Surgical debridement and maggot debridement therapy can survive patient with diabetic foot ulcer after foot trauma: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers, a common issue associated with diabetes, can pose challenges in treatment, especially when they do not respond to traditional therapies. Maggot therapy, known as larval therapy, has surfaced as a substitute approach for managing stubborn wounds. CASE PRESENTATION: A 42-year-old male with a history of type 2 diabetes and peripheral neuropathy presents at the clinic with a long-lasting sore on the bottom of his right foot. The individual reveals that the ulcer has persisted for multiple months and has shown no improvement despite trying different remedies like creams and dressings. CLINICAL DISCUSSION: Diabetic foot ulcers are significant complications associated with diabetes, commonly triggered by neuropathy, peripheral artery disease, and impaired wound healing mechanisms. These ulcers can result in severe infections, amputations, and reduced quality of life for those affected. CONCLUSION: Maggot therapy arises as a valuable additional option for chronic ulcers in diabetic patients, providing a secure and efficient method for cleaning wounds and promoting healing.

Ignatzschineria indica Bacteremia Initially Misdiagnosed in a Patient With a Maggot-Infested Wound.

Gram-negative bacteremia in hospitalized patients often leads to prolonged hospital stays, increased healthcare costs, and mortality rates. Simultaneously, the presence of comorbidities like chronic wounds increases the risk of severe infection and complicated hospital courses involving amputation, broad-spectrum antibiotic use, and repeat hospital admissions, after discharge. This case presents a 72-year-old male with a past medical history significant for chronic lower extremity cellulitis with multiple prior hospitalizations. On admission, the patient had a chief complaint of progressively worsening left lower extremity pain along with nausea, vomiting, and diarrhea. CT imaging of the left lower extremity suggested severe cellulitis without signs of osteomyelitis. Blood cultures initially suggested Corynebacterium jeikeium, but were sent to an outside facility due to ambiguity of results. The outside facility identified the pathogen as Ignatzschineria indica. After confirming the results, antibiotics were appropriately de-escalated to oral levofloxacin. The patient continued to show clinical improvement and was discharged with follow-up appointments scheduled for infectious disease and bi-weekly visits to wound care. Considering the increasing prevalence of chronic wounds in the United States, awareness and recognition of emerging pathogens are crucial for the timely diagnosis, treatment, and management of these complex patients. Our case adds to the growing body of reports on the management of I. indica bacteremia resulting from maggot-infested wounds.

Comprehensive infectious diabetic foot ulcer repair through multiple dressing methods, maggot therapy, and vacuum therapy after amputation: A case report study.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers are a prevalent and challenging issue among diabetes patients, frequently leading to notable health concerns and reduced quality of life. Effectively addressing diabetic foot ulcers necessitates a comprehensive treatment strategy. CASE PRESENTATION: The 69-year-old patient with Type 2 diabetes, complicated by illiteracy and poor glycemic control, developed a foot wound that escalated to cellulitis and abscess due to diabetes and peripheral vascular disease. After angioplasty and midfoot amputation, treatment focused on wound healing with antibiotics, local anesthesia, larval therapy, vacuum-assisted closure (VAC), platelet-rich plasma (PRP) injections, and specialized dressings. A multidisciplinary team approach facilitated successful wound healing and functional improvement, highlighting the importance of comprehensive care and innovative treatments in complex diabetic foot ulcers. DISCUSSION: Diabetic foot ulcers, a frequent complication of diabetes, present notable hurdles in treatment and care. Comprehensive strategies are typically essential for managing these ulcers efficiently and averting additional issues. Recently, there has been increasing attention towards employing various dressing techniques, maggot therapy, and vacuum therapy as integral components of a holistic diabetic foot ulcer treatment approach. CONCLUSION: Employing a comprehensive method involving various dressing techniques, maggot therapy, and vacuum therapy for diabetic foot ulcers can significantly boost wound healing, curb infections, and lower the chances of additional complications.

Maggot therapy for resistant infections: the disconnect between scientific evidence, clinical acceptance and practice.

OBJECTIVE: Practitioners and scientists are re-examining marginalised wound care therapies to find strategies that combat the growing problem of antimicrobial resistance (AMR) without compromising patient outcomes. Maggot therapy (MT) makes up just an estimated 0.02% of UK's National Health Service spending on wound care. This study aims to uncover why MT is not used more often, despite its affordability and high level of efficacy for both debridement and disinfection, particularly in the context of AMR infections, and to determine what can be done to ensure MT is more effectively used in the future to improve patient outcomes and manage the growing problem of AMR. METHOD: For this investigation, a qualitative review of case studies using MT against AMR infections and a quantitative analysis of randomised control trials (RCTs) were performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework. RESULTS: Analysis showed that MT is highly effective against a range of infections and wound types, and compares well against conventional therapies. The low use of MT may be due in part to the documented 'yuck factor', often associated with maggots as well as misconceptions around the cost, efficacy and accessibility of MT. To overcome these factors, more RCTs on the spectrum and efficacy of MT across various clinical manifestations are needed, as well as professional and public engagement campaigns. CONCLUSION: MT is an underused therapy, particularly regarding AMR infections, and expanding its use in these circumstances appears warranted. MT could play a vital role in conserving the efficacy of the existing pool of antimicrobials available and should be considered in the development of antimicrobial stewardship programmes. DECLARATION OF INTEREST: This work was supported by the Swansea Employability Academy, Swansea University (internal funding). The authors have no conflicts of interest to declare.

Can Parasites be Useful?

Parasites are commonly associated with harm, but they also have beneficial aspects that are still being discovered. It is important to acknowledge both the harmful and beneficial aspects of parasites. They have been found to have positive effects on non-healing wounds, surgical wounds, obesity, glucose metabolism disorders, nerve repair, cancer treatments, and fertility. Research has shown that helminths, protozoa, and arthropods have the ability to correct, prevent, and cure certain disorders through the use of the parasite itself, its molecules, or even its eggs. This article includes studies on the beneficial aspects of parasites. However, further research is needed to fully understand the mechanisms by which parasites stimulate or affect the immune system and how they can be used therapeutically.

Detoxification of phoxim by a gut bacterium of Delia antiqua.

The presence of certain associated bacteria has been reported to increase pest resistance to pesticides, which poses a serious threat to food security and the environment. Researches on the above microbe-derived pesticide resistance would bring innovative approaches for pest management. Investigations into the phoxim resistance of Delia antiqua, one Liliaceae crop pests, revealed the contribution of a phoxim-degrading gut bacterium, D39, to this resistance. However, how the strain degraded phoxim was unknown. In this study, the role of D39 in phoxim degradation and resistance was first confirmed. DT, which had an identical taxonomy but lacked phoxim-degrading activity, was analyzed alongside D39 via comparative genomics to identify the potential phoxim degrading genes. In addition, degradation metabolites were identified, and a potential degradation pathway was proposed. Furthermore, the main gene responsible for degradation and the metabolites of phoxim were further validated via prokaryotic expression. The results showed that D39 contributed to resistance in D. antiqua larva by degrading phoxim. Phoxim was degraded by an enzyme encoded by the novel gene phoD in D39 to O,O-diethyl hydrogen phosphorothioate and 2-hydroxyimino-2-phenylacetonitrile. Finally, downstream products were metabolized in the tricarboxylic acid cycle. Further analysis via prokaryotic expression of phoD confirmed its degradation activity. The mechanisms through which gut microbes promote pesticide resistance are elucidated in this study. These results could aid in the development of innovative pest control methods. In addition, this information could also be used to identify microbial agents that could be applied for the remediation of pesticide contamination.

Effects of four types of natural bait on water quality, feeding, growth, and antioxidant enzyme activity of Monopterus albus in a recirculating aquaculture system.

Monopterus albus is one of China's renowned and superior aquaculture species, with its seedlings mainly sourced from wild capture. One of the bottlenecks in M. albus aquaculture is the high mortality rate and low feeding initiation rate from stocking wild fry to the initiation of feeding. In production, trash fish is commonly used to wean M. albus juveniles onto feeding. In this study, we introduced three other natural feeds, earthworms (EW), yellow mealworms (YMW), and fly maggots (FM), with frozen trash fish (TF) serving as the control group, to evaluate the effects of these four natural feeds on the survival rate, feeding initiation, antioxidant enzymes activity, and body composition of M. albus juveniles under recirculating water aquaculture conditions. The experiment comprised four treatments, each with three replicates. Each replicate consisted of stocking 150 M. albus juveniles weighing 10.02 ± 0.89 g in size, raised for 5 weeks. The survival rate of the YMW group was 73.33%-85.33%, which was significantly higher than that of the other three bait groups (p < 0.05). The four bait groups showed no significant differences in final body weight and specific growth rate (SGR) (p > 0.05). The EW group showed the highest final body weight, with an average SGR of 2.73, whereas the YMW group had an average SGR of 1.87. The average daily feeding amount was significantly higher in EW and YMW groups than in the other two groups (p < 0.05). The percentage of feeding amount to fish weight in the EW group reached 7.3% in the fifth week. After 5 weeks of cultivation, NO2 --N content was significantly higher in the waters of the TF and EW groups than in the waters of the FM and YMW groups (p < 0.05), there was no significant difference in TAN content among the treatment groups (p > 0.05). Liver malondialdehyde content was significantly higher in the TF group than in the other bait groups (p < 0.05). GSH-Px activity was significantly higher in the EW group than in the FM group and YMW group. No significant differences in SOD and CAT activity and T-AOC were observed among the bait groups (p > 0.05). The increase in crude protein content was significantly higher in the TF group than in the FM group, but the increase in crude ash content was significantly lower in the TFgroup. In conclusion, Tenebrio molitor could potentially serve as one of the alternative feeds during the initial stages of M. albus juveniles stocking.

Variation in Thermal Sensitivity of Diapause Development among Individuals and over Time Predicts Life History Timing in a Univoltine Insect.

AbstractPhysiological time is important for understanding the development and seasonal timing of ectothermic animals but has largely been applied to developmental processes that occur during spring and summer, such as morphogenesis. There is a substantial knowledge gap in the relationship between temperature and development during winter, a season that is increasingly impacted by climate change. Most temperate insects overwinter in diapause, a developmental process with little obvious morphological change. We used principles from the physiological time literature to measure and model the thermal sensitivity of diapause development rate in the apple maggot fly Rhagoletis pomonella, a univoltine fly whose diapause duration varies substantially within and among populations. We show that diapause duration can be predicted by modeling a relationship between temperature and development rate that is shifted toward lower temperatures compared with typical models of morphogenic, nondiapause development. However, incorporating interindividual variation and ontogenetic variation in the temperature-to-development rate relationship was critical for accurately predicting fly emergence, as diapause development proceeded more quickly at high temperatures later in diapause. We conclude that the conceptual framework may be flexibly applied to other insects and discuss possible mechanisms of diapause timers and implications for phenology with warming winters.

Polysaccharides extracted from larvae of Lucilia sericata ameliorated ulcerative colitis by regulating the intestinal barrier and gut microbiota.

Pest management technology has been a promising bioconversion method for waste resource utilization. Unlike many pests that consume waste, the larvae of Lucilia sericata, also known as maggots, have many outstanding advantages as following: with their strong adaption to environment and not easily infected and exhibiting a medicinal nutritional value. Herein, the potential efficacies of maggot polysaccharides (MP), as well as their underlying mechanisms, were explored in Dextran sulfate sodium (DSS)-induced colitis mice and TNF-α-elicited Caco-2 cells. We extracted two bioactive polysaccharides from maggots, MP-80 and MP-L, whose molecular weights were 4.25 × 103 and 2.28 × 103 g/mol, respectively. MP-80 and MP-L contained nine sugar residues: 1,4-α-Arap, 1,3-ß-Galp, 1,4,6-ß-Galp, 1,6-α-Glcp, 1-α-Glcp, 1,4-ß-Glcp, 1-ß-Xylp, 1,2-α-Manp, and 1-ß-Manp. We demonstrated that MP-80 and MP-L significantly ameliorated DSS-induced symptoms and histopathological damage. Immuno-analysis revealed that compared with MP-L, MP-80 could better restore intestinal barrier and reduced inflammation by suppressing NLRP3/NF-κB pathways, which might be attributed to its enriched galactose fraction. Moreover, 16S rRNA sequencing revealed that MP-80 and MP-L both improved the dysbiosis and diversity of gut microbiota and acted on multiple microbial functions. Our study sheds new light on the possibility of using maggot polysaccharides as an alternative therapy for colitis.

Use of biosurgery for the treatment of foot ulcers infected with therapy-resistant bacteria: a case report.

Biosurgery (larval therapy) has been used for centuries. However, in recent times, this treatment has been replaced with the use of antibiotics for the treatment of wounds. Due to increasing antibiotic resistance, larval therapy is once again coming to the fore as an effective and efficient treatment. Due to the increasing ageing population, along with an increase in patients with arterial occlusive disease, diabetes and immobility, the number of patients with hard-to-heal wounds will increase. The stressors associated with wounds, such as pain, limited physical functionality, depression and social withdrawal, have a negative impact on patient quality of life. This case report documents the performance of biosurgery in a patient with multimorbidities.

Synergistic improvement of humus formation in compost residue by fenton-like and effective microorganism composite agents.

Improving the humification of compost through a synergistic approach of biotic and abiotic methods is of great significance. This study employed a composite reagent, comprising Fenton-like agents and effective microorganisms (EM) to improve humification. This composite reagent increased humic-acid production by 37.44 %, reaching 39.82 g kg-1, surpassing the control group. The composite reagent synergistically promoted micromolecular fulvic acid and large humic acid production. Collaborative mechanism suggests that Fenton-like agents contributed to bulk residue decomposition and stimulated the evolution of microbial communities, whereas EMs promoted highly aromatic substance synthesis and adjusted the microbial community structure. Sequencing analysis indicates the Fenton-like agent initiated compost decomposition by Firmicutes, and EM reduced the abundance of Virgibacillus, Lentibacillus, and Alcanivorax. Applied as an organic fertilizer in Brassica chinensis L. plantations, the composite reagent considerably improved growth and photosynthetic pigment content. This composite reagent with biotic and abiotic components provides a learnable method for promoting humification.

Dietary replacement of maggot meal for soybean meal: implication on performance indices, nutrient digestibility, nitrogen utilisation and carcass characteristics of grower rabbits.

A study was conducted to investigate the effect of replacing soybean meal (SBM) with maggot meal (MM) in growing rabbits' diets on their performance, nutrient digestibility, and carcass characteristics. In the 56 days feeding trials, sixty unsexed mixed breeds (New Zealand White x California) rabbits were allotted on a weight equalization basis into five dietary treatments where a standard corn-soybean meal based diet (0% of maggot meal) (MM0 diet) served as the while other diets had soybean meal replaced with MM at graded levels of 25, 50, 75 and 100% to give MM25, MM50, MM75, and MM100 diets respectively. Each treatment comprises of four replicates having three rabbits each (12 rabbits per treatment). Growth performance parameters were monitored and recorded weekly, carcass and organ weights evaluation was conducted on day 56. Nutrient digestibility commenced on the 56th day and lasted for 6 days. Feed and water were offered to the rabbits ad-libitum throughout the experimental period. All the performance parameters were significantly (P < 0.05) affected by MM inclusion in the diet of rabbits. Rabbits fed MM100 diet had the highest (P < 0.05) final weight (FW), total weight gain (TWG), and the best feed conversion ratio (FCR). The feed cost reduced (P < 0.05) with inclusion of MM in rabbit's diet. Feed cost per kg live weight (FC/LW) (1110.79 ₦/kg) and feed cost per kg weight gain (FC/WG) (1110.62 ₦/kg) was lowest (P < 0.05) for rabbits fed MM100 diet. Crude protein digestibility (CPD) (74.05%) was highest (P < 0.05) for rabbits fed the MM100 diet. The feeding of MM75 and MM100 diets to rabbits resulted in increased (P < 0.05) dry matter digestibility (DMD) (68.22 and 69.34%), nitrogen free extract digestibility (NFED) (65.52 and 65.22%) and neutral detergent fibre digestibility (NDFD) (70.05 and 69.58%). The highest (P < 0.05) nitrogen retained (NR) (2.10 g/d) occurred in rabbits fed the MM100 diet. The dressing percentage (DP) (71.01%) increased (P < 0.05) for rabbits fed the MM100 diet. The weight of forelimbs (10.48 and 10.45%) and hind limbs (17.42 and 18.07%) were highest (P < 0.05) for rabbits fed MM50 and MM100 diets respectively. Total gastrointestinal tract (GIT) and liver weight were highest (P < 0.05) for rabbits fed MM0 and MM100 diets respectively. It was concluded that MM can conveniently replace SBM in the diets of rabbits up to 100% for improved growth performance and increased nutrient digestibility. In addition, it can enhance DP and increase the carcass yield of rabbits.

Pain Assessment in Patients Undergoing Maggot Debridement Therapy in the Process of Local Treatment of Chronic Wounds.

(1) Background: Developing and implementing strategies for local wound care focused on improving the quality of life related to health status and reducing treatment costs for this patient group poses a challenge to contemporary healthcare systems. The utilization of Maggot Debridement Therapy (MDT) is one potential form of local therapy for preparing wounds for the healing process. The debridement of the wound bed with medical maggots is highly precise, and the defensins produced by the larvae eliminate bacteria and stimulate tissue regeneration. However, the presence of larvae in the wound may lead to the occurrence of pain symptoms. The aim of the study was to assess the intensity of pain during larval therapy in patients with chronic wounds treated in outpatient settings. (2) Patients and Methods: The study employed a diagnostic survey and estimation; the tool consisted of a research protocol comprising three parts (questionnaires). Inclusion criteria for the study were voluntary consent to participate (completion of the MDT acceptance questionnaire), chronic wounds of vascular etiology or pressure injuries, full-thickness skin or deep tissue damage, and pain intensity not exceeding four on the NRS (Numerical Rating Scale: 0-no pain, 10-the most severe pain) at the time of the study. Patient observation during the 3-day treatment was conducted by a wound care clinic nurse, assessing pain intensity once every 24 h during the larval dressing changes. (3) Results: Out of 348 individuals who qualified for MDT during the study period, 215 individuals participated in the study: 94 women (43.7%) and 121 men (56.3%). The age of the participants ranged from 28 to 97 years (mean 69.87 ± 12.95). Each participant experienced mild pain (2.26 ± 1.60 on the NRS) on the day of qualification for the study. An increase in pain intensity, according to subjective assessments, was reported by 29.3% of participants (n = 63). On the third day of MDT therapy, an increase in pain intensity was observed, reaching a mean value of 4.79 ± 2.12 (p < 0.0001). Participants with pressure injuries showed the lowest pain intensity, which increased in consecutive days for all types of wounds. Additionally, the increase in pain intensity in patients with vascular etiology wounds was greater compared to patients with pressure injuries (p < 0.001). (4) Conclusions: Local wound therapy with Lucilia sericata larvae increases pain intensity in the consecutive days of treatment. The wound area and the time since its occurrence may determine pain symptoms.

Efficacy of conventional and organic pesticides following ingestion by Delia radicum (Diptera: Anthomyiidae).

Cabbage maggot (CM) (Delia radicum L.) is a devastating pest of Brassicaceae crops throughout the world, including the Willamette Valley in western Oregon, USA. Chemical control methods for this pest are limited, with reduction or elimination of chlorpyrifos tolerances and expensive alternative chemistries; therefore, there is an increasing need for novel chemical control options. Adult feeding, a strategy used with insecticide-treated baits for other fly species, has yet to be tested as an option for a chemical control delivery for cabbage maggot. Treated bait can exploit the feeding behavior of CM and expose them to insecticides in a field setting. In this study, the efficacy of 5 organic and 5 conventional insecticides was compared in laboratory bioassays of treated bait stations in Aurora, Oregon, USA. The mortality of adult female cabbage maggot flies was assessed over time following ingestion of insecticides. Among organic insecticides tested, spinosad was highly effective 4 h after exposure, while pyrethrins + azadirachtin was moderately effective following 18 h after exposure. Flies exposed to conventional-use pesticides zeta-cypermethrin and bifenthrin had high mortality 1.75 h after exposure, while spinetoram had moderate efficacy 2 h after exposure. Insecticides identified with high or moderate efficacy may have the potential for use in baits or lure formulations that could be used to augment the control of cabbage maggots in field settings.

The role of medical-grade maggots in facilitating healing of diabetic foot ulcers in Kano, northern Nigeria: a case series.

OBJECTIVE: Approximately 13% of people living with diabetes develop one or more ulcers during the course of the disease, and diabetic foot ulcer (DFU) is responsible for >60% of lower limb amputations worldwide. This case series aimed to demonstrate the effectiveness of medical-grade maggots on DFUs in promoting wound healing and reducing related hospital stays in northern Nigeria. METHOD: Maggot debridement therapy (MDT) was applied to the DFUs of patients who consented to this treatment between January-August 2021 at the Orthopaedic Unit of the Aminu Kano Teaching Hospital (AKTH), Kano, Nigeria. Sterile first instar larvae of Lucilia sericata were obtained indigenously and applied using the confinement (free-range) method under aseptic procedure. RESULTS: A total of 15 patients with DFUs of Wagner classification grades III (33.3%) and IV (66.7%), were seen and documented. The patients included 10 (66.7%) females and five (33.3%) males, giving a female:male ratio of 2:1. The mean age (±standard deviation) of the respondents was 51.6±10.8 years. The surface area of the wounds ranged from 24-140cm2, with a median value of 75cm2. Among the patients, 60% had two cycles of MDT, with a median duration of five days. Most of the wounds (53.3%) were debrided within five days; 13.3% (two wounds) took seven days to be fully debrided. A paired sample t-test showed a statistically significant association between wound surface area and therapy duration (t=8.0; p=0.000) and between wound surface area and cycles of therapy (t=8.3; p=0.000). Before maggot application, 14 (93.3%) DFUs were completely (100%) covered with slough and only one (6.7%) was 95% covered with slough. After maggot application, 10 (66.7%) wounds were completely debrided while five (33.3%) wounds required bedside surgical debridement to achieve complete debridement. A paired sample t-test showed statistically significant difference between the pre- and post-MDT slough covering the wounds (t=45.1; p=0.000). CONCLUSION: In this case series, MDT was successfully used in the debridement of DFUs, which facilitated the healing process with an encouraging clinical outcome.

Use of thermal drone in detection and assessment of larval mass temperature in decomposed rabbit carcasses.

Manual ground searches and cadaver dogs are traditional methods for locating remains, but they can be time- and resource-intensive, resulting in the decomposition of bodies and delay in victim identification. Therefore, thermal imaging has been proposed as a potentially useful tool for detecting remains based on their temperature. This study investigated the potential of a novel search technique of thermal drones to detect surface remains through the detection of maggot mass temperatures. Two trials were carried out at Selangor, Malaysia, each utilizing 12 healthy male Oryctolagus cuniculus European white rabbits and DJI Matrice 300 RTK drone China, equipped with a thermal camera; Zenmuse H20T to record the thermal imaging footage of the carcasses at various heights (15, 30, 60-100 m) for 14 days for each trial. Our results demonstrated that the larval masses and corresponding heat emissions were at their largest during the active decay stage; therefore, all the carcasses were observable in thermal images on day 5 and remained until day 7. Statistical analyses showed that (1) no statistically significant differences in thermal images between clothed and unclothed subjects (p > 0.05); (2) 15 m above ground level was proven to be the optimal height, as it showed the greatest contrast between the carcass heat signature and the background (p < 0.005). Our data suggested the potential window of detection of thermal signatures was detectable up to 7 days post-deposition. This could be an important guideline for the search and recovery teams for operational implementation in this tropical region.

Effects of nonnutritive sugar inclusion in laboratory diets and attracticidal spheres on survivorship and mobility of 2 Dipteran species, Rhagoletis pomonella (Diptera: Tephritidae) and Drosophila suzukii (Diptera: Drosophilidae).

Native apple maggot fly, Rhagoletis pomonella, and invasive spotted-wing drosophila, Drosophila suzukii, are key pests of apple and small fruit, respectively, in the United States. Both species are typically managed with standard insecticide applications. However, interest in alternative strategies that result in insecticide reductions has led to evaluations of nonnutritive sugars as toxicants for Drosophila species and development of attracticidal spheres for both species. Here, we evaluated the survivorship of R. pomonella and D. suzukii when provided with standard diets that substituted saccharin, sucralose, aspartame, erythritol, dextrose, or mannitol for the sucrose component and compared them with standard diets and water-only controls for up to 15 days. Presence of erythritol and mannitol significantly decreased survivorship of R. pomonella and erythritol significantly decreased the survivorship of D. suzukii. However, mobility trials following a 2 h exposure to aqueous solutions of each sugar treatment resulted in no strong impact on either species. Survivorship after 30 min exposure to erythritol or mannitol alone, or in combination with varying concentrations of sucrose (serving as a phagostimulant) at 30 min and 24 h were evaluated for both species. Only D. suzukii survivorship was affected with decreased survivorship on erythritol:sucrose solutions of 20:0% and 15:5% for 24 h. Based on all results, erythritol appeared most promising, and was integrated into attracticidal spheres as a toxicant but even at the highest concentration, survivorship remained unaffected for either species, thus making this nonnutritive sugar impractical and ineffective as a toxicant substitute in attracticidal spheres.

Hybrid approach in sacral sore management with maggot debridement therapy and flap reconstruction.

Sacral sore is a common problem in patients with spinal cord injury. It leads to prolonged hospitalization and recurrent infections which might require repeated surgery to treat. Flap reconstruction allows soft tissue coverage of sacral sore under the premise of infection-free wound base. Maggot debridement therapy (MDT) has been described as an alternative non-surgical management as opposed to the traditional surgical debridement in case of infected sore, reducing number of surgeries under anaesthesia. However, MDT and surgery are not mutually exclusive. In this article we describe a hybrid approach combining MDT and flap reconstruction with multi-disciplinary effort in management of sacral sore, which accelerates wound healing and prevents morbidities, while lowering the risks associated with repeated surgical debridement at the same time.

Effect of Fly Maggot Protein as Dietary on Growth and Intestinal Microbial Community of Pacific White Shrimp Litopenaeus vannamei.

As the intensive development of aquaculture persists, the demand for fishmeal continues to grow; however, since fishery resources are limited, the price of fishmeal remains high. Therefore, there is an urgent need to develop new sources of protein. They are rich in proteins, fatty acids, amino acids, chitin, vitamins, minerals, and antibacterial substances. Maggot meal-based diet is an ideal source of high-quality animal protein and a new type of protein-based immune enhancer with good application prospects in animal husbandry and aquaculture. In the present study, we investigated the effects of three different diets containing maggot protein on the growth and intestinal microflora of Litopenaeus vannamei. The shrimp were fed either a control feed (no fly maggot protein added), FM feed (compound feed with 30% fresh fly maggot protein added), FF feed (fermented fly maggot protein), or HT feed (high-temperature pelleted fly maggot protein) for eight weeks. The results showed that fresh fly maggot protein in the feed was detrimental to shrimp growth, whereas fermented and high-temperature-pelleted fly maggot protein improved shrimp growth and survival. The effects of different fly maggot protein treatments on the intestinal microbiota of L. vannamei also varied. Fermented fly maggot protein feed and high-temperature-pelleted fly maggot protein feed increased the relative abundance of Ruegeria and Pseudomonas, which increased the abundance of beneficial bacteria and thus inhibited the growth of harmful bacteria. In contrast, fresh fly maggot proteins alter the intestinal microbiome, disrupting symbiotic relationships between bacteria, and causing invasion by Vibrio and antibiotic-resistant bacteria. These results suggest that fresh fly maggot proteins affect the composition of intestinal microorganisms, which is detrimental to the intestinal tract of L. vannamei, whereas fermented fly maggot protein feed affected the growth of L. vannamei positively by improving the composition of intestinal microorganisms.

Fighting diabetic foot ulcer by combination therapy, including larva therapy, Medi honey ointment, and silver alginate dressings: A case report.

INTRODUCTION AND IMPORTANCE: Diabetic foot ulcers (DFUs) are a common complication of diabetes and can be challenging to manage. A combined approach can lead to faster healing and better outcomes for individuals with DFUs. CASE PRESENTATION: This case report presents a 70-year-old man with a 15-year history of diabetes who developed a diabetic foot ulcer. The patient was undergoing treatment with routine therapy. Despite the severity of the ulcer, a combination therapy approach, including larva therapy, Medi honey ointment, and silver alginate dressings, was implemented, leading to successful healing. CLINICAL DISCUSSION: By combining these three treatment modalities, we may be able to achieve a synergistic effect and maximize wound healing and infection control benefits. CONCLUSION: The combined use a honey-based Media Honey ointment and silver alginate larva therapy can be an effective treatment option for diabetic foot ulcers.