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Journal articles on the topic 'The European medicinal leech'

Author: Grafiati

Published: 28 June 2021

Last updated: 1 February 2022

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1

Siddall, Mark E., Peter Trontelj, Serge Y. Utevsky, Mary Nkamany, and Kenneth S. Macdonald. "Diverse molecular data demonstrate that commercially available medicinal leeches are not Hirudo medicinalis." Proceedings of the Royal Society B: Biological Sciences 274, no. 1617 (April 10, 2007): 1481–87. http://dx.doi.org/10.1098/rspb.2007.0248.

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The European medicinal leech is one of vanishingly few animal species with direct application in modern medicine. In addition to the therapeutic potential held by many protease inhibitors purified from leech saliva, and notwithstanding the historical association with quackery, Hirudo medicinalis has been approved by the United States Food and Drug Administration as a prescription medical device. Accurate annotation of bioactive compounds relies on precise species determination. Interpretations of developmental and neurophysiological characteristics also presuppose uniformity within a model species used in laboratory settings. Here, we show, with mitochondrial sequences and nuclear microsatellites, that there are at least three species of European medicinal leech, and that leeches marketed as H. medicinalis are actually Hirudo verbana . Beyond the obvious need for reconsideration of decades of biomedical research on this widely used model organism, these findings impact regulatory statutes and raise concerns for the conservation status of European medicinal leeches.

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2

Rio, Rita V. M., Michele Maltz, Benjamin McCormick, Alexander Reiss, and Joerg Graf. "Symbiont Succession during Embryonic Development of the European Medicinal Leech, Hirudo verbana." Applied and Environmental Microbiology 75, no. 21 (July 31, 2009): 6890–95. http://dx.doi.org/10.1128/aem.01129-09.

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ABSTRACT The European medicinal leech, Hirudo verbana, harbors simple microbial communities in the digestive tract and bladder. The colonization history, infection frequency, and growth dynamics of symbionts through host embryogenesis are described using diagnostic PCR and quantitative PCR. Symbiont species displayed diversity in temporal establishment and proliferation through leech development.

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3

Surugiu, Victor. "On the presence of the European Medicinal Leech Hirudo medicinalis Linnaeus, 1758 (Annelida: Hirudinea) in Romania." Travaux du Muséum National d’Histoire Naturelle “Grigore Antipa” 61, no. 1 (June 1, 2018): 7–11. http://dx.doi.org/10.2478/travmu-2018-0002.

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Abstract An isolated, but persistent population of the European medicinal leech Hirudo medicinalis Linnaeus, 1758 is reported from the “Mestecănișul de la Reci” Natural Reserve (ROSCI0111, Covasna County), representing the first confirmed record of this species in Romania. Information regarding habitat characteristics, main diagnostic features and protection status of the species is presented.

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4

Kutschera, U., and Joy Elliott. "The European medicinal leech Hirudo medicinalis L.: Morphology and occurrence of an endangered species." Zoosystematics and Evolution 90, no. 2 (November 18, 2014): 271–80. http://dx.doi.org/10.3897/zse.90.8715.

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5

Ascenzi, Paolo, Gino Amiconi, Wolfram Bode, Martino Bolognesi, Massimo Coletta, and Enea Menegatti. "Proteinase inhibitors from the european medicinal leech Hirudo medicinalis: Structural, functional and biomedical aspects." Molecular Aspects of Medicine 16, no. 3 (January 1995): 215–313. http://dx.doi.org/10.1016/0098-2997(95)00002-x.

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6

WENNING, ANGELA. "Salt and Water Regulation in Macrobdella Decora (Hirudinea: Gnathobdelliformes) Under Osmotic Stress." Journal of Experimental Biology 131, no. 1 (September 1, 1987): 337–49. http://dx.doi.org/10.1242/jeb.131.1.337.

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The anatomy, infrastructure and innervation of the nephridia of the North American leech, Macrobdella decora (Say), are described. The osmotic concentrations of blood, crop fluid and final urine, as well as urine flow under normal conditions, were found to be similar to those of the well-studied European medicinal leech, Hirudo medicinalis L. The capacity of the excretory system after changes in external salinity, and after salt and water loading with artificial blood meals, was investigated. In contrast to H. medicinalis, M. decora does not tolerate hypertonic environments and is less efficient in rapidly excreting excess salt and water. Three factors make salt and water regulation in M. decora different from that in H. medicinalis: a slower fluid resorption from the crop, a limited transport capacity of the primary urine-forming cells, and a lower rate of salt reabsorption in the central canal. Note: Dedicated to Professor Dr Ernst Florey on the occasion of his 60th birthday.

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7

Lemke, Sarah, and Andreas Vilcinskas. "European Medicinal Leeches—New Roles in Modern Medicine." Biomedicines 8, no. 5 (April 27, 2020): 99. http://dx.doi.org/10.3390/biomedicines8050099.

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Before the advent of modern medicine, natural resources were widely used by indigenous populations for the prevention and treatment of diseases. The associated knowledge, collectively described as folk medicine or traditional medicine, was largely based on trial-and-error testing of plant extracts (herbal remedies) and the use of invertebrates, particularly medicinal maggots of the blowfly Lucilia sericata and blood-sucking leeches. The widespread use of traditional medicine in the West declined as scientific advances allowed reproducible testing under controlled conditions and gave rise to the modern fields of biomedical research and pharmacology. However, many drugs are still derived from natural resources, and interest in traditional medicine has been renewed by the ability of researchers to investigate the medical potential of diverse species by high-throughput screening. Likewise, researchers are starting to look again at the benefits of maggot and leech therapy, based on the hypothesis that the use of such animals in traditional medicine is likely to reflect the presence of specific bioactive molecules that can be developed as drug leads. In this review, we consider the modern medical benefits of European medicinal leeches based on the systematic screening of their salivary proteins.

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8

Laufer, Alison S., Mark E. Siddall, and Joerg Graf. "Characterization of the Digestive-Tract Microbiota of Hirudo orientalis, a European Medicinal Leech." Applied and Environmental Microbiology 74, no. 19 (August 8, 2008): 6151–54. http://dx.doi.org/10.1128/aem.00795-08.

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ABSTRACT FDA-approved, postoperative use of leeches can lead to bacterial infections. In this study, we used culture-dependent and culture-independent approaches to characterize the digestive-tract microbiota of Hirudo orientalis. Surprisingly, two Aeromonas species, A. veronii and A. jandaei, were cultured. Uncultured Rikenella-like bacteria were most similar to isolates from Hirudo verbana.

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9

Gagiu, Adrian. "The first recorded occurrence of Hirudo verbana Carena, 1820 (Hirudinea: Arhynchobdellida: Hirudinidae) in Romania." Travaux du Muséum National d'Histoire Naturelle "Grigore Antipa" 53, no. 1 (December 1, 2010): 7–11. http://dx.doi.org/10.2478/v10191-010-0001-z.

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The first recorded occurrence of Hirudo verbana Carena, 1820 (Hirudinea: Arhynchobdellida: Hirudinidae) in Romania In 2005, a Hirudo verbana specimen was observed in Stracoş Valley, within the Tăşad Reserve (Bihor county, north-western Romania). Since the coloration pattern of this once forgotten species matches its genetic differentiation, the identification of the specimen as belonging to the southeastern European H. verbana appears plausible. The species was previously cited in southern, central and eastern Europe, but not in Romania. Therefore, the present observation might be its first recognized occurrence in the country. As recently pointed out, H. verbana is one of the three species commonly known as the European medicinal leech and the most abundant as such. Most international and national conservation legislation containing only H. medicinalis (including IUCN, CITES, Berne Convention) needs completion, according to the new taxonomy.

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10

Wakeman, Lisa J., Roger C. Munro, and Saad Al-Ismail. "Anti-Platelet Properties of Salivary Secretions of the Avian Leech." Blood 108, no. 11 (November 16, 2006): 4115. http://dx.doi.org/10.1182/blood.v108.11.4115.4115.

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Abstract Introduction Haematophages, animals evolved to a bloodsucking lifestyle as their exclusive mode of feeding secrete compounds capable of arresting haemostasis in the host. It is clear that exploitation of host haemostasis is an absolute requirement for the survival of these species. Since the discovery and with the subsequent characterisation and engineering of Hirudin a potent thrombin inhibitor from the European medicinal leech Hirudo medicinalis, attention has been focused on the potential anticoagulant and platelet aggregation inhibitors derived from an array of different species of leech from both the Rhynchobdellid and Arhynchobdellid orders. Haematophagous leeches of the genus Theromyzon sp. of the Rhynchobdellid order, also termed duck leeches, feed directly on the nasal passages, trachea and nictating membranes of migratory birds. We present the novel observation of inhibition of aggregation of human platelets by the salivary secretion extracts of the avian leech Theromyzon tessulatum. Methods Twelve adult leeches of the species T. tessulatum (total weight 2.828g) were anaesthetised with ethanol vapour. The leeches were severed at the anterior end and a homogenate produced containing salivary gland secretions. The posterior two thirds of the leeches were treated identically to serve as control material. Platelet rich plasma (PRP) was prepared from blood from a normal individual (free from known platelet modifying medicines) mixed 9:1 (v:v) with 0.105 M trisodium citrate in siliconised glass vacutainers. Platelet numbers were adjusted with autologous platelet poor plasma (PPP) to obtain concentrations of approximately 300 × 109/L. Leech extracts (anterior or posterior control) were added to PRP at a ratio of 1:4. Aggregation studies were performed using thrombin (10units/ml), collagen 10μg/ml, Ristocetin (1.5mg/ml) and ADP (5μm/ml). Results Data from this study shows that platelet aggregation was completely inhibited when stimulated by thrombin, collagen and ADP and partially inhibited (40%) on the addition of ristocetin. Conclusion Our observations contradict the belief that the anti-thrombocyte properties of this species of haematophagous leech are restricted to duck thrombocytes. We suggest the presence of one or more inhibitory molecules acting by various mechanisms including inhibition of vWF and platelet integrin mediated collagen interactions, inhibition of ristocetin mediated vWF and platelet GPIb receptor binding and salivary secretion derived apyrase inhibition of arachidonic acid mediated platelet aggregation. These findings provide conclusive evidence that this blood sucking bird leech has the ability to overcome thrombocyte function in higher vertebrates.

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11

Munro, R., M. Siddall, S. S. Dessert, and R. T. Sawyer. "Bleeding in human volunteers from the bite of the American medicinal leech Macrobdella decora compared with its European counterpart Hirudo medicinalis." Comparative Haematology International 1, no. 4 (November 1991): 214–16. http://dx.doi.org/10.1007/bf00235373.

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12

Neupane, Saraswoti, David Modry, Barbora Pafčo, and Ludek Zurek. "Bacterial Community of the Digestive Tract of the European Medicinal Leech (Hirudo verbana) from the Danube River." Microbial Ecology 77, no. 4 (February 26, 2019): 1082–90. http://dx.doi.org/10.1007/s00248-019-01349-z.

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13

Arias, Andrés, Victor Surugiu, Rafael Carballeira, Oana Paula Popa, Luis Ovidiu Popa, and Serge Utevsky. "Unravelling the Extent of Diversity within the Iberian Medicinal Leeches (Hirudinea: Hirudo) Using Molecules and Morphology." Biology 10, no. 4 (April 9, 2021): 315. http://dx.doi.org/10.3390/biology10040315.

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Until the beginning of the 21st century, the famous medicinal leech was thought to be represented by only one species, Hirudo medicinalis. However, recent publications have demonstrated that under that name, at least five different species of medicinal leeches were hidden. During the last decade, the biogeography of Western-Palaearctic leeches has begun to unravel, untangling their diversity in practically all of Europe, except for its westernmost peninsula, Iberia. Hirudo medicinalis has been repeatedly reported from Iberia, but those records were considered questionable. We discovered H. verbana in northern Spain, constituting its first record in Iberia. Using an integrative approach (combining morpho-anatomical data and molecular analyses using three genes, COI,12S rRNA, and ITS2), two endemic and geographically separated Iberian lineages have been found. One of them is easily distinguished by its distinctive colour-pattern and is described as H. verbana bilineata ssp. nov. We characterized the new subspecies morphologically, ecologically, and genetically. We also established its phylogenetic relationships with other European Hirudo spp. and confirm the presence of H. troctina in Iberia, occurring as far as 43° lat. N. Iberian H. verbana records constitute its westernmost known distribution to date. The provided distribution pattern of H. verbana contributes to a better understanding of the complexity of Iberia as a glacial refugium/cradle for endemisms, harbouring populations with a high degree of genetic structure that began to settle throughout the Pleistocene. Iberian Hirudo populations are declining in recent decades and there is an urgent need to assess their conservation status and to initiate conservation measures to reverse their decline.

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14

Neupane, Saraswoti, David Modry, Barbora Pafčo, and Ludek Zurek. "Correction to: Bacterial Community of the Digestive Tract of the European Medicinal Leech (Hirudo verbana) from the Danube River." Microbial Ecology 77, no. 4 (March 26, 2019): 1091. http://dx.doi.org/10.1007/s00248-019-01363-1.

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15

Wakeman, Lisa, Roger Munro, and Saad Al-Ismail. "Anti-Haemostatic Properties of Salivary Secretions of the Rhynchobdellid Leech Theromyzon tessulatum and the Arhynchobdellid Leech Haemopis sanguisuga: Potentially New Therapeutic Agents." Blood 106, no. 11 (November 16, 2005): 4139. http://dx.doi.org/10.1182/blood.v106.11.4139.4139.

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Abstract Haematophages, animals evolved to a bloodsucking lifestyle as their exclusive mode of feeding, secrete compounds capable of arresting haemostasis in the host. Ubiquitous throughout the animal kingdom, most are invertebrates of the Annelid class and insects of the Arthropod class. Since the discovery and subsequent characterisation and engineering of Hirudin, a potent thrombin inhibitor of the European medicinal leech Hirudo medicinalis, attention has been focused on the potential anticoagulant and platelet aggregation inhibitors derived from an array of different species of leech from both the Rhynchobdellid and Arhynchobdellid orders. The aim of this study was to investigate the anticoagulant properties of the salivary secretions of the phylogenetically diverse haematophagous Theromyzon tessulatum and the opportunistic predatory Haemopis sanguisuga of the Rhynchobdellid and Aryhchobdellid orders of the Hirudinae respectively. Leeches of both species were collected from their natural habitat. Adult leeches of the species T. tessulatum (total weight 2.828g) and of the species H. sanguisuga (total weight 4.758g) were anaesthetised with ethanol vapour. Homogenates of the salivary gland secretion containing anterior portions of the leeches were prepared and added to commercial pooled citrated plasma (Dade Behring Ci trol 1) which was subsequently centrifuged and the supernatant aspirated. The posterior two thirds of the leeches of the same weights were treated identically to serve as control material. Standard coagulation parameters of each preparation (PT, APTT, TCT and Clauss fibrinogen) were determined along with anti-FXa activity, assays of intrinsic and extrinsic coagulation factors, multi dilutional assays (MDA) and platelet aggregation studies employing the aggregation inducers thrombin (10 units/ml), collagen (10μg/ml), ristocetin (1.5 mg/ml) and ADP (5μm/ml). Results: Anterior portion preparations from both species caused a prolongation of the APTT. Prolongation of the TCT and the presence of anti-FXa activity were observed in T. tessulatum test preparations. Factor V was the factor most reduced following exposure of plasma to extract of T. tessulatum. A marked reduction in FV (0.24 of control value) and moderate reduction in FVIII and FIX (0.6 of control values) were seen following similar exposure to H. sanguisuga extract. MDA of all factors exhibited parallelism for both species. Platelet aggregation responses to thrombin, collagen and ADP agonists were abolished and that to ristocetin was reduced in T. tessulatum salivary gland preparations. Platelet aggregation responses to all inducers in presence of H. sanguisuga extract showed no difference with control preparations. This study confirms the presence of anti-thrombin and anti-FXa properties in the salivary secretions of T. Tessulatum. The presence of platelet aggregation inhibitors in T. tessulatum and the factor V, VIII and IX reducing properties of H. sanguisuga are novel findings. The ability of H. sanguisuga to reduce these factors may indicate general proteolytic activity directed at common domain structures in these molecules or the legacy of a haematophagous ancestry. The presence of anti-FXa activity in this species remains to be determined in order to establish whether H. sanguisuga is truly a misnomer or whether its nomenclature is taxonomically correct. These new anti-haemostatic properties in different species could have further potential therapeutic applications.

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16

Kutschera, U., I. Pfeiffer, and E. Ebermann. "The European land leech: biology and DNA-based taxonomy of a rare species that is threatened by climate warming." Naturwissenschaften 94, no. 12 (July 24, 2007): 967–74. http://dx.doi.org/10.1007/s00114-007-0278-3.

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17

Adams, Stephen L. "The Medicinal Leech." Annals of Internal Medicine 109, no. 5 (September 1, 1988): 399. http://dx.doi.org/10.7326/0003-4819-109-5-399.

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18

Liu, Celina, and Thomas W. Barkley. "Medicinal leech therapy." Nursing 45, no. 11 (November 2015): 25–30. http://dx.doi.org/10.1097/01.nurse.0000472561.41030.2d.

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19

Orgill, Dennis P. "Medicinal Leech Therapy." Plastic and Reconstructive Surgery 120, no. 3 (September 2007): 808. http://dx.doi.org/10.1097/01.prs.0000244306.39396.7e.

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20

Spear, Marcia. "Medicinal Leech Therapy." Plastic Surgical Nursing 36, no. 3 (2016): 121–25. http://dx.doi.org/10.1097/psn.0000000000000152.

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21

Ward, P. Daniel, and Shan R. Baker. "Medicinal Leech Therapy." Archives of Facial Plastic Surgery 9, no. 6 (November 1, 2007): 448. http://dx.doi.org/10.1001/archfaci.9.6.448.

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22

Cairns, Scott A., and Iain S. Whitaker. "Medicinal Leech Therapy." Annals of Plastic Surgery 60, no. 6 (June 2008): 723. http://dx.doi.org/10.1097/sap.0b013e31817739c4.

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23

Namias, Nicholas. "Medicinal Leech Therapy." Journal of Trauma: Injury, Infection, and Critical Care 63, no. 5 (November 2007): 1191. http://dx.doi.org/10.1097/ta.0b013e31814224ff.

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24

Cooper, M. A. C. S. "Controlling the medicinal leech." British Journal of Plastic Surgery 42, no. 2 (March 1989): 244. http://dx.doi.org/10.1016/0007-1226(89)90216-6.

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25

Martin, D. L., and R. Hunsaker. "Controlling the medicinal leech." British Journal of Plastic Surgery 42, no. 1 (January 1989): 116. http://dx.doi.org/10.1016/s0007-1226(89)90128-8.

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26

Hammerschmidt, Dale E. "Hirudo medicinalis: The medicinal leech." Journal of Laboratory and Clinical Medicine 132, no. 3 (September 1998): 236. http://dx.doi.org/10.1016/s0022-2143(98)90173-1.

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27

Ouderkirk, John P., David Bekhor, Glenn S. Turett, and Raj Murali. "AeromonasMeningitis Complicating Medicinal Leech Therapy." Clinical Infectious Diseases 38, no. 4 (February 15, 2004): e36-e37. http://dx.doi.org/10.1086/381438.

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28

Aslan, Gürcan, Ahmet Terzioglu, and Dogan Tuncali. "THE RE-USABLE MEDICINAL LEECH." Plastic and Reconstructive Surgery 111, no. 3 (March 2003): 1358–59. http://dx.doi.org/10.1097/00006534-200303000-00063.

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29

Andrews, Sasha. "Hirudo medicinalis : the medicinal leech." Journal of Audiovisual Media in Medicine 24, no. 3 (January 2001): 126–27. http://dx.doi.org/10.1080/01405110120071566.

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30

Adams, Stephen. "The Medicinal Leech: Historical Perspectives." Seminars in Thrombosis and Hemostasis 15, no. 03 (July 1989): 261–64. http://dx.doi.org/10.1055/s-2007-1002717.

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31

Green, Peter A., and Adam B. Shafritz. "Medicinal Leech Use in Microsurgery." Journal of Hand Surgery 35, no. 6 (June 2010): 1019–21. http://dx.doi.org/10.1016/j.jhsa.2010.03.014.

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32

Kristina Hoong Yew, Lim. "Prolonged Bleeding due to Hirudotherapy (Medicinal Leech Therapy)." Medicine & Health 16, no. 1 (June 28, 2021): 271–76. http://dx.doi.org/10.17576/mh.2021.1601.23.

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Medicinal leech therapy is a form of complementary medicine that has long been practised and is gaining popularity in recent years for various illnesses and surgical applications. However, leech saliva contains proteins with anticoagulant properties that can lead to prolonged bleeding from the bite area. We report a case of a 35-year-old male who presented to the Emergency Department due to prolonged bleeding from a leech-bite wound. He did not have any significant past medical history or medication history. He had undergone medicinal leech therapy for chronic back pain. After the therapy, he noted that the bleeding did not stop after 7 hours (which normally stops within 30 minutes) and decided to seek treatment. There were wounds over his lower back and both feet, which were all clean. The wound over the lower back had persistent oozing. We applied topical adrenaline and manual compression on the wound, and eventually the bleeding reduced and stopped. There are many suggested methods to stop bleeding from leech-bite wounds but there is scarcity of evidence regarding the superiority of any method. This is the first case report regarding bleeding complications in medicinal leech therapy in Malaysia. This report aims to raise awareness regarding the complications arising from a leech bite among the practitioners of medicinal leech therapy, the public and healthcare providers in emergency facilities. We also suggest using topical adrenaline as an alternative to help stop bleeding from leech-bite wounds.

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33

Baker, Cynthia A., and Donna A. Nayduch. "Medicinal Leech Therapy: A Case Study." Orthopaedic Nursing 8, no. 2 (March 1989): 21–24. http://dx.doi.org/10.1097/00006416-198903000-00004.

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34

Bank, Jonathan, Yizhak Zilinsky, Joseph Haik, Eyal Winkler, and Oren Goldan. "Medicinal Leech Fixation in Precarious Locations." Journal of Reconstructive Microsurgery 24, no. 1 (January 2008): 067–68. http://dx.doi.org/10.1055/s-2008-1042963.

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35

Pleteneva, T. V., A. A. Mokrousov, T. V. Maksimova, I. S. Luzanova, M. A. Tambovtseva, and A. V. Syroeshkin. "Elemental analysis of the medicinal leech." Pharmaceutical Chemistry Journal 44, no. 11 (February 2011): 632–34. http://dx.doi.org/10.1007/s11094-011-0534-x.

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36

Şenel, Engin, Ayşegül Taylan Özkan, and Kosta Y. Mumcuoglu. "Scientometric analysis of medicinal leech therapy." Journal of Ayurveda and Integrative Medicine 11, no. 4 (October 2020): 534–38. http://dx.doi.org/10.1016/j.jaim.2018.11.006.

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37

Sig, Ali K., Mustafa Guney, Aylin Uskudar Guclu, and Erkan Ozmen. "Medicinal leech therapy—an overall perspective." Integrative Medicine Research 6, no. 4 (December 2017): 337–43. http://dx.doi.org/10.1016/j.imr.2017.08.001.

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38

Singh, Amrit Pal. "Medicinal leech therapy (Hirudotherapy) : A brief overview." Complementary Therapies in Clinical Practice 16, no. 4 (November 2010): 213–15. http://dx.doi.org/10.1016/j.ctcp.2009.11.005.

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39

Bates, Mercedes, Karen Kneer, and Cathy Logan. "CE Feature: Medicinal Leech Therapy: An Overview." Orthopaedic Nursing 8, no. 2 (March 1989): 12–16. http://dx.doi.org/10.1097/00006416-198903000-00003.

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40

Zavalova, L. L., I. I. Artamonova, S. N. Berezhnoy, A. A. Tagaev, I. P. Baskova, J. Andersen, P. Roepstorff, and Ts A. Egorov. "Multiple forms of medicinal leech destabilase-lysozyme." Biochemical and Biophysical Research Communications 306, no. 1 (June 2003): 318–23. http://dx.doi.org/10.1016/s0006-291x(03)00896-9.

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41

Ikizceli, I. "Bleeding due to a medicinal leech bite." Emergency Medicine Journal 22, no. 6 (June 1, 2005): 458–60. http://dx.doi.org/10.1136/emj.2003.013847.

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42

Cooper, J., P. Mahaffey, and K. Applebee. "Anaesthesia of the medicinal leech (Hirudo medicinalis)." Veterinary Record 118, no. 21 (May 24, 1986): 589–90. http://dx.doi.org/10.1136/vr.118.21.589.

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43

Haycox, Claire L., Peter B. Odland, Marc D. Coltrera, and Gregory J. Raugi. "Indications and complications of medicinal leech therapy." Journal of the American Academy of Dermatology 33, no. 6 (December 1995): 1053–55. http://dx.doi.org/10.1016/0190-9622(95)90320-8.

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44

Verriere, B., B. Sabatier, E. Carbonnelle, J. l. Mainardi, P. Prognon, I. Whitaker, L. Lantieri, and M. Hivelin. "Medicinal leech therapy and Aeromonas spp. infection." European Journal of Clinical Microbiology & Infectious Diseases 35, no. 6 (April 2, 2016): 1001–6. http://dx.doi.org/10.1007/s10096-016-2629-5.

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45

Bracken, L., E. McDonough, S. Ashleigh, F. Wilson, U. Ohia, P. Mistry, H. Jones, N. Kanji, F. Liu, and M. Peak. "O23 Can children swallow tablets? outcome data from a feasibility study to assess the swallowability and acceptability of different sized placebo tablets in children and young people (creating acceptable tablets – cat)." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e10.2-e10. http://dx.doi.org/10.1136/archdischild-2019-esdppp.23.

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BackgroundIt can be challenging to administer medicines to children and young people (CYP); due to the lack of available age-appropriate formulations. Developing medicines that are acceptable to CYP has the potential to improve treatment outcomes.1 Acceptability has been defined as ‘an overall ability of the patient and caregiver (defined as ‘user’) to use a medicinal product as intended’.2 There is limited evidence for the acceptability of tablets in CYP. This feasibility study aimed to investigate the swallowability and acceptability of different sized placebo tablets in CYP aged 4–12.MethodParticipants were asked to swallow three different sized placebo tablets; 6 mm, 8 mm and 10 mm, smallest to largest. Both healthy children and NHS patients were recruited. The researcher observed and recorded children’s facial expressions as they swallowed each tablet.3 Following administration, an internal inspection of the mouth was conducted to identify any residue or non-swallowed tablet.4 Participants completed a questionnaire about the acceptability of each tablet. For analysis participants were stratified by age: 4–8 and 9–12 years.Results55 participants were recruited to the study. 30 children were in the younger group, of which 23% had taken a tablet before. 84% of the 25 older children had previously taken a tablet. 100% of participants attempted to swallow the 6mm tablet, with 67% of younger children and all older children successfully swallowing the tablet. All participants in the older group attempted to swallow the 8 mm and 10 mm tablet with 100% successfully swallowing the 8 mm and 96% successfully swallowing the 10 mm tablet. 77% of younger children attempted to swallow the 8 mm tablet, with 91% succeeding. 70% of younger children attempted the 10mm tablet, with 95% succeeding.ConclusionThis study demonstrates that tablets of 6mm, 8mm and 10mm are potentially an acceptable formulation for children aged 4–12 years.ReferencesVenables R, Batchelor HK, Hodson J, Stirling H, Marriott J. Determination of formulation factors that affect oral medicines acceptability in a domiciliary paediatric population. Int J Pharm 2015;480(1–2):55–62.Kozarewicz P. Regulatory perspectives on acceptability testing of dosage forms in children. Int J Pharm 2014;469:245–8. doi:10.1016/j.ijpharm.2014.03.057. European Medicines Agency. Guideline on pharmaceutical development of medicines for paediatric use. 2013;44:1–24.Zeinstra GG, Koelen MA, Colindres D, et al. Facial expressions in school-aged children are a good indicator of ‘dislikes’but not of ‘likes’. Food Quality and Preference 2009 December 2009;20(8):620–624.Klingmann V, Spomer N, Lerch C, et al. Favorable Acceptance of Mini-Tablets Compared with Syrup: A Randomized Controlled Trial in Infants and Preschool Children. The Journal of Pediatrics 2013 December 2013;163(6):1728–1732.e1.Disclosure(s)Nothing to disclose

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Ugural, Bahadır, and Ramazan Serezli. "Effects of various environments on number of cocoon and offspring in breeding of southern medicinal leech, Hirudo verbana Carena, 1820." Ege Journal of Fisheries and Aquatic Sciences 37, no. 3 (September 15, 2020): 207–11. http://dx.doi.org/10.12714/egejfas.37.3.01.

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Breeding medicinal leeches in controlled environments is extremely important in order to prevent their extinction. Moreover, due to medicinal leeches coming into contact with the patient's blood, breeding medicinal leeches in hygienic conditions is essential to prevent possible complications. In this study, breeding patterns of Hirudo verbana were studied in controlled conditions and the effects of various moist environments were examined. Peat, hydrogel and chopped sponge materials were compared in terms of number of cocoon and offspring in medicinal leech breeding. Peat and hydrogel environments didn’t show any statistically significant difference for number of cocoon and offspring breeding. Cocoon per leech was 3.13 ± 0.74 for peat and 2.80 ± 0.56 for hydrogel respectively. Offspring per cocoon was 11.81 ± 2.27 for peat and 12.52 ± 1.98 for hydrogel (P>0.05) respectively. In conclusion, hydrogel could be a new material for medicinal leech cocoon deposition environment especially for laboratory breeders.

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Parkes, Leighanne Olivia, Kevin Barker, Susan M. Poutanen, Jennifer M. Grant, Michael Libman, Jerome Leis, Patrick Stapleton, Michael Silverman, and Susy Hota. "1144. Modern Problem, Medieval Cure-Resistant Aeromonas in Medicinal Leeches." Open Forum Infectious Diseases 5, suppl_1 (November 2018): S344. http://dx.doi.org/10.1093/ofid/ofy210.977.

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Abstract Background Medicinal leeches are used primarily in plastic and reconstructive surgery when venous congestion threatens tissue viability. The associated infection risk ranges from 4.1 to 20%. Prophylactic antimicrobials such as fluoroquinolones (FQ) or trimethoprim-sulfamethoxazole (SXT) are recommended and target commonly isolated pathogen and gut symbiont, Aeromonas. However, resistance to these agents has been reported and detected in leeches, including at hospital systems across Canada that acquire their stock from the same supplier. Our objective was to describe the local epidemiology of leech-related Aeromonas resistant to one or more commonly used prophylactic agents, and determine if such resistance originates from the common supplier. Methods Six hospital systems across Canada using leech therapy, purchased from the same supplier, were surveyed. A 5-year retrospective review of all antimicrobial resistant leech-related Aeromonas, derived from clinical, leech, and tank fluid specimens was performed. All Aeromonas resistant to either FQ or SXT were included, and retained frozen isolates from each system were analysed by pulse-field gel electrophoresis (PFGE) using a published Aeromonas protocol. Results All six hospital systems reported leech-related Aeromonas resistant to one or more antimicrobials, totalling 15 isolates. Three systems only reported data from the last year. Four systems used FQ and two used SXT as prophylaxis. Fifteen of 15 were either FQ resistant or intermediate, and four of 15 were SXT resistant. Three of 10 isolates tested for ceftriaxone (CRO) susceptibility were resistant. Five of 15 of the isolates were resistant to two or more agents. Of the two leech quality control isolates, 2/2 were FQ resistant and 1/2 was FQ, SXT and CRO resistant. Only three isolates, each from a different, geographically distinct hospital system, had been retained. PFGE analysis indicated 2/3 are closely related (Figure 1). Conclusion Our preliminary investigation suggests that the presence of FQ and SXT resistance in leech-related Aeromonas might be more common than previously suspected, and that such resistance might originate from a common source. A broader study of the molecular epidemiology of leech-related Aeromonas is warranted. Disclosures All authors: No reported disclosures.

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Lee, Jong Ho, Do Gon Kim, Kang Young Choi, Ho Yun Chung, and Joon Seok Lee. "Successful Microsurgical Replantation of Scalp Amputation Using Medicinal and Chemical Leech Therapy: A Case Report." Archives of Hand and Microsurgery 25, no. 4 (December 1, 2020): 320–25. http://dx.doi.org/10.12790/ahm.20.0058.

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Scalp amputation is a very rare occurrence worldwide. In particular, replantation failure may occur from venous congestion, which represents a major complication of replantation. Accordingly, this study reports on a scalp amputation case with successful replantation treatment using medicinal and chemical leech therapy. On November 11, 2017, a 47-year-old female patient experienced a complete amputation injury starting from the top of the nose involving the total scalp by rolling machine that packs laundry. Severe venous congestion was controlled by medicinal leech therapy performed six times a day and chemical leech therapy (subcutaneous low-molecular-weight heparin injection) three times a day for 10 days. Approximately 85% of the scalp was replanted, and hair growth was confirmed. The basic concept of replantation surgery, “replace tissue with like tissue,” makes replacement impossible with tissues other than the hair-bearing scalp. Accordingly, the authors present a case of successful replantation with both medicinal and chemical leech therapy.

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Nelson, Michael C., and Joerg Graf. "Bacterial symbioses of the medicinal leech Hirudo verbana." Gut Microbes 3, no. 4 (July 14, 2012): 322–31. http://dx.doi.org/10.4161/gmic.20227.

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Adams, Stephen L. "The emergency management of a medicinal leech bite." Annals of Emergency Medicine 18, no. 3 (March 1989): 316–19. http://dx.doi.org/10.1016/s0196-0644(89)80422-6.

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