Bakgrund: Larvterapi är en alternativ behandlingsmetod i bensårsläkning. Sårläkning med larver har förekommit i mer än 70 år men vid antibiotikans introduktion minskades användandet av larvterapi. Då det idag finns problem med antibiotikaresistens introducerades larvterapi åter. Syftet med denna studie var att belysa hur larvterapi påverkar bensårsbehandlingen för patienter med kroniska bensår. Metod: En integrativ litteraturstudie genomfördes utifrån två kvalitativa och sju kvantitativa vetenskapliga artiklar.  Resultat: Det som belystes var fysiologisk påverkan av bensåret såsom debridering och läkning samt upplevelsen av larvterapi såsom smärta, obehagskänslor och lukt. Studien visade att debridering vid bensår med larvterapi gav bättre resultat än med hydrogelbehandling. Larverna debriderade såren från nekrotisk vävnad så att bensårens omfång minskade drastiskt. Anmärkningsvärt var att sex av nio studier nämnde att smärta upplevdes under behandlingsprocessen men att acceptansen av larvterapi som behandlingsform var över förväntan trots smärtan. En del patienter hade initialt en negativ inställning inför larvterapi men var villiga att prova behandlingsmetoden. Larvterapi kunde förbättra patienters välbefinnande och vid smärtförekomst gick behandlingsmetoden att genomföra med hjälp av information och smärtstillande läkemedel varvid den totala läkningstiden förkortades. / Background: Larval therapy is an alternative treatment method in wound healing. Wound healing with larvae has occurred for more than 70 years. The introduction of antibiotics decreased larval therapy, but though there are problems with the resistance of antibiotics, larval therapy returned. The objective of this study was to highlight the impact of larval therapy for chronic leg ulcers.  Method: An integrative literature study was performed based on two qualitative and seven quantitative scientific articles.  Results: The impacts of the leg ulcers that were highlighted were physiological such as debridement and healing, also the experience of larval therapy such as pain, feelings of discomfort and wound odor. The study showed that the debridement in leg ulcers with larval therapy gave better results than hydrogel treatment. The larvae debrided necrotic tissue from the wounds and decreased the wound dramatically. Remarkably, six out of nine studies mentioned pain as a big factor during treatment but the acceptance of larval therapy was beyond expectation. Although some patients were reluctant to try larval therapy, most patients were willing to go through with the treatment. Larval therapy improved the wellbeing of patients and if pain occurred during larval therapy patients were motivated with information and were relieved with painkillers so the total time of healing was shortened.

Chrysomya rufifacies and Cochliomyia macellaria are two medically and forensically important necrophagous flies that dominate ephemeral resources in the southern US. Since its introduction in 1981, Ch. rufifacies has become established throughout the New World due to its larvae being facultative predators. Through this research I examined the interaction between the native, primary colonizer C. macellaria and the invasive, secondary colonizer Ch. rufifacies and elucidated the olfactory mechanisms used to locate, colonize, and exploit ephemeral resources. This work used competition experiments, olfactometer experiments, and high-throughput sequencing to investigate the effects of priority colonization of ephemeral resources on both species, the olfactory mechanisms employed by gravid females to locate a resource, and the effects of egg-associated volatiles on those females. Results from competition experiments indicated that priority sequence significantly affected the fitness of both C. macellaria and Ch. rufifacies. Regulation of colonization time is not chiefly governed by resource age, as previously thought, but is affected by colonization of the resource by conspecific and heterospecific individuals. Colonizing adults may use cues from early colonizers to assess resource quality. These cues may be derived from the physiology of the eggs, the 31-39 species of bacteria I determined are present on the egg chorion, or some combination of both. Design of these experiments facilitated the development of techniques to surface-sterilize Calliphoridae eggs, analyze behavior of adults in a dual choice olfactometer, and associate adult response to conspecific and heterospecific eggs with environmental cues that ultimately affect larval fitness.

Orientador: Patricia Jacqueline Thyssen / Texto em português e inglês / Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Biologia / Made available in DSpace on 2018-08-25T17:11:16Z (GMT). No. of bitstreams: 1 Nassu_MarianaPrado_M.pdf: 4567544 bytes, checksum: 960ea243ca753828c2fce7d481fa59ff (MD5) Previous issue date: 2014 / Resumo: A terapia larval (TL) consiste na aplicação de larvas estéreis de moscas necrófagas (Diptera) sobre lesões crônicas ou infectadas visando promover ou acelerar o processo de cicatrização. Para garantir segurança e sucesso, dois fatores tem de ser alcançados: a esterilidade das larvas que serão utilizadas e a confirmação de que a espécie, durante o seu processo de alimentação, consumirá apenas tecido necrosado. No presente estudo, pretendeu-se avaliar se a espécie Cochliomyia macellaria F. (Calliphoridae), de ampla distribuição em território brasileiro, pode ser uma excelente candidata para aplicação da TL, levando em conta seu comportamento e biologia. Foi avaliada a esterilização e a viabilidade pós-esterilização de larvas de C. macellaria em hipoclorito de sódio (NaClO) a 0,5% por um e por três minutos. Adicionalmente, lesões foram induzidas em ratos Wistar, para avaliar a qualidade e o tempo de cicatrização frente a diferentes tipos de tratamento. Para tanto, foram montados cinco grupos experimentais, sendo que em um deles os animais não foram submetidos a qualquer tipo de tratamento, e em outro foi feito desbridamento mecânico. Também foi avaliada qual a densidade larval (5, 15 ou 25 larvas/cm2) mais apropriada para obter melhor qualidade de cicatrização e, ao mesmo tempo, menor período de aplicação, visando adequar a TL a um atendimento do tipo ambulatorial, isto é, sem internação. O processo de cicatrização foi avaliado qualitativamente (a partir da mensuração de certos parâmetros associados às lesões) e quantitativamente (tempo). Fragmentos de pele foram coletados antes do tratamento e 12 h, 7 dias e 14 dias pós-tratamento, e processados para análise histológica. Em relação ao comportamento, foi observado que os imaturos de C. macellaria se alimentaram apenas de tecido necrosado. O uso de solução de NaClO a 0,5% por três minutos é o mais recomendado para obtenção de larvas estéreis com alta taxa de viabilidade. Não houve diferença significativa nos tempos de cicatrização entre os grupos experimentais. Contudo, foi observado que na relação de 25 larvas/cm2 houve um maior grau de vascularização nos tecidos, quando comparado aos demais tratamentos. Os mecanismos envolvidos nesse processo ainda são desconhecidos, mas concluiu-se que as larvas tem um importante papel na modulação da resposta imunológica do hospedeiro, sendo promissor o seu uso, provavelmente, em maiores densidades do que o preconizado na literatura / Abstract: Larval therapy (LT) is the application of sterile larvae of carrion flies (Diptera) on chronic or infected wounds to promote or accelerate the healing process. To ensure safety and success two aspects must be met: the sterility of the larvae and confirmation that the species consume only necrotic tissue during the feeding process. The present study intended to evaluate whether the species Cochliomyia macellaria F. (Calliphoridae), widely distributed in Brazil, could be a viable candidate for application of LT, taking into account their behavior and biology. Sterilization and post-sterilization viability of larvae of C. macellaria were evaluated after being treated with sodium hypochlorite (NaClO) at 0.5% during one and three minutes. Additionally, lesions were induced in Wistar rats to evaluate the healing quality and healing time against different types of treatment. For that, the rats were divided in five experimental groups, in one of them the animals were not subjected to any treatment and in another only mechanical debridement was performed. It was also evaluated which larval density (5, 15 or 25 maggots/cm2) is the most suitable for better quality of healing and at the same time, shorter period of application, in order to improve the LT to an outpatient care type, that is, without hospitalization. The healing process was assessed qualitatively (from the measurement of certain parameters associated with injuries) and quantitatively (time). Skin fragments were collected before treatment and 12 h, 7 days and 14 days post-treatment, and processed for histological analysis. Regarding the behavior, it was observed that immature C. macellaria fed only of necrotic tissue. The use of NaClO 0.5% solution for three minutes is the most recommended to obtain sterile larvae with high viability rate. There was no significant difference in healing times between the experimental groups. However, it was observed that in the group of 25 maggots/cm2 there was a higher degree of vascularization in tissues, as compared to other treatments. The mechanisms involved in this process are unknown, but it appears that the larvae have an important role in modulating the host immune response, and their use in higher density than that recommended in the literature is probably promising / Mestrado / Relações Antrópicas, Meio Ambiente e Parasitologia / Mestra em Biologia Animal

Made available in DSpace on 2014-07-29T15:04:31Z (GMT). No. of bitstreams: 1 Leticia Cunha Franco.pdf: 698845 bytes, checksum: a75fb6bf6b52a01cbfd87faf3ef4a052 (MD5) Previous issue date: 2010-05-28 / The larval therapy (LT) is a biotherapy applied for hundreds of years and understands the use of live larvae of flies in the treatment of wounds of various etiologies. The aims of this study were to assess the "acceptance" or "refusal" of larval therapy in wound healing between doctors and nurses from CAIS (Centre for Integral Care of Health) in Goiânia, GO and evaluate the factors affecting "acceptance "or" refusal "of the TL in wound healing, in the body and the bodies of others. This study takes a quantitative, descriptive and analytical study carried out in the period between June and December 2009, on the 14 CAIS, Goiânia, GO. The study population consisted of 209 professionals and of these, 92 nurses and 41 doctors completed the data collection instrument. The questionnaire took over identifying data, socioeconomic, demographic, religious, vocational training and qualification, "acceptance" and "refusal" of the TL and evaluation of factors that could influence the responses "acceptance" and "refusal" of biotherapy. All tests were performed using the software "Statistical Package for Social Sciences (SPSS). The data were explored by frequency, mean, standard deviation, median and interquartile range. The Wilcoxon test was used to compare the characteristics of variables in two different situations, in the body and the body of another person (acceptance or refusal of health professionals). P values <0.05 were considered statistically significant. Among the 133 professionals, 76.7% were female, 58.6% were aged between 23 and 32 years, 63.2% and 76.0% were Catholics from the State of Goiás. Among the professionals, 48.1% (n=64) said they would use maggots to treat wounds in his body and 51.8% (n=69) would use in the wounds of others. The factors that most interfered with the response "acceptance" among professionals, both for use in the same body as the body of others were: wound that does not respond to other treatments, reducing the healing time, rapid and selective debridement and effectiveness against microorganisms (Md=8 to 9; Q1=7 to 8;Q3=10;MIN=0 to 2;MAX=10). As for the answer "refusal", the factors that most interfered with this choice, the two situations were: insufficient knowledge and disgust manipulation (Md=9;Q1=3 to 6;Q3=10;MIN=0;MAX=10). Despite therapy with fly larvae is still poorly understood by physicians and nurses from CAIS, Goiânia, GO, almost half of these professionals agree to use this therapy, a factor that indicates the need for approximation of scientific research to practical reality. / A terapia larval (TL) é uma bioterapia aplicada há centenas de anos e compreende na utilização de larvas vivas de moscas no tratamento de feridas de variadas etiologias. Os objetivos gerais deste estudo foram: avaliar a aceitação ou recusa da terapia larval na cicatrização de feridas entre médicos e enfermeiros dos CAIS (Centro de Atendimento Integral à Saúde) de Goiânia, GO e avaliar os fatores que interferiram na aceitação ou recusa da TL na cicatrização de feridas, no próprio corpo e no corpo de outras pessoas. Trata-se de estudo de natureza quantitativa, descritivo e analítico, realizado no período compreendido entre junho e dezembro de 2009, nos 14 CAIS de Goiânia, GO. A população foi constituída por 209 profissionais e destes, 92 enfermeiros e 41 médicos preencheram o instrumento de coleta de dados. O questionário encampou dados de identificação, socioeconômicos, demográficos, de religiosidade, formação e qualificação profissional, aceitação e recusa da TL e avaliação dos fatores que poderiam influenciar nas respostas aceitação e recusa da bioterapia. Todas as análises foram realizadas utilizando o software Statistical Package for the Social Sciences (SPSS). Os dados foram explorados pela frequência, média, desvio padrão, mediana e intervalo interquartil. O teste de Wilcoxon foi utilizado para comparação das características das variáveis em duas situações distintas, no próprio corpo e no corpo de outra pessoa (aceitação ou recusa dos profissionais de saúde). Valores de p<0,05 foram considerados estatisticamente significativos. Entre os 133 profissionais, 76,7% eram do sexo feminino; 58,6% tinham idade entre 23 e 32 anos; 63,2% eram católicos e 76,0% procedentes do Estado de Goiás. Entre os profissionais, 48,1% (n=64) disseram que aceitariam utilizar as larvas para tratamento de feridas em seu próprio corpo e 51,8% (n=69) a utilizariam nas feridas de outras pessoas. Os fatores que mais interferiram na resposta aceitação entre os profissionais, tanto para utilização no próprio corpo como no corpo de outras pessoas foram: ferida que não responde a outros tratamentos, redução no tempo de cicatrização, desbridamento rápido e seletivo e eficácia contra microrganismos (Md=8 a 9;Q1=7 a 8;Q3=10;MIN=0 a 2;MAX=10). Quanto à resposta recusa , os fatores que mais interferiram nesta escolha, nas duas situações foram: conhecimento insuficiente e asco à manipulação (Md=9;Q1=3 a 6;Q3=10;MIN=0;MAX=10). Apesar da terapia com larvas de moscas ainda ser pouco conhecida por médicos e enfermeiros dos CAIS de Goiânia, GO, quase metade desses profissionais aceitaria utilizar esta terapêutica, fator que aponta a necessidade de aproximação das pesquisas científicas à realidade prática.