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“  Gli antibiotici hanno cambiato il mondo , ma ora rischiamo di tornare ad un mondo senza antibiotici “
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APITHERAPY Dott. Franco Feraboli
 
Honey ,[object Object],[object Object],[object Object],[object Object],[object Object]
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Manuka Honey ,[object Object],[object Object],[object Object],[object Object]
BIOSURGERY
 
Maggot therapy
 
 
 
Chunky ,[object Object]
 
 
 
 
 
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Wound healing is a dynamic process and the performance requirements of a dressing can change as the wound progresses towards healing.
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Wound Type  :  ,[object Object],[object Object],[object Object],[object Object]
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Sloughy  wound
Granulating wounds
Epithelialising wounds
Malignant wound ,[object Object]
 
[object Object]
WOUND LOCATION
 
 
 
 
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Product related factors Conformability Mass or volume ( for cavity wounds ) Fluid handling properties Sensitisation potential Odour absorbing ptoperties Antibacterial activity Haemostatic properties Permeability to tissue fluid and microorganisms Ease to use Pain related factors Non toxic
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History
People survived for hundreds of thousands of years without modern antibiotics , and it is worth thinking about how that was possible. In the Smith papyrus of 1700 B.C. and the Ebers papyrus of 1500 B.C. we find described the treatment of very severe wounds and burns with a combination of coagulated milk and honey kept in place by a muslin bandage.
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Recently doctor Majno of the Harvard  Medical School put Egyptian pharmacy to the test of science and compared wounds of a few guinea pigs , that had been treated with either honey and grease or Vaseline ( it is said to be practically indifferent to wound healing )
After eights days the microscopic section of the surface of an open wound in guinea pig skin , treated with vaseline dressing , was filled with granulation tissue , that is the normal course of events without any treatment. The microscopic section of a similar wound of the same age , which has been kept under a dressing of honey and grease , showed no harm , no “ proud flesh”.
Dr. Majno   (HARVARD MEDICAL SCHOOL)     Vaseline dressing   Honey and grease   dressing
To give the mixture the roughest possible test , doctor Majno made it up with butter , which contains many bacteria of its own , including a group of coliform bacteria. Result : the bacteria initially present tended to disappear , and if pathogenic bacteria were added , like Escherichia coli and Staphylococcus aureus , they were killed just as fast.
 
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Dr. Leon Herszage ( Torcuato de Alvear Hospital – Buenos Aires ) : in 1980 he achieved a cure rate of over 99 percent in the treatment with sugar of the surgical wounds of 120 patients. Dr. Richard Knutson ( Trauma Clinic of the Delta Orthopedic Center – Mississippi ) : in 1981 he published a five years study of 605 patients with burns , ulcers , lacerations , gunshot wounds and amputations , treated with honey and sugar.  He showed that 98 percent complete healing.
 
HONEY
Our bacteriological  test
 
 
Our  medical  honey ( Acacia honey + Acetic Acid 3% )
 
 
 
 
 
G.A.  53 years old (M) Patella open fracture. Honey dressing after surgery
HONEY and sugar ,[object Object],[object Object],[object Object]
HONEY and sugar 21 / 11/ 1999 : Honey and  sugar dressing 7/1/2000 : Healing
HONEY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
Infected patella open fracture treated  with acacia honey
 
 
 
 
 
 
 
 
M.P.  37 years old (M) Open femur fracture (bull gored) treated by intramedullary nailing. Wound infection (Enterococcus faecalis and Staphilococcus Aureus)
Wound and fracture irrigation by acacia honey and propolis. Reduction of secretion and hyperpyrexia after one week . The patient was reoperated 15 days later : the intramedullary nail was removed and an external device was applied.
 
 
 
 
 
 
 
 
 
 
 
Treatment of necrotic and sloughy wounds
S.M. 43 (F)  Infected wound by fish bone ( Staphilococcus aureus ) . The seventh day after.
This is the situation after 7 days of  antibiotic therapy.
Healing after 10 days of maggot therapy and 25 days of honey dressing. This is the situation one year later.
V.A. (64 F) Open tibial fracture. Honey dressing after maggot therapy.
Healing 60 days after .
73 years old (F) Leg necrotic wound. Honey  medication  Healing after 42 days
B.R.  68 years old. (M) Very large  haematoma in the thigh with necrotic wound. Irrigation by acacia and multiflowers honey. Healing  60 days later.
 
C.L.  67 years old (M)  Necrotic wound on the left foot.  Honey dressing twice a day.  Healing 35 days later.
P.L. (38 M) Infected open leg fracture with muscle and skin loss.  (Staphilococcus Aureus and Pseudomonas aeruginosa.)
Healing 90 days after
F.A. ( 56 M ) Compound tibial fracture.
Sugar and honey dressing.
Healing 60 days after.
Treatment of pressure ulcers
 
 
 
 
 
 
 
 
 
 
 
S.B.  28 years old  (M) Open ankle fracture
Infected malleolar pressure ulcer ( Staphilococcus Aureus )  following the open ankle fracture.
Healing 60 days after.
Treatment of ulcers in venous stasis
Treatment of diabetic ulcers
 
 
Treatment of burns
Propolis ,[object Object],[object Object],[object Object],[object Object],[object Object]
PROPOLIS
Honey  and  propolis . Lesion by hand-granade explosion.
B.R. ( 64 M ) Infected hip prosthesis ( Staphilococcus aureus MRSA) . After 30 days of antibiotic therapy I began to inject  honey in the wound twice a day for 35 days.
Injection of propolis  Healing 70 days after.
L.A. ( 49 M )  Hip open fracture. Intramedullary nailing and infection by  Staphilococcus  Aureus , Enterobacter cloacae and Enterococcus faecalis.
Nail was removed 3 months later and he was treated with intramedullary  antibiotic (Gentamicina) beads and Antibiotic therapy for 20 days.
Five months later I began to inject dissolved propolis intramedullary,twice a day for 20 days.
Healing 30 days later .
B.L. ( 58 M )  Infected compound fracture of the forearm. ( Staphilococcus aureus and Acinet. Lwoffii)
Propolis therapy
Healing 28 days later.
D.G.F. (22 M ) Traumatic amputation of  the right leg.
Staphilococcus aureus  infection
Propolis therapy
Healing 3 months later.
Use of solid propolis in fistolous channel.
O.L. ( 39 M )  Infected compound leg fracture ( Staphilococcus aureus and Pseudomonas aeruginosa ).
After 20 days of antibiotic therapy I began propolis therapy.
Healing 20 days later.
Four months later.
 
POLLINE E’ un alimento cosiddetto completo perché è una miscela perfettamente bilanciata  di aminoacidi , vitamine , sali minerali , enzimi ed acidi grassi. Esso è fondamentale nelle diete , soprattutto nell’alimentazione vegetariana , essendo il suo apporto proteico sovrapponibile a quello della carne , privata però di tutti i grassi. E’ pure ricco di vitamine e di flavonoidi. La sola vitamina mancante è la D ,per cui possiamo ritenere una alimentazione che comprenda il polline ed i prodotti del latte come una dieta perfettamente equilibrata e naturale. L’unico inconveniente legato alla assunzione del polline è rappresentato dalla possibilità che il suo sapore non incontri il favore del consumatore , fattore quest’ultimo fondamentale per la riuscita di un regime dietetico.
PAPPA REALE E’ nutrizionalmente importante almeno quanto il polline per l’elevata quantità di vitamine della crescita ( gruppo B) in particolare di acido pantotenico (B5) , la cui concentrazione in questo alimento ne supera qualsiasi altra. E’ attiva a dosi ponderali (2-3 cucchiaini da caffè al giorno ) nelle lesioni eczematose della pelle , contro la caduta dei capelli , per incrementare la crescita del neonato prematuro , nell’affaticamento fisico ed intellettuale , nei disturbi intestinali e digestivi , e può essere d’aiuto nell’insonnia e nell’agitazione di origine nervosa.  Unica controindicazione è la marcata acidità , che può causare , in soggetti predisposti , l’irritazione della mucosa gastrica.
Bee Venom
 
Bee Venom SIDE EFFECTS (Allergy)
 
 
 
Epidemiological aspects of hymenoptera stings
 
 
IMMUNOTHERAPY
Bee Venom Therapy
 
 
 
 
 
VELENO Per intraprendere con successo una terapia antiinfiammatoria a base di veleno d’ape , due sono i requisiti essenziali : un accurato inquadramento diagnostico e , conseguentemente , la constatazione dell’esistenza di una indicazione specifica. Il campo d’azione del veleno si estende a numerose affezioni acute e croniche, quali gli stati infiammatori acuti articolari (reumatismo articolare acuto e gotta), alla lombalgia , cervicalgia e sciatalgia , alla erisipela , all’artrosi ed all’artrite reumatoide , all’orticaria , alla nefrite , ai disturbi del sonno e persino alla sclerosi multipla.  Paziente affetto da artrite reumatoide.
VELENO Le più importanti componenti del veleno sono l ‘ ISTAMINA , la LECITINASI e la IALURONIDASI. L ‘ ISTAMINA provoca dolore locale , edema , aumento dell’afflusso sanguigno ed agisce come un potente antiinfiammatorio. La vasodilatazione da essa provocata avviene per via riflessa , attraverso il sistema nervoso , anche nei tessuti profondi e può esercitare una influenza favorevole sulle infiammazioni croniche aumentando il metabolismo tissutale ed eliminando i prodotti dannosi dell’infiammazione.  La LECITINASI trasforma la lecitina in isolecitina (FOSFOLIPASI B)  che ha uno spiccato effetto emolitico distruggendo i globuli rossi ed altre cellule dei tessuti e partecipa all’azione fibrinolitica caratteristica del veleno d’api. La IALURONIDASI agisce come un fattore di diffusione del veleno , sciogliendo l’acido ialuronico del tessuto connettivo. Altre sostanze proteiche presenti nel veleno hanno caratteristiche antigeniche e stimolano in questo modo le reazioni di difesa del sistema immunitario. A quale di tutti questi fattori sia da attribuire l’effetto curativo del veleno d’api resta un mistero.
VELENO Generalmente nel punto in cui si viene punti da un imenottero si forma una piccola tumefazione di colore rosso , pruriginosa e calda che persiste per alcune ore o per alcuni giorni. Reazioni più violente sono caratterizzate da un gonfiore più esteso che può interessare anche un intero arto. In alcuni pazienti si associano effetti collaterali quali dolori in altre articolazioni ed in altre parti del sistema muscolo scheletrico , affaticamento , tumefazione generalizzata a tutto il corpo , cefalea , nausea , vomito , caduta della pressione sanguigna , aumento della temperatura corporea. Queste reazioni non alterano l’efficacia terapeutica del veleno e non sono considerate un ostacolo al proseguimento della terapia , che potrà continuare utilizzando dosaggi di veleno inferiori a quello che ha scatenato l’effetto indesiderato.  Dove si punge ? Si punge generalmente sulle zone dolenti utilizzando l’ape viva applicata più volte , con l’ausilio di una retina finissima per estrarre il  pungiglione  oppure più api fino ad un massimo di 30 punture. La durata della terapia varia da un minimo di una seduta fino ad una massimo di alcuni mesi , come nel caso dei pazienti affetti da sclerosi multipla.
Role of sympathetic nerve fibers in maintaining joint pain and inflammation in arthritis
Each joint has a dual nerve supply:  primary nerves that penetrate the capsule as independent branches of adjacent peripheral nerves , and accessory nerves sending a branch to the joint and another either to the muscle  ( articulomuscular nerves ) or to the skin and subcutaneous tissues  (  articulocutaneous  )
 
One may wonder why inflammation inside the joint manifest itself with signs on the skin and subcutaneous tissues that contribute to the acute pain.
To understand this phenomenon let us examine some studies on experimental inflammation induced on the skin.
Many algogenic substances  (  Histamine  , cantharidin , substance P ,  Bee Venom  , etc ) when injected into the derma induced a reaction that was first  described by Lewis.
The reaction is due to a substance released by tissues that was named by Lewis  substance H  . It was subsequently found that this substance was  Histamine  .
The  bee sting  induces three phenomena which are known as the  Lewis triple reaction  .
1- An area of redness , due to a local vasodilatatory effect , that spreads a few millimeters around the injected area , reaches its maximum 1 min after the injection ;
2 – A cutaneous erythematous area of a brighter red with an irregular contour , which spreads over 1 cm beyond the area of initial red discoloration and develops more slowly , it is probably due to activation of axon reflexes ;
3 – a blister that appears 1 to 2 min. after  the sting and replaces the initial red discoloration , due to an increase of capillary permeability.
The most interesting phenomenon of this reaction is the erythema (secodary hyperalgesia). This is probably due to the fact that the nociceptive and damaging stimuli induce release of  substance P  by free endings induces release of histamine by neighbor mastocytes, which in turn release histamine , which excites other nerve endings and so forth; the spreading of secondary hyperalgesia is so explained.
 
Why does the erythema stop?  One possible explanation is derived from the observation of an ischemic halo of regular shape developing around the erythematous area.
This white ischemic halo , which stops the spreading of the erythema , is produced via a reflex arc with an efferent branch that is sympathetic.
Erythralgia  is a skin phenomenon characterized by redness , increase of cutaneous temperature , subcutaneous swelling and hyperalgesia.
The concept of erythralgia may be extended from the skin to mucosal and synovial tissues. Synovial erythralgia induces the described  superficial phenomena probably through axon reflexes running on the articulocutaneous nerves which release inflammatory polypeptides in the skin.  When  sympathetic nerves overdischarge (after a few bee stings ) , they release large amounts of neuropeptide Y , which has analgesic and anti-inflammatory properties .
VELENO Il veleno d’api si trova in commercio in forma grezza disidratata, sotto forma di granuli omeopatici , liquido ,  pronto per essere iniettato , ed in preparati farmaceutici.
VELENO Ma la forma generalmente più utilizzata è la puntura diretta dell’ape .
VELENO E’ estremamente efficace nel trattamento della borsite dolorosa nell’alluce valgo. Ciò dipende probabilmente dal fatto che il veleno blocca la trasmissione nervosa di un ramo sensitivo che corre sotto cute in corrispondenza della borsa infiammata.
VELENO Vediamo due casi particolarmente significativi. G.A. Sesso : F.  Anni 49.  Da 6 mesi dolore ed impotenza funzionale alla caviglia sinistra per artropatia gottosa. Ha già eseguito numerose terapie mediche e fisiche. Completa guarigione dopo 4 sedute di apiterapia ( 6 punture per seduta sulla caviglia).
 
Smelling others
 
 
 
 
Grazie

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Apiterapia Oo

  • 1. “ Gli antibiotici hanno cambiato il mondo , ma ora rischiamo di tornare ad un mondo senza antibiotici “
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  • 30. Wound healing is a dynamic process and the performance requirements of a dressing can change as the wound progresses towards healing.
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  • 48. Product related factors Conformability Mass or volume ( for cavity wounds ) Fluid handling properties Sensitisation potential Odour absorbing ptoperties Antibacterial activity Haemostatic properties Permeability to tissue fluid and microorganisms Ease to use Pain related factors Non toxic
  • 49.
  • 51. People survived for hundreds of thousands of years without modern antibiotics , and it is worth thinking about how that was possible. In the Smith papyrus of 1700 B.C. and the Ebers papyrus of 1500 B.C. we find described the treatment of very severe wounds and burns with a combination of coagulated milk and honey kept in place by a muslin bandage.
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  • 54. Recently doctor Majno of the Harvard Medical School put Egyptian pharmacy to the test of science and compared wounds of a few guinea pigs , that had been treated with either honey and grease or Vaseline ( it is said to be practically indifferent to wound healing )
  • 55. After eights days the microscopic section of the surface of an open wound in guinea pig skin , treated with vaseline dressing , was filled with granulation tissue , that is the normal course of events without any treatment. The microscopic section of a similar wound of the same age , which has been kept under a dressing of honey and grease , showed no harm , no “ proud flesh”.
  • 56. Dr. Majno (HARVARD MEDICAL SCHOOL) Vaseline dressing Honey and grease dressing
  • 57. To give the mixture the roughest possible test , doctor Majno made it up with butter , which contains many bacteria of its own , including a group of coliform bacteria. Result : the bacteria initially present tended to disappear , and if pathogenic bacteria were added , like Escherichia coli and Staphylococcus aureus , they were killed just as fast.
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  • 60. Dr. Leon Herszage ( Torcuato de Alvear Hospital – Buenos Aires ) : in 1980 he achieved a cure rate of over 99 percent in the treatment with sugar of the surgical wounds of 120 patients. Dr. Richard Knutson ( Trauma Clinic of the Delta Orthopedic Center – Mississippi ) : in 1981 he published a five years study of 605 patients with burns , ulcers , lacerations , gunshot wounds and amputations , treated with honey and sugar. He showed that 98 percent complete healing.
  • 61.  
  • 62. HONEY
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  • 66. Our medical honey ( Acacia honey + Acetic Acid 3% )
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  • 72. G.A. 53 years old (M) Patella open fracture. Honey dressing after surgery
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  • 74. HONEY and sugar 21 / 11/ 1999 : Honey and sugar dressing 7/1/2000 : Healing
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  • 81. Infected patella open fracture treated with acacia honey
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  • 90. M.P. 37 years old (M) Open femur fracture (bull gored) treated by intramedullary nailing. Wound infection (Enterococcus faecalis and Staphilococcus Aureus)
  • 91. Wound and fracture irrigation by acacia honey and propolis. Reduction of secretion and hyperpyrexia after one week . The patient was reoperated 15 days later : the intramedullary nail was removed and an external device was applied.
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  • 103. Treatment of necrotic and sloughy wounds
  • 104. S.M. 43 (F) Infected wound by fish bone ( Staphilococcus aureus ) . The seventh day after.
  • 105. This is the situation after 7 days of antibiotic therapy.
  • 106. Healing after 10 days of maggot therapy and 25 days of honey dressing. This is the situation one year later.
  • 107. V.A. (64 F) Open tibial fracture. Honey dressing after maggot therapy.
  • 108. Healing 60 days after .
  • 109. 73 years old (F) Leg necrotic wound. Honey medication Healing after 42 days
  • 110. B.R. 68 years old. (M) Very large haematoma in the thigh with necrotic wound. Irrigation by acacia and multiflowers honey. Healing 60 days later.
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  • 112. C.L. 67 years old (M) Necrotic wound on the left foot. Honey dressing twice a day. Healing 35 days later.
  • 113. P.L. (38 M) Infected open leg fracture with muscle and skin loss. (Staphilococcus Aureus and Pseudomonas aeruginosa.)
  • 114. Healing 90 days after
  • 115. F.A. ( 56 M ) Compound tibial fracture.
  • 116. Sugar and honey dressing.
  • 117. Healing 60 days after.
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  • 130. S.B. 28 years old (M) Open ankle fracture
  • 131. Infected malleolar pressure ulcer ( Staphilococcus Aureus ) following the open ankle fracture.
  • 132. Healing 60 days after.
  • 133. Treatment of ulcers in venous stasis
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  • 140. Honey and propolis . Lesion by hand-granade explosion.
  • 141. B.R. ( 64 M ) Infected hip prosthesis ( Staphilococcus aureus MRSA) . After 30 days of antibiotic therapy I began to inject honey in the wound twice a day for 35 days.
  • 142. Injection of propolis Healing 70 days after.
  • 143. L.A. ( 49 M ) Hip open fracture. Intramedullary nailing and infection by Staphilococcus Aureus , Enterobacter cloacae and Enterococcus faecalis.
  • 144. Nail was removed 3 months later and he was treated with intramedullary antibiotic (Gentamicina) beads and Antibiotic therapy for 20 days.
  • 145. Five months later I began to inject dissolved propolis intramedullary,twice a day for 20 days.
  • 146. Healing 30 days later .
  • 147. B.L. ( 58 M ) Infected compound fracture of the forearm. ( Staphilococcus aureus and Acinet. Lwoffii)
  • 149. Healing 28 days later.
  • 150. D.G.F. (22 M ) Traumatic amputation of the right leg.
  • 151. Staphilococcus aureus infection
  • 153. Healing 3 months later.
  • 154. Use of solid propolis in fistolous channel.
  • 155. O.L. ( 39 M ) Infected compound leg fracture ( Staphilococcus aureus and Pseudomonas aeruginosa ).
  • 156. After 20 days of antibiotic therapy I began propolis therapy.
  • 157. Healing 20 days later.
  • 159.  
  • 160. POLLINE E’ un alimento cosiddetto completo perché è una miscela perfettamente bilanciata di aminoacidi , vitamine , sali minerali , enzimi ed acidi grassi. Esso è fondamentale nelle diete , soprattutto nell’alimentazione vegetariana , essendo il suo apporto proteico sovrapponibile a quello della carne , privata però di tutti i grassi. E’ pure ricco di vitamine e di flavonoidi. La sola vitamina mancante è la D ,per cui possiamo ritenere una alimentazione che comprenda il polline ed i prodotti del latte come una dieta perfettamente equilibrata e naturale. L’unico inconveniente legato alla assunzione del polline è rappresentato dalla possibilità che il suo sapore non incontri il favore del consumatore , fattore quest’ultimo fondamentale per la riuscita di un regime dietetico.
  • 161. PAPPA REALE E’ nutrizionalmente importante almeno quanto il polline per l’elevata quantità di vitamine della crescita ( gruppo B) in particolare di acido pantotenico (B5) , la cui concentrazione in questo alimento ne supera qualsiasi altra. E’ attiva a dosi ponderali (2-3 cucchiaini da caffè al giorno ) nelle lesioni eczematose della pelle , contro la caduta dei capelli , per incrementare la crescita del neonato prematuro , nell’affaticamento fisico ed intellettuale , nei disturbi intestinali e digestivi , e può essere d’aiuto nell’insonnia e nell’agitazione di origine nervosa. Unica controindicazione è la marcata acidità , che può causare , in soggetti predisposti , l’irritazione della mucosa gastrica.
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  • 164. Bee Venom SIDE EFFECTS (Allergy)
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  • 168. Epidemiological aspects of hymenoptera stings
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  • 178. VELENO Per intraprendere con successo una terapia antiinfiammatoria a base di veleno d’ape , due sono i requisiti essenziali : un accurato inquadramento diagnostico e , conseguentemente , la constatazione dell’esistenza di una indicazione specifica. Il campo d’azione del veleno si estende a numerose affezioni acute e croniche, quali gli stati infiammatori acuti articolari (reumatismo articolare acuto e gotta), alla lombalgia , cervicalgia e sciatalgia , alla erisipela , all’artrosi ed all’artrite reumatoide , all’orticaria , alla nefrite , ai disturbi del sonno e persino alla sclerosi multipla. Paziente affetto da artrite reumatoide.
  • 179. VELENO Le più importanti componenti del veleno sono l ‘ ISTAMINA , la LECITINASI e la IALURONIDASI. L ‘ ISTAMINA provoca dolore locale , edema , aumento dell’afflusso sanguigno ed agisce come un potente antiinfiammatorio. La vasodilatazione da essa provocata avviene per via riflessa , attraverso il sistema nervoso , anche nei tessuti profondi e può esercitare una influenza favorevole sulle infiammazioni croniche aumentando il metabolismo tissutale ed eliminando i prodotti dannosi dell’infiammazione. La LECITINASI trasforma la lecitina in isolecitina (FOSFOLIPASI B) che ha uno spiccato effetto emolitico distruggendo i globuli rossi ed altre cellule dei tessuti e partecipa all’azione fibrinolitica caratteristica del veleno d’api. La IALURONIDASI agisce come un fattore di diffusione del veleno , sciogliendo l’acido ialuronico del tessuto connettivo. Altre sostanze proteiche presenti nel veleno hanno caratteristiche antigeniche e stimolano in questo modo le reazioni di difesa del sistema immunitario. A quale di tutti questi fattori sia da attribuire l’effetto curativo del veleno d’api resta un mistero.
  • 180. VELENO Generalmente nel punto in cui si viene punti da un imenottero si forma una piccola tumefazione di colore rosso , pruriginosa e calda che persiste per alcune ore o per alcuni giorni. Reazioni più violente sono caratterizzate da un gonfiore più esteso che può interessare anche un intero arto. In alcuni pazienti si associano effetti collaterali quali dolori in altre articolazioni ed in altre parti del sistema muscolo scheletrico , affaticamento , tumefazione generalizzata a tutto il corpo , cefalea , nausea , vomito , caduta della pressione sanguigna , aumento della temperatura corporea. Queste reazioni non alterano l’efficacia terapeutica del veleno e non sono considerate un ostacolo al proseguimento della terapia , che potrà continuare utilizzando dosaggi di veleno inferiori a quello che ha scatenato l’effetto indesiderato. Dove si punge ? Si punge generalmente sulle zone dolenti utilizzando l’ape viva applicata più volte , con l’ausilio di una retina finissima per estrarre il pungiglione oppure più api fino ad un massimo di 30 punture. La durata della terapia varia da un minimo di una seduta fino ad una massimo di alcuni mesi , come nel caso dei pazienti affetti da sclerosi multipla.
  • 181. Role of sympathetic nerve fibers in maintaining joint pain and inflammation in arthritis
  • 182. Each joint has a dual nerve supply: primary nerves that penetrate the capsule as independent branches of adjacent peripheral nerves , and accessory nerves sending a branch to the joint and another either to the muscle ( articulomuscular nerves ) or to the skin and subcutaneous tissues ( articulocutaneous )
  • 183.  
  • 184. One may wonder why inflammation inside the joint manifest itself with signs on the skin and subcutaneous tissues that contribute to the acute pain.
  • 185. To understand this phenomenon let us examine some studies on experimental inflammation induced on the skin.
  • 186. Many algogenic substances ( Histamine , cantharidin , substance P , Bee Venom , etc ) when injected into the derma induced a reaction that was first described by Lewis.
  • 187. The reaction is due to a substance released by tissues that was named by Lewis substance H . It was subsequently found that this substance was Histamine .
  • 188. The bee sting induces three phenomena which are known as the Lewis triple reaction .
  • 189. 1- An area of redness , due to a local vasodilatatory effect , that spreads a few millimeters around the injected area , reaches its maximum 1 min after the injection ;
  • 190. 2 – A cutaneous erythematous area of a brighter red with an irregular contour , which spreads over 1 cm beyond the area of initial red discoloration and develops more slowly , it is probably due to activation of axon reflexes ;
  • 191. 3 – a blister that appears 1 to 2 min. after the sting and replaces the initial red discoloration , due to an increase of capillary permeability.
  • 192. The most interesting phenomenon of this reaction is the erythema (secodary hyperalgesia). This is probably due to the fact that the nociceptive and damaging stimuli induce release of substance P by free endings induces release of histamine by neighbor mastocytes, which in turn release histamine , which excites other nerve endings and so forth; the spreading of secondary hyperalgesia is so explained.
  • 193.  
  • 194. Why does the erythema stop? One possible explanation is derived from the observation of an ischemic halo of regular shape developing around the erythematous area.
  • 195. This white ischemic halo , which stops the spreading of the erythema , is produced via a reflex arc with an efferent branch that is sympathetic.
  • 196. Erythralgia is a skin phenomenon characterized by redness , increase of cutaneous temperature , subcutaneous swelling and hyperalgesia.
  • 197. The concept of erythralgia may be extended from the skin to mucosal and synovial tissues. Synovial erythralgia induces the described superficial phenomena probably through axon reflexes running on the articulocutaneous nerves which release inflammatory polypeptides in the skin. When sympathetic nerves overdischarge (after a few bee stings ) , they release large amounts of neuropeptide Y , which has analgesic and anti-inflammatory properties .
  • 198. VELENO Il veleno d’api si trova in commercio in forma grezza disidratata, sotto forma di granuli omeopatici , liquido , pronto per essere iniettato , ed in preparati farmaceutici.
  • 199. VELENO Ma la forma generalmente più utilizzata è la puntura diretta dell’ape .
  • 200. VELENO E’ estremamente efficace nel trattamento della borsite dolorosa nell’alluce valgo. Ciò dipende probabilmente dal fatto che il veleno blocca la trasmissione nervosa di un ramo sensitivo che corre sotto cute in corrispondenza della borsa infiammata.
  • 201. VELENO Vediamo due casi particolarmente significativi. G.A. Sesso : F. Anni 49. Da 6 mesi dolore ed impotenza funzionale alla caviglia sinistra per artropatia gottosa. Ha già eseguito numerose terapie mediche e fisiche. Completa guarigione dopo 4 sedute di apiterapia ( 6 punture per seduta sulla caviglia).
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  • 208. Grazie