We evaluated antibody reactivity against Borrelia burgdorferi in 20 consecutive patients with newly diagnosed isolated optic neuritis who resided in a region endemic for Lyme disease. Four (20%) patients had positive serology. All three patients who had follow-up serologies showed rising convalescent levels of Borrelia-specific IgM. One patient refused lumbar puncture, one had normal CSF constituents except for an elevated Lyme antibody index, and two had CSF lymphocytic pleocytosis that remained unexplained after extensive evaluations for causes other than Lyme disease. We treated both patients who had CSF pleocytosis with intravenous ceftriaxone; the pleocytosis and optic nerve function improved. The other two patients received oral antibiotics and showed excellent recovery of visual acuity. We believe that serologic testing for Lyme disease is warranted for individuals with optic neuritis who reside in an endemic region, and patients with rising convalescent antibody levels or unexplained CSF pleocytosis should receive antibiotic treatment for Lyme disease.

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Abstract:Objectives: The aim of our study was to evaluate the relationship between bone mineral density (examined by DXA -dual energy x-ray absorptiometry), vitamin D 3 levels and the signs of metabolic syndrome. Methods: We examined 55 subjects (37 women, 18 men, age median 67.8 years) with no history of osteoporosis, suffering from metabolic syndrome (defi ned as abdominal obesity and more than 2 of other componentsarterial hypertension, dyslipidemia and diabetes mellitus or impaired glucose tolerance, according to IDF, 2006). Results: Osteoporosis (T-score less than -2.5) was found in 32.7 % (15 women and 3 men) and osteopenia (T-score between -1.5 and -2.5) in 29 % (13 women and 3 men) of patients. We observed a negative correlation between BMI and fat percentage (examined by DXA) and vitamin D 3 levels. Low concentration of vitamin D 3 was found in 90 % of patients with median 19.36 ug/l (64 % measured in winter, 36 % in summer, no relationship between vitamin D 3 levels and season). We also observed a negative correlation between the low concentration of vitamin D 3 and presence of diabetes mellitus as a part of metabolic syndrome. Conclusion:The link between osteoporosis and metabolic syndrome could infl uence the therapeutic approach in both disorders and vitamin D supplementation may play an important role in prevention of these severe conditions (Tab. 5, Fig. 1, Ref. 29). Full Text in PDF www.elis.sk.

LETTERS 1055was highly significant ( P < 0.001). Esophageal peristalsis remained unchanged after administration of each drug.Diltiazem does not show a tendency to lower LES pressure, which is the major drawback with nifedipine. Therefore, diltiazem is to be preferred over nifedipine in the treatment of Raynaud's phenomenon in patients with PSS.