Sensitivity and specificity of a commercial C6 peptide enzyme immuno assay in diagnosis of acute Lyme neuroborreliosis.

The purpose of this study was to evaluate the diagnostic sensitivity and specificity of a commercial C6 enzyme immuno assay, QuickC6, in acute Lyme neuroborreliosis (LNB) in endemic areas. Paired sera and cerebral spinal fluids (CSFs) from 60 patients with definite LNB, eight patients with possible LNB, 18 patients with conditions mimicking LNB and 42 persons with noninfectious neurological disease were examined. The case definition of LNB was based on strict criteria during a prospective 4-month follow-up. The sensitivity of QuickC6 was 98% both in sera and CSFs, and the diagnostic specificity was 61% in sera and 88% in CSFs. QuickC6 is a sensitive, simple and cost-effective screening test in serum and CSF in diagnosis of acute LNB. Specificity needs further evaluation.

Serum diazepam and serum creatine kinase after intra-muscular injection of diazepam in two different vehicles.

Serum diazepam concentration and serum creatine kinase activity (serum CK) were measured in 35 patients (who were divided into three groups (A, B, and C)), over a period of 24 hours after administration of diazepam. An increase in serum CK was regarded as an indication of local muscle injury. In group A, diazepam in a polyethyleneoxydricinolate vehicle was injected intramuscularly; in group B, diazepam in a propyleneglycol-ether alcohol vehicle was injected intramuscularly; and in group C, diazepam was administered orally, combined with intramuscular administration of the vehicle used in group B. The investigation was double-blind and randomized. Serum diazepam absorption expressed as the area under the concentration curve was identical in groups A and C and significantly higher than in group B. Serum CK rose in all groups. The differences among the groups were not significant. There were considerable individual variations in all three groups, and almost half the patients showed no increase in serum CK at all. No negative correlation was found between serum diazepam and serum CK. Thus no effect of muscle injury--if present--on absorption rate could be demonstrated.