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Lyme Disease Prophylaxis: Idsa Guidelines, Kristine Cruz Md

Family Medicine Scholarly Works

Clinical Question: When should patients be given antibiotics for lyme prophylaxis after a tick bite?

Bottom Line Answer: To provide antibiotic prophylaxis for Lyme disease ALL of these criteria should be met:

• Tick identified as an adult or nymphal deer tick
• Attached for > or = 36 hours (by engorgement or time of exposure)
• Treatment started within 72 hours of tick removal
• Local rate of infection of ticks with B. Bourgdorferi >=20% (assumed in Vermont)
• Doxyclycline is not contraindicated

Early Course Of Nicotine Dependence In Adolescent Smokers, Chyke Doubeni, George Reed, Joseph Difranza

Chyke A. Doubeni

OBJECTIVE: The goal was to characterize the early course of nicotine dependence. METHODS: Data were collected from 1246 sixth-graders in a 4-year (2002-2006) prospective study using 11 individual interviews. Subjects were monitored for 10 symptoms of dependence by using the Hooked on Nicotine Checklist. The bidirectional prospective relationship between the intensity of dependence (number of symptoms) and smoking frequency was examined by using cross-lagged analyses. RESULTS: Of the 370 subjects who had inhaled from a cigarette, 62% smoked at least once per month, 53% experienced dependence symptoms, and 40% experienced escalation to daily smoking. Smoking frequency predicted the number of …