosis. The frequency and new concepts in the disease were analyzed.

Adolescent↗
PubMedDate not supplied

[Geriatric digestive surgery. An analysis of 163 cases].

The aim of our study is to analyze the clinical features and outcome of digestive surgery in the aged. From Jan. 1979 to Dec. 1981, 1,389 operations under general anesthesia were performed on patients 75 years old and more. From this group, 163 patients (111 females and 52 males, mean age: 79 +/- 0.7 years) underwent surgery of the alimentary tract. The procedures were divided in: colorectal (48%), biliary (32%), gastric (10%), small bowel (6%), esophagus (1%) and others (3%). An operation for cancer was performed in 63 patients: palliative (69%), curative (31%). The mean length of hospital stay is 23 days (pre-op 7 days, post-op 16 days). Only 16% of the patients needed intensive care. Postoperative complications occurred in 43 patients (26%); cardiovascular (47%), psychiatric (26%), pulmonary (23%) and others (4%). The overall mortality rate is 10%: 6% for elective cases and 24% for urgent cases (49 patients). The mortality is related to: sepsis and peritonitis (53%), cardiopulmonary disease (23%), hemorrhage (12%), cachexia (12%). At discharge, 62% of the patients returned home directly, 18% to convalescent homes, 10% to unknown places and 10% in nursing homes. Our data supports the benefit of surgery in the aged.

Aged↗
PubMed2002

Technical considerations and pitfalls in laparoscopic live donornephrectomy.

BACKGROUND: Recent developments in laparoscopic solid organ surgery suggest a possible reduction in postoperative discomfort and disability for kidney donors. Technical aspects and the influence of surgical experience in laparoscopic donor nephrectomy were evaluated. METHODS: The clinical outcome of 57 laparoscopic donor nephrectomies (LapNx) was compared with that for a historic control group of 27 open donor nephrectomies (OpenNx). RESULTS: Three conversions to open nephrectomy (5.2%) were necessary. Postoperative complications were minor and comparable in both groups. Patients who underwent laparoscopic surgery demonstrated significantly less postoperative pain and a shorter hospital stay, but operative time and warm ischemia time were significantly longer. Graft survival after LapNx was 100% during a median follow-up period of 13 months. Operative time for LapNx decreased considerably with experience gained and seemed to be less for right nephrectomy. Stenotic ureter-bladder anastomoses occurred after LapNx in four patients during the first half year (7.0%), but this problem seemed to be resolved after modification of the technique. CONCLUSION: LapNx is associated with less postoperative discomfort and improved convalescence.

Case-Control Studies↗
PubMed1994

Fast-track recovery of the coronary bypass patient.

A new approach termed "fast-track recovery" ws undertaken at both the Baystate Medical Center and Hartford Hospital. The fast-track protocol involves the following principles: (1) preoperative education; (2) early extubation; (3) methylprednisolone sodium succinate before bypass followed by dexamethasone for 24 hours postoperatively; (4) prophylactic digitalization, metoclopramide HCl, docusate sodium, and ranitidine HCl; (5) accelerated rehabilitation; (6) early discharge; (7) a dedicated fast-track coordinator to perform both daily telephone contact and a 1-week postoperative examination; and (8) a routine 1-month postoperative visit with a PA or MD. To evaluate the effects of this approach on patient care, a retrospective 1-year analysis was undertaken in both institutions with all coronary artery bypass grafting patients compared in a consecutive manner before the origin of the fast-track protocol and subsequent to its beginning. There were 280 patients in the fast-track and 282 in the non-fast-track group. The two groups were not significantly different except inexplicably there was a lower ejection fraction in the fast-track group and a longer cross-clamp time. Postoperatively, the mean time to extubation decreased from 22.1 to 15.4 hours, and peak weight gain decreased from 2.8 to 1.6 kg from the non-fast-track to the fast-track group (p < 0.01). This was accompanied by significant (p < 0.001) decreases in intensive care unit duration from 2.4 to 1.9 days and in postoperative length of stay from 8.3 to 6.8 days from the non-fast-track to the fast-track group. There was no increase in morbidity or mortality associated with the fast-track protocol either early or late. Thirty-day hospital readmission was not significantly different between the two groups. Fast-track methodology is effective, and we routinely employ this approach for all patients undergoing cardiopulmonary bypass.

Aged↗
PubMed1978

Nutritional status of patients undergoing valve replacement by open heart surgery.

In 10 patients undergoing heart-valve replacement with cardiopulmonary bypass total-body potassium was measured non-invasively with a whole-body monitor, and this measurement was used to derive the lean body mass as an index of the nutritional status. From measurements made before operation and on the 7th postoperative day, the metabolic response to surgery was found to be equivalent to a negative nitrogen balance of 10.8 g of nitrogen a day (50% greater than that calculated from conventional nitrogen-balance studies). 4 patients had a mean preoperative potassium depletion of 17.2%, and this was associated with increased morbidity. Well-nourished patients had a mean postoperative hospital stay of 16 days, whereas those in a depleted state before operation had an increased morbidity, as measured by their mean postoperative stay of 30 days. More attention needs to be given to the preoperative nutritional status of patients undergoing heart-valve replacement.

Cardiopulmonary Bypass↗
PubMed1979

Cell-free and cell-bound antibody in nasal secretions from infants with respiratory syncytial virus infection.

Twenty-two infants under 9 months of age hospitalized with bronchiolitis or pneumonia due to respiratory syncytial virus (RSV) were serially sampled to determine the pattern of secretory antibody response. Using double labeling techniques, we found several types of immunoglobulin in secretions: cell-free antibody to RSV of the immunoglobulin A (IgA), immunoglobulin G (IgG), and immunoglobulin M (IgM) classes; and immunoglobulins of all three classes bound to RSV-infected cells shed from the nasal epithelium (presumably cell-bound antibody to RSV). IgA attached to RSV-infected epithelial cells was almost always detected in the first available nasal sample (day 1 or 2 of hospitalization). In contrast, cell-free anti-RSV IgA first appeared an average of 3.5 days later at a time when virus antigen was disappearing from the secretion. IgG and IgM attached to RSV-infected cells appeared more irregularly. The titer of cell-free anti-RSV IgM was often higher than that of IgA early in the illness and declined as the infection resolved. Cell-free anti-RSV IgG was usually present earlier than IgA and rose during convalescence.

Antibodies, Viral↗
PubMed1998

Urinary tract injuries after hysterectomy.

OBJECTIVE: To evaluate the nationwide incidence and characteristics of urinary tract injuries after laparoscopic hysterectomy, total abdominal hysterectomy, supracervical abdominal hysterectomy, and vaginal hysterectomy. METHODS: We analyzed retrospectively 142 urinary tract injuries after hysterectomy, reported to the National Patient Insurance Association in Finland from 1990 through 1995. The Finnish Hospital Discharge Register collects data on procedures from all hospitals, and 62,379 hysterectomies were carried out during the study period. RESULTS: The total incidence of ureteral injury after all hysterectomies was 1.0 of 1000 procedures: 13.9 of 1000 after laparoscopic, 0.4 of 1000 after total abdominal, 0.3 of 1000 after supracervical abdominal, and 0.2 of 1000 after vaginal hysterectomy. Difficulties during an operation with a ureteral injury were encountered in 51%, 76%, 100%, and 100%; the failure rates of primary repair of a ureteral injury were 5%, 12%, 0%, and 0%; and the convalescence times after a ureteral injury were 86 days, 94 days, 71 days, and 47 days after laparoscopic, abdominal, supracervical abdominal, and vaginal hysterectomies, respectively. The incidence of bladder injury was 1.3 of 1000 procedures. Sixty-five percent of reported bladder injuries were fistulas, giving an incidence of vesicovaginal fistula of 0.8 of 1000 procedures after all hysterectomies: 2.2 of 1000 after laparoscopic, 1.0 of 1000 after total abdominal, 0 of 1000 after supracervical abdominal, and 0.2 of 1000 after vaginal hysterectomy. Difficulties during an operation with a bladder injury were encountered in 53%, 37%, 100%, and 0%; the failure rates of primary repair of a simple bladder injury were 5%, 18%, 0%, and 0%; the failure rates of primary repair of a vesicovaginal fistula were 17%, 20%, 0%, and 0%; and the convalescence times after a bladder injury were 51 days, 118 days, 71 days, and 99 days after laparoscopic, abdominal, supracervical abdominal, and vaginal hysterectomy, respectively. CONCLUSION: The risk of ureteral injury is higher after laparoscopic hysterectomy compared with traditional hysterectomies.

Female↗
PubMed2005

Disparities between black and white patients in functional improvement after hospitalization for an acute illness.

The aim of this study was to determine whether older black and white patients experience different rates of improvement in functioning after being acutely hospitalized. Of the 2,364 community-living patients in this prospective cohort study, 25% self-reported their race/ethnicity to be black. The outcomes were improvement in basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) from admission to discharge and 90 days postdischarge. Multivariable models that included statistical adjustment for age, illness severity, in-hospital social service referral, dementia, admission level of functioning, and change in functioning from 2 weeks before admission were computed to determine whether black and white patients experienced significantly different rates of recovery at discharge and 90 days after discharge in ADL and IADL functioning. Black patients were as likely as white patients to improve in ADL functioning by discharge (odds ratio (OR)=0.97, 95% confidence interval (CI)=0.76-1.24) or by 90 days after discharge (OR=0.95, 95% CI=0.73-1.24) but significantly less likely to improve IADL functioning by discharge (OR=0.72, 95% CI=0.56-0.93) or by 90 days after discharge (OR=0.68, 95% CI=0.51-0.90). The findings suggest that differential rates of recovery in functioning after an acute hospitalization may contribute to racial/ethnic disparities in IADL functioning, which has implications for the setting of future interventions oriented toward reducing these disparities.

Activities of Daily Living↗
PubMed1997

[The effect of the tempi of rehabilitation on the psychological status and quality of life in myocardial infarct patients].

104 patients 3 to 12 months after myocardial infarction were evaluated psychologically and by quality of life. Faster hospital rehabilitation contributed to better quality of life than in patients on conventional rehabilitation. The absence of sanatorium rehabilitation was associated with anxiety, hypochondria, depression registered 12 months after MI onset and thus with lowering of life quality.

Adult↗
PubMed1999

Pneumococcal pneumonia diagnosis by demonstration of pneumolysin antibodies in precipitated immune complexes: a study in 350 Philippine children with acute lower respiratory infection.

In searching for suitable methods for aetiological diagnosis of pneumococcal disease we determined capsular polysaccharide, C-polysaccharide and pneumolysin antibodies bound in immune complexes (IC) in Filipino children. Sera were obtained from 150 healthy infants (all under 12 months old) and from 350 paediatric patients (mean age 18 months) hospitalized with severe pneumonia. The findings in healthy children were not associated with age, sex or pneumococcal carrier status; 3-7% exceeded the cut-off limits for positivity in different antibody assays. By contrast, 97 (51%) of the 190 patients with a complete 3-sample series exceeded the cut-off limit for IC-bound pneumolysin-IgG in at least 1 of the serum samples studied. Positivity rates for IC-bound pneumolysin-IgG in the admission day, in-patient and convalescent sample of the 350 patients were 25%, 25% and 34%. Pneumolysin-IgM, capsular polysaccharide and C-polysaccharide antibodies in the IC were positive in only 4-6% of the patients' samples. IC-bound pneumolysin-IgG antibody assay seem to be a useful method for species-specific diagnosis of pneumococcal infections.

Antibodies, Bacterial↗
PubMed1976

Complement activity in children with protein-calorie malnutrition.

Using the hemolytic complement (CH50) assay, we evaluated the complement system of 28 children with severe protein calorie malnutrition (PCM) during their hospital admission and recovery. The mean CH50 activity in children with kwashiorkor was significantly less on hospital days 1 and 4 than in 17 healthy control subjects. On day 8 it rose to normal, and by day 50 it was significantly higher than the controls. The mean CH50 titer of 16 well-nourished febrile children was, in contrast to that of untreated PCM, significantly greater than the healthy controls. Of the children with PCM, 11 (40%) evidenced anticomplementary (AC) activity in their serum on either day or 1 or 4, but only two (7%) had detectable serum AC activity during later convalescence. Significantly, the CH50 titer in a PCM serum correlated inversely to the amount of AC activity in that serum (P less than 0.01). These results indicate that, in children with PCM, the complement system is compromised functionally, and that its repair coincides with intake of adequate diet. The presence of AC activity provides a possible mechanism for depressed complement activity in some untreated PCM children.

Child, Preschool↗
PubMed2002

Impact of intraoperative donor management on short-term renal function after laparoscopic donor nephrectomy.

OBJECTIVE: To determine whether intraoperative diuresis, postoperative recovery, and early graft function differ between laparoscopic open nephrectomy (LDN) and open donor nephrectomy (ODN). SUMMARY BACKGROUND DATA: Laparoscopic donor nephrectomy can reduce donor complications in terms of decreased pain and shorter convalescence. Although its technical feasibility has been established, concerns have been raised about the impaired renal function resulting from pneumoperitoneum and short- and long-term function of kidneys removed by LDN. METHODS: Between December 1997 and December 2000, 89 LDNs were performed at the authors' institution. These were compared with 83 conventional ODNs performed between January 1994 and December 1997. Graft function, intraoperative variables, and clinical outcome were compared. RESULTS: Laparoscopic donor nephrectomy was attempted in 89 patients and completed in 91% (81/89). Length of hospital stay was significantly shorter in the laparoscopic group. During kidney dissection, the amount of fluids administered and intraoperative diuresis were significantly lower for LDN. In recipients, mean serum creatinine was higher after LDN compared with ODN 1 day after surgery. From postoperative days 2 until 28, there were no differences in serum creatinine. Graft survival rates were similar for LDN and ODN. CONCLUSIONS: Donors can benefit from an improvement in postoperative recovery after LDN. Assessment of an adequate perioperative hydration protocol is mandatory to ensure optimal kidney quality during laparoscopic procurement. The initial graft survival and function rates justify continued development and adoption of LDN.

Adult↗
PubMed1999

[Open versus laparoscopic treatment in inguinal hernia. Our experience].

The knowledge acquired in recent years in the field of etiopathogenesis of materials for prosthesis and of surgical technics regarding inguinal hernias together with a renewed interest for local-regional anesthesia has created a real revolution in a field that for almost 100 years had been dominated by the same uncontrasted ideas. The fundamental stages in the evolution of surgical technics are reviewed as well as the most recent discoveries in the field of biochemical textiles and prosthesis available today that have contributed to the development of new surgical methods. These, distinguishing between "open" and laparoscopic technics, are compared on the basis of the data found in the literature concerning recurrence, morbidity, period of convalescence and costs. Personal experience concerns the last four years with 632 patients treated, some in emergency conditions and others in programmed operations, using the foremost methods of "open" surgery but preferring, among these, those that are tension free. The follow-up involved 84% of the patients for a period of no less than 18 months. A reduction of complications and of relapses was obtained: 5-9% in traditional operations against 0.5% for those that were tension free. With this type of operation the postoperative hospitalization was considerably reduced so that 35% of them could fit into the "one day surgery" category. On the basis of these results it is stressed that both the laparoscopic technics and the tension free technics offer advantages as compared to so called traditional methods; however, even though the first type seems to assure a shorter postoperative period, there is the inconvenience of higher costs and the necessity of general anesthesia.

Follow-Up Studies↗
PubMedDate not supplied

[Clinical and microbiological features of acute enteric mixed infection caused by Hafnia alvei and rotavirus].

The data obtained in the clinical and laboratory study of 72 hospitalized patients with acute enteric infection are presented. The observed outbreak was caused by H. alvei producing heat-stable enterotoxin. The role of this etiological agent is also confirmed by simultaneous occurrence of the disease after using the same foodstuff, a short incubation period, the severity of the course of the disease with pronounced symptoms of neurotoxicosis, a high detection rate of H. alvei in material taken from patients at the acute period of the disease, rapid disappearance of this agent in the period of convalescence and a pronounced rise in the titer of specific antibodies to H. alvei in the dynamics of the disease. At the same time in the feces of 8 patients rotavirus antigen was detected, which, in combination with residual catarrhal phenomena, hyperemia and granularity of the pharynx, yellow stool, was indicative of the simultaneous circulation of rotavirus among these patients.

Acute Disease↗
PubMed2001

Eating difficulties, complications and nursing interventions during a period of three months after a stroke.

AIM: The aim of this study was to describe eating difficulties and especially swallowing in patients with dysphagia, types of nursing intervention, and the development of complications over 3 months. The aim was also to explore common characteristics of eating difficulties that influenced the ability to finish meals. METHODS: Twenty-four consecutive patients admitted because of stroke and dysphagia were included. Nursing interventions, based on assessments, were individually designed. RESULTS: Three subgroups could be identified: those (n=9) who were unable to complete a meal, despite assisted feeding, because of reduced alertness/energy and impaired swallowing function; those (n=5) who could complete a meal, despite suffering from reduced alertness/energy; and those (n=10) who could complete meals with minor difficulties. Patients in the first two groups developed complications such as respiratory infections and/or malnutrition. There was a tendency towards that complications in the third group were less frequent and the hospital stay was significantly shorter than in the other groups. CONCLUSION: The level of alertness/energy in patients with dysphagia after stroke was important for the ability to eat and swallow and the development of complications over time, and thus of great importance for the interventions applied.

Activities of Daily Living↗
PubMed2000

Lactulose-mannitol intestinal permeability test in children with diarrhea caused by rotavirus and cryptosporidium. Diarrhea Working Group, Peru.

BACKGROUND: The relationship between intestinal permeability and acute secretory diarrheal syndromes caused by rotavirus and Cryptosporidium parvum in infants less than 36 months of age was studied using the lactulose-mannitol excretion assay. METHODS: An oral solution containing 0.4 g/kg lactulose and 0.1 g/kg mannitol was administered to 15 infants with rotavirus, 7 with Cryptosporidium infection and a control group of 7 with secretory diarrhea admitted to the Oral Rehydration Unit of the National Children's Hospital in Lima, Peru. Urinary sugar excretion was measured using an enzymatic spectrophotometric method. The ratio of urinary excretion of lactulose to mannitol was used to measure intestinal mucosal permeability, with higher ratios indicative of increased intestinal permeability. Infants in all three groups were retested 20 days after the initial test. RESULTS: The (mean +/- SE) lactulose:mannitol (L:M) excretion ratios during the acute phase (day 1) of diarrhea in infants with rotavirus or Cryptosporidium and control infants were 0.67 +/- 0.1, 0.76 +/- 0.16, and 0.26 +/- 0.04, respectively. In the convalescent phase (day 20) the ratios were 0.19 +/- 0.02, 0.28 +/- 0.05, and 0.29 +/- 0.07, respectively. Significant reductions in L:M ratios were noted in rotavirus patients between days 1 and 20 (paired t-test; P < 0.01), Cryptosporidium patients between days 1 and 20 (paired t-test; P < 0.05), and between control subjects on day 1 and rotavirus patients on day 1 and Cryptosporidium patients on day 1 (unpaired t-tests; P < 0.05 for both). There were no significant differences in control subjects between days 1 and 20, control subjects and rotavirus patients on day 20, or control subjects and Cryptosporidium patients on day 20. CONCLUSIONS: The results indicate that increased intestinal permeability caused by rotavirus or cryptosporidium infections in Peruvian infants less than 36 months of age is a significant but reversible phenomenon. The temporal relationship observed in the current study and the contribution of such alterations in intestinal mucosal integrity to the burden of diarrheal disease and the development of malnutrition in developing countries is discussed.

Animals↗
PubMed1999

Sensitive and specific serodiagnosis of Lyme disease by enzyme-linked immunosorbent assay with a peptide based on an immunodominant conserved region of Borrelia burgdorferi vlsE.

VlsE, the variable surface antigen of Borrelia burgdorferi, contains an immunodominant conserved region named IR(6). In the present study, the diagnostic performance of a peptide enzyme-linked immunosorbent assay (ELISA) based on a 26-mer synthetic peptide (C(6)) with the IR(6) sequence was explored. Sensitivity was assessed with serum samples (n = 210) collected from patients with clinically defined Lyme disease at the acute (early localized or early disseminated disease), convalescent, or late disease phase. The sensitivities for acute-, convalescent-, and late-phase specimens were 74% (29 of 39), 85 to 90% (34 of 40 to 35 of 39), and 100% (59 of 59), respectively. Serum specimens from early neuroborreliosis patients were 95% positive (19 of 20), and those from an additional group of patients with posttreatment Lyme disease syndrome yielded a sensitivity of 62% (8 of 13). To assess the specificity of the peptide ELISA, 77 serum samples from patients with other spirochetal or chronic infections, autoimmune diseases, or neurologic diseases and 99 serum specimens from hospitalized patients in an area where Lyme disease is not endemic were examined. Only two potential false positives from the hospitalized patients were found, and the overall specificity was 99% (174 of 176). Precision, which was assessed with a panel of positive and negative serum specimens arranged in blinded duplicates, was 100%. Four serum samples with very high anti-OspA antibody titers obtained from four monkeys given the OspA vaccine did not react with the C(6) peptide. This simple, sensitive, specific, and precise ELISA may contribute to alleviate some of the remaining problems in Lyme disease serodiagnosis. Because of its synthetic peptide base, it will be inexpensive to manufacture. It also will be applicable to serum specimens from OspA-vaccinated subjects.

Animals↗