This document discusses the history and mechanisms of maggot therapy. It begins by outlining the long history of using maggot therapy to treat chronic wounds, dating back to the 16th century. However, maggot therapy fell out of favor with the widespread adoption of antibiotics in the 1940s. The document then discusses the selection and use of fly larvae (maggots) in modern maggot therapy. Specifically, it focuses on using maggot secretions from Lucilia sericata fly larvae to clean wounds through debridement and promote healing through their antimicrobial properties.
This document provides a summary of a scientific article about maggot therapy. It discusses:
1) The history of maggot therapy and its rise and fall with the introduction of antibiotics.
2) The selection of the common green bottle fly (Phaenicia sericata) for use in maggot therapy due to its ability to feed on necrotic tissue without damaging healthy tissue.
3) How maggot therapy works through the secretion of digestive enzymes by maggots that debride and cleanse wounds, along with their mechanical removal of debris through movement in the wound.
This document summarizes research on how maggots combat infection in wounds. It discusses how maggots likely kill bacteria through multiple mechanisms, including ingesting bacteria in their digestive tract and secreting potent antibacterial factors. Recent research has found two discrete antibacterial factors secreted by maggots, including a potent factor under 500 Da that is effective against MRSA. This research improves understanding of maggot secretions' antibacterial properties and their clinical potential for treating antibiotic-resistant infections.
The document discusses wound microbiology and infection. It describes how wounds provide an environment for dynamic microbial ecosystems involving both aerobic and anaerobic bacteria. The types and quantities of microbes in a wound can impact healing and risk of infection. Chronic wounds often contain mixed populations of bacteria, and the microbial composition changes over time as the wound environment evolves from aerobic to more anaerobic conditions. Understanding wound microbiology is important for assessing infection risk and promoting wound healing.
This document discusses the human skin microbiome and key pathogenic microbes associated with skin diseases. It begins by providing background on culture-dependent and culture-independent methods used to characterize microbial communities. It then discusses the diversity of bacteria, fungi and viruses found on healthy human skin using culture-independent methods. Several key pathogenic skin microbes are then highlighted - Staphylococcus aureus, Propionibacterium acnes, and Malassezia species. For each, their role as commensals and association with specific skin diseases like atopic dermatitis and acne are described. Exciting new areas of skin microbiome research are also outlined.
Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infect...Crimsonpublisherssmoaj
Over the two decades there has been an increase in Non Tuberculous Mycobacterium (NTM) organisms in post laparoscopic port site skin and soft tissue infections. Presenting a patient who underwent eight successive surgical explorations of multiple skin and soft tissue sinuses and for aggressive necrosectomy and debridement of multiple sinuses caused by NTM organisms which ended up in abdominoplasty and meshplasty 2 months after the infection had been completely controlled. She finally had complete relief from the infection and had 6 months follow up from the last meshplasty surgery. The presentation and treatment of NTM skin and soft tissue infection are briefly outlined.
This document reviews the history of development of antifungal azoles. It discusses four generations of azole drugs classified based on their structural similarities. The first generation included topical imidazole drugs like miconazole, clotrimazole, and econazole. The second generation saw the first oral drug ketoconazole which had improved properties but also toxicity issues. A key development was the introduction of triazole rings in the second generation drugs fluconazole and itraconazole. The third generation built on these second generation structures with improved safety profiles. The review covers the structures, mechanisms of action, and structure-activity relationships of these azole generations to provide context for developing
Wagner College Forum for Undergraduate Research, Vol 10 No 2Wagner College
This document summarizes an experiment that investigated the ability of Listeria monocytogenes to infect the central nervous system of adult zebrafish. Approximately 20 adult zebrafish were injected in the eye with L. monocytogenes. Imaging techniques were then used to study the time course of the infection. The experiment found that when injected into the vitreous humor of the eye, L. monocytogenes was able to invade retinal cells, move through the optic nerve, and ultimately gain access to the optic tectum region of the brain. This demonstrated that adult zebrafish can serve as a model for studying L. monocytogenes infections of the central nervous system.
This document provides a summary of a scientific article about maggot therapy. It discusses:
1) The history of maggot therapy and its rise and fall with the introduction of antibiotics.
2) The selection of the common green bottle fly (Phaenicia sericata) for use in maggot therapy due to its ability to feed on necrotic tissue without damaging healthy tissue.
3) How maggot therapy works through the secretion of digestive enzymes by maggots that debride and cleanse wounds, along with their mechanical removal of debris through movement in the wound.
This document summarizes research on how maggots combat infection in wounds. It discusses how maggots likely kill bacteria through multiple mechanisms, including ingesting bacteria in their digestive tract and secreting potent antibacterial factors. Recent research has found two discrete antibacterial factors secreted by maggots, including a potent factor under 500 Da that is effective against MRSA. This research improves understanding of maggot secretions' antibacterial properties and their clinical potential for treating antibiotic-resistant infections.
The document discusses wound microbiology and infection. It describes how wounds provide an environment for dynamic microbial ecosystems involving both aerobic and anaerobic bacteria. The types and quantities of microbes in a wound can impact healing and risk of infection. Chronic wounds often contain mixed populations of bacteria, and the microbial composition changes over time as the wound environment evolves from aerobic to more anaerobic conditions. Understanding wound microbiology is important for assessing infection risk and promoting wound healing.
This document discusses the human skin microbiome and key pathogenic microbes associated with skin diseases. It begins by providing background on culture-dependent and culture-independent methods used to characterize microbial communities. It then discusses the diversity of bacteria, fungi and viruses found on healthy human skin using culture-independent methods. Several key pathogenic skin microbes are then highlighted - Staphylococcus aureus, Propionibacterium acnes, and Malassezia species. For each, their role as commensals and association with specific skin diseases like atopic dermatitis and acne are described. Exciting new areas of skin microbiome research are also outlined.
Non Tuberculous Mycobacterium as a Causative Factor in Port Site Wound Infect...Crimsonpublisherssmoaj
Over the two decades there has been an increase in Non Tuberculous Mycobacterium (NTM) organisms in post laparoscopic port site skin and soft tissue infections. Presenting a patient who underwent eight successive surgical explorations of multiple skin and soft tissue sinuses and for aggressive necrosectomy and debridement of multiple sinuses caused by NTM organisms which ended up in abdominoplasty and meshplasty 2 months after the infection had been completely controlled. She finally had complete relief from the infection and had 6 months follow up from the last meshplasty surgery. The presentation and treatment of NTM skin and soft tissue infection are briefly outlined.
This document reviews the history of development of antifungal azoles. It discusses four generations of azole drugs classified based on their structural similarities. The first generation included topical imidazole drugs like miconazole, clotrimazole, and econazole. The second generation saw the first oral drug ketoconazole which had improved properties but also toxicity issues. A key development was the introduction of triazole rings in the second generation drugs fluconazole and itraconazole. The third generation built on these second generation structures with improved safety profiles. The review covers the structures, mechanisms of action, and structure-activity relationships of these azole generations to provide context for developing
Wagner College Forum for Undergraduate Research, Vol 10 No 2Wagner College
This document summarizes an experiment that investigated the ability of Listeria monocytogenes to infect the central nervous system of adult zebrafish. Approximately 20 adult zebrafish were injected in the eye with L. monocytogenes. Imaging techniques were then used to study the time course of the infection. The experiment found that when injected into the vitreous humor of the eye, L. monocytogenes was able to invade retinal cells, move through the optic nerve, and ultimately gain access to the optic tectum region of the brain. This demonstrated that adult zebrafish can serve as a model for studying L. monocytogenes infections of the central nervous system.
This document summarizes periodontal diseases as bacterial infections. It discusses how certain bacteria in dental plaque, such as Porphyromonas gingivalis, are essential causes of the disease. However, the severity and progression depends on an interplay between the bacteria, a susceptible host, and environmental factors. Periodontal diseases range from gingivitis, limited to gums, to periodontitis, which spreads deeper and can lead to bone loss and tooth loss over time.
This document provides a review of the literature on larval therapy (also known as maggot therapy or therapeutic myiasis) for wound management. It discusses the applications, benefits, and disadvantages of larval therapy. Some key points:
- Larval therapy uses fly larvae to debride wounds, disinfect them, and promote healing. It has been used for hundreds of years and regained popularity with antibiotic-resistant bacteria.
- Studies show larval therapy effectively treats various wound types like leg ulcers, burns, and diabetic foot ulcers. It reduces wound pain/odor and promotes healing at a lower cost than conventional dressings.
- Larvae eliminate bacteria through ingestion and secretions with evidence
This document provides a historical overview of integrated pest management (IPM) from its origins in the late 1800s through the late 20th century. It discusses how early crop protection specialists relied on pest biology and cultural practices before pesticides were widely available. It then describes how the development of synthetic pesticides in the 1940s shifted the focus to chemical control alone, leading to problems. Integrated control was first proposed in the 1950s as a way to combine biological and chemical control methods to minimize pesticide risks. Pest management became a related concept in the 1960s that emphasized managing pest populations rather than outright control. The document focuses on the history within entomology but acknowledges contributions from other fields like plant pathology and weed science.
The document defines key terms related to infection and host-pathogen interactions. It describes the process by which bacteria, viruses, and fungi cause infection, including how they evade host defenses. Clinical manifestations of infection result from direct microbial effects as well as the host inflammatory response, commonly including fever. A variety of microbes are capable of infecting the HEENT, respiratory, and GU tracts.
Antibiotics for surgical prophylaxis.
Surgical site infections(SSIs) are a significant cause of morbidity and mortality.
Approximately 2% to 5% of patients undergoing clean extra-abdominal operations and 20%undergoing intra-abdominal operations will develop an SSI.
SSIs have become the second most common cause of nosocomial infection and these data are likely underestimated.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This document summarizes research on the use of probiotics for the management of periodontal disease. It begins with background on probiotics and criteria for probiotic strains. It then reviews the potential mechanisms by which probiotics could help treat periodontal disease, such as inhibiting pathogenic bacteria, reducing inflammation, and modulating the immune response. Several clinical studies are summarized that showed probiotics like certain Lactobacillus and Bifidobacterium strains reduced plaque, gingivitis symptoms and periodontal pathogens. Finally, some commercially available probiotic products for periodontal disease are listed.
Subgingival biofilm as etiological factor of periodontal diseaseDr Heena Sharma
This document summarizes subgingival biofilms as etiological factors of periodontal disease. It defines biofilms and describes the stages of biofilm formation. It discusses how subgingival biofilms are associated with periodontitis, including their composition, structure, and role in pathogenesis. The document also covers what metagenomics has revealed about subgingival biofilm composition and how in vitro models are used to study subgingival biofilms.
Mighty Maggots and Bairnsdale Ulcer TOWN talk 21st Nov 2013VeraQ Pty Ltd
This is an example of one of the many community outreach talks I have been asked to deliver as the result of my pozible.com/mightymaggots crowdfunding campaign. It is hoped one day that Deakin will have KPIs for this kind of engagement, so I can get professional recognition on top of the warm fuzzy feelings I get from Outreach!
This document provides guidelines for eliminating the transmission of multidrug-resistant organisms (MDROs) in healthcare settings. It discusses the history and development of antibiotic resistance, factors that facilitate MDRO transmission, and key prevention strategies including optimizing antibiotic use, preventing transmission, preventing infections, effective diagnosis and treatment, and involving infectious disease experts. Major tactics for preventing transmission involve proper isolation precautions, hand hygiene, environmental cleaning, and monitoring healthcare workers to break the chain of contagion.
Rational use of antibiotics is important for patient safety and public health. Antibiotics play an important role in orthopedic surgeries, both for treating infections and as prophylaxis when implants are used. The characteristics of implant materials also impact infection risk, with titanium having lower risk than other materials due to its biocompatibility. Antibiotic prophylaxis is justified for surgeries involving implants as it can reduce infection rates. However, irrational antibiotic usage has contributed to rising antibiotic resistance, so prudent antibiotic stewardship following guidelines is important.
R. Villano-Transatlantic Taskforce on Antimicrobial ResistanceRaimondo Villano
54. R. Villano “Antibioticoresistenza”. Si tracciano cenni storici sul concetto di antibiosi, su ricerche, scoperta e produzione degli antibiotici e sul loro ruolo mondiale non solo terapeutico ma anche strategico dal secondo dopoguerra. Poi, si esaminano a livello nazionale ed internazionale: le problematiche inerenti consumo, uso improprio e abuso di antibiotici nell’uomo, in zootecnia, agricoltura e, quindi, nel ciclo alimentare e nell’ambiente; le politiche di contrasto al fenomeno dell’iperprescrizione e nei cittadini il grado di informazione e consapevolezza dei rischi; le linee guida di buona prassi comportamentale del malato; i documenti principali di lotta a tale emergenza. Si effettuano, inoltre, una rassegna analitica e un approfondimento sualcune super patologie (tubercolosi, gonorrea, meningite, ecc.) e sulle resistenze batteriche ai principali antibiotici. Si realizzano, infine, una ricognizione sull’attualità delle tecnologie e degli indirizzi di ricerca applicata e una rassegna sulle principali recenti nuove terapie. Chiude il lavoro un’appendice tecnica contenente un apparato essenziale di normative e direttive ministeriali italiane e comunitarie europee sul tema. È in diverse istituzioni scientifiche, storiche, professionali e in molte Biblioteche specialistiche, civiche e nazionali in Italia e all’estero, tra cui: Ministero della Salute; Accademia Nazionale delle Scienze detta dei XL; Institute for the Preservation of Medical Traditions of Smithsonian Institution-Washington USA; Medica Statale; Scienze Mediche e farmaceutiche Sede di Medicina Università di Genova; Dipartimento di Scienze farmaceutiche Università di Padova;Nobile Collegio Chimico Farmaceutico Universitas Aromatariorum Urbis; nazionali: Napoli, Roma, Firenze, Potenza; Malatestiana di Cesena.(Chiron, ISBN 978-88-97303-25-1, CDD 610VILant2015 it, LCC DG461-583.8, Prima Edizione, pp. 164, Napoli, maggio 2015; Prima Ristampa giugno 2015; Seconda EdizioneISBN 978-97303-27-5, CDD 610VILant2015it , LCC NXI-820, pp. 256, Roma,luglio 2015);
This document discusses a consensus meeting regarding the use of polyhexamethylene biguanide (PHMB) in wound management. PHMB is a synthetic antimicrobial compound similar to natural peptides. It works by disrupting bacterial cell membranes. The meeting discussed PHMB's history, mechanisms of action, evidence for use, and clinical indications. Attendees sought to establish consensus on PHMB's effectiveness and appropriate clinical usage to improve patient outcomes and control healthcare costs.
The document discusses the Journal of Medical Microbiology & Diagnosis, an open access clinical-medical journal published by OMICS Group that provides an international platform covering fields like bacteriology, mycology, and clinical microbiology. It publishes research articles, review papers, and editorials with the goal of disseminating scientific research. The quality of the journal is ensured by its international editorial board.
Fungal superbugs are fungi that are resistant to most commonly used antifungals and fungicides. Candida auris is a deadly fungal superbug that is often drug-resistant and misidentified in laboratories. It can spread between patients in healthcare facilities through contact with contaminated surfaces or other carriers. Treatment is difficult as C. auris is usually resistant to multiple antifungal classes. Researchers are studying ancient remedies, combination therapies, and biological controls to address the growing problem of antifungal resistance outpacing new drug development.
This document discusses maggot therapy, which involves using fly larvae to treat wounds. It notes that maggots effectively remove dead tissue from wounds, leaving healthy tissue to heal. Specific fly species, Lucilia sericata and Phormia regina, are used. Larvae are placed on the wound and covered for 3 days to eat dead tissue. Maggot therapy is effective, safe, easy to apply, and affordable compared to other wound treatments. Potential downsides are pain sensation from larvae and that maggots must be used within 24 hours.
Identification and characterization of actinomycetes forAlexander Decker
This document describes a study that identified and characterized two actinomycete bacterial strains with
antagonistic activity against Streptomyces scabies, the pathogen that causes potato scab disease. The two strains
were isolated from soil samples. Molecular characterization using 16S rDNA gene sequencing identified the first
strain as Streptomyces avermitilis and the second strain as Actinomyces odontolyticus. Both strains showed high
levels of antibiosis against S. scabies in in vitro and in vivo assays, effectively controlling potato scab disease
symptoms on potato varieties Cara and Diamond.
MRSA is a bacterium that causes antibiotic-resistant infections in both humans and horses. It has been found in many countries worldwide with some strains being indistinguishable between species. The document discusses the risk factors, prevalence, and preventative measures for MRSA in horses and equine hospitals. Screening studies have found carriage rates of 0.7-10.1% in horses and veterinary professionals. Preventative strategies include active screening, strict isolation protocols, hygiene practices like regular surface disinfection, and in some cases targeted antibiotic treatment.
This document summarizes a study on using maggot debridement therapy (MDT) to treat necrotizing fasciitis. It found that among 15 patients treated with surgery, antibiotics, and MDT: 1) MDT reduced the number of surgical debridements needed, especially when started within 9 days of diagnosis; and 2) the wounds eventually healed in all patients except two who died from unrelated causes. It also describes in detail one patient's case of necrotizing fasciitis that was successfully treated with multiple debridements and 19 days of MDT.
Maggot therapy was compared to conventional debridement therapy for treating pressure ulcers. Maggot therapy resulted in a significantly smaller average surface area of necrotic tissue compared to conventional therapy. Maggot therapy also produced a significantly higher average percentage of wound base covered by granulation tissue than conventional therapy alone.
This case report describes the successful use of maggot therapy to treat an acute burn on the foot of a diabetic patient. Maggots were applied to the burn wound after initial treatment with silver sulfadiazine and saline soaks failed to adequately debride necrotic tissue. Over three applications of maggots spanning two weeks, the maggots effectively cleaned and debrided the wound. This accelerated healing and reduced the need for surgical debridement and skin grafting. The report concludes that maggot therapy can be a useful treatment even for some acute burns when standard treatments are ineffective or unsuitable due to patient comorbidities.
This document summarizes periodontal diseases as bacterial infections. It discusses how certain bacteria in dental plaque, such as Porphyromonas gingivalis, are essential causes of the disease. However, the severity and progression depends on an interplay between the bacteria, a susceptible host, and environmental factors. Periodontal diseases range from gingivitis, limited to gums, to periodontitis, which spreads deeper and can lead to bone loss and tooth loss over time.
This document provides a review of the literature on larval therapy (also known as maggot therapy or therapeutic myiasis) for wound management. It discusses the applications, benefits, and disadvantages of larval therapy. Some key points:
- Larval therapy uses fly larvae to debride wounds, disinfect them, and promote healing. It has been used for hundreds of years and regained popularity with antibiotic-resistant bacteria.
- Studies show larval therapy effectively treats various wound types like leg ulcers, burns, and diabetic foot ulcers. It reduces wound pain/odor and promotes healing at a lower cost than conventional dressings.
- Larvae eliminate bacteria through ingestion and secretions with evidence
This document provides a historical overview of integrated pest management (IPM) from its origins in the late 1800s through the late 20th century. It discusses how early crop protection specialists relied on pest biology and cultural practices before pesticides were widely available. It then describes how the development of synthetic pesticides in the 1940s shifted the focus to chemical control alone, leading to problems. Integrated control was first proposed in the 1950s as a way to combine biological and chemical control methods to minimize pesticide risks. Pest management became a related concept in the 1960s that emphasized managing pest populations rather than outright control. The document focuses on the history within entomology but acknowledges contributions from other fields like plant pathology and weed science.
The document defines key terms related to infection and host-pathogen interactions. It describes the process by which bacteria, viruses, and fungi cause infection, including how they evade host defenses. Clinical manifestations of infection result from direct microbial effects as well as the host inflammatory response, commonly including fever. A variety of microbes are capable of infecting the HEENT, respiratory, and GU tracts.
Antibiotics for surgical prophylaxis.
Surgical site infections(SSIs) are a significant cause of morbidity and mortality.
Approximately 2% to 5% of patients undergoing clean extra-abdominal operations and 20%undergoing intra-abdominal operations will develop an SSI.
SSIs have become the second most common cause of nosocomial infection and these data are likely underestimated.
IOSR Journal of Pharmacy (IOSRPHR), www.iosrphr.org, call for paper, research...iosrphr_editor
This document summarizes research on the use of probiotics for the management of periodontal disease. It begins with background on probiotics and criteria for probiotic strains. It then reviews the potential mechanisms by which probiotics could help treat periodontal disease, such as inhibiting pathogenic bacteria, reducing inflammation, and modulating the immune response. Several clinical studies are summarized that showed probiotics like certain Lactobacillus and Bifidobacterium strains reduced plaque, gingivitis symptoms and periodontal pathogens. Finally, some commercially available probiotic products for periodontal disease are listed.
Subgingival biofilm as etiological factor of periodontal diseaseDr Heena Sharma
This document summarizes subgingival biofilms as etiological factors of periodontal disease. It defines biofilms and describes the stages of biofilm formation. It discusses how subgingival biofilms are associated with periodontitis, including their composition, structure, and role in pathogenesis. The document also covers what metagenomics has revealed about subgingival biofilm composition and how in vitro models are used to study subgingival biofilms.
Mighty Maggots and Bairnsdale Ulcer TOWN talk 21st Nov 2013VeraQ Pty Ltd
This is an example of one of the many community outreach talks I have been asked to deliver as the result of my pozible.com/mightymaggots crowdfunding campaign. It is hoped one day that Deakin will have KPIs for this kind of engagement, so I can get professional recognition on top of the warm fuzzy feelings I get from Outreach!
This document provides guidelines for eliminating the transmission of multidrug-resistant organisms (MDROs) in healthcare settings. It discusses the history and development of antibiotic resistance, factors that facilitate MDRO transmission, and key prevention strategies including optimizing antibiotic use, preventing transmission, preventing infections, effective diagnosis and treatment, and involving infectious disease experts. Major tactics for preventing transmission involve proper isolation precautions, hand hygiene, environmental cleaning, and monitoring healthcare workers to break the chain of contagion.
Rational use of antibiotics is important for patient safety and public health. Antibiotics play an important role in orthopedic surgeries, both for treating infections and as prophylaxis when implants are used. The characteristics of implant materials also impact infection risk, with titanium having lower risk than other materials due to its biocompatibility. Antibiotic prophylaxis is justified for surgeries involving implants as it can reduce infection rates. However, irrational antibiotic usage has contributed to rising antibiotic resistance, so prudent antibiotic stewardship following guidelines is important.
R. Villano-Transatlantic Taskforce on Antimicrobial ResistanceRaimondo Villano
54. R. Villano “Antibioticoresistenza”. Si tracciano cenni storici sul concetto di antibiosi, su ricerche, scoperta e produzione degli antibiotici e sul loro ruolo mondiale non solo terapeutico ma anche strategico dal secondo dopoguerra. Poi, si esaminano a livello nazionale ed internazionale: le problematiche inerenti consumo, uso improprio e abuso di antibiotici nell’uomo, in zootecnia, agricoltura e, quindi, nel ciclo alimentare e nell’ambiente; le politiche di contrasto al fenomeno dell’iperprescrizione e nei cittadini il grado di informazione e consapevolezza dei rischi; le linee guida di buona prassi comportamentale del malato; i documenti principali di lotta a tale emergenza. Si effettuano, inoltre, una rassegna analitica e un approfondimento sualcune super patologie (tubercolosi, gonorrea, meningite, ecc.) e sulle resistenze batteriche ai principali antibiotici. Si realizzano, infine, una ricognizione sull’attualità delle tecnologie e degli indirizzi di ricerca applicata e una rassegna sulle principali recenti nuove terapie. Chiude il lavoro un’appendice tecnica contenente un apparato essenziale di normative e direttive ministeriali italiane e comunitarie europee sul tema. È in diverse istituzioni scientifiche, storiche, professionali e in molte Biblioteche specialistiche, civiche e nazionali in Italia e all’estero, tra cui: Ministero della Salute; Accademia Nazionale delle Scienze detta dei XL; Institute for the Preservation of Medical Traditions of Smithsonian Institution-Washington USA; Medica Statale; Scienze Mediche e farmaceutiche Sede di Medicina Università di Genova; Dipartimento di Scienze farmaceutiche Università di Padova;Nobile Collegio Chimico Farmaceutico Universitas Aromatariorum Urbis; nazionali: Napoli, Roma, Firenze, Potenza; Malatestiana di Cesena.(Chiron, ISBN 978-88-97303-25-1, CDD 610VILant2015 it, LCC DG461-583.8, Prima Edizione, pp. 164, Napoli, maggio 2015; Prima Ristampa giugno 2015; Seconda EdizioneISBN 978-97303-27-5, CDD 610VILant2015it , LCC NXI-820, pp. 256, Roma,luglio 2015);
This document discusses a consensus meeting regarding the use of polyhexamethylene biguanide (PHMB) in wound management. PHMB is a synthetic antimicrobial compound similar to natural peptides. It works by disrupting bacterial cell membranes. The meeting discussed PHMB's history, mechanisms of action, evidence for use, and clinical indications. Attendees sought to establish consensus on PHMB's effectiveness and appropriate clinical usage to improve patient outcomes and control healthcare costs.
The document discusses the Journal of Medical Microbiology & Diagnosis, an open access clinical-medical journal published by OMICS Group that provides an international platform covering fields like bacteriology, mycology, and clinical microbiology. It publishes research articles, review papers, and editorials with the goal of disseminating scientific research. The quality of the journal is ensured by its international editorial board.
Fungal superbugs are fungi that are resistant to most commonly used antifungals and fungicides. Candida auris is a deadly fungal superbug that is often drug-resistant and misidentified in laboratories. It can spread between patients in healthcare facilities through contact with contaminated surfaces or other carriers. Treatment is difficult as C. auris is usually resistant to multiple antifungal classes. Researchers are studying ancient remedies, combination therapies, and biological controls to address the growing problem of antifungal resistance outpacing new drug development.
This document discusses maggot therapy, which involves using fly larvae to treat wounds. It notes that maggots effectively remove dead tissue from wounds, leaving healthy tissue to heal. Specific fly species, Lucilia sericata and Phormia regina, are used. Larvae are placed on the wound and covered for 3 days to eat dead tissue. Maggot therapy is effective, safe, easy to apply, and affordable compared to other wound treatments. Potential downsides are pain sensation from larvae and that maggots must be used within 24 hours.
Identification and characterization of actinomycetes forAlexander Decker
This document describes a study that identified and characterized two actinomycete bacterial strains with
antagonistic activity against Streptomyces scabies, the pathogen that causes potato scab disease. The two strains
were isolated from soil samples. Molecular characterization using 16S rDNA gene sequencing identified the first
strain as Streptomyces avermitilis and the second strain as Actinomyces odontolyticus. Both strains showed high
levels of antibiosis against S. scabies in in vitro and in vivo assays, effectively controlling potato scab disease
symptoms on potato varieties Cara and Diamond.
MRSA is a bacterium that causes antibiotic-resistant infections in both humans and horses. It has been found in many countries worldwide with some strains being indistinguishable between species. The document discusses the risk factors, prevalence, and preventative measures for MRSA in horses and equine hospitals. Screening studies have found carriage rates of 0.7-10.1% in horses and veterinary professionals. Preventative strategies include active screening, strict isolation protocols, hygiene practices like regular surface disinfection, and in some cases targeted antibiotic treatment.
This document summarizes a study on using maggot debridement therapy (MDT) to treat necrotizing fasciitis. It found that among 15 patients treated with surgery, antibiotics, and MDT: 1) MDT reduced the number of surgical debridements needed, especially when started within 9 days of diagnosis; and 2) the wounds eventually healed in all patients except two who died from unrelated causes. It also describes in detail one patient's case of necrotizing fasciitis that was successfully treated with multiple debridements and 19 days of MDT.
Maggot therapy was compared to conventional debridement therapy for treating pressure ulcers. Maggot therapy resulted in a significantly smaller average surface area of necrotic tissue compared to conventional therapy. Maggot therapy also produced a significantly higher average percentage of wound base covered by granulation tissue than conventional therapy alone.
This case report describes the successful use of maggot therapy to treat an acute burn on the foot of a diabetic patient. Maggots were applied to the burn wound after initial treatment with silver sulfadiazine and saline soaks failed to adequately debride necrotic tissue. Over three applications of maggots spanning two weeks, the maggots effectively cleaned and debrided the wound. This accelerated healing and reduced the need for surgical debridement and skin grafting. The report concludes that maggot therapy can be a useful treatment even for some acute burns when standard treatments are ineffective or unsuitable due to patient comorbidities.
1) Maggot excretions have potent bactericidal properties that can destroy important pathogens like Staphylococcus aureus and Streptococcus pyogenes.
2) Testing showed that maggot excretions killed S. aureus in as little as 5 minutes when exposed to various densities of the bacteria. Even resistant broth cultures were killed within 60 minutes of exposure.
3) Excretions from both sterile and non-sterile maggots demonstrated bactericidal effects, though excretions from non-sterile maggots appeared more potent. The active bactericidal principle may be present in maggot feces and able to be isolated in a dried powder form.
This document summarizes 5 studies that compared maggot debridement therapy (MDT) to conventional debridement therapy (CDT) for wound healing. Most studies found MDT to be as effective as or better than CDT at removing dead tissue from wounds. Specifically, 2 studies found MDT removed only dead tissue, allowing faster healing, while 1 study found no difference in healing rates between MDT and CDT. The studies examined wounds in patients with diabetes and chronic wounds. Overall, the studies suggest MDT is a viable alternative to CDT, especially for wounds that require fast debridement.
Chronic wounds can develop due to various pathologies and are characterized by impaired healing. Larval debridement therapy has been shown to effectively treat chronic wounds. This study investigated additional factors in maggot secretions that may contribute to wound healing. The researchers found that maggot secretions significantly increased fibroblast migration even when protease inhibitors were added. Western blot analysis also revealed the presence of human growth factor homologues in the maggot secretions, which may further explain their wound healing effects during larval debridement therapy.
1) Maggot therapy employs sterile fly larvae to promote wound healing through debridement, disinfection, and stimulation of wound healing.
2) Maggots secrete antibacterial factors that combat wound infections, including potential agents active against methicillin-resistant Staphylococcus aureus (MRSA).
3) Maggots may enhance wound healing through physical stimulation of tissue, secretion of allantoin and ammonia to increase pH, and stimulation of growth factors involved in proliferation and remodeling of extracellular matrix.
This document describes a study investigating the potential of anti-adhesion therapies for treating bacterial skin infections. Synthetic peptides of the tetraspanin CD9 were tested for their ability to reduce adhesion of Staphylococcus aureus and Pseudomonas aeruginosa, two common causes of skin infections, to human keratinocyte cells. Both peptides showed a reduction in bacterial adherence individually and when the bacteria were present together, demonstrating the peptides' potential as an alternative treatment to combat antimicrobial resistance by disrupting bacterial adhesion.
A Review on Transomal Gels Therapy for Fungus Diseaseijtsrd
Fungal infections are induced by means of microscopic organisms that can invade the epithelial tissue. It detailed about the mechanism of occarance of fungus. The fungal kingdom entails yeasts, molds, rusts and mushrooms. This article detail about the fungus disease, their types, transomal gel technology, advantages and disadvantages. Bajrangi Poddar | Dr. Hariom Sharma | Jaya Singh "A Review on Transomal Gels Therapy for Fungus Disease" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-5 , August 2020, URL: https://www.ijtsrd.com/papers/ijtsrd32988.pdf Paper Url :https://www.ijtsrd.com/pharmacy/other/32988/a-review-on-transomal-gels-therapy-for-fungus-disease/bajrangi-poddar
This document discusses the history and modern use of maggot therapy in medicine. Maggot therapy involves using fly larvae to clean infected and necrotic wounds. Maggots secrete enzymes that eat away dead tissue while leaving healthy tissue intact. They also secrete antibacterial compounds. This "debridement" action helps disinfect wounds and stimulate healing. While widely used in the early 20th century, maggot therapy fell out of favor after antibiotics were discovered. However, it is seeing renewed interest due to antibiotic-resistant infections. The FDA now regulates the use of medicinal maggots to treat chronic wounds.
History of the Forgotten Cure - Phage therapyStudent
1) The document provides a history of phage therapy, from its discovery in the late 19th/early 20th century to its decline with the rise of antibiotics and recent rediscovery due to antibiotic resistance. Key figures who discovered and explored phages and phage therapy include Ernest Hankin, Frederick Twort, and Félix d'Herelle.
2) It discusses how phage therapy works, involving using bacteriophages to treat bacterial infections. Advantages over antibiotics include phages' ability to self-replicate and adapt versus antibiotics being fixed molecules.
3) Problems that initially limited phage therapy are addressed, such as host range, bacterial debris in preparations, and lysogeny.
Myiasis is the infestation of humans and other animals with fly larvae that feed on dead or living tissue. There are several types of myiasis including accidental, facultative, and obligatory. The main flies that cause myiasis belong to the families Calliphoridae, Sarcophagidae, and Oestridae. Myiasis can cause damage and disfigurement if tissues like the face are invaded, and larvae in body openings cause severe pain. However, maggot therapy uses fly larvae to remove dead tissue from wounds, as the maggots secrete enzymes that debride the wound and kill bacteria while avoiding healthy tissue.
This document provides an overview of wound management principles including the TIME framework. It discusses debridement as the primary tissue management intervention to remove non-viable tissue. Signs of infection and treatments are outlined, including topical and systemic antimicrobial therapies. The benefits of moist wound healing are described. Finally, the document reviews different types of wound dressings and their properties and indications. The overall goal is to educate on wound bed preparation and management of chronic wounds.
Clinical Management of Cutaneous Myiasis Wound Due To Post Traumatic Horn Inj...iosrjce
IOSR Journal of Agriculture and Veterinary Science (IOSR-JAVS) is a double blind peer reviewed International Journal edited by the International Organization of Scientific Research (IOSR). The journal provides a common forum where all aspects of Agricultural and Veterinary Sciences are presented. The journal invites original papers, review articles, technical reports and short communications containing new insight into any aspect Agricultural and Veterinary Sciences that are not published or not being considered for publication elsewhere.
This document summarizes recent advances in biological viruses. It discusses how researchers used gene editing to create pigs resistant to the costly Porcine Reproductive and Respiratory Syndrome virus. It also describes the discovery of a novel giant virus infecting marine algae in Hawaii waters. Additionally, it outlines how a study revealed a new path of viral evolution through host recognition protein mutations. The document concludes by summarizing research that identified the first treatment for the deadly Marburg virus and findings that Pandoraviruses can invent their own genes.
Vancomycin-resistant Staphylococcus aureus (VRSA) is a serious antibiotic-resistant bacterial infection. Overuse and misuse of antibiotics has encouraged the emergence of resistant strains like VRSA. VRSA was first identified in the 1990s and cases have been reported worldwide since then. VRSA poses a major health risk as it can be difficult to treat and has the potential to spread rapidly internationally through human travel and contact. Proper infection control practices and antibiotic stewardship are important to prevent the further emergence and spread of VRSA.
This document discusses dento-alveolar infections, including:
- The stages of inflammation and types of irritants that can cause infections.
- The bacteria commonly found in oral infections and the environments they thrive in.
- The progression of odontogenic (tooth-related) infections from early to late stages and the spread of infection through facial spaces.
- The principles of diagnosing and managing odontogenic infections, including determining severity, evaluating the host, surgical drainage, antibiotic therapy, and frequent evaluation of the patient.
causes and mangment of post endodontic diseasepraveen_512
The document discusses causes and management of post-treatment endodontic disease. It identifies several potential causes of post-treatment apical periodontitis including persistent or reintroduced intraradicular microorganisms, extraradicular infection, foreign body reaction, and true cysts. Persistent intraradicular infections are the major cause, with bacteria able to survive through biofilm formation, entering dormant states, and activating stress response genes. Extraradicular infections may also develop through biofilm formation on root surfaces. While some case reports have suggested non-microbial causes, microbes are often difficult to rule out as a contributing factor.
Larval therapy uses fly larvae to debride wounds and promote healing. It has been used for hundreds of years and research is increasing due to antibiotic resistance. Larval therapy debrides wounds, kills bacteria including MRSA through ingestion and secretions, and promotes granulation. However, the yuk factor of seeing maggots in wounds limits its acceptance. Further large studies are still needed to fully understand larval therapy's mechanisms and advantages compared to other treatments.
Furuncularmyiasis in a Child Caused by Flesh Fly (Wohlfahrtia magnifica) and ...inventionjournals
We report the case of a two-year-old boy with hyper eosinophilia who presented with a swelling on his left scapular that had persisted for more than three weeks. A second-stage larva of Wohlfahrtia magnifica was found with associated bacterial organisms such as Proteus vulgaris, Staphylococcus aureus and Staphylococcus epidermidis, leading to the diagnosis of cutaneous myiasis. Following removal of the larva and secondary bacterial therapy, the clinical and hematological manifestations returned to normal. Diagnosis of myiasis and associated secondary infections should always be kept in mind in the event of clinical signs of furuncular lesions, pain, fever, exudation which may be accompanied by eosinophilia.
THE PHARMACOLOGY AND EFFICACY OF ANTIFUNGALS: A LITERATURE REVIEWPARUL UNIVERSITY
This article reviews the pharmacology and efficacy of antifungal drugs. It discusses the classification of antifungals which include polyenes, azoles, echinocandins, and antimetabolites. It also describes the types of fungal infections such as superficial, subcutaneous, and systemic infections. Finally, it provides an overview of antifungal pharmacology and discusses considerations for antifungal drug selection.
1) A study investigated Pseudomonas aeruginosa isolated from 65 burn victims admitted to a hospital in Iraq over 2 months.
2) PCR and phenotypic assays found that the majority of P. aeruginosa isolates were able to form alginate biofilm and had high antibiotic multi-drug resistance.
3) Specifically, 82% of isolates were found to be positive for alginate biofilm formation by PCR and 91% by a phenotypic assay, and the isolates showed resistance to many antibiotics with a multiple antibiotic resistance index of 0.4.
The document provides an updated international consensus on definitions and management of wound infection in clinical practice. It defines key terms like acute wound, chronic wound, and biofilm. It presents an updated wound infection continuum that recognizes the role of microbes other than bacteria and the presence of biofilm. The continuum stages the gradual increase in microorganism number and virulence and resulting host response, from contamination to systemic infection. The consensus aims to guide best practices in preventing, identifying, and treating wound infection.
This document provides an updated international consensus on wound infection in clinical practice from experts in the field. It defines key terms related to wound infection and chronicity. It presents an updated wound infection continuum that includes biofilm and removes the term "critical colonization". It describes the signs and symptoms associated with different stages of infection from contamination to systemic infection. It also discusses the biofilm cycle and emphasizes the importance of biofilm-based wound care to prevent, interrupt, and delay biofilm formation and reformation.
Molluscum contagiosum is a viral disease with following characteristics:
Benign viral infection
Caused by a pox virus
Double stranded DNA virus
Spread by direct contact, bath towels, tattoo instruments, beauty parlour implements, swimming pools in children
In adults, most commonly an STD, males>females
Incubation period – 2-7 weeks but can be as long as 26 weeks
More common and severe in patients with A.D.
More common in certain geographic areas with warm climates (Fiji, Congo, Papua New Guinea)
Abstract— Season seems to have its role in wound infection which is the second commonest nosocomial infection and most troublesome disorder of wound healing. This study was carried out on 100 post-operative cases of Surgical Unit 1st of General Surgery Department of Sawai Man Singh Hospital, Jaipur (Rajasthan) India in years 2014. This study aimed to find out the seasonal trend in Post-operative wound infections (PSI). After interview of these, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Results were inferred by Chi-square test. In this study, post-operative wound infection rate was found 21%. In majority of cases, causative agent found in post-operative infected wound was Staphylococci (90.48%) followed with Streptococci, E. Coli, Klebsella and Pseudomonas. Maximum cases were found in April followed by March, January and none was found in other months but this variation was not found significant.
Este documento describe el único caso reportado en el mundo de un paciente diabético con gangrena necrotizante que fue tratado exitosamente con terapia larvaria en lugar de una amputación. El paciente de 58 años llegó con infección severa en sus brazos y piernas pero rechazó la amputación y optó por la terapia alternativa con larvas. Luego de varios tratamientos con antibióticos y desbridamiento con larvas, logró salvar sus extremidades.
Este documento presenta tres casos de pacientes con úlceras varicosas que fueron tratados exitosamente con terapia de larvas en el Instituto de Investigación del Dr. Vincent. El primer caso involucra a un hombre de 61 años cuya úlcera se curó completamente en 6 días con larvas sin antibióticos. El segundo caso describe a un hombre de 59 años cuya úlcera de 14 años de evolución se curó en 8 días con larvas. El tercer caso es de una mujer diabética de 80 años cuya úlcera de 42 años de evolución se
Este documento presenta 5 casos de pacientes con osteomielitis y gangrena que fueron tratados exitosamente con larvas medicinales sin necesidad de amputaciones. Los pacientes tenían condiciones como diabetes, infecciones resistentes a antibióticos y necrosis ósea extensa. Tras el tratamiento con larvas durante varias semanas, los huesos y tejidos afectados sanaron completamente sin complicaciones.
(1) Un hombre de 82 años tuvo que ser amputado debajo de la rodilla debido a una gangrena masiva en el pie derecho. (2) Más tarde, su muñón también se gangrenó y los médicos querían amputar más arriba, pero la familia optó por terapia larvaria. (3) La terapia larvaria resolvió exitosamente el problema en 2 semanas sin necesidad de una amputación más extensa.
El documento describe las etapas y niveles de una organización de marketing multinivel, incluyendo los requisitos para alcanzar cada nivel y los beneficios asociados como regalías, bonos de liderazgo y otros premios. Para avanzar de nivel se requiere reclutar y mantener un número creciente de personas en las generaciones debajo, con mayores beneficios al alcanzar los niveles más altos que requieren ampliar la organización de manera exponencial.
Este documento describe las ventajas del plan de compensación de matriz única global de una compañía sobre otros planes como binarios, uniniveles o matrices forzadas. Ofrece ingresos garantizados en cada rango al pagar a los distribuidores por todo el volumen generado debajo de ellos, sin importar su posición. También destaca premios por alcanzar nuevos rangos y bonos para constructores de negocios.
El documento describe dos casos de úlceras gigantes por presión que fueron tratadas exitosamente con larvas medicinales. El primer caso involucra a un hombre de 82 años con una úlcera gigante en el sacro que no respondía a otros tratamientos. Luego de la aplicación de larvas medicinales, la herida sanó notablemente en 48 horas. El segundo caso describe a un hombre de 27 años con úlceras en ambos trocánteres que sanaron completamente después de 4 aplicaciones de larvas, a pesar de sus múltiples complicaciones médicas. Ambos pac
Este documento describe un caso de tendinitis de la pata de ganso en un paciente diabético que no respondía a tratamientos antibióticos y quirúrgicos. El jefe de cirugía decidió probar terapia con larvas, la cual curó completamente las 3 úlceras del paciente en solo 6 sesiones, para asombro de los colegas.
El documento habla sobre la ignorancia que ha llevado a muchas amputaciones innecesarias de dedos de los pies, pies, piernas y brazos de personas diabéticas debido al tratamiento inadecuado de úlceras por parte de personas sin los conocimientos médicos adecuados.
Este documento presenta tres casos de pacientes con fascitis necrotizante y gangrena que fueron tratados exitosamente con terapia de larvas. El primer caso es de un hombre diabético con gangrena gaseosa del pie derecho que rechazó la amputación. El segundo caso es de una mujer diabética con abscesos y necrosis en el talón izquierdo a quien también le recomendaron la amputación. El tercer caso es de un hombre con gangrena gaseosa en el pie izquierdo a quien le querían amputar la pierna en el hospital. En
Este documento presenta dos casos clínicos de hombres con infecciones graves en los pies. En el primer caso, un hombre de 63 años tenía una infección en el dedo gordo del pie que los doctores recomendaron amputar, pero fue tratado con éxito usando larvas sin necesidad de amputación. En el segundo caso, un hombre de 56 años tenía una celulitis necrotizante grave en el pie que también iba a ser amputado, pero las larvas curaron la infección y salvó su pie de la amputación. Ambos casos muestran los benefic
Las larvas y la Biblia se refieren a un versículo de Job que describe su piel cubierta de larvas y polvo, y su piel hendida y abominable. El documento también menciona al Dr. Vincent, M.D.
Una mujer diabética de 64 años fue ingresada al hospital para tratar un ántrax en la espalda que era resistente a varios antibióticos. Se llamó a un cirujano reconstructivo para tratarla con larvas de mosca, lo que resultó en una mejoría notable de sus úlceras en solo dos semanas sin usar antibióticos, sanando completamente y sin rastros de las larvas.
Un hombre de 67 años tenía un absceso perianal y un cirujano experimentado recomendó una colostomía. El paciente pidió el alta y fue tratado con larvas medicinales por el Dr. Vincent, lo que curó el absceso sin necesidad de cirugía. El Dr. Vincent incluyó fotografías del paciente curado para demostrar la eficacia del tratamiento con larvas.
This document provides an introduction to the first issue of Biosurgical News, a newsletter about biosurgery and the use of maggots in wound treatment. It discusses the history of maggot therapy and its resurgence in recent decades. It also introduces the Biosurgical Research Unit, which produces the sterile maggot product LarvE, and announces new staff and training opportunities. Short articles describe awards for LarvE and a case study using maggots to treat a donkey.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
#cALL# #gIRLS# In Dehradun ꧁❤8107221448❤꧂#cALL# #gIRLS# Service In Dehradun W...
Evidencias2006 i
1. Advance Access Publication 5 May 2006 eCAM 2006;3(2)223–227
doi:10.1093/ecam/nel021
Review
Maggot Therapy: The Science and Implication for CAM
Part I—History and Bacterial Resistance
Yamni Nigam1, Alyson Bexfield1,2, Stephen Thomas3 and Norman Arthur Ratcliffe2
1
School of Health Science, University of Wales Swansea, Singleton Park, Swansea SA2 8PP, UK,
2
Department of Biological Sciences, University of Wales Swansea, Singleton Park, Swansea SA2 8PP, UK and
3
Biosurgical Research Unit (SMTL), Princess of Wales Hospital, Coity Road, Bridgend CF31 1RQ, UK
It is now a universally acknowledged fact that maggot therapy can be used successfully to treat chronic,
long-standing, infected wounds, which have previously failed to respond to conventional treatment.
Such wounds are typically characterized by the presence of necrotic tissue, underlying infection and
poor healing. Maggot therapy employs the use of freshly emerged, sterile larvae of the common green-
bottle fly, Phaenicia (Lucilia) sericata, and is a form of artificially induced myiasis in a controlled clin-
ical situation. In this review article, we will discuss the role of maggots and their preparation for clinical
use. Maggot therapy has the following three core beneficial effects on a wound: debridement, disinfec-
tion and enhanced healing. In part I we explore our current understanding of the mechanisms underlying
these effects.
Keywords: Maggot debridement therapy – MRSA – antimicrobial – Lucilia sericata – wounds
Introduction I—The Rise and Fall of made by many surgeons who followed, but it was William
Maggot Therapy Baer, Professor of Orthopaedic Surgery at the John Hopkins
School of Medicine in Maryland, USA, who is believed to be
Numerous clinical reports have been published that describe the founder of modern maggot therapy (14).
the outstanding effects of maggot therapy, most notably on It was Baer who pioneered the use of sterile maggots as a
debridement, cleansing, disinfection and healing of indolent reputable method of wound therapy, following observations
wounds, many of which have previously failed to respond to he made about the value of maggots in traumatic wounds on
conventional treatment (1–11). Current day maggot therapy, the battlefield in France during World War 1. Such was the
with its multi-action approach to wound cleansing and healing, success of Baer’s work that by the mid-1930s almost 1000
is highly successful. North American surgeons employed maggot therapy (15) and
Records of maggots in wounds, however, and the recogni- by the end of the decade it was in use in over 300 hospitals
tion of improvement in the wound state as a consequence of in the US and Canada. However, by 1940, a new era was dawn-
infestation, date back to the 16th century (12). In 1829, Baron ing. This era which saw the introduction and widespread use of
Dominic Larrey, Napoleon’s battlefield surgeon, described antibiotics following the mass production of penicillin (16). So
how men had arrived at his field hospital with healing despite the obvious success of maggot therapy, by the
maggot-infested wounds (13). The wounds were sustained in mid-1940s it had practically disappeared from use. In Part 1
battle, but, owing to the presence of maggots, were not infected of this review, we introduce the stages involved in the wound
and showed accelerated healing. Such positive accounts were healing process, the advantages in the use of maggots for the
cleaning (debridement) of infected wounds, and the possible
mechanisms underlying the debridement of wounds by mag-
For reprints and all correspondence: Yamni Nigam, University of Wales
Swansea, Singleton Park, Swansea SA2 8PP, UK. E-mail: gots. The antimicrobial activity of maggots to treat methicillin-
Y.Nigam@swansea.ac.uk resistant Staphylococcus aureus (MRSA)-infected wounds
Ó The Author (2006). Published by Oxford University Press. All rights reserved.
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access
version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and Oxford University
Press are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its
entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org
2. 224 Maggot therapy: Part I
is also described and details of the nature of the potent Maggot Therapy: Selection of the Flies
antibacterial activity of maggot secretions are then considered
in Part II of this review. Many dipteran species are capable of infesting living verte-
brate hosts (a condition termed myiasis). Maggot therapy is
Review of Wounds and Events during Healing essentially artificially induced myiasis, performed in a con-
trolled environment by experienced medical practitioners.
A wound is a breach in the skin, which may allow the entry of Myiasis-causing flies may be grouped into two categories as
microorganisms, possibly leading to infection. Wound tissue follows: obligate and facultative parasites. Obligate parasites
provides the rich environment necessary for the proliferation require the ingestion of living tissue in order to complete their
of microbes. It is characterized by hypoxia, necrosis and often lifecycles (22). Larvae of obligate parasites can cause severe
an accompanying impaired immune response owing to subop- damage to healthy tissue and are therefore unsuitable for use
timal delivery of immune effector molecules through damaged in maggot therapy. Facultative parasites are able to parasitize
blood vessels (17). This compromised, necrotic, sloughy tissue living hosts if conditions are favorable, but more commonly
provides a warm, moist and nutritive environment, perfect for develop on carrion and therefore have greater potential for
replication of colonizing bacteria. Bacterial species which therapeutic use.
were previously harmless commensals of the human body, Selection of a suitable fly species for use in maggot therapy
most commonly on the skin, may become pathogenic in a is of paramount importance, determining both the safety and
wound environment (18). In order for a wound to heal, it success of the treatment. It is imperative to select a species
must progress through the following four main stages of the that feeds almost exclusively on necrotic tissue. William
healing process (19): (i) the inflammatory phase where hemo- Baer chose the larvae of Phaenicia sericata, the common
stasis occurs and numerous inflammatory mediators are green-bottle, as the most appropriate species for this applica-
released. Leukocytes migrate into the wound, and the bacterial tion and this is the species still used by practitioners today.
burden of the wound is decreased. (ii) The destructive phase Phaenicia larvae are facultative parasites, unable to ingest or
which sees the phagocytosis of necrotic tissue and killing of significantly damage healthy human tissue (2). Infestations
ingested microbes and foreign particles. Numerous growth fac- of living hosts by Phaenicia do, however, occur, most com-
tors are released during this phase. (iii) The proliferative phase monly in sheep to induce an often fatal condition known as
involves the formation of new capillary loops and granulation sheep strike. Exactly why Phaenicia attack the healthy tissue
tissue (angiogenesis), fibroplasia and the synthesis of new of sheep and appear unable to do the same to human tissue is
matrix and collagen. (iv) The maturation phase occurs when as yet unknown.
wound collagen is remodeled and reorganized. The wound
contracts and epithelialization occurs. These events often hap-
pens during wound healing using adaptogens (20) (natural herb Female Flies, Eggs, Larvae and
products that increase the body’s resistance to physical, chem- Preparation for Clinical Use
ical or biological stresses). There is considerable overlap
In the wild, adult female Phaenicia lay a large number of eggs
between the various stages, and the entire healing process
(2000–3000) over the course of a few weeks, a necessity as
can take months to complete, with full maturation often not
relatively few will survive to adults. The eggs are laid in
achieved until a year after the wound was initiated.
clusters directly onto the chosen food source, upon which the
emerging larvae will feed. Larval development requires a
Types of Wounds
moist environment to prevent desiccation, so larvae are gener-
Wounds can be broadly divided into two types, acute and ally found in nutritious, damp places such as decaying animal
chronic, which exhibit significant differences in the healing corpses or moist, necrotic wounds (22). Eggs hatch within
process. An acute wound is one which is usually instigated 18–24 h, depending on optimal conditions, into first instar
by a sudden, solitary insult, such as a traumatic injury. Such larvae (maggots), 1–2 mm in length, which immediately
wounds generally proceed through the healing process in an and actively begin to feed. It is this vigorous feeding activity,
orderly manner. In contrast, a chronic wound, such as a leg which is beneficial to an infected or necrotic wound. Maggots
ulcer, is usually owing to an underlying pathological process, feed by the extracorporeal secretion of a wide spectrum of
such as diabetes or vascular insufficiency, which produces a proteolytic enzymes that liquefy the host tissue (23–26). This
repeated and prolonged insult to the tissue, resulting in severe semi-digested liquid material is then ingested as a source
damage. The chronic wound does not normally progress of nutrients. The maturing first instar larvae continue to feed
through the healing process, often remaining in the inflammat- for 4–5 days, molting twice as they increase in size to
ory, infected phase and causing much discomfort and distress 8–10 mm, at which point they stop feeding and leave the
to the patient. Although maggots can be used for any kind of wound or corpse to search for a dry place in the ground where
purulent, sloughy wound on the skin, independent of the they pupate (25). Following metamorphosis, an adult fly
underlying disease or the location on the body (21), it is in emerges from the pupa. In preparation for clinical use, flies
the cleansing and healing of such chronic wounds that maggot typically oviposit onto porcine liver, and the eggs are separated
therapy becomes an invaluable tool. and chemically sterilized. Resultant (L1) larvae are sterile
3. eCAM 2006;3(2) 225
upon emergence from the egg and undergo rigorous testing to deep crevices that may be beyond the reach of a surgeon’s
ensure their microbiological status (3). Larvae are then main- scalpel. Reports have been published marveling at the benefits
tained under aseptic conditions prior to wound application. of maggot debridement therapy (MDT) in all sorts of wounds,
including abscesses, burns, gangrenous wounds, arterial and
venous ulcers, osteomyelitis, diabetic foot ulcers and pressure
Debridement (Wound Clearing)
sores (7,9,31–33). One such study compared MDT with con-
Maggot therapy has the following three core beneficial effects servative debridement therapy for the treatment of pressure
on a wound: debridement, disinfection and enhanced healing. sores (34). Here, 80% of maggot-treated wounds (n ¼ 43)
Debridement is the removal of cellular debris and non-viable were completely debrided, while only 48% of conventionally
necrotic tissue from the wound bed. This is a first, essential treated wounds (n ¼ 49) were completely debrided. Also, by
step before healing can commence. Removal of necrotic tissue using maggots, total wound surface area decreased, whereas
abolishes many of the associated bacteria and also reduces during conventional debridement therapy, the total wound
wound odor. The removal of necrotic tissue, which acts as a area had increased (p ¼ 0.001) (34). The report concluded
microbial substrate, may also reduce the risk of infection. Dur- that maggot therapy was a more effective and efficient way
ing the inflammatory stage of wound healing host leucocytes of debriding chronic pressure sores than the conventional
play an important role in debridement of wound sites, degrad- treatments prescribed.
ing damaged extracellular matrix (ECM) components through
the release of proteases. The injury is initially filled with a pro-
Mechanisms of MDT
visional wound matrix consisting predominantly of fibrin and
fibronectin. Key proteases are involved in ECM degradation How exactly maggots remove devitalized, necrotic tissue from
(see below). These are released from neutrophils, macro- the wound is currently actively being investigated. Research
phages, fibroblasts, epithelial and endothelial cells. As healing into the debridement mechanisms underlying maggot therapy
proceeds, and new ECM constituents such as collagen, elastin has revealed that maggots secrete a rich soup of digestive
and proteoglycans are synthesized, damaged ECM is removed enzymes while feeding, including carboxypeptidases A and B
by these proteases (27). (35), leucine aminopeptidase (35), collagenase (23,36) and
serine proteases (trypsin-like and chymotrypsin-like enzymes)
(35,37). Recently, workers in Nottingham, UK, demonstrated
Chronic Wounds
in vitro a range of enzymes secreted by P. sericata larvae
Chronic wounds do not proceed through the normal healing (26). Four proteolytic enzymes, comprising two serine pro-
process and are typically characterized by prolonged inflam- teases, a metalloproteinase and an aspartyl proteinase, were
mation, inhibition of cell proliferation (28,29), incomplete detected, with molecular weights ranging from 20 to 40 kDa,
ECM remodeling and a failure to epithelialize (30). Over with activity across a wide pH range. A chymotrypsin-like
expression and inefficient debridement of temporary ECM serine proteinase exhibited excellent degradation of ECM
components, e.g. fibronectin and fibrin, contribute to the fail- components laminin, fibronectin, and collagen types I and III
ure of chronic wounds to heal. The entire environment of a (26), and may therefore play a significant role in the digestion
chronic wound must be rebalanced for wound repair to proceed of wound matrix and effective debridement.
to completion, an undertaking which is unlikely to occur The mechanical action of numerous wriggling maggots in a
without extraneous intervention and one of the explanations necrotic debris-filled wound has also been suggested in aiding
as to why chronic wounds may persist for many years. wound debridement. Maggots possess a pair of mandibles
There are a number of existing methods for the debridement (hooks) which assist with locomotion and attachment to tissue.
of chronic wounds as described by Schultz et al. (27). These This probing and maceration of wound tissue with maggot
include surgical and sharp debridement (using scalpel or mouthhooks may enhance debridement (38), but these hooks
scissors to remove debris and necrotic tissue), mechanical are used during feeding to disrupt membranes and thus facilit-
debridement using methods such as wet-to-dry dressings, ate the penetration of proteolytic enzymes (3). Together, this
wound irrigation and whirlpool techniques, enzymatic debri- mechanical action and the secretion of powerful, proteolytic
dement using the application of exogenous enzymes, and enzymes may be the secret of efficient tissue debridement.
autolytic debridement using hydrogels and hydrocolloids.
Each of these techniques has associated disadvantages such Disinfection (Introduction to
as extended treatment times, pain and mechanical damage to
Antibiotic Activity)
underlying healthy tissue.
For wounds to heal, and progress through stages of destruc-
tion and proliferation onto maturation, infection needs to be
Maggot Debridement Therapy
eliminated. The majority of wounds are polymicrobial, hosting
The alternative is maggot therapy. Maggots debride wounds a range of both anaerobic and aerobic bacteria (18,39).
quickly and effectively, without damage to viable tissue. Antimicrobial treatment of clinically infected and non-healing
Maggots are photophobic and will naturally move into the wounds, should, therefore, encompass broad-spectrum anti-
4. 226 Maggot therapy: Part I
Figure 1. Wound before maggot debridement therapy. This wound, covered Figure 2. Wound following three applications of maggots. The wound is com-
with a thick layer of slough, failed to respond to conventional treatment over pletely free of slough and rich with granulation tissue.
18 months.
microbials in order to cleanse the wound effectively. The kill clinical isolates of MRSA (51,52). As an example, Fig. 1
application of maggots to an infected wound results in shows a wound 5 cm in diameter and totally covered with a
the rapid elimination of such infecting microorganisms thick layer of viscous slough. One pot of larvae was applied
(2,6,40,41). The most frequently isolated pathogen from acute and left for 48 h, after which there was an immediate and
and chronic wounds is Staphylococcus aureus. S. aureus is marked improvement to the wound. Two further applications
carried innocuously by 30% of the general population (42) of larvae were made. At this point, only 6 days after maggot
[40–70% of hospital staff (43,44)], usually on the moist skin therapy had commenced, the wound, which had not responded
in the nose, axillae (armpits) and perineum (groin), but can to conventional treatment over 18 months, was now com-
become pathogenic when able to enter damaged skin. S. aureus pletely free from slough. It was filling rapidly with healthy
has caused great concern owing to its ability to acquire granulation tissue and a swab failed to detect any presence
resistance to a range of antimicrobials. of MRSA (Fig. 2). Larval therapy was now discontinued
and the wound continued to progress normally and healed
uneventfully (6).
Penicillin Methicillin Resistance and MRSA
In 1948, 4 years after the widespread introduction of penicillin,
Acknowledgments
over 50% of nosocomial S. aureus were penicillin-resistant
(45) owing to the production of penicillinase (b-lactamase), We wish to thank Bro Morgannwg and Action Medical
an enzyme which inactivates b-lactam antibiotics (46). Research (grant number AP1010) for financial support. The
Currently, the majority (80–90%) of S. aureus are penicillin- work was partly funded by the Bro Morgannwg NHS Trust.
resistant. In 1960, a structural modification of penicillin saw
the synthetic production of methicillin, which was active
against penicillin-resistant strains of S. aureus. The launch References
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