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Biomedical subjects

K Y Mumcuoglu

Publications and source records attributed to K Y Mumcuoglu.

At least 19 recordsLinked to original sources

In vitro antibacterial activity of Lucilia sericata maggot secretions.

Maggots of the green blowfly, Lucilia sericata, are used as an alternative to surgical intervention and long-term antiseptic therapy for the treatment of chronic wounds. The secretions of maggots are known to have antibacterial properties. To quantify the bactericidal effect of secretions from larvae of L. sericata, an in vitro test model based on the modified European quantitative suspension test (EN 1040) was developed, in which a co-culture of maggots and bacteria (Micrococcus luteus,Escherichia coli, methicillin-sensitive Staphylo-coccus aureus) in tryptic soy broth was tested. The numbers of bacterial colonies with and without maggot exposure were compared after 24, 48 and 72 h of exposure. The mean log(10) reduction factor (RF) for bacterial elimination per maggot was >4 at all examined times for all tested bacteria. Thus, maggot secretion fulfilled the required definitions of an antiseptic. In addition, the maggots' ability to ingest bacteria was also evaluated. Maggots contained viable bacteria after 48 h of contact with the respective organisms. These maggots also continued excreting bacteria. Therefore, maggots should be disposed of after use as they must be regarded as medical waste.

Animals↗

Use of temperature and water immersion to control the human body louse (Anoplura: Pediculidae).

Physical methods such as high and low temperatures were used in the past for the control of human body louse, Pediculus humanus humanus L. (Anoplura: Pediculidae). In the current study, the minimum time necessary to kill all lice after exposing them to temperatures other than those described in the literature, the mortality of lice after immersing them in water, and the survival of lice whose legs were amputated were studied. All lice died after 6 d at 6 degrees C, after 11 d at 24 degrees C, and after 9 d at 31 degrees C. At -17 degrees C, all lice were dead after 35 min, whereas at -70 degrees C, all lice were dead after 1 min. All lice died after immersion in water within 19 h. The differences in mortality were significant but borderline between controls and lice whose two legs were amputated immediately or 24 h after feeding (3.3 versus 13.3% and 8.3 versus 21.7%). For lice whose leg was amputated 48 h after feeding, significant differences were found between controls and lice with one amputated leg (13.3 versus 48.3%), between controls and lice with two amputated legs (13.3 versus 68.3%), and between lice with one and two amputated legs (48.3 versus 68.3%).

Amputation, Surgical↗

Immune response in demodicosis.

BACKGROUND: Demodex folliculorum and Demodex brevis are obligatory parasites in the hair follicles and in the pilosebaceous glands. Although most people are infested with these mites, only a small number develop the clinical symptoms of demodicosis. The objective of this study was to determine the distinguishing features of the immune response to the infestation of the skin by Demodex mites. METHODS: Twenty-nine patients with human demodicosis and 13 age- and sex-matched healthy subjects participated in the study. The presence of mites was determined by microscopic inspection of secretion from sebum glands. The immune response was evaluated in the peripheral blood by identifying membrane markers of different immune cells using monoclonal antibodies, while the concentration of immunoglobulin (Ig)A, IgM and IgG was calculated by simple radial immunodiffusion using anti-IgA, anti-IgM and anti-IgG. The level of circulating immune complexes and total haemolytic complement, as well as the preparatory and digestive function of neutrophils, and the functional activity of leucocytes were also studied. RESULTS: The absolute number of CD95+ was higher in patients with demodicosis. The absolute number of CD3+, CD4+, CD8+ and CD16+ cells, the ratio CD3+/CD20+ and the functional activity of leucocytes were significantly lower in individuals infested with Demodex mites. No significant differences were found in the percentage and absolute number of CD20+ cells, the ratio of CD4+/CD8+ T-cell subpopulations, circulating immune complexes, level of serum complement activity (CH(50)), activity and index of phagocytosis and the levels of IgA, IgM and IgG antibodies between individuals infested with Demodex mites and the control group. CONCLUSION: The readiness of lymphocytes to undergo apoptosis increases in parallel to the increasing density of the mites. This could be the result of local immunosuppression caused by the mites, which allows them to survive in the host skin.

Adult↗

Association between human demodicosis and HLA class I.

Demodex folliculorum and D. brevis are obligatory parasites in hair follicles and in pilosebaceous glands of human skin. Although most people are infested with these mites, only a small number develop the clinical symptoms of skin demodicosis. The objective of this study was to determine the association between HLA specificity and demodicosis. Twenty-five patients with human demodicosis and 150 controls were typed for HLA-A, B, Bw, and Cw using the microlymphocytotoxicity method. The immune response was evaluated by identifying membrane markers of different immune cells using monoclonal antibodies. An association between the frequency of HLA Cw2 and Cw4 haplotypes and human demodicosis was established. The risk of developing clinical symptoms of this disease is 5.0 times higher for people with the Cw2 phenotype and 3.1 times higher for those with the Cw4 haplotype. Individuals who have the HLA A2 phenotype are 2.9 times more resistant to demodicosis. A positive correlation between demodicosis and the haplotypes A3-Cw4, A3-Cw2, A3-B17, A3-B35 and B35-Cw4 was found. In addition, an association between Cw2 and Cw4 alleles in the phenotype of patients with demodicosis and a decrease in the number of natural killer cells was found.

Adult↗

Body louse remains found in textiles excavated at Masada, Israel.

A leg of the body louse, Pediculus humanus humanus L. (Phthiraptera: Pediculidae), was found in a storeroom at Masada build during the reign of King Herod the Great. The unearthed culture material clearly indicates that the room was occupied by the rebels during the first Jewish revolt against the Romans (AD 66-73/4). The context of the textiles associated with the louse and their nature suggest a rebel origin. An exuvium of a leg of the third nymphal stage of body louse was found. The first three parts of the leg (tarsus, including the tarsal claw, tibia and femur) were preserved entirely, while the fourth segment of the leg, the trochanter, was only partially conserved. The comparison of the tarsus of this specimen with the legs of present day third instar nymphs of body and head lice revealed that the leg found within the archaeological debris belongs to a body louse.

Animals↗

Maggot débridement therapy in outpatients.

OBJECTIVE: To identify the benefits, risks, and problems associated with outpatient maggot therapy. DESIGN: Descriptive case series, with survey. SETTING: Urban and rural clinics and homes. PARTICIPANTS: Seven caregivers with varying levels of formal health care training and 21 ambulatory patients (15 men, 6 women; average age, 63 yr) with nonhealing wounds. INTERVENTION: Maggot therapy. MAIN OUTCOME MEASURE: Therapists' opinions concerning clinical outcomes and the disadvantages of therapy. RESULTS: More than 95% of the therapists and 90% of their patients were satisfied with their outpatient maggot débridement therapy. Of the 8 patients who were advised to undergo amputation or major surgical débridement as an alternative to maggot débridement, only 3 required surgical resection (amputation) after maggot therapy. Maggot therapy completely or significantly débrided 18 (86%) of the wounds; 11 healed without any additional surgical procedures. There was anxiety about maggots escaping, but actual escapes were rare. Pain, reported by several patients, was controlled with oral analgesics. CONCLUSIONS: Outpatient maggot débridement is safe, effective, and acceptable to most patients, even when administered by nonphysicians. Maggot débridement is a valuable and rational treatment option for many ambulatory, home-bound, and extended care patients who have nonhealing wounds.

Adult↗

Destruction of bacteria in the digestive tract of the maggot of Lucilia sericata (Diptera: Calliphoridae).

Green fluorescent protein-producing Escherichia coli were used to investigate the fate of bacteria in the alimentary tract of sterile grown maggots, Lucilia sericata (Meigen), using a laser scanning confocal microscope. A computer program was used to analyze the intensity of the fluorescence and to quantify the number of bacteria. The crop and the anterior midgut were the most heavily infected areas of the intestine. A significant decrease in the amount of bacteria was observed in the posterior midgut. The number of bacteria decreased even more significantly in the anterior hindgut and practically no bacteria were seen in the posterior end, near the anus. The viability of bacteria in the different gut sections was examined. It was shown that 66.7% of the crops, 52.8% of the midguts, 55.6% of the anterior hindguts, and 17.8% of posterior hindguts harbored living bacteria. In conclusion, during their passage through the digestive tract the majority of E. coli was destroyed in the midgut. Most of the remaining bacteria were killed in the hindgut, indicating that the feces were either sterile or contained only small numbers of bacteria.

Animals↗

Prevalence of vectors of the spotted fever group Rickettsiae and murine typhus in a Bedouin town in Israel.

A survey of the vectors of spotted fever group Rickettsiae and of murine typhus was carried out in Rahat, a Bedouin town in the Negev Desert, where the diseases are endemic. Houses with known cases of spotted fever group Rickettsiae or murine typhus were compared with those without reported clinical cases. A neighboring Jewish community, Lehavim, where no cases of spotted fever group Rickettsiae and murine typhus were reported in recent years, was used as a control. In the houses of patients with spotted fever group Rickettsiae in Rahat, an average of 7.4 times more ticks were found than in control houses. Out of 190 ticks isolated from sheep and goats or caught by flagging in Rahat, 90% were Rhipicephalus sanguineus (Latreille), 7.9% Rhipicephalus turanicus Pomerantzev, and 2.1% were Hyalomma sp. In the houses of patients with murine typhus, three times more rats were caught and, on the average, each rat was infested with 2.2 times more fleas than rats in the control houses. Out of 323 fleas collected from 35 Norwegian rats (Rattus norvegicus Berkenhout), 191 were Xenopsylla cheopis Rothschild and 132 Echidnophaga murina Tiraboschi. Thus, there was a six to seven times higher probability of encountering a tick or flea vector where infections had occurred than in control houses in Rahat. The percentage of rats seropositive to Rickettsia typhi was similar in study and control households (78.3 and 76.2, respectively). In the control settlement, Lehavim, only three Mus musculus L. were caught, which were not infested with ectoparasites and their sera were negative for murine typhus. Out of 10 dogs examined in this settlement, 15 R. sanguineus and eight specimens of the cat flea (Ctenocephalides felis felis Bouché) were isolated. No rats were caught in this settlement. These data indicate that there is a correlation among the density of domestic animals, their ectoparasites, and the incidence of spotted fever group Rickettsiae and murine typhus in Rahat.

Animals↗

Clinical applications for maggots in wound care.

Maggot debridement therapy (MDT) was first introduced in the US in 1931 and was routinely used there until mid-1940s in over 300 hospitals. With the advent of antibacterials, maggot therapy became rare until the early 1990s, when it was re-introduced first in the US, and later in Israel, the UK, Germany, Sweden, Switzerland, Ukraine and Thailand. Sterile maggots of the green bottle fly, Lucilia (Phaenicia) sericata, are used for MDT. Up to 1000 maggots are introduced in the wound and left for 1 to 3 days. MDT could be used for any kind of purulent, sloughy wound on the skin, independent of the underlying diseases or the location on the body for ambulatory as well as for hospitalized patients. One of the major advantages of MDT is that the maggots separate the necrotic tissue from the living tissue, making a surgical debridement easier. In 80 to 95% of the cases, a complete or significant debridement of the wound is achieved. As therapy progresses, new layers of healthy tissue are formed over the wounds. The offensive odor emanating from the necrotic tissue and the intense pain accompanying the wound decrease significantly. In a significant number of patients, an immediate amputation can be prevented as a result of MDT. In other cases, a more proximal amputation could be avoided. It is also possible that in patients with deep wounds, where septicemia is a serious threat, this can be prevented as a result of MDT. The majority of patients do not complain of any major discomfort during the treatment. Psychological and esthetic considerations are obvious. Maggots can occasionally cause a tickling or itching sensation. Approximately 20 to 25% of the patients with superficial, painful wounds, complain of increased pain during treatment with maggots, and are treated with analgesics. MDT has been proven to be an effective method for cleaning chronic wounds and initiating granulation. It is a simple, efficient, well tolerated and cost-effective tool for the treatment of wounds and ulcers, which do not respond to conventional treatment and surgical intervention.

Aged↗

Pyrethroid resistance mechanisms in the head louse Pediculus capitis from Israel: implications for control.

In Israel, the head louse, Pediculus capitis, developed resistance to DDT through the extensive use of this insecticide until the 1980s. In 1991, permethrin was introduced for control of DDT resistant P. capitis in Israel, leading to control failure of this pyrethroid insecticide by 1994. Pyrethroid resistance of P. capitis in Israel extends to phenothrin, which has not been used for louse control. We identified a glutathione S-transferase(GST)-based mechanism of DDT resistance in the Israeli head lice. This GST mechanism occurred before 1989, while permethrin resistance in P. capitis developed after 1994, suggesting that the main GST resistance mechanism selected by DDT use does not confer any pyrethroid cross-resistance. Esterase activity levels were equivalent in pyrethroid resistant and susceptible P. capitis field-collected in Israel, and in a susceptible strain of P. humanus, the body louse, indicating no involvement of any esterase-based mechanism in resistance. A weak monooxygenase-based permethrin metabolism resistance mechanism was the only factor identified which could account for any of the observed pyrethroid resistance in P. capitis. However, the lack of synergism of phenothrin resistance by piperonyl butoxide suggests that a non-oxidative mechanism is also present in the resistant lice. Therefore it seems probable that pyrethroid resistance in Israeli P. capitis is due to a combination of nerve insensitivity (knockdown resistance or 'kdr') and monooxygenase resistance mechanisms.

Animals↗

Abundance of house dust mites in relation to climate in contrasting agricultural settlements in Israel.

The correlation between climatic conditions and mite numbers in houses from rural areas was studied in 13 agricultural communities (kibbutzim and moshavim) in nine geo-climatic subregions of Israel. Mites were present in 97% of the dust samples. The average number of mites per gram of dust in the different localities ranged between 84 and 2053. The maximum number of mites (7440/g dust) was found in a carpet from a house in Geva Carmel in the northern coastal region. The most prevalent species of mites were Dermatophagoides pteronyssinus and Dermatophagoides farinae, which were found in 85.6% and 71.3% of the samples, respectively. The house dust mites D. pteronyssinus, D. farinae and Euroglyphus maynei constituted 94.8% of the mites. Most of the mites were isolated from the carpets and sofas (37.0% and 33.7%, respectively), and a smaller number from beds (29.3%). The smallest number of mites (< or = 250/g dust) were found at a minimum relative humidity (RH) of 30% and lower, with a maximum temperature of 32 degrees C and higher, i.e. in the Jordan valley and Negev mountains. A greater number of mites (250-500/g dust) were found at a minimum ambient RH of 35-40% and a maximum temperature of 32 degrees C and higher, i.e. the Hula valley. A large number of mites (500-1000/g dust) were found at a minimum RH of 35-40% with a maximum temperature of 30 degrees C and lower, i.e. in the Judean and Samarian range, as well as in upper Galilee. The largest number of mites (1000-2000/g dust) was found at a minimum RH of 45% and higher, with a maximum temperature ranging between 30 and 32 degrees C. These conditions occur in the coastal strip, the coastal plain and in the Judean and Samarian foothills. A monthly examination of two houses in Zova, a kibbutz in the Judean hills next to Jerusalem, and two houses from Palmachim, a kibbutz in the coastal region, revealed that the highest prevalence of mites was found in the months April-November and May-November, respectively. In Zova, the highest number of mites were found during the months of June and July while the highest concentrations of D. pteronyssinus-antigen (Der p I) were measured during the month of September. A positive correlation between mite numbers and the quantity of Der p I in house dust was found.

Agriculture↗

Maggot therapy for the treatment of intractable wounds.

BACKGROUND: Fly maggots have been known for centuries to help debride and heal wounds. Maggot therapy was first introduced in the USA in 1931 and was routinely used there until the mid-1940s in over 300 hospitals. With the advent of antimicrobiols, maggot therapy became rare until the early 1990s, when it was re-introduced in the USA, UK, and Israel. The objective of this study was to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds and ulcers in long-term hospitalized patients in Israel. METHODS: Twenty-five patients, suffering mostly from chronic leg ulcers and pressure sores in the lower sacral area, were treated in an open study using maggots of the green bottle fly, Phaenicia sericata. The wounds had been present for 1-90 months before maggot therapy was applied. Thirty-five wounds were located on the foot or calf of the patients, one on the thumb, while the pressure sores were on the lower back. Sterile maggots (50-1000) were administered to the wound two to five times weekly and replaced every 1-2 days. Hospitalized patients were treated in five departments of the Hadassah Hospital, two geriatric hospitals, and one outpatient clinic in Jerusalem. The underlying diseases or the causes of the development of wounds were venous stasis (12), paraplegia (5), hemiplegia (2), Birger's disease (1), lymphostasis (1), thalassemia (1), polycythemia (1), dementia (1), and basal cell carcinoma (1). Subjects were examined daily or every second day until complete debridement of the wound was noted. RESULTS: Complete debridement was achieved in 38 wounds (88.4%); in three wounds (7%), the debridement was significant, in one (2.3%) partial, and one wound (2.3%) remained unchanged. In five patients who were referred for amputation of the leg, the extremities was salvaged after maggot therapy. CONCLUSIONS: Maggot therapy is a relatively rapid and effective treatment, particularly in large necrotic wounds requiring debridement and resistant to conventional treatment and conservative surgical intervention.

Adult↗

[Maggot therapy for gangrene and osteomyelitis].

5 patients with diabetic-foot were treated by maggot therapy. The most serious case was in a 75-year-old man who had gangrene and osteomyelitis of the right foot. Proteus mirabilis, Enterococcus sp., Providencia stuartii and Staphylococcus spec. (coagulase positive) were isolated from lesions which did not respond to antibiotic therapy. The patient had twice refused amputation but agreed to maggot therapy. Larvae of the sheep blowfly Phoenicia (Lucilia) sericata were used for twice-weekly treatment over a period of 7 months. Sterile larvae were applied to the wound and replaced every 3-4 days. After 4 months of treatment, the necrotic tissue around the toes and on the sole of the foot detached from the healthy tissue. During the last 3 months of treatment the larvae removed the remaining infected tissue. As therapy progressed, new layers of healthy tissue covered the wound. The offensive odor associated with the necrotic tissue and the intense pain in the foot decreased significantly. At the end of therapy, during which there were no complaints of discomfort, he was able to walk. In the 4 other patients who had relatively superficial gangrene, the maggots debrided the wounds within 2-4 weeks. Thereafter treatment was continued with antibiotics. Maggot therapy can be recommended in cases of intractable gangrene and osteomyelitis, when treatment with antibiotics and surgical debridement have failed.

Aged↗

Rhipicephalus sanguineus and R. turanicus (Acari:Ixodidae): closely related species with different biological characteristics.

Life cycle parameters of 2 closely related tick species, Rhipicephalus sanguineus Latreille and R. turanicus Pomerantsev, were studied under laboratory conditions. Both Rhipicephalus, which have small adults, demonstrated the same adaptations as large tick species inhabiting deserts and semideserts: high reproductive rate, decrease in egg size, and an increase in interstage growth to compensate for the smaller size at birth. Pronounced quantitative differences between both species were discerned in relation to these adaptations. Female R. turanicus produced twice as many eggs as R. sanguineus which was facilitated by the greater amount of blood engorged by females and by the smaller egg weight in R. turanicus as compared with R. sanguineus. In all developmental stages, the weight increase from unfed to fed ticks was greater in R. turanicus than in R. sanguineus (23% higher in larvae, 118% in nymphs, and 26% in females). The increase in weight in R. turanicus from the unfed larva (0.013 mg) to the unfed female (3.31 mg) was 254-fold, and in R. sanguineus it was 127-fold (from 0.021 to 2.54 mg). In nymphal R. turanicus, the higher density and the greater height of the dorsal epicuticular folds, as well as procuticular indentations found inside the folds allow this tick to stretch its alloscutum during blood engorgement to a greater extent than R. sanguineus. The rates of blood ingestion (for nymphs and females), egg maturation, and metamorphosis were 1.1-1.7 times greater in R. turanicus than in R. sanguineus. A life cycle strategy with both a higher reproductive rate and faster development in R turanicus may be explained by its greater dependence on environmental factors than that in R. sanguineus.

Animals↗

Immunization of rabbits with faecal extract of Pediculus humanus, the human body louse: effects on louse development and reproduction.

Immunization of rabbits with a faecal extract of the human body louse (Pediculus humanus) induced a high titre of specific IgG. The mean weight of blood taken by females fed on the immunized rabbits was significantly lower (29%) than taken by females fed on the control rabbits. The mean number of eggs per female fed on the immunized rabbits was significantly lower than for females fed on the control rabbits. The hatchability of the eggs laid by lice fed on immunized rabbits (91%) was significantly lower than of those fed on control rabbits (94%). The rate of development of nymphs fed on control rabbits was significantly higher than those fed on the immunized rabbits. There was no difference in survival rates of lice fed on immunized and control rabbits.

Animals↗

Human toxicosis caused by the tick Ixodes redikorzevi in Israel.

The clinical symptoms of a tick toxicosis caused by Ixodes redikorzevi in northern Israel are described. The patient was a nine-year-old Arab boy from an agricultural village who was admitted to a local hospital and had been suffering for 4 days from fever and torticollis. A partially engorged female tick was removed from the nuchal area of the scalp, and the symptoms disappeared within 2 hours. Morphometrical measurements indicated that the tick was attached to the skin for 3-4 days.

Animals↗