NEWSLETTER 11 (MAY, 2009)
REPORTS OF THE DIFFERENT REPRESENTATIVES OF IBS
KOSTA Y. MUMCUOGLU (PRESIDENT)
Next international IBS conference
MDT in Israel
In 2008, our team in collaboration with a large number of physicians from 5 hospitals in Israel, treated ca. 60 patients by applying over 170 treatments. Most of the treatments were applied in the Hadassah Medical Center, Jerusalem, and in the Beit Meir Hospital in Kfar Sava. At least 6 imminent leg amputations were canceled as a result of MDT.
Apitherapy in Israel
On February 2008 the Israeli Apitherapy Organization organized the First National Apitherapy Congress in Sheba Hospital, Tel Hashomer. Eleven lecturers gave presentations on apitherapy and bee-venom therapy in the country. I was invited to give the following presentation: Mumcuoglu, K.Y. Apitherapy in the frame of the International Biotherapy Society.
Hirudotherapy in Israel
In addition to our group in Hadassah Hospital, Jerusalem, physicians in the Sourasky Medical Center in Tel-Aviv (Dr. I. Kirschfeld) and Soroka Hospital in Beer-Sheva (Prof. L. Rosenberg), are applying hirudotherapy in the Plastic Surgery Departments of their hospitals. There are an additional 3-4 biotherapists (mainly immigrants from Russia and Ukraine), who treat patients with leeches. Regarding hirudotherapy in the veterinary medicine, see the report of Sagiv Ben-Yakir.
Daeschlein, G., K.Y. Mumcuoglu, O. Assadian, B. Hoffmeister & A. Kramer. 2007.
In vitro antibacterial activity of Lucilia sericata maggot secretions. Skin Pharmacol. Physiol. 20:112–115 (DOI: 10.1159/000097983).
Huberman, L., N. Gollop, K.Y. Mumcuoglu, C. Blockc & R. Galun. 2007.
Antibacterial properties of the whole body extracts and hemolymph of Lucilia sericata maggots. J. Wound Care 16: 123-127.
Huberman, L., N. Gollop, K.Y. Mumcuoglu, E. Breuer, S.R. Bhusare, Y. Shai & R. Galun. 2007.
Antibacterial substances of low molecular weight isolated from Lucilia sericata (Diptera: Muscidae). Med. Vet. Entomol. 21: 127-131.
Taylan-Ozkan, A. & K.Y. Mumcuoglu. 2007.
Maggot debridement therapy for the treatment of a venous stasis ulcer (in Turkish). Turkish Bull. Hyg. Exp. Biol. 64: 31-34.
Mumcuoglu, K.Y., L. Huberman, R. Cohen, V. Temper, A. Adler, R. Galun & C. Block. 2009.
Elimination of symbiotic Aeromonas spp. from the intestinal tract of the medicinal leech, Hirudo medicinalis using ciprofloxacin feeding. Clin. Microbiol. Infect. (in press).
Lectures/seminars on MDT were given to physicians and nurses of the Beit Meir Hospital in Kfar Sava and Tel Hashomer Hospital, Ramat Gan, Israel.
An interview was given to a Brazilian TV (Record TV, reaching more than 100 million viewers daily), which is going to be shown in Brazil and other South American countries. This will be in the form of a documentary on MDT in Israel.
There has been a weekly (sometimes more often) Email correspondence with students, biotherapists, physicians and scientists from Israel and abroad, who had questions regarding MDT and hirudotherapy.
At present we are working on the excretions and pheromones of Lucilia sericata maggots.
In order to inform physicians on the theoretical and practical aspects of MDT, KYM wrote two articles on the biggest website for physicians in Israel (Reshet Refuah (http://www.mednet.co.il/)
MDT in Egypt
The team of Tantawi et al. is treating patients with MDT in Alexandria, Egypt. Tantawi TI, Gohar YM, Kotb MM, Beshara FM, El-Naggar MM. Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers. J Wound Care. 2007 Oct;16(9):379-83 (Department of Zoology, Faculty of Science, Alexandria University, Alexandria, Egypt; firstname.lastname@example.org)
Biotherapy in Turkey
Dr. Erdal Polat (Clinical Microbiology Department) and Prof. Turgut Ipek (Department of Surgery) from the Cerrahpasa Medical Center, Istanbul, Turkey, visited our laboratories in Jerusalem during the period 17-22.2.2007 and received instruction on sterile maggot production and MDT. Shortly after, with the financial help of Tubitac, they opened a laboratory for MDT in their hospital. By September 2008, when I visited the new installations, I learned that in the meantime dozens of patients had been treated with maggots and a student started her MSc thesis on this subject.
Tanyuksel, M. & E. Araz. 2007. Maggot treatment (in Turkish).
In Ozcel’in Tibbi Parasit Hastaliklari (Ozcel, A. ed.). Turkish Parasitology Society, Izmir, pp. 883-890.
Ozcelik, S. Leeches and human health (in Turkish).
In Ozcel’in Tibbi Parasit Hastaliklari (Ozcel, A. ed.). Turkish Parasitology Society, Izmir, pp. 895-898.
Taylan-Ozkan, A. & K.Y. Mumcuoglu. 2007. Maggot debridement therapy for the treatment of a venous stasis ulcer (in Turkish).
Turkish Bull. Hyg. Exp. Biol. 64: 31-34.
SAGIV BEN-YAKIR (SECRETARY)In 2008, I had the pleasure to lecture for thousands of veterinarians and biotherapists globally about the different options biotherapy is providing us (veterinarians) in treating animals for different conditions:
1) "North American Veterinary Conference" (NAVC) - Jan 2008, Orlando, Florida, USA (25th year). I lectured there for some 10 hrs about veterinary hirudotherapy and veterinary bee venom therapy etc.
2) "American Veterinary Medical Association" (AVMA) 142nd annual convention - July 2008, New Orleans, Louisiana, USA. I lectured there for some 8 hrs about veterinary hirudotherapy and veterinary bee venom therapy etc.
3) "2nd Academic Conference of Asian Society for Traditional Veterinary Medicine" - Sept 2008, Taipei, Taiwan. Presenting different aspects of Vet Biotherapy.
4) "The 34th Annual Congress of The International Veterinary Acupuncture Society" - Sept 2008, Keystone, Colorado, USA. I presented different aspects of Veterinary Biotherapy.
5) Seminar in Equilibre – Zentrum for Ganzheitliche Medicine, Frankfurt/Main, Germany, November 15-16, 2008. Difficult Cases in Holistic Veterinary Medicine Acupuncture - TCVM– Homoopathy – Homoosiniatry (see details of the program).
6) Veterinarians and medical team members are getting lectures + labs routinely about the different aspects of veterinary biotherapy in the 2 yrs course for Complementary and Alternative Veterinary Medicine at Zinman College, Wingate Institute, Israel (I am the academic manager of the course).
7) Promoting veterinary biotherapy routinely on 2 different Web veterinary discussion groups.
8) 2 lectures for The Israeli Medical Association - its acupuncture section, about veterinary hirudotherapy and veterinary bee venom therapy.
9) Article in Germany - ”Veterinarmedizinische Bienengift-Therapie” in Zeitschrift fur Ganzheitliche Tiermedizin, 2008; vol 22:30-32.
10) I think that due to my activities in the veterinary communities we add some tens of veterinarians that did registration to IBS as new members.
RONALD SHERMAN (TREASURER) AND ALETHA TIPPETT (MEMBER AT LARGE)Biotherapy Progress in North America, 2008 - Report to IBS
In the U.S., the year 2008 marks numerous advancements in Biotherapy, especially maggot debridement therapy (MDT), leech therapy and apitherapy.
Maggot therapy was the subject of several lectures, both locally and at national conferences. Dr. Tippett lectured on maggot therapy at the Ohio hospice conference, and at the national AAHPM conference. The BioTherapuetics, Education & Research (BTER) Foundation lectured at the Soughtwest Regional Conference of the Wound, Ostomy and Continence Nurses Society (Carmel, CA; March 27-28), and presented maggot therapy workshops at the Symposium on Advanced Wound Care (San Diego, CA, April 24-27), the Undersea & Hyperbaric Medical Society (June 25; Salt Lake City, UT), the American Podiatric Medical Association Conference (Honolulu, HI, July 24-27), and Wild on Wounds (Orlando, Florida Sept 18). The BTER Foundation also met directly with the diabetes patient and care-giver community, exhibiting at Diabetes Expo, Los Angeles (Long Beach, CA; May 3). The BTER Foundation circulated draft guidelines for leech therapy in 2008; final Policy and Procedure template should be out in 2009. The Policies and Procedures address only those indications that received marketing clearance by FDA in 2004: to relieve venous congestion, such as after transplantation or replantation surgery.
A phase I clinical study of bacteriophage therapy safety in venous stasis ulcers was completed in 2008; results should be available (published) in 2009.
Since Publications are really international, I assume that they will be listed separately. If not, let us know and we will list those publications out of the U.S. and Canada that we are aware of.
Clinical & Commercial Biotherapy
Monarch Labs began its 3rd year of commercial production and distribution of medicinal maggots. Medicinal maggots were distributed to over 800 therapists and centers in North America. Among maggot therapists, veterinarians and animal handlers are becoming more prominent, especially equine practitioners. Maggot therapy for chronic laminitis, navicular abscesses and other foot and leg wounds is more common then ever before. Additionally, Monarch Labs received FDA marketing clearance for a new patented maggot therapy dressing – a single-piece hinged maggot cage dressing (“Le Flap”) which should be simpler to apply than the current method of constructing cage dressings at the bedside from hydrocolloid pads, netting and adhesives. The dressing is expected to be on the market in early 2009. There is probably an increase in leech therapy use, but no numbers are available. We are aware of several therapists who are adding leech therapy to their tool bag (including Dr. Tippett). Two well-established leech suppliers continue to do business in the U.S.: Leeches USA (distributor of Ricarimpex leeches from France), and Carolina Biological Supply (distributor of Biopharm leeches, UK). Several patients sought Helmintherapy this year for their immunologic and autoimmune illnesses (i.e., Crohn’s Disease), through Autoimmunetherapies. As therapeutic helminthes are not legally marketed in the U.S., these American patients received their treatments in Mexico. To our knowledge, there are no known clinical studies of helmintherapy in the U.S. at the present time. Payment for biotherapy can be an impediment for many patients and therapists in the U.S., because there is no system in place for universal health care, and even products with FDA clearance (such as medicinal maggots and leeches) may not always be reimbursed by health insurance companies. The BTER Foundation petitioned the American Medical Association and spoke at a public hearing in April before a Medicare Panel, to argue in favor of insurance coding that would improve the chances of reimbursement for maggot therapy through Medicare and private insurance. A coding guidance document was issued 6 months later, and it is hoped that reimbursement in 2009 will be easier for all.
On the media front, biotherapy was featured in several documentaries and national television programs in 2008. Demi Moore brought a lot of attention to leech therapy, as she related her experience with hirudotherapy to David Letterman. The media also promoted maggot therapy when they announced that one of the 100 winners of the Medical Device & Diagnostic Industry “Most Notable People for 2008” awards was credited with advancing maggot therapy (http://www.devicelink.com/mddi/archive/08/06/002.html).
Biotherapy Support Organizations
Both the BTER Foundation (www.BTERFoundation.org) and the American Apitherapy Society (www.apitherapy.org) are expanding their membership offerings, and began talks to combine efforts in the advancement of biotherapy in the U.S. Talks will continue during 2009; hopefully with a solid plan to bring the International Biotherapy Conference to the U.S. within 2 years.
LETTER TO BMJ REGARDING MAGGOT THERAPYThis following letter was recently published in the BMJ as a reactions to the article of Dumville et al. 2009 (http://www.bmj.com/cgi/eletters/338/mar19_2/b773#213657)
NEW LITERATURE IN BIOTHERAPYA. MAGGOT DEBRIDEMENT THERAPY
C. BEE-VENOM THERAPY