When to think about a Lachesis muta envenomation in the Western Brazilian Amazon: Lessons from a case report

ABSTRACT In the Brazilian Amazon, envenomations by lancehead pit vipers prevail across the region, while bushmaster (Lachesis muta) envenomations are rarely confirmed. Here, we described a moderate snakebite, diagnosed as a lancehead pit viper envenomation upon admission and treated with four vials of Bothrops antivenom. Blood remained unclottable for 4 days of hospitalization. On day 4, after admission, the patient presented pictures of the perpetrating snake to the hospital staff, which was identified as a Lachesis muta specimen. After administering 10 vials of Lachesis antivenom, blood became clottable 12 hours after treatment. The patient was discharged without complaints.

Inhibition by essential oils of Mentha viridis and Mentha pulegium (Lamiaceae) in proteolysis, fibrinogenolysis and coagulation caused by venomous snakes

Snake venoms are widely used as laboratory tools for studies of physiological, pharmacological and toxicological mechanisms. Venoms used here are rich sources of several classes of proteases that act on factors of the coagulation cascade, fibrinogenolysis and fibrinolysis, altering the hemostatic processes, and phospholipases A2 which are involved mainly in inflammatory and clotting processes. Natural products such as essential oils are made up of active ingredients with wide application in the food, pharmaceutical and cosmetic industries. Thus, this study evaluates the essential oils from Mentha viridis and Mentha pulegium on coagulation, fibrinogenolysis and degradation of azocasein, induced by Bothrops sp and Lachesis muta muta venoms. These oils were achieved by hydrodistillation and presented, respectively, as the main constituents linalool (40.70 %), carvone (13.52 %) and α-terpinene (8.56 %); pulegone (50.01 %), menthol (31.90 %) and menthone (16.56 %). The essential oils were previously incubated with Bothrops alternatus venom, for two different times, then plasma was added and time was recorded. The M. viridis oil presented greater anticlotting potential. Meanwhile, the M. pulegium oil presented anticlotting or proclotting activity dependent on the dose tested. The incubation time also influenced the effect of the oils on the coagulation time. At azocaseinolytic assay, the oil from M. pulegium reduced the activity for all evaluated venoms. The highest inhibition was of 39.99 %; on activity induced by B. jararacussu, M. viridis reduced the activity in 57.72 %. On B. moojeni, the major inhibition observed was of 74.67 %. The fibrinogenolysis induced by B. moojeni venom was totally inhibited by both oils in the evaluated proportions. The results show the presence in oils of protease inhibitors, considering serine and metalloproteases (acting on clotting factors or with hemorrhagic activity), as well as phospholipase A2 (enzymes involved in inflammation and clotting processes) inhibitors of wide application in medical and biotechnology areas.

Los venenos de serpientes son ampliamente utilizados como herramientas de laboratorio para estudios de mecanismos fisiológicos, farmacéuticos y toxicológicos. Los venenos son recursos ricos en diferentes clases de proteasas que actúan sobre los factores de la cascada de coagulación, fibrinogenólisis y fibrinólisis, alterando los procesos homeostáticos y las fosfolipasas A2, los cuales están involucrados en procesos inflamatorios y de coagulación. Los productos naturales como los aceites esenciales se componen de ingredientes activos de amplia aplicación en las industrias alimentaria, farmacéutica y cosmética. El presente estudio evalúa los aceites esenciales de Mentha viridis y Mentha pulegium sobre la coagulación, fibrinogenólisis y degradación de azocaseína, inducida por los venenos de Bothrops sp. y Lachesis muta muta. Los aceites esenciales fueron obtenidos por hidrodestilación y sus componentes principales fueron identificados respectivamente como el linalool (40.70 %), carvona (13.52 %) y α-terpineno (8.56 %); pulegone (50.01 %), mentol (31.9 %) y mentona (15.56 %). Los aceites esenciales fueron previamente incubados con veneno de Bothrops alternatus, durante dos tiempos diferentes, luego se agregó el plasma y fue registrado el tiempo. El aceite de M. viridis presentó el más grande potencial anticoagulante. Mientras tanto, el aceite de M. pulegium presentó actividad anticoagulante o procoagulante dependiendo de la dosis evaluada. El tiempo de incubación también influyó en el efecto de los aceites sobre el tiempo de coagulación. En el ensayo azocaseínolitico, el aceite de M. pulegium redujo la actividad para todos los venenos evaluados. La inhibición más alta inducida para el veneno de B. jararacussu fue de 39.99 %, para M. viridis la actividad fue reducida en 57.72 %, mientras que para B. moojeni, la mayor inhibición observada fue de 74.67 %. La fibrinogenólisis inducida por el veneno de B. moojeni fue totalmente inhibida por ambos aceites en las proporciones evaluadas. Los resultados muestran la presencia de inhibidores de proteasas en los aceites, como las serinas y metaloproteasas (actuando sobre los factores de coagulación o sobre la actividad hemorrágica), como también fosfolipasas A2 (enzimas involucradas en los procesos de inflamación y coagulación), los cuales son inhibidores de amplia aplicación en áreas médicas y biotecnológicas.

Evaluación del Tratamiento Homeopático de Mujeres en Climaterio entre los 45 y 60 años con la Menopause Rating Scale (MRS) / Treatment Evaluation Homeopathic Women in Climacteric between 45 and 60 years old with Menopause Rating Scale (MRS)

La terapia hormonal es el tratamiento convencional para contrarrestar síntomas propios del climaterio; sin embargo, algunas mujeres tienen contraindicada esta terapia debido a los efectos adversos que provoca. El objetivo de este estudio fue evaluar la utilidad del tratamiento homeopático durante el climaterio con el uso de la Menopause Rating Scale (MRS) o Escala de Calificación Menopáusica. El estudio incluyó a 31 mujeres, sin problemas cardiacos, sin terapia de reemplazo hormonal y sin antecedentes de cáncer, a quienes se les aplicó el cuestionario de la MRS para obtener un puntuaje antes del tratamiento. Para determinar el tratamiento se utilizó el repertorio electrónico Radar 10.0 para Windows, con el objetivo de repertorizar los síntomas característicos de cada paciente y determinar el medicamento similar. El medicamento fue prescrito en dinamizaciones 30CH, indicando 5 gotas sublinguales cada 8 horas. La evaluación de los pacientes se llevó a cabo cada mes durante tres meses. Se realizó una evaluación final a los tres meses por comparación de puntajes de la escala inicial y final, a través de un análisis estadístico y utilizando la prueba de Wilcoxon. Lachesis trigonocephalus y Pulsatilla nigricans fueron los medicamentos indicados con mayor frecuencia, de acuerdo con los síntomas de cada paciente. La comparación del puntaje, antes y después del tratamiento, evidenció una reducción de síntomas con diferencia estadística, lo cual reflejó una mejoría global del 35%. Esta evidencia sugiere que el tratamiento homeopático beneficia a las mujeres en el climaterio. (AU)

Hormonal therapy is the conventional treatment for counteracting climacteric symptoms; however, this treatment is contraindicated in some women due to the adverse effects that this therapy may cause. The purpose of this study was to evaluate the usefulness of homeopathic therapy during the climacteric using the Menopause Rating Scale (MRS). The study included 31 women, without cardiac problems, history of no cancer or hormone replacement therapy; a MRS scale questionnaire was applied to these women to evaluate each symptom before to treatment. The Radar 10.0 for Windows electronic repertoire was used to repertorize the characteristic symptoms of each patient and determine the similarly. Homeopathic medication was prescribed in 30CH dynamization as 5 sublingual drops every 8 hrs. Patient evaluation took place monthly for 3 months. The evaluation of the results was performed by the comparison of scale scores through a statistical analysis using the Wilcoxon test. Lachesis trigonocephalus and Pulsatilla nigricans were the most frequent treatment indications, according to the symptoms of each patient. At the end of the homeopathic treatment, symptoms reduction was observed with statistical significance in the score, which reflects an overall improvement of 35%. This evidence suggested that homeopathic treatment benefits women in climacteric. (AU)

Purification and enzymatic characterization of a novel metalloprotease from Lachesis muta rhombeata snake venom

Lachesis muta rhombeata (Lmr) is the largest venomous snake in Latin America and its venom contains mainly enzymatic components, such as serine and metalloproteases, L-amino acid oxidase and phospholipases A2. Metalloproteases comprise a large group of zinc-dependent proteases that cleave basement membrane components such as fibronectin, laminin and collagen type IV. These enzymes are responsible for local and systemic changes, including haemorrhage, myonecrosis and inflammation. This study aimed the isolation and enzymatic characterization of the first metalloprotease (Lmr-MP) from Lmr venom (LmrV). Methods and results: Lmr-MP was purified through two chromatographic steps and submitted to enzymatic characterization. It showed proteolytic activity on azocasein with maximum activity at pH 7.0-9.0. It was inhibited by EDTA (a metal chelator that removes zinc, which is essential for enzymatic activity) and no effect was observed with PMSF, iodoacetic acid or pepstatin (inhibitors of serine, cysteine and aspartyl proteases, respectively). Ca2+, Mg2+ and Ba2+ ions increased its activity, while Al3+, Cu2+, Ni2+ and Zn2+ inhibited it. Additionally, ZnCl2 showed a dose dependent inhibition of the enzyme. Lmr-MP activity was also evaluated upon chromogenic substrates for plasma kallikrein (S-2302), plasmin and streptokinase-activated plasminogen (S-2251) and Factor Xa (S-2222) showing the highest activity on S-2302. The activity in different solutions (5 mM or 50 mM ammonium bicarbonate, pH 7.8; 0.1% trifluoroacetic acid + 50% acetonitrile; phosphate buffer saline, pH 7.4; 50 mM sodium acetate, pH 4.0 or ammonium acetate pH 4.5) was also evaluated and the results showed that its activity was abolished at acidic pHs. Its molecular mass (22,858 Da) was determined by MALDI-TOF and about 90% of its primary structure was verified by high-resolution mass spectrometry using HCD and ETD fragmentations and database search against the sequence of closely related species. It is a novel enzyme which shared high identity with other snake venom metalloproteases (svMPs) belonging to the P-I group. Conclusion: The purification procedure achieved a novel pure highly active metalloprotease from LmrV. This new molecule can help to understand the metalloproteases mechanisms of action, the Lachesis envenoming, as well as to open new perspectives for its use as therapeutic tools.(AU)

Experimental Lachesis muta rhombeata envenomation and effects of soursop (Annona muricata) as natural antivenom

Background In the Atlantic forest of the North and Northeast regions of Brazil, local population often uses the fruit juice and the aqueous extract of leaves of soursop (Annona muricata L.) to treat Lachesis muta rhombeata envenomation. Envenomation is a relevant health issue in these areas, especially due to its severity and because the production and distribution of antivenom is limited in these regions. The aim of the present study was to evaluate the relevance of the use of soursop leaf extract and its juice against envenomation by Lachesis muta rhombeata. Methods We evaluated the biochemical, hematological and hemostatic parameters, the blood pressure, the inflammation process and the lethality induced by Lachesis muta rhombeata snake venom. We also assessed the action of the aqueous extract of leaves (AmL) and juice (AmJ) from A. muricata on the animal organism injected with L. m. rhombeata venom (LmrV) in the laboratory environment. Results LmrV induced a decrease of total protein, albumin and glucose; and increase of creatine kinase, aspartate aminotransferase, and urea concentrations. It provoked hemoconcentration followed by reduction of hematocrit, an increase in prothrombin time and partial thromboplastin time and a decrease of the blood pressure. LmrV induced the release of interleukin-6, an increase in neutrophils and changes in the serum protein profile, characteristic of the acute inflammatory process. LD50 values were similar for the groups injected with LmrV and treated or untreated with AmJ and AmL. Both treatments play a role on the maintenance of blood glucose, urea and coagulation parameters and exert a protective action against the myotoxicity. However, they seem to worsen the hypotension caused by LmrV. Conclusion The treatments with AmJ and AmL present some beneficial actions, but they might intensify some effects of the venom. Therefore, additional studies on A. muricata are necessary to enable its use as natural antivenom for bushmaster snakebite.(AU)

A snakebite caused by a bushmaster (Lachesis muta): report of a confirmed case in State of Pernambuco, Brazil

ABSTRACTWe report a case of envenomation caused by a bushmaster ( Lachesis muta) in a male child in State of Pernambuco, Brazil. The victim showed discrete local manifestations, but presented altered blood coagulation 2 hours after the bite. Ten ampoules of bothropic-lachetic antivenom therapy were administered, and 48 hours later, the patient showed discrete edema, pain, and ecchymosis around the bite and normal blood coagulation. The patient was discharged 5 days after the envenomation. The prompt administration of specific treatment was important for the favorable outcomes observed.

Acción de Lachesis trigonocephalus en diferentes potencias sobre las catecolaminas cerebrales / Lachesis trigonocephalus action in different potencies on brain catecholamines

Durante el Congreso Internacional del Centenario de la Escuela Libre de Homeopatía de México, celebrado en 2012, la doctora Josefina Sánchez Reséndiz presentó esta ponencia para hablar de los beneficios que la salud femenina puede tener gracias al uso de algunos medicamentos homeopáticos, en especial Lachesis trigonocephalus. De manera breve y precisa, la doctora Sánchez Reséndiz recordó los resultados de las investigaciones que realizó con el doctor Ángel Lerdo de Tejada y colaboradores sobre las catecolaminas cerebrales, partiendo de que la dopamina cerebral, a nivel del hipotálamo, tiene una gran influencia en la hormona luteinizante y en la conducta. Se pudo observar que el medicamento homeopático Lachesis trigonocephalus, a diferentes potencias, puede generar modificaciones estadísticamente significativas en las catecolaminas cerebrales, mecanismo por el cual, su uso podría ser capaz de mejorar los síntomas de la mujer durante el climaterio y la menopausia...

During the International Congress, in the 100th aniversary of the Escuela Libre de Homeopatía in Mexico, held in 2012, Josefina Sanchez Resendiz MD presented this conference to discuss about women’s health benefits that can be obtained by the use of some homeopathic medicines, especially Lachesis trigonocephalus. In a brief and precise way, Dr. Sanchez Resendiz recalled the results of the research conducted with Angel Lerdo de Tejada MD and collaborators on brain catecholamines, since brain dopamine in the hypothalamus, has a great influence in the luteinizing hormone its behavior. She observed that different potencies of the homeopathic remedy Lachesis trigonocephalus, can generate statistically significant changes in brain catecholamines. This could explain why its use may improve women’s symptoms during perimenopause and menopause...

Efecto de Lachesis trigonocephalus sobre dopamina cerebral en la rata / Lachesis trigonocephalus effect on dopamine in the rat brain

La dopamina (DA) estimula el factor liberador de hormona luteinizante (LHR), incrementa la hormona luteinizante (LH) e induce ovulación. El precursor inmediato, la L-dopa, ha sido usado para inducir la ovulación y en el síndrome amenorrea-galactorrea, pero esta droga produce varios efectos indeseables. Por esta razón pareció conveniente investigar drogas capaces de elevar la DA cerebral con menos efectos colaterales. La acción del veneno de la serpiente Lachesis trigonocephalus sobre la DA cerebral fue estudiada en ratas Wistar. Treinta y nueve animales recibieron el veneno a una dinamización de 1 x 10-24 = 12CH en etanol al 22.5%. La droga fue administrada per os con un catéter a la dosis de 0.25 ml, con intervalos de 8 horas, durante 10 días. Treinta y tres ratas sirvieron como controles y recibieron la misma dosis de etanol sin la droga. El grupo control mostró un nivel medio de 998 ± 43 ng/g (X ± SE) y los animales que recibieron la droga 1136 ± 57 ng/g (P < 0.05). La concentración de noradrenalina (NA) fue de 528 ± 29 ng/g en el grupo control y de 452 ± 16 ng/g en el grupo que recibió Lachesis (P < 0.025). Los niveles de adrenalina no mostraron cambios significativos con la droga...

Dopamine (DA) stimulates hormone luteinizing liberator (LHR), increases hormone luteinizer (LH) and induces ovulation. L-Dopa, its immediate precursor, has been used to induce ovulation and in the amenorrhea-galactorrhea syndrome, but this drug produces several undesirable effects. It was therefore considered convenient to investigate drugs which can raise Brain DA with less side effects. The effect of Lachesis trigonocephalus snake poison was studied in rats. Thirty nine animals received the venom at a 1 x 10-24 dynamization (Lachesis trig. 12CH), in ethanol at 22.5%. The drug was administered per os through a catheter on a 0.25 ml dose, at 8 hour intervals during 10 days. Thirty three rats were used as controls and received the same dosage of ethanol without the drug. The control batch gave a mean level of 998 ± 29 ng/g (X ± SE) and animals which received the drug showed 1136 ± 57 ng/g (P < 0.025). The concentration of noradrenaline (NA) was 528 ± 29 ng/g in the group which received Lachesis trig. 12CH (P < 0.025). No significant variations of adrenaline levels were apparent with the drug...

Inhibitory effect of a Brazilian marine brown alga Spatoglossum schröederi on biological activities of Lachesis muta snake venom

The ability of crude extracts of the brown seaweed Spatoglossum schröederi to counteract some of the biological activities of Lachesis muta snake venom was evaluated. In vitro assays showed that only the extract of S. schröederi prepared in ethyl acetate was able to inhibit the clotting of fibrinogen induced by L. muta venom. On the other hand, all extracts were able to inhibit partially the hemolysis caused by venom and those prepared in dichloromethane or ethyl acetate fully neutralized the proteolysis and hemorrhage produced by the venom. Moreover, the dichloromethane or ethyl acetate extracts inhibited the hemolysis induced by an isolated phospholipase A2 from L. muta venom, called LM-PLA2-I. In contrast, the hexane extract failed to protect mice from hemorrhage or to inhibit proteolysis and clotting. These results show that the polarity of the solvent used to prepare the extracts of S. schröederi algae influenced the potency of the inhibitory effect of the biological activities induced by L. muta venom. Thus, the seaweed S. schröederi may be a promising source of natural inhibitors of the enzymes involved in biological activities of L. muta venom.

Development of a sensitive enzyme immunoassay (ELISA) for specific identification of Lachesis acrochorda venom

The snake genus Lachesis provokes 2 to 3% of snakebites in Colombia every year. Two Lachesis species, L. acrochorda and L. muta, share habitats with snakes from another genus, namely Bothrops asper and B. atrox. Lachesis venom causes systemic and local effects such as swelling, hemorrhaging, myonecrosis, hemostatic disorders and nephrotoxic symptoms similar to those induced by Bothrops, Portidium and Bothriechis bites. Bothrops antivenoms neutralize a variety of Lachesis venom toxins. However, these products are unable to avoid coagulation problems provoked by Lachesis snakebites. Thus, it is important to ascertain whether the envenomation was caused by a Bothrops or Lachesis snake. The present study found enzyme linked immunosorbent assay (ELISA) efficient for detecting Lachesis acrochorda venom in a concentration range of 3.9 to 1000 ng/mL, which did not show a cross-reaction with Bothrops, Portidium, Botriechis and Crotalus venoms. Furthermore, one fraction of L. acrochorda venom that did not show crossreactivity with B. asper venom was isolated using the same ELISA antibodies; some of its proteins were identified including one Gal-specific lectin and one metalloproteinase. This test may be useful to physicians, since it could be applicable for tracking the kinetic distribution of antigens in patients or experimentally envenomed animals.(AU)

Anti-snake venom effect of secodolastane diterpenes isolated from Brazilian marine brown alga Canistrocarpus cervicornis against Lachesis muta venom

The effect of a Brazilian algae extract and also a mixture of two secodolastane diterpenes (linearol/isolinearol) that were isolated from the marine brown alga Canistrocarpus cervicornis were evaluated against biological activities of Lachesis muta snake venom. In vitro assays showed that the crude extract and the diterpenes were able to inhibit the clotting and proteolytic activity induced by L. muta crude venom, but not the hemolytic activity. However, only the diterpenes inhibited the hemolysis caused by a purified phospholipase A2 previously isolated from L. muta venom, denoted LM-PLA2-I. Interestingly, the crude algal extract and the diterpenes were able to protect mice from hemorrhage induced by L. muta venom. Thus, we may conclude that marine algae are rich and powerful sources of molecules that may be used against L. muta accidents in order to improve treatment of envenomation by this snake.

Clonaje y caracterización molecular in silico de un transcrito de fosfolipasa A2 aislado del veneno de la serpiente peruana Lachesis muta / Molecular cloning and characterization in silico of phospholipase A2 transcripto isolated from Lachesis muta peruvian snake venom

Objetivo. Aislar y caracterizar in silico un transcrito del gen de fosfolipasa A2 (PLA2) aislado del veneno de Lachesis muta de la Amazonía peruana. Materiales y métodos. Se amplificó el transcrito del gen sPLA2 mediante la técnica de RT-PCR a partir de RNA total utilizando cebadores específicos, el producto de DNA amplificado se insertó en el vector pGEM para su posterior secuenciación. Mediante análisis bioinformático de la secuencia nucleotídica se determinó un marco de lectura abierta de 414 nucleótidos que codifica 138 aminoácidos, incluyendo16 aminoácidos del péptido señal, el peso molecular y el pI fueron de 13 976 kDa y 5,66 respectivamente. Resultados. La secuencia aminoacídica denominada Lm-PLA2- Perú, contiene Asp49, así como Tyr-28, Gly-30, Gly-32, His-48, Tyr52, Asp99 importantes para la actividad enzimática. La comparación de Lm-PLA2-Perú con las secuencias aminoacídicas de los bancos de datos mostró 93 por ciento de similitud con las sPLA2 de Lachesis stenophrys y más del 80 por ciento con otras sPLA2 de venenos de la familia Viperidae. El análisis filogenético de la secuencia nucleotídica del transcrito del gen sPLA2 indica que Lm-PLA2-Perú se agrupa con otras sPLA2 [Asp49] ácidas previamente aisladas del veneno de Bothriechis schlegelii con un 89 por ciento de identidad. El modelaje tridimensional de Lm-PLA2-Perú, presenta una estructura característica de sPLA2 del Grupo II formada por tres hélices-α, una lámina-β, una hélice corta y un lazo de unión con calcio. Conclusión. La secuencia nucleotídica corresponde al primer transcripto del gen de PLA2 clonado a partir del veneno de la serpiente Lachesis muta, que habita en la selva del Perú.

Objective. Isolate and characterize in silico gene phospholipase A2 (PLA2) isolated from Lachesis muta venom of the Peruvian Amazon. Material and methods. Technique RT-PCR from total RNA was using specific primers, the amplified DNA product was inserted into the pGEM vector for subsequent sequencing. By bioinformatic analysis identified an open reading frame of 414 nucleotides that encoded 138 amino acids including a signal peptide of 16 aminoacids, molecular weight and pI were 13 976 kDa and 5.66 respectively. Results. The aminoacid sequence was called Lm-PLA2-Peru, contains an aspartate at position 49, this aminoacid in conjunction with other conserved residues such as Tyr-28, Gly-30, Gly-32, His-48, Tyr52, Asp99 are important for enzymatic activity. The comparison with the amino acid sequence data banks showed of similarity between PLA2 from Lachesis stenophrys (93 percent) and other PLA2 snake venoms and over 80 percent of other sPLA2 family Viperidae venoms. A phylogenetic analysis showed that Lm-PLA2-Peru grouped with other acidic [Asp49] sPLA2 previously isolated from Bothriechis schlegelii venom showing 89 percent nucleotide sequence identity. Finally, the computer modeling indicated that enzyme had the characteristic structure of sPLA2 group II that consisted of three α-helices, a β-wing, a short helix and a calcium-binding loop. Conclusion. The nucleotide sequence corresponding to the first transcript of gene from PLA2 cloned of Lachesis muta venom, snake from the Peruvian rainforest.

Antiophidian properties of plant extracts against Lachesis muta venom

Snakebites comprise a serious health problem in several countries due to their global incidence, which exceeds 2.5 million per year, and the elevated number of victim fatalities. To counteract envenomations, antivenoms have been used regularly for more than a century. Apart from side effects including anaphylactic reactions, antivenoms are not able to efficiently neutralize local tissue damage, which contributes to increasing the severity and morbidity observed in patients. This fact, in turn, may be responsible for economic hardship, particularly in rural populations of developing countries. In the present work, we evaluated the antiophidian properties of 12 Brazilian plant extracts against the hemolytic, coagulant, hemorrhagic and proteolytic effects of Lachesis muta venom. Taken together, our data revealed that most of these aqueous products were capable of inhibiting those activities at different levels, except for Sapindus saponaria extract. In contrast, Stryphnodendron barbatiman extract completely neutralized all the analyzed biological activities. Thus, we may conclude that Brazilian flora may also be useful against L. muta accidents.

Acidente por surucucu (Lachesis muta muta) em Belém-Pará: relato de caso / Snakebite by the bushmaster (Lachesis muta muta) in Belém-Pará: a case report

Objetivo: relatar um caso de envenenamento por Lachesis, atendido no Hospital Universitário João de Barros Barreto de Belém-Pará, ano de 2006. Relato do caso: paciente masculino, 19 anos, picado no antebraço direito, quando alimentava o animal; admitido e internado no Hospital apresentando edema discreto no antebraço direito, dor intensa no local, náuseas e vômitos, que coincidiam com cólicas abdominais paroxísticas, além de sudorese, visão turva, discreta epistaxe e diarréia; a freqüência cardíaca, ao início, com 108 batimentos por minuto, chegando a 62 após a soroterapia e pressão arterial em 130/80 mmHg; tempo de sangria em 4 min 15 seg, tempo de coagulação acima de 15 min, tempo de protrombina acima de 1 minuto. Como tratamento, foi realizado pré-medicação e soroterapia com 10 ampolas de soro antibotrópico-laquético. Após o anti-veneno o paciente evoluiu com melhora clínica; continuou assintomático até receber alta, curado. Considerações Finais: o envenenamento laquético é episódio raro, principalmente, entre profissionais que manipulam o animal. A descrição do caso é alertar os que manipulam serpentes peçonhentas, para redobrarem os cuidados e a atenção em seu ambiente de trabalho.

Objetive: report a case of snake envenomation by Lachesis, admitted at João de Barros Barreto University Hospital, in Belém, state of Pará, in 2006. Case Report: man, 19 years old, was bitten in the right foreann while was ft!eding the animal; he was hospitalized presenting mild edema in the right forearm, severe and localized ache, nauseas and vomiting, concomitant paroxistics abdominal colics, moreover blurred vision, mild epistaxis and diarrhea; At the first physical exam the heart beat was 108 bpm, and afier serotherapy got 62 bpm, the blood pressure was 130/80 mmHg, Bleeding time was 4 min 15 seg, Coagulation time was over than 15 min, Prothrombin time was aver than 1 minute. The treatment consisted of pre-medicationand serotherapy using 10 ampoules of bothropiclaquetic antivenom. Afier the serotherapy, the patient improved clinically and remained asymptomatic until he was sent home, cured. Final considerations: the snake envenomation by Lachesis is arare fact, mainly within professionals whose handle with those animals. This report intent to alert those whom handle poisoning snake and improve the attention at workplace.

Epidemiologia dos acidentes por serpentes peçonhentas no Estado do Ceará--Brasil / The epidemiology of accidental bites by venomous snakes in the state of Ceará, Brazil

Foram notificados à Secretaria de Saúde do Estado do Ceará, no período de 1992 a 1995, 688 acidentes causados por serpentes peçonhentas (média anual de 172 casos), com coeficiente de incidência variando entre 0,9 e 5,8 por 100.000 habitantes. Dentre 473 casos em que houve referência ao gênero da serpente 88,3% foram por Bothrops, 10,6% por Crotalus, 0,8% por Micrurus e 0,2% por Lachesis. Os meses de abril a setembro apresentaram maior incidência. Houve predominância de pacientes do sexo masculino (75,6%) e com idades entre 10 a 49 anos (72,3%). As regiões anatômicas mais freqüentemente picadas foram os membros inferiores (81,9%) e superiores (14,7%). O atendimento na unidade de saúde que notificou o acidente ocorreu dentro de seis horas em 66,9% dos casos. A letalidade foi de 0,7%. Os acidentados foram sobretudo agricultores (62,7%), a maioria dos casos ocorreu no próprio local de trabalho. Os autores reforçam que os acidentes ofídicos no Estado do Ceará podem ser considerados acidentes de trabalho, acometem principalmente os trabalhadores rurais e constituem causa de óbito.

From 1992 to 1995, 688 accidents by venomous snakes (mean of 192 cases/year) have been notified to the Health Ministry of the State of Ceará, with an incidence between 0.9 and 5.8/100.000 inhabitants. Among 473 cases, 88.3% were of the genus. Bothrops, 10.7% Crotalus, 0.8% Micrurus and 0.2% Lachesis. The highest incidence occurred from April to September. Male (75.6%) predominated with ages from 10 to 49 years old (72.3%). The more frequently bitten anatomical region were the lower limbs (81.9%) and upper limbs (14.7%). The attendance at health unit which notified the accident took place within 6 hours in 66.9% of the cases. Lethality was 0.7%. The afflicted people were mainly peasants (62.7%), and most of the accidents took place in their own work place. The authors emphasize that the snake bites in the state of Ceará may be considered work accidents, concern mainly peasants and constitute a cause of death.

Purificação e caracterização bioquímica-funcional de duas toxinas (serinas proteinases) do veneno de Lachesis muta rhombeata / Purification and biochemical characterization of two toxins-functional (serine proteinases) of Lachesis muta rhombeata

Duas toxinas foram purificadas do veneno de Lachesis muta rhombeata com uma rendimento de aproximadamente 74 a 76%, empregando uma etapa de focalização isoelétrica preparativa seguida por gel filtração (HPLC)...Quando injetada em camundongos (0,25 ug/g), a LMR 47 induziu episódios de opistótono e giros, evidenciando a atividade giroxina. A análise histopatológica mostrou microhemorragias focais e outras alterações celulares a nível do cerebelo. A injeção intraplantar de 10ug da proteína, LMR 32, em camundongos induziu um incremento do volume (edema) de 45% e a inoculação de 0,1 e 0,25 ug/g da mesma proteína em ratos causou uma queda significativa na pressão arterial.