“ Gli antibiotici hanno cambiato il mondo , ma ora rischiamo di tornare

ad un mondo senza antibiotici “

“La rapidità con cui i batteri riescono a sopravvivere ai nostri antibiotici è molto superiore al ritmo con cui le aziende

farmaceutiche mettono a punto nuove armi”

Ogni volta che si usa un antibiotico , alcuni batteri

sopravvivono al trattamento . Il ceppo resistente si

moltiplica e si rafforza in base al principio della selezione naturale. La

prossima volta che l’antibiotico verrà usato non

avrà alcuna efficacia.

Lo STAFILOCOCCO AUREO RESISTENTE ALLA METICILLINA (Mrsa)

Provoca vari tipi di infezione , fra cui una gravissima forma di polmonite. Mentre nel 1989 i

ceppi di Stafilococco sensibili agli antibiotici erano il 99% fra tutti quelli isolati , nel 2002 ben

una infezione su due era causata da ceppi resistenti ai farmaci.

I decessi negli ospedali britannici causati da Mrsa sono passati dai 50 del 1993 ad un impressionante 1600

del 2007

APITHERAPYAPITHERAPYDott. Franco Feraboli

Honey

Blood type diet values :Type A : neutralType B : neutralType AB : neutral / avoidType 0 : neutral / avoid

Honey

• Anti-inflammatory• Stimulates granulation tissue

• Acid (3.2 – 4.5 pH)• Antibacterial

• High osmolarity• Reduces odour

• Effect reduced by diluition

Honey

NOT sterile , risk of clostridium infections

Destroyed by heat

Should purchase sterilised honey (gamma irradiated)

Manuka Honey

-New Zealand manuka has a

unique properly

-UMF – not found in any other honey . Twice as effective as hydrogen peroxide against

staph. Aureus and Escherichia Coli

-Change honey daily with high exudate , then can go to 2-3 days.

BIOSURGERY

Maggot therapy

ChunkyLicking therapy

Wound Healing( De rara medicazione vulnerum )

Wound healing is a dynamic process and the performance requirements of a dressing can change as the wound progresses towards healing.

Wound dressings may be used to :2. Produce rapid and cosmetically acceptable healing3. Remove or contain odour4. Prevent or combat infection5. Reduce pain6. Contain exudate7. Promote autolytic debridement (wound cleaning)8. Provide and maintain a moist environment at the wound surface

to facilitate the production of granulation tissue and the process of epithelialisation.

9. Cause minimum distress or disturbance to the patient

Wound Type :

• NECROTIC WOUNDS – covered with devitalised epidermis,frequently black in colour

• SLOUGHY WOUNDS – which contain a layer of viscous adherent slough , generally yellow in colour

• GRANULATING WOUNDS – which contain significant amounts of highly vascularized granulation tissue , generally red or deep pink in colour

• EPITHELIALISING WOUNDS – which show evidence of a pink margin to the wound or isolated pink islands on the surface.

+

Necrotic wounds (black)

Sloughy wound

Granulating wounds

Epithelialising wounds

Malignant wound+

WOUND INFECTION

WOUND LOCATION

Factors influencing dressing selection• WOUND TYPE : - superficial - full thickness - cavity• WOUND DESCRIPTION : - necrotic - sloughy - granulating - epithelialising• WOUND CHARACTERISTIC : dry , moist , heavily exuding ,

malodorous , excessively painful , difficult to dress , liable to bleed easily

• BACTERIAL PROFILE : - sterile - colonised - infected

Product related factorsConformabilityMass or volume ( for cavity wounds )Fluid handling propertiesSensitisation potentialOdour absorbing ptopertiesAntibacterial activityHaemostatic propertiesPermeability to tissue fluid and microorganismsEase to usePain related factorsNon toxic

PATIENT RELATED FACTORS

• Wound aetiology

• State of continence

• Known sensitivity to medicated dressings

• Fragile or easily damaged skin

• The need to bathe or shower frequently

• Compliance

History

People survived for hundreds of thousands of years without modern antibiotics , and it is worth thinking

about how that was possible.In the Smith papyrus of 1700 B.C. and the Ebers papyrus of 1500 B.C. we find described the treatment of very severe

wounds and burns with a combination of coagulated milk and honey kept in place

by a muslin bandage.

Smith and Ebers papyrus

(1500 – 1700 B.C.)

Recently doctor Majno of the Harvard Medical School put Egyptian pharmacy

to the test of science and compared wounds of a few guinea pigs , that had

been treated with either honey and grease or Vaseline ( it is said to be practically

indifferent to wound healing )

After eights days the microscopic section of the surface of an open wound in

guinea pig skin , treated with vaseline dressing , was filled with granulation tissue , that is the normal course of

events without any treatment.The microscopic section of a similar

wound of the same age , which has been kept under a dressing of honey and

grease , showed no harm , no “ proud flesh”.

Dr. Majno (HARVARD MEDICAL SCHOOL)

Vaseline dressing

Honey and grease dressing

To give the mixture the roughest possible test , doctor Majno made it up with butter , which contains many bacteria of its own ,

including a group of coliform bacteria.Result : the bacteria initially present

tended to disappear , and if pathogenic bacteria were added , like Escherichia coli

and Staphylococcus aureus , they were killed just as fast.

Honey kills bacteria

Dr. Leon Herszage ( Torcuato de Alvear Hospital – Buenos Aires ) : in 1980 he achieved a cure rate of over 99 percent in the treatment with sugar of the surgical wounds of 120 patients.

Dr. Richard Knutson ( Trauma Clinic of the Delta Orthopedic Center – Mississippi ) : in 1981 he published a five years study of 605 patients with burns , ulcers , lacerations , gunshot wounds and amputations , treated with honey and sugar. He showed that 98 percent complete healing.

HONEY

Our bacteriological test

Our medical honey( Acacia honey + Acetic Acid 3% )

G.A. 53 years old (M)Patella open fracture. Honey dressing after surgery

HONEY and sugar

O.L. 48 years old (M).

Tibial open fracture with muscle and skin loss , infected by Stafilococco epidermidis e Pseudomonas Aeruginosa.

4/11/1999 : Honey and sugar dressing.

HONEY and sugar

21 / 11/ 1999 : Honey and

sugar dressing

7/1/2000 : Healing

HONEY

From 1990 I have treated 54 cases of infected wounds , not controlled by standard treatments.

The bacteria were:

- Staphilococcus aureus ………………………. 43 casi

- Staphilococcus epidermidis …………………. 19 casi

- Staphilococcus aureus MRSA ……………… 32 casi

- Pseudomonas aeruginosa ……………………. 12 casi

- Enterobacter cloacae ………………………… 8 casi

- Enterococcus faecalis …………………………. 1 caso

- Acinet. Lwoffii ………………………………… 1 caso

Infected patella open fracture treated with acacia honey

M.P. 37 years old (M)Open femur fracture (bull gored) treated by intramedullary nailing.Wound infection (Enterococcus faecalis and Staphilococcus Aureus)

Wound and fracture irrigation by acacia honey and propolis.Reduction of secretion and hyperpyrexia after one week .The patient was reoperated 15 days later : the intramedullary nail was removed and an external device was applied.

Treatment of necrotic and sloughy wounds

S.M. 43 (F) Infected wound by fish bone ( Staphilococcus aureus ) . The seventh day after.

This is the situation after 7 days of antibiotic therapy.

Healing after 10 days of maggot therapy and 25 days of honey dressing.

This is the situation one year later.

V.A. (64 F)

Open tibial fracture. Honey dressing after maggot therapy.

Healing 60 days after.

73 years old (F)Leg necrotic wound.Honey medication Healing after 42 days

B.R. 68 years old. (M)Very large haematoma in the thigh with necrotic wound.Irrigation by acacia and multiflowers honey.Healing 60 days later.

C.L. 67 years old (M) Necrotic wound on the left foot. Honey dressing twice a day. Healing 35 days later.

P.L. (38 M)

Infected open leg fracture with muscle and skin loss. (Staphilococcus Aureus and Pseudomonas aeruginosa.)

Healing 90 days after

F.A. ( 56 M )

Compound tibial fracture.

Sugar and honey dressing.

Healing 60 days after.

Treatment of pressure ulcers

S.B. 28 years old (M)Open ankle fracture

Infected malleolar pressure ulcer ( Staphilococcus Aureus ) following the open ankle fracture.

Healing 60 days after.

Treatment of ulcers in venous stasis

Treatment of diabetic ulcers

Treatment of burns

PropolisIt has been used in 14 cases of soft tissue infections, caused

by these bacteria :

• Staphilococcus aureus ……………. 7 cases• Staphilococcus epidermidis ……….. 2

• Pseudomonas aeruginosa ………... 3

• Escherichia coli …………………... 2

PROPOLIS

Honey and propolis .

Lesion by hand-granade explosion.

B.R. ( 64 M )

Infected hip prosthesis ( Staphilococcus aureus MRSA) .

After 30 days of antibiotic therapy I began to inject honey in the wound twice a day for 35 days.

Injection of propolis Healing 70 days after.

L.A. ( 49 M )

Hip open fracture.

Intramedullary nailing and infection by Staphilococcus Aureus , Enterobacter cloacae and Enterococcus faecalis.

Nail was removed 3 months later and

he was treated with intramedullary

antibiotic (Gentamicina) beads and

Antibiotic therapy for 20 days.

Five months later I began to inject dissolved propolis intramedullary,twice a day for 20 days.

Healing 30 days later.

B.L. ( 58 M ) Infected compound fracture of the forearm.

( Staphilococcus aureus and Acinet. Lwoffii)

Propolis therapy

Healing 28 days later.

D.G.F. (22 M ) Traumatic amputation of the right leg.

Staphilococcus aureus infection

Propolis therapy

Healing 3 months later.

Use of solid propolis in fistolous channel.

O.L. ( 39 M ) Infected compound leg fracture ( Staphilococcus aureus and Pseudomonas aeruginosa ).

After 20 days of antibiotic therapy I began propolis therapy.

Healing 20 days later.

Four months later.

POLLINEE’ un alimento cosiddetto completo perché è una miscela perfettamente bilanciata di aminoacidi , vitamine , sali minerali , enzimi ed acidi grassi. Esso è fondamentale nelle diete , soprattutto nell’alimentazione vegetariana , essendo il suo apporto proteico sovrapponibile a quello della carne , privata però di tutti i grassi. E’ pure ricco di vitamine e di flavonoidi. La sola vitamina mancante è la D ,per cui possiamo ritenere una alimentazione che comprenda il polline ed i prodotti del latte come una dieta perfettamente equilibrata e naturale.

L’unico inconveniente legato alla assunzione del polline è rappresentato dalla possibilità che il suo sapore non incontri il favore del consumatore , fattore quest’ultimo fondamentale per la riuscita di un regime dietetico.

PAPPA REALEE’ nutrizionalmente importante almeno quanto il polline per l’elevata quantità di vitamine della crescita ( gruppo B) in particolare di acido pantotenico (B5) , la cui concentrazione in questo alimento ne supera qualsiasi altra. E’ attiva a dosi ponderali (2-3 cucchiaini da caffè al giorno ) nelle lesioni eczematose della pelle , contro la caduta dei capelli , per incrementare la crescita del neonato prematuro , nell’affaticamento fisico ed intellettuale , nei disturbi intestinali e digestivi , e può essere d’aiuto nell’insonnia e nell’agitazione di origine nervosa.

Unica controindicazione è la marcata acidità , che può causare , in soggetti predisposti , l’irritazione della mucosa gastrica.

Bee Venom

Bee Venom

SIDEEFFECTS(Allergy)

Epidemiological aspects of hymenoptera stings

IMMUNOTHERAPY

Bee Venom TherapyBee Venom Therapy

VELENOPer intraprendere con successo una terapia antiinfiammatoria a base di veleno d’ape , due sono i requisiti essenziali : un accurato inquadramento diagnostico e , conseguentemente , la constatazione dell’esistenza di una indicazione specifica.Il campo d’azione del veleno si estende a numerose affezioni acute e croniche, quali gli stati infiammatori acuti articolari (reumatismo articolare acuto e gotta), alla lombalgia , cervicalgia e sciatalgia , alla erisipela , all’artrosi ed all’artrite reumatoide , all’orticaria , alla nefrite , ai disturbi del sonno e persino alla sclerosi multipla.

Paziente affetto da artrite reumatoide.

VELENOLe più importanti componenti del veleno sono l ‘ ISTAMINA , la LECITINASI e la IALURONIDASI.

L ‘ ISTAMINA provoca dolore locale , edema , aumento dell’afflusso sanguigno ed agisce come un potente antiinfiammatorio. La vasodilatazione da essa provocata avviene per via riflessa , attraverso il sistema nervoso , anche nei tessuti profondi e può esercitare una influenza favorevole sulle infiammazioni croniche aumentando il metabolismo tissutale ed eliminando i prodotti dannosi dell’infiammazione.

La LECITINASI trasforma la lecitina in isolecitina (FOSFOLIPASI B) che ha uno spiccato effetto emolitico distruggendo i globuli rossi ed altre cellule dei tessuti e partecipa all’azione fibrinolitica caratteristica del veleno d’api.

La IALURONIDASI agisce come un fattore di diffusione del veleno , sciogliendo l’acido ialuronico del tessuto connettivo.

Altre sostanze proteiche presenti nel veleno hanno caratteristiche antigeniche e stimolano in questo modo le reazioni di difesa del sistema immunitario.

A quale di tutti questi fattori sia da attribuire l’effetto curativo del veleno d’api

resta un mistero.

VELENO

Generalmente nel punto in cui si viene punti da un imenottero si forma una piccola tumefazione di colore rosso , pruriginosa e calda che persiste per alcune ore o per alcuni giorni. Reazioni più violente sono caratterizzate da un gonfiore più esteso che può interessare anche un intero arto.

In alcuni pazienti si associano effetti collaterali quali dolori in altre articolazioni ed in altre parti del sistema muscolo scheletrico , affaticamento , tumefazione generalizzata a tutto il corpo , cefalea , nausea , vomito , caduta della pressione sanguigna , aumento della temperatura corporea.

Queste reazioni non alterano l’efficacia terapeutica del veleno e non sono considerate un ostacolo al proseguimento della terapia , che potrà continuare utilizzando dosaggi di veleno inferiori a quello che ha scatenato l’effetto indesiderato.

Dove si punge ? Si punge generalmente sulle zone dolenti utilizzando l’ape viva applicata più volte , con l’ausilio di una retina finissima per estrarre il pungiglione oppure più api fino ad un massimo di 30 punture.

La durata della terapia varia da un minimo di una seduta fino ad una massimo di alcuni mesi , come nel caso dei pazienti affetti da sclerosi multipla.

Role of sympathetic nerve fibers in maintaining joint pain and inflammation in

arthritis

Each joint has a dual nerve supply: primary nerves that penetrate the

capsule as independent branches of adjacent peripheral nerves , and

accessory nerves sending a branch to the joint and another either to the

muscle ( articulomuscular nerves ) or to the

skin and subcutaneous tissues ( articulocutaneous )

One may wonder why inflammation inside the joint

manifest itself with signs on the skin and subcutaneous tissues

that contribute to the acute pain.

To understand this phenomenon let us examine some studies on

experimental inflammation induced on the skin.

Many algogenic substances ( Histamine , cantharidin ,

substance P , Bee Venom , etc )when injected into the derma induced a reaction that was first described by Lewis.

The reaction is due to a substance released by tissues

that was named by Lewis substance H .

It was subsequently found that this substance was Histamine .

The bee sting induces three phenomena which are known as the Lewis triple reaction .

1- An area of redness , due to a local

vasodilatatory effect , that spreads a few

millimeters around the injected area , reaches its

maximum 1 min after the injection ;

2 – A cutaneous erythematous area of a

brighter red with an irregular contour ,

which spreads over 1 cm beyond the area of

initial red discoloration and develops more

slowly , it is probably due to activation of

axon reflexes ;

3 – a blister that appears 1 to 2 min. after the sting and replaces the initial red discoloration ,

due to an increase of capillary

permeability.

The most interesting phenomenon of this reaction is the erythema (secodary hyperalgesia). This is probably due to

the fact that the nociceptive and damaging stimuli induce release of substance P by free endings induces

release of histamine by neighbor mastocytes, which in turn release

histamine , which excites other nerve endings and so forth; the spreading of secondary hyperalgesia is so explained.

Why does the erythema stop? One

possible explanation is derived from the observation of an ischemic halo of regular shape

developing around the erythematous area.

This white ischemic halo , which stops the spreading of

the erythema , is produced via a reflex arc with an efferent branch that is sympathetic.

Erythralgia is a skin phenomenon characterized by redness , increase of cutaneous

temperature , subcutaneous swelling and hyperalgesia.

The concept of erythralgia may be extended from the skin to mucosal and synovial tissues.

Synovial erythralgia induces the described superficial phenomena probably through

axon reflexes running on the articulocutaneous nerves which release inflammatory polypeptides in the skin.

When sympathetic nerves overdischarge (after a few bee stings ) , they release large

amounts of neuropeptide Y , which has

analgesic and anti-inflammatory properties.

VELENOIl veleno d’api si trova in commercio in forma grezza disidratata, sotto forma di granuli omeopatici , liquido , pronto per essere iniettato , ed in preparati farmaceutici.

VELENO

Ma la forma generalmente più utilizzata è la puntura diretta dell’ape .

VELENOE’ estremamente efficace nel trattamento della borsite dolorosa nell’alluce valgo. Ciò dipende probabilmente dal fatto che il veleno blocca la trasmissione nervosa di un ramo sensitivo che corre sotto cute in corrispondenza della borsa infiammata.

VELENO

Vediamo due casi particolarmente significativi.

G.A. Sesso : F. Anni 49. Da 6 mesi dolore ed impotenza funzionale alla caviglia sinistra per artropatia gottosa. Ha già eseguito numerose terapie mediche e fisiche. Completa guarigione dopo 4 sedute di apiterapia ( 6 punture per seduta sulla caviglia).

Smelling others

Grazie