Picadura de escorpión en Bolivia: una revisión crítica de la literatura

Las picaduras son frecuentes y se consideran un verdadero problema de salud pública. Objetivo: describir las especies de escorpiones, propiedades del veneno, fisiopatología, manifestaciones clínicas, diagnóstico y su manejo en la unidad de cuidados intensivos. Metodología: se realizó una búsqueda de la literatura en las bases de datos SciELO, LILACS, Scopus, PubMed-MedLine, Google Académico, así como en los servicios ClinicalKeys, se extrajo la información relevante, se seleccionaron aquellos estudios de tipo serie de casos, artículos originales o revisiones narrativas, de alcance y sistemáticas. Desarrollo: en Bolivia, fue descrita la especie Tityus (Tityus) sorataensis. El 66 al 90 por ciento de las picaduras tienen signos y síntomas limitados a dolor local, parestesias y cambios en la piel. Los efectos sistémicos se hacen evidentes a los 30 minutos y por lo general, dentro de las cuatro horas posteriores a la picadura. El tratamiento puede ser empírico, aplicar medidas generales, manejo del dolor y si está presente algunas complicaciones como edema pulmonar, choque cardiogénico es necesario su manejo en una sala de cuidados intensivos. Conclusiones: la intoxicación por picadura de escorpión, es rara, es un reto terapéutico, parece ser recomendable la administración del antídoto (antiveneno) junto al tratamiento de sostén. un mejor conocimiento de los escorpiones, puede alentar el interés en realizar nuevas investigaciones.

Bites are frequent and are considered a real public health problem. Objective: describe the species of scorpions, properties of the venom, pathophysiology, clinical manifestations, diagnosis and its management in the intensive care unit. Methodology: a literature search was carried out in the SciELO, LILACS, Scopus, PubMed-MedLine, Google Scholar databases, as well as in the ClinicalKeys services, in the period February-April 2023. Relevant information was extracted, They selected case series studies, original articles or narrative, scoping and systematic reviews. Development: in Bolivia, the species Tityus (Tityus) sorataensis was described. 66 to 90 percent of bites have signs and symptoms limited to local pain, paresthesias, and skin changes. Systemic effects become apparent within 30 minutes and generally within four hours of being bitten. The treatment can be empirical, apply general measures, pain management and if some complications are present such as pulmonary edema, cardiogenic shock, it is necessary to manage it in an intensive care room. Conclusions: Scorpion sting poisoning is rare, it is a therapeutic challenge, it seems to be advisable to administer the antidote (antivenoin) together with supportive treatment. a better understanding of scorpions may encourage interest in further research.

Scorpion envenomation in Brazil: an update / Escorpionismo en Brasil: Una actualización

Abstract Accidents caused by scorpions represent a major health problem on planet, both in individual terms and in the public health sphere. Morbid events can occur in different manifestations, and different clinical conditions must be differentiated for adequate treatment. In addition to the potential injury to human hosts, scorpion venom has been investigated for the therapy of several illnesses. Based on these aspects, the present article aims to present the clinical, diagnostic, therapeutic and prophylactic aspects of scorpionism.

Resumen Los accidentes causados por escorpiones representan un problema mayor de salud pública tanto en términos de daños individuales como en la esfera de la salud pública. Los eventos mórbidos pueden ocurrir con diferentes manifestaciones y condiciones clínicas que deben ser diferenciadas para un manejo adecuado. Ade más del daño potencial que ocasionan a los humanos, el veneno del escorpión ha sido estudiado con el fin de analizar su potencia aplicación para le tratamiento de algunas enfermedades. Este articulo presenta una actualización sobre los aspectos clínicos, terapéuticos y profilácticos del escorpionismo.

Epidemiological aspects of scorpionic accidents in a municipality in Brazil's northeastern / Aspectos epidemiológicos dos acidentes escorpiônicos em um munícipio do nordeste brasileiro

Scorpionic accidents are a major public health problem due to the high occurrence with potential seriousness. In this manner, the research aimed to analyze the occurrence of scorpionic accidents in a municipality in the northeastern of Brazil. An exploratory, descriptive study was made, with a quantitative approach, using secondary data which was gotten from the Notifiable Diseases Information System (SINAN), from 2008 to 2018. Data such as neighborhood, presence of street markets were also used, and the existence of sanitation and climatic data such as temperature and season. Geoprocessing was used to identify possible changes in the environment. In the analyzed period, 9,330 cases of scorpion accidents were recorded, with an average of 848 annual notifications. Scorpionic accidents occurred more frequently in women (5,686; 60.94%). Individuals aged 20 to 29 years (1.727; 18.51%) were more frequent to scorpion stings. Regarding the body parts where the stings were made, the highlights were on the foot (3.515; 37.67%) followed by the hand (2.818; 30.20%). No statistically significant relation was observed between climatic factors and scorpionic accidents. However, the high number of cases of scorpionic accidents was observed in the last 11 years studied. It was evident that during the study period there was no statistical relationship when climatic factors were correlated to scorpionic accidents. On its turn, when it was verified the results of the geoprocessing analysis, it was seen that anthropic factors have been motivating the potentiation of the occurrence of these accidents.

Os acidentes escorpiônicos apresentam-se como um grande problema de saúde pública em virtude da grande ocorrência com potencial gravidade. Nesse sentido, o trabalho teve como objetivo analisar a ocorrência de acidentes escorpiônicos em um município do nordeste brasileiro. Foi realizado um estudo descritivo, de caráter exploratório, com abordagem quantitativa em que foram utilizados dados secundários obtidos no Sistema de Informação de Agravos de Notificação (SINAN), no período de 2008 a 2018. Também foram utilizados dados como bairro, presença de feiras livres e a existência de saneamento básico e dados climáticos como temperatura e estação do ano. O geoprocessamento foi utilizado para identificar as possíveis alterações no ambiente. No período analisado, foram registrados 9,330 casos de acidentes com escorpião, com média de 848 notificações anuais. Os acidentes escorpiônicos ocorreram com mais frequência em mulheres (5,686; 60,94%). Em indivíduos na faixa etária de 20 a 29 anos (1,727; 18,51%) foram mais frequentes a picada de escorpião. Com relação ao local das picadas destacaram-se o pé (3,515; 37,67%), seguido da mão (2,818; 30,20%). Não foi observada relação estatisticamente significativa entre os fatores climáticos e os acidentes escorpiônicos. Foi observado elevado número de casos de acidentes escorpiônicos nos últimos 11 anos estudados. Ficou evidente que durante o período de estudo não existiu relação estatística quando se correlacionou fatores climáticos aos acidentes escorpiônicos. Por sua vez, ao verificar os resultados da análise de geoprocessamento foi visto que fatores antrópicos têm sido motivadores da potencialização da ocorrência desses acidentes.

Epidemiological aspects of scorpionic accidents in a municipality in Brazils northeastern

Abstract Scorpionic accidents are a major public health problem due to the high occurrence with potential seriousness. In this manner, the research aimed to analyze the occurrence of scorpionic accidents in a municipality in the northeastern of Brazil. An exploratory, descriptive study was made, with a quantitative approach, using secondary data which was gotten from the Notifiable Diseases Information System (SINAN), from 2008 to 2018. Data such as neighborhood, presence of street markets were also used, and the existence of sanitation and climatic data such as temperature and season. Geoprocessing was used to identify possible changes in the environment. In the analyzed period, 9,330 cases of scorpion accidents were recorded, with an average of 848 annual notifications. Scorpionic accidents occurred more frequently in women (5,686; 60.94%). Individuals aged 20 to 29 years (1.727; 18.51%) were more frequent to scorpion stings. Regarding the body parts where the stings were made, the highlights were on the foot (3.515; 37.67%) followed by the hand (2.818; 30.20%). No statistically significant relation was observed between climatic factors and scorpionic accidents. However, the high number of cases of scorpionic accidents was observed in the last 11 years studied. It was evident that during the study period there was no statistical relationship when climatic factors were correlated to scorpionic accidents. On its turn, when it was verified the results of the geoprocessing analysis, it was seen that anthropic factors have been motivating the potentiation of the occurrence of these accidents.

Resumo Os acidentes escorpiônicos apresentam-se como um grande problema de saúde pública em virtude da grande ocorrência com potencial gravidade. Nesse sentido, o trabalho teve como objetivo analisar a ocorrência de acidentes escorpiônicos em um município do nordeste brasileiro. Foi realizado um estudo descritivo, de caráter exploratório, com abordagem quantitativa em que foram utilizados dados secundários obtidos no Sistema de Informação de Agravos de Notificação (SINAN), no período de 2008 a 2018. Também foram utilizados dados como bairro, presença de feiras livres e a existência de saneamento básico e dados climáticos como temperatura e estação do ano. O geoprocessamento foi utilizado para identificar as possíveis alterações no ambiente. No período analisado, foram registrados 9,330 casos de acidentes com escorpião, com média de 848 notificações anuais. Os acidentes escorpiônicos ocorreram com mais frequência em mulheres (5,686; 60,94%). Em indivíduos na faixa etária de 20 a 29 anos (1,727; 18,51%) foram mais frequentes a picada de escorpião. Com relação ao local das picadas destacaram-se o pé (3,515; 37,67%), seguido da mão (2,818; 30,20%). Não foi observada relação estatisticamente significativa entre os fatores clímáticos e os acidentes escorpiônicos. Foi observado elevado número de casos de acidentes escorpiônicos nos últimos 11 anos estudados. Ficou evidente que durante o período de estudo não existiu relação estatística quando se correlacionou fatores climáticos aos acidentes escorpiônicos. Por sua vez, ao verificar os resultados da análise de geoprocessamento foi visto que fatores antrópicos têm sido motivadores da potencialização da ocorrência desses acidentes.

Linking toxicity and predation in a venomous arthropod: the case of Tityus fuhrmanni (Scorpiones: Buthidae), a generalist predator scorpion

Background: Scorpions are arachnids that have a generalist diet, which use venom to subdue their prey. The study of their trophic ecology and capture behavior is still limited compared to other organisms, and aspects such as trophic specialization in this group have been little explored. Methods: In order to determine the relationship between feeding behavior and venom toxicity in the scorpion species Tityus fuhrmanni, 33 specimens were offered prey with different morphologies and defense mechanisms: spiders, cockroaches and crickets. In each of the experiments we recorded the following aspects: acceptance rate, immobilization time and the number of capture attempts. The median lethal dose of T. fuhrmanni venom against the three different types of prey was also evaluated. Results: We found that this species does not have a marked difference in acceptance for any of the evaluated prey, but the number of capture attempts of spiders is higher when compared to the other types of prey. The immobilization time is shorter in spiders compared to other prey and the LD50 was higher for cockroaches. Conclusions: These results indicate that T. fuhrmanni is a scorpion with a generalist diet, has a venom with a different potency among prey and is capable of discriminating between prey types and employing distinct strategies to subdue them.(AU)

Toxinology in the proteomics era: a review on arachnid venom proteomics

Abstract The word venomics was coined to acknowledge the studies that use omics to investigate venom proteins and peptides. Venomics has evolved considerably over the last 20 years. The first works on scorpion or spider venomics were published in the early 2000s. Such studies relied on peptide mass fingerprinting (PMF) to characterize venom complexity. After the introduction of new mass spectrometers with higher resolution, sensitivity and mass accuracy, and the next-generation nucleotide sequencing, the complexity of data reported in research on scorpion and spider venomics increased exponentially, which allowed more comprehensive studies. In the present review article, we covered key publications on scorpion venomics and spider venomics, presenting historical grounds and implemented technologies over the last years. The literature presented in this review was selected after searching the PubMed database using the terms (scorpion venom) AND (proteome) for scorpion venomics, and (spider venom) AND (proteome) for publications on spider venomics. We presented the key aspects related to proteomics in the covered papers including, but not restricted to, the employed proteomic strategy (i.e., PMF, two-dimensional gel electrophoresis, shotgun/bottom-up and/or top-down/peptidome), and the type of mass spectrometer used. Some conclusions can be drawn from the present study. For example, the scorpion genus Tityus is the most studied concerning venomics, followed by Centruroides; whereas for spiders the studied genera were found more equally distributed. Another interesting conclusion is the lack of high throughput studies on post-translational modifications (PTMs) of scorpion and spider proteins. In our opinion, PTMs should be more studied as they can modulate the activity of scorpion and spider toxins.

Linking toxicity and predation in a venomous arthropod: the case of Tityus fuhrmanni (Scorpiones: Buthidae), a generalist predator scorpion

Abstract Background: Scorpions are arachnids that have a generalist diet, which use venom to subdue their prey. The study of their trophic ecology and capture behavior is still limited compared to other organisms, and aspects such as trophic specialization in this group have been little explored. Methods: In order to determine the relationship between feeding behavior and venom toxicity in the scorpion species Tityus fuhrmanni, 33 specimens were offered prey with different morphologies and defense mechanisms: spiders, cockroaches and crickets. In each of the experiments we recorded the following aspects: acceptance rate, immobilization time and the number of capture attempts. The median lethal dose of T. fuhrmanni venom against the three different types of prey was also evaluated. Results: We found that this species does not have a marked difference in acceptance for any of the evaluated prey, but the number of capture attempts of spiders is higher when compared to the other types of prey. The immobilization time is shorter in spiders compared to other prey and the LD50 was higher for cockroaches. Conclusions: These results indicate that T. fuhrmanni is a scorpion with a generalist diet, has a venom with a different potency among prey and is capable of discriminating between prey types and employing distinct strategies to subdue them.

Toxinology in the proteomics era: a review on arachnid venom proteomics

The word venomics was coined to acknowledge the studies that use omics to investigate venom proteins and peptides. Venomics has evolved considerably over the last 20 years. The first works on scorpion or spider venomics were published in the early 2000's. Such studies relied on peptide mass fingerprinting (PMF) to characterize venom complexity. After the introduction of new mass spectrometers with higher resolution, sensitivity and mass accuracy, and the next-generation nucleotide sequencing, the complexity of data reported in research on scorpion and spider venomics increased exponentially, which allowed more comprehensive studies. In the present review article, we covered key publications on scorpion venomics and spider venomics, presenting historical grounds and implemented technologies over the last years. The literature presented in this review was selected after searching the PubMed database using the terms "(scorpion venom) AND (proteome)" for scorpion venomics, and "(spider venom) AND (proteome)" for publications on spider venomics. We presented the key aspects related to proteomics in the covered papers including, but not restricted to, the employed proteomic strategy (i.e., PMF, two-dimensional gel electrophoresis, shotgun/bottom-up and/or top-down/peptidome), and the type of mass spectrometer used. Some conclusions can be drawn from the present study. For example, the scorpion genus Tityus is the most studied concerning venomics, followed by Centruroides; whereas for spiders the studied genera were found more equally distributed. Another interesting conclusion is the lack of high throughput studies on post-translational modifications (PTMs) of scorpion and spider proteins. In our opinion, PTMs should be more studied as they can modulate the activity of scorpion and spider toxins.(AU)

Epidemiological aspects of scorpionic accidents in a municipality in Brazil's northeastern / Aspectos epidemiológicos dos acidentes escorpiônicos em um munícipio do nordeste brasileiro

Scorpionic accidents are a major public health problem due to the high occurrence with potential seriousness. In this manner, the research aimed to analyze the occurrence of scorpionic accidents in a municipality in the northeastern of Brazil. An exploratory, descriptive study was made, with a quantitative approach, using secondary data which was gotten from the Notifiable Diseases Information System (SINAN), from 2008 to 2018. Data such as neighborhood, presence of street markets were also used, and the existence of sanitation and climatic data such as temperature and season. Geoprocessing was used to identify possible changes in the environment. In the analyzed period, 9,330 cases of scorpion accidents were recorded, with an average of 848 annual notifications. Scorpionic accidents occurred more frequently in women (5,686; 60.94%). Individuals aged 20 to 29 years (1.727; 18.51%) were more frequent to scorpion stings. Regarding the body parts where the stings were made, the highlights were on the foot (3.515; 37.67%) followed by the hand (2.818; 30.20%). No statistically significant relation was observed between climatic factors and scorpionic accidents. However, the high number of cases of scorpionic accidents was observed in the last 11 years studied. It was evident that during the study period there was no statistical relationship when climatic factors were correlated to scorpionic accidents. On its turn, when it was verified the results of the geoprocessing analysis, it was seen that anthropic factors have been motivating the potentiation of the occurrence of these accidents.

Os acidentes escorpiônicos apresentam-se como um grande problema de saúde pública em virtude da grande ocorrência com potencial gravidade. Nesse sentido, o trabalho teve como objetivo analisar a ocorrência de acidentes escorpiônicos em um município do nordeste brasileiro. Foi realizado um estudo descritivo, de caráter exploratório, com abordagem quantitativa em que foram utilizados dados secundários obtidos no Sistema de Informação de Agravos de Notificação (SINAN), no período de 2008 a 2018. Também foram utilizados dados como bairro, presença de feiras livres e a existência de saneamento básico e dados climáticos como temperatura e estação do ano. O geoprocessamento foi utilizado para identificar as possíveis alterações no ambiente. No período analisado, foram registrados 9,330 casos de acidentes com escorpião, com média de 848 notificações anuais. Os acidentes escorpiônicos ocorreram com mais frequência em mulheres (5,686; 60,94%). Em indivíduos na faixa etária de 20 a 29 anos (1,727; 18,51%) foram mais frequentes a picada de escorpião. Com relação ao local das picadas destacaram-se o pé (3,515; 37,67%), seguido da mão (2,818; 30,20%). Não foi observada relação estatisticamente significativa entre os fatores clímáticos e os acidentes escorpiônicos. Foi observado elevado número de casos de acidentes escorpiônicos nos últimos 11 anos estudados. Ficou evidente que durante o período de estudo não existiu relação estatística quando se correlacionou fatores climáticos aos acidentes escorpiônicos. Por sua vez, ao verificar os resultados da análise de geoprocessamento foi visto que fatores antrópicos têm sido motivadores da potencialização da ocorrência desses acidentes.

Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019 / Tendencia temporal y perfil epidemiológico de los accidentes por animales venenosos en Brasil, 2007-2019 / Temporal trend and epidemiological profile of accidents involving venomous animals in Brazil, 2007-2019

Objetivo: Analisar a tendência temporal dos acidentes causados por animais peçonhentos no Brasil, de 2007 a 2019. Métodos: Estudo transversal, realizado com dados do Sistema de Informação de Agravos de Notificação (Sinan). Para a análise temporal, utilizou-se a regressão linear de Prais-Winsten. Foram calculadas as incidências por sexo e faixa etária, risco relativo e letalidade. Resultados: No período de estudo, houve 2.102.657 casos de acidentes por animais peçonhentos. Com exceção do ofidismo, os demais acidentes apresentaram tendência temporal crescente na maioria das macrorregiões nacionais. Escorpionismo, ofidismo e araneísmo foram responsáveis por 86% dos acidentes, principalmente entre pessoas do sexo masculino em idade economicamente ativa. A de letalidade foi mais elevada para acidentes ofídicos (0,4%) e apílicos (0,3%). As crianças foram as principais vítimas de acidentes com abelhas, lagartas e "outros". Conclusão: Os acidentes com animais peçonhentos apresentaram tendência temporal crescente para a maioria dos agravos e diferentes perfis epidemiológicos.

Objetivo: Analizar la tendencia temporal de los accidentes con animales ponzoñosos en Brasil de 2007 a 2019. Métodos: Estudio transversal realizado con datos del Sistema de Información de Enfermedades de Declaración Obligatoria (Sinan). Para el análisis temporal se utilizó la Regresión Lineal de Prais-Wisten. Se calcularon las incidencias por sexo y grupo de edad, riesgo relativo y letalidad. Resultados: Durante el período del estudio hubo 2.102.657 casos de accidentes con animales ponzoñosos. Con excepción de la mordedura de serpiente, los demás accidentes mostraron una tendencia temporal creciente en la mayoría de las regiones del país. El escorpionismo, la mordedura de serpiente y la picadura de araña fueron responsables del 86% de los accidentes, afectando principalmente a personas del sexo masculino en edad laboral. Las tasas de letalidad más altas fueron por accidentes de mordedura de serpiente (0,4%) y picadura de araña (0,3%). Los niños fueron las principales vitimas de los acidentes con abejas, lagartas y "otros". Conclusión: Los accidentes com animales ponzoñosos mostraron una tendencia temporal creciente para la mayoría de las enfermedades y diferentes perfiles epidemiológicos.

Objective: to analyze the temporal trend of accidents involving venomous animals in Brazil from 2007 to 2019. Methods: this was a cross-sectional study carried out with data from the Notifiable Health Conditions Information System (SINAN). Prais-Winsten linear regression was used for the temporal analysis. We calculated incidence rates according to sex and age group, relative risk and case fatality ratio. Results: during the study period there were 2,102,657 cases of accidents involving venomous animals. With the exception of snakebite, the remaining accidents showed a rising temporal trend in most regions of the country. Scorpion stings, snake bites and spider bites were responsible for 86% of accidents, mainly affecting male people of working age. Accidents involving snakes (0.4%) and bees (0.3%) had the highest case fatality ratios. Children were the main victims of accidents involving bees, caterpillars and "others". Conclusion: accidents involving venomous animals showed a rising temporal trend for most conditions, as well as different epidemiological profiles.

Distribución del género Tityus Koch, 1836 (Scorpiones: Buthidae) en la ciudad de La Plata (Argentina) / Distribution of the genus Tityus Koch, 1836 (Scorpiones: Buthidae) in the city of La Plata (Argentina)

Resumen En la ciudad de La Plata se encuentra el género Tityus con registros desde 1943. Se estudió la distribución territorial del género Tityus en esta ciudad y su expansión en los últimos 15 años a partir de las consultas recibidas en el Laboratorio de Aracnología del CEPAVE, provenientes de particulares e instituciones públicas y privadas. Se recibieron 189 consultas desde el año 2005 al 2020. Se utilizó el programa QGIS para geolocalizar cada escorpión con capas de trazado urbano y desagües pluviales. Para el análisis espacial de distribución se consideró un home range de una hectárea por individuo para el cálculo de área y en los casos de áreas de influencias solapadas durante el mismo año se consideró el área como la unión de las mismas. El género Tityus en la ciudad de La Plata está representado por las especies T. carrilloi y T. confluens ambas de interés sanitario y de hábitos sinantrópicos, que ocupan dos zonas diferentes bien definidas. El análisis de la dispersión independiente en las dos zonas indicaría que podrían usar los desagües para dispersarse, y al ser inconexos estos no habría flujo de escorpiones entre ambas zonas. La colonización de estas especies en la zona en estudio se vio afianzada para T. confluens a partir del año 2005 y para T. carrilloi a partir del 2011. Los mayores registros son en los meses cálidos, desde enero a abril, siendo este último el de mayor valor. Septiembre es el único mes sin denuncia. La tasa de expansión calculada fue de 4.42 ha/año.

Abstract In the city of La Plata occurs the genus Tityus with records dating back to 1943. The territorial distribution of the genus Tityus in this city and its expansion was studied based on inquiries received at the CEPAVE Arachnology Laboratory from individuals and public and private institutions. 189 inquiries were received from 2005 to 2020. The QGIS program was used to geolocate each scorpion with urban layout layers and storm drains. For the spatial analysis of distribution, a home range of one hectare per individual was considered to calculate the area and in the cases of areas of overlapping influences during the same year, the area was considered as their union. The genus Tityus in the city of La Plata is represented by the species T. carrilloi and T. confluens, both of health interest and of synanthropic habits, which occupy two different well-defined areas. The analysis of the independent dispersion in the two zones would indicate that they could use the drains to disperse, and since they are unconnected there would be no flow of scorpions between both zones. The colonization of these species in the study area was strengthened for T. confluens as of 2005 and for T. carrilloi as of 2011. The highest records are in the warm months, from January to April, the latter being of higher value. September is the only month without complaints. The expansion rate calculated was 4.42 ha/year.

Control y prevención de los accidentes causados por Tityus trivittatus (Scorpiones: Buthidae) / Control and prevention of accidents caused by Tityus trivittatus (Scorpiones: Buthidae)

Resumen Las picaduras por alacranes pueden producir cuadros de intoxicación aguda y conducir a la muerte por falla cardíaca y distrés respiratorio, siendo la población pediátrica la de mayor riesgo, tanto en Argentina como en el resto del mundo. Muchasde las especies de escorpiones en el mundo son sinantrópicas, y en Argentina, las que se han relacionado con muertes, comoTityus trivittatus y Tityus confluens, poseen esas características. La sinantropía, aumenta la posibilidad de contacto humano -escorpión y por lo tanto la ocurrencia de accidentes, por lo que las medidas de prevención en este caso, deben tomarse no soloconductualmente sino ambientalmente para evitar ese contacto. Las características biológicas de los escorpiones del géneroTityus dificultan las labores de prevención. Muchas son las herramientas para disminuir el contacto con los escorpiones y de esamanera prevenir los accidentes como los controles químicos, biológicos y ambientales, así como la búsqueda y eliminación deescorpiones. Sin embargo, no todas son efectivas si no son aplicadas racionalmente y si no son combinadas. En ocasiones lamala planificación o uso de las diferentes medidas para el combate de escorpiones pueden ser contraproducentes y no solo serinefectivas sino aumentar la probabilidad de ocurrencia de accidentes. En esta revisión se exponen los diferentes métodos deprevención del escorpionismo, con especial referencia a las especies de Tityus de Argentina.

Abstract Scorpion stings may produce acute envenoming and lead to death from heart failure and respiratory distress, being the pediatric population that with the highest risk of severe envenomation and death, in Argentina as in the rest of the world. Manyof the scorpion species in the world are synanthropic, including Tityus trivittatus and Tityus confluens, which are responsible forhuman deaths in Argentina. Synanthropy increases the possibility of human-scorpion contact and therefore the occurrence ofaccidents, so preventive measures to avoid the contact must be taken not only behaviorally but environmentally. The biologi-cal characteristics of scorpions of the genus Tityus make prevention of the contact with humans rather difficult. There are manychemical, biological and environmental tools to reduce the possibility of contact between humans and scorpions. However, notall these measures are effective if they are not rationally applied and if these are not combined. Sometimes the poor planningor use of different measures to control scorpions' population can be counterproductive and not only ineffective, increasing theprobability of accidents. In this review, we discuss the different methods of prevention and combat of scorpionism, with specialreference to the prevention of accidents with Tityus species from Argentina.

Mortalidad causada por animales venenosos en Venezuela (2000-2009): nuevo patrón epidemiológico / Mortality caused by venomous animals in Venezuela (2000-2009): A new epidemiological pattern

Resumen | Introducción. Los accidentes causados por animales venenosos ocurren con mucha frecuencia en comunidades pobres con acceso limitado a los servicios de salud. Se les consideran enfermedades desatendidas y son una de las causas importantes de morbimortalidad en varias naciones del mundo, incluida Venezuela. Objetivo. Evaluar la mortalidad por contacto traumático con animales venenosos (serie X20-X29) en Venezuela en el periodo de 2000 a 2009. Materiales y métodos. Los datos se obtuvieron de los anuarios de mortalidad del Ministerio de Salud. Resultados. Se registraron 759 decesos, la mayoría de ellos en el 2009. La primera causa fue la mordedura de serpientes (n=323; 42,6 %), seguida por la picadura de himenópteros (n=170; 22,4 %), la mordedura de centípedos (n=106; 14,0 %) y la picadura de escorpiones (n=76; 10,0 %). La mediana de la tasa de mortalidad general para el periodo fue de 0,285 fallecidos por 100.000 habitantes, en tanto que, por grupo específico, fue de 0,120 para ofidios, de 0,065 para himenópteros, de 0,035 para centípedos y de 0,025 para escorpiones. Conclusión. Al comparar estos datos con los antecedentes históricos, se evidenció la modificación del patrón de mortalidad en el país caracterizada por un aumento significativo de los decesos por centípedos, tercera causa de muerte, lo que reubica la picadura de escorpiones como la cuarta causa de mortalidad.

Abstract | Introduction: Injuries by venomous animals frequently occur in impoverished communities with limited access to health services. They are considered neglected diseases that stand out as important causes of morbidity and mortality in various countries, including Venezuela. Objective: To assess mortalities resulting from contact with venomous animals in Venezuela from 2000 to 2009 (X20-X29 series). Materials and Methods: The data were obtained from the annual mortality records of the Venezuelan Ministry of Health. Results: From 2000-2009, 759 fatalities were recorded with the greatest number taking place in 2009. Snakebites (n=323; 42.6%) accounted for the largest percentage of envenomation-related deaths in that period, followed by hymenopteran stings (n=170; 22.4%), centipede bites (n=106; 14.0%), and scorpion stings (n=76; 10.0%). The median value of envenomation-related deaths per 100,000 inhabitants (period 2000-2009) was 0.285: 0.120 corresponded to snakebites, 0.065 to hymenopteran stings, 0.035 to centipede bites, and 0.025 to scorpion stings. Conclusions: Taking into account previous records of animal envenomations in Venezuela, we provided evidence for a shift in the pattern of mortality. Deaths due to centipede bites have increased, making it the third leading cause of envenomation-related mortality in Venezuela. Scorpionism, on the other hand, has declined to the fourth most common cause of fatal envenomations in the country.

Scorpions from the province of Misiones, Argentina: An assemblage of medical interest / Escorpiones de la provincia de misiones, argentina: un elenco de interés médico

RESUMEN INTRODUCCIÓN : Los envenenamientos producidos por escorpiones son un problema de salud pública en constante aumento en Argentina y el mundo. Por diversas causas, los ensambles de animales venenosos de una región varían en el tiempo. El objetivo de este trabajo fue presentar la información reciente y actualizar el elenco de escorpiones de la provincia de Misiones. MÉTODOS : Se realizó un estudio descriptivo observacional a partir de la revisión de los ejemplares depositados en la Colección de Herpetología y Arácnidos del Instituto Nacional de Medicina Tropical. RESULTADOS : Se obtuvieron los primeros registros para la provincia de Títyusconfluens, mientras que nuevos registros de accidentes con Títyus trívíttatus ampliaron la zona de presencia de la especie en la provincia. El ensamble de escorpiones de Misiones reúne a las cuatro especies de interés médico del país. DISCUSIÓN : La detección del elenco de escorpiones de interés médico más importante del país fue consecuencia del trabajo conjunto entre los especialistas de los distintos grupos de animales ponzoñosos y los profesionales de la salud. Es importante generar y profundizar los espacios de interacción de saberes, con el objetivo de mejorar la Vigilancia de la Salud.

ABSTRACT INTRODUCTION : Scorpíon poísoníng ís a growíng publíc health problem ín Argentina and around the world. For varíous reasons, the poísonous animal assemblages ín a regíon vary over tíme. The aím of thís work was to present recent ínformatíon and update the assemblage of scorpions ín the province of Misiones. METHODS : An observatíonal descríptíve study was carríed out by revíewíng the specímens deposíted ín the Collectíon of Herpetology and Arachníds of the National Instítute of Tropical Medicine. RESULTS : The first records of Tityus confluens were obtaíned for the province, whíle new records of accídents wíth Tityus trivittatus extended the area of presence of the specíes ín the province. The scorpíon assemblage of Misiones gathers all the four specíes of medical interest ín the country. DISCUSSION : The detectíon of the most ímportant assemblage of scorpions of medical interest ín the country arose from the joínt work between specíalísts ín the dífferent groups of poísonous anímals and health professíonals. It ís ímportant to generate and deepen the spaces of knowledge ínteractíon, wíth the objectíve of ímprovíng Health Surveíllance.

Armed stem to stinger: a review of the ecological roles of scorpion weapons

Scorpions possess two systems of weapons: the pincers (chelae) and the stinger (telson). These are placed on anatomically and developmentally well separated parts of the body, that is, the oral appendages and at the end of the body axis. The otherwise conserved body plan of scorpions varies most in the shape and relative dimensions of these two weapon systems, both across species and in some cases between the sexes. We review the literature on the ecological function of these two weapon systems in each of three contexts of usage: (i) predation, (ii) defense and (iii) sexual contests. In the latter context, we will also discuss their usage in mating. We first provide a comparative background for each of these contexts of usage by giving examples of other weapon systems from across the animal kingdom. Then, we discuss the pertinent aspects of the anatomy of the weapon systems, particularly those aspects relevant to their functioning in their ecological roles. The literature on the functioning and ecological role of both the chelae and the telson is discussed in detail, again organized by context of usage. Particular emphasis is given on the differences in morphology or usage between species or higher taxonomic groups, or between genders, as such cases are most insightful to understand the roles of each of the two distinct weapon systems of the scorpions and their evolutionary interactions. We aimed to synthesize the literature while minimizing conjecture, but also to point out gaps in the literature and potential future research opportunities.(AU)

Scorpion species of medical importance in the Brazilian Amazon: a review to identify knowledge gaps

Scorpionism is a relevant medical condition in Brazil. It is responsible for most accidents involving venomous animals in the country, which leads to severe symptoms that can evolve to death. In recent years, an increase of almost 50% in the incidence of scorpionism has been observed in the Northern Region, where the highest severity of envenoming has been notified since the beginning of the 21st century. This review aims to provide an in-depth assessment of public data and reports on symptoms and epidemiology of envenoming, ecological aspects of scorpions, and characterization of venoms and toxins to access the gaps that need to be filled in the knowledge of the scorpion species of medical importance from the Brazilian Amazon. A systematic search using the string words "Amazon" and "scorpion" was performed on 11 databases. No restriction on date, language or status of the publication was applied. Reports not related to the Brazilian Amazon were excluded. Therefore, 88 studies remained. It is shown that populations of scorpions of medical importance, even of the same species, may present significant toxic variations peculiar to some regions in the Brazilian Amazon, and commercial scorpion antivenoms were not able to shorten the intensity and duration of neurological manifestations in patients stung by T. silvestris, T. apiacas or T. obscurus. It is also highlighted that the toxins responsible for triggering these alterations have not been elucidated yet and this is a fruitful field for the development of more efficient antivenoms. Furthermore, the geographic distribution of scorpions of the genus Tityus in the Brazilian Amazon was revised and updated. The cumulative and detailed information provided in this review may help physicians and scientists interested in scorpionism in the Brazilian Amazon.(AU)

Landscape of research, production, and regulation in venoms and antivenoms: a bibliometric analysis / Panorama de la investigación, la producción y la regulación de venenos y antivenenos: un análisis bibliométrico / Panorama de pesquisa, produção e regulação de venenos e antivenenos: análise bibliométrica

ABSTRACT Objectives. To assess the productivity and visibility in research, clinical studies, treatment, use and production of antivenoms against poisonous snakes, scorpions and spiders. Methods. Bibliometric analysis of research and other activities. Articles on venoms and antivenoms published between 2000 and 2020 were retrieved from the Scopus database. The records were analyzed by bibliometric indicators including number of documents per year, journals, authors, and citation frequency. VOSviewer® v.1.6.13 was used to construct bibliometric networks for country co-authorships and co-occurrence of terms. Results. Australia, Brazil, Costa Rica and India were among the six top countries with most documents and were selected for more detailed analysis. Costa Rica was the country with the largest percentage of its publications dedicated to antivenom production and venomics. Only a few papers dealt with the issues of quality, safety, and efficacy of antivenoms or the role of the national regulatory authorities. The use of VOSviewer® allowed visualization through joint publications of networking between countries. Visualization by co-occurrence of terms showed differences in the research carried out. Conclusions. Working in a collaborative and coordinated manner these four countries could have a major impact on envenoming globally. Attention should be given not only to antivenom production but also to strengthening regulatory oversight of antivenom products.

RESUMEN Objetivos. Evaluar la productividad y la visibilidad en la investigación, los estudios clínicos, el tratamiento, el uso y la producción de antivenenos contra las picaduras de serpientes, arañas y escorpiones venenosos. Métodos. Análisis bibliométrico de la investigación y de las otras actividades. Se tomaron los artículos sobre venenos y antivenenos publicados entre el 2000 y el 2020 en la base de datos de Scopus. Estos documentos se analizaron mediante indicadores bibliométricos como el número de documentos por año, revistas, autores o frecuencia en las citas. Se utilizó VOSviewer® v.1.6.13 para crear una red bibliométrica para coautorías de países y coapariciones de términos. Resultados. Australia, Brasil, Costa Rica e India estaban entre los seis primeros países con más documentos y se seleccionaron para un análisis más detallado. Costa Rica fue el país con el mayor porcentaje de sus publicaciones dedicadas a la producción de antivenenos y la venómica. Solo unos pocos artículos trataban los temas de la calidad, la seguridad y la eficacia de los antivenenos, o la función de las autoridades regulatorias nacionales. Gracias a VOSviewer® pudimos visualizar las publicaciones conjuntas de las colaboraciones entre países. La visualización por la coaparición de términos arrojó diferencias en la investigación realizada. Conclusiones. Si estos cuatro países trabajasen de forma colaborativa y coordinada, podrían tener una repercusión mayor en los envenenamientos por picaduras en el mundo. El foco no debe ponerse solo en la producción de antivenenos, sino también en fortalecer la supervisión regulatoria de estos productos.

RESUMO Objetivos. Avaliar a produtividade e visibilidade em pesquisa, estudos clínicos, tratamento, uso e produção de antivenenos contra peçonhas de serpentes, escorpiões e aranhas. Métodos. Análise bibliométrica de pesquisas e outras atividades. Artigos sobre venenos e antivenenos publicados entre 2000 e 2020 foram obtidos da base de dados Scopus. O conteúdo foi analisado segundo indicadores bibliométricos, como número de artigos por ano, periódicos, autores e frequência de citação. Utilizou-se o software VOSviewer® v.1.6.13 para construir redes bibliométricas de coautoria de países e co-ocorrência de termos. Resultados. Austrália, Brasil, Costa Rica e Índia figuraram entre os seis principais países com o maior número de artigos e, assim, foram selecionados para uma análise mais aprofundada. A Costa Rica teve a maior porcentagem de publicações dedicadas à produção de antivenenos e pesquisa em venômica. Apenas um pequeno número de artigos tratou de questões relacionadas à qualidade, segurança e eficácia dos antivenenos ou ao papel das autoridades nacionais reguladoras. O software VOSviewer® permitiu visualizar, através das publicações conjuntas, as redes formadas entre diferentes países. A visualização por co-ocorrência de termos revelou diferenças nas pesquisas realizadas. Conclusões. Trabalhando de forma colaborativa e coordenada, esses quatro países tiveram uma influência importante em nível mundial no campo de acidentes por animais peçonhentos. Deve-se atentar não apenas à produção de antivenenos, mas também ao fortalecimento da fiscalização regulatória destes.

Clinical and epidemiological aspects of scorpionism in the interior of the state of Bahia, Brazil: retrospective epidemiological study

ABSTRACT BACKGROUND: Scorpion accidents have gained great visibility around the world because of the high frequency and severity with which they occur, and have become a global medical-sanitary problem. OBJECTIVE: The aim of this study was to describe the sociodemographic, clinical and epidemiological profile of scorpionism in the municipality of Jequié, Bahia, Brazil, from 2007 to 2015. DESIGN AND SETTING: Retrospective epidemiological study in the municipality of Jequié, Bahia, Brazil. METHODS: This study was based on data collected from the epidemiological investigation notification forms of the injury information system. RESULTS: There was an increase in the coefficient of incidence of scorpion accidents in Jequié from 23.4/100,000 in 2007 to 413.6/100,000 in 2015. There were 3565 cases: 54.9% were female, 58.8% were aged 20-59 years, 63.5% had brown skin color and 48.6% had incomplete primary education. Most accidents occurred in urban areas (93.1%). Homes were the main place of occurrence (84.5%) and upper limbs were the commonest sting sites (53.0%). Regarding clinical aspects, 66.4% of the cases received hospital assistance within one hour after the bite, 84.1% presented mild severity, 97.1% had local manifestations and 10.2% had systemic symptoms. Serum therapy was administered in 17.3% of the cases, and 99.9% evolved to cure. CONCLUSION: There was an increase in the incidence of scorpion accidents in the municipality, which demonstrates the need for investment in actions that reduce the morbidity and mortality caused by these accidents, such as educational campaigns and improvements in socioeconomic and health conditions.

Effects of Brazilian scorpion venoms on the central nervous system

In Brazil, the scorpion species responsible for most severe incidents belong to the Tityus genus and, among this group, T. serrulatus, T. bahiensis, T. stigmurus and T. obscurus are the most dangerous ones. Other species such as T. metuendus, T. silvestres, T. brazilae, T. confluens, T. costatus, T. fasciolatus and T. neglectus are also found in the country, but the incidence and severity of accidents caused by them are lower. The main effects caused by scorpion venoms - such as myocardial damage, cardiac arrhythmias, pulmonary edema and shock - are mainly due to the release of mediators from the autonomic nervous system. On the other hand, some evidence show the participation of the central nervous system and inflammatory response in the process. The participation of the central nervous system in envenoming has always been questioned. Some authors claim that the central effects would be a consequence of peripheral stimulation and would be the result, not the cause, of the envenoming process. Because, they say, at least in adult individuals, the venom would be unable to cross the blood-brain barrier. In contrast, there is some evidence showing the direct participation of the central nervous system in the envenoming process. This review summarizes the major findings on the effects of Brazilian scorpion venoms on the central nervous system, both clinically and experimentally. Most of the studies have been performed with T. serrulatus and T. bahiensis. Little information is available regarding the other Brazilian Tityus species.

Scorpion stings and spider bites in the Upper Juruá, Acre - Brazil / Acidentes com aranhas e escorpiões no Alto Juruá, Acre - Brasil

INTRODUCTION: Epidemiological information on poisonings by venomous animals is fundamental in order to elaborate proposals for educational campaigns for prevention of poisonings, and may contribute to the improvement of the care of patients admitted to health facilities OBJECTIVE: Thus, the objective is to analyze the epidemiological profile of spider and scorpion poisoning in the Upper Juruá region, Western Amazonia, Brazil, from 2012 to 2017. METHODS: Epidemiological data were obtained from the records of SINAN (Information System of Notifiable Diseases) in the Epidemiological Surveillance Sector of the Juruá Regional Hospital located in Cruzeiro do Sul. RESULTS: There were 207 cases of accidents with arachnids, predominantly stinging by scorpions (148 cases, 71.9%), in the Regional Epidemiological Surveillance Sector of the Juruá Regional Hospital located in Cruzeiro do Sul. The average morbidity coefficient during the study period was 12 cases per 100,000 inhabitants for spider bites and 29.28 for scorpion stings. There was no correlation between spider and scorpion incidents with rainfall over the months during the study period. CONCLUSION: The average incidence of spider and scorpion incidents in the Upper Juruá region is one of the highest recorded for the Brazilian Amazon and is higher than the averages for Brazil, the Northern region and the state of Acre. Incidents with spiders and scorpions were not correlated with rainfall, and other factors associated with species biology or with human activities related to the temporal distribution, therefore there could be a risk of an arachnid incident throughout the year.

INTRODUÇÃO: Informações epidemiológicas sobre envenenamentos por animais peçonhentos são fundamentais para elaborar propostas de campanhas educativas para prevenção e podem contribuir para a melhoria do atendimento de pacientes admitidos nas unidades de saúde OBJETIVO: Assim, o objetivo é Analisar o perfil epidemiológicos sobre o envenenamento por aranhas e escorpiões ocorridos na região do Alto Juruá, Amazônia Ocidental, Brasil no período de 2012 a 2017. MÉTODO: Os dados epidemiológicos foram obtidos a partir das fichas do SINAN (Sistema de Informação de Agravos de Notificação) no Setor de Vigilância Epidemiológica do Hospital Regional do Juruá localizado em Cruzeiro do Sul. RESULTADOS: Foram registrados 207 casos de acidentes com aracnídeos, predominando as picadas por escorpiões (148 casos; 71,9%). A média do coeficiente de morbidade durante o período de estudo foi de 12 casos por 100.000 habitantes para o araneísmo e de 29,28 para o escorpionismo. Não houve correlação entre os acidentes com aranhas e escorpiões com a pluviosidade ao longo dos meses durante o período de estudo. CONCLUSÃO: A média da incidência de acidentes com aranhas e escorpiões na região do Alto Juruá é uma das maiores registradas para a Amazônia brasileira e é maior do que as médias para o Brasil, região Norte e para o estado do Acre. Os acidentes com aranhas e escorpiões não estiveram correlacionados com a pluviosidade, podendo outros fatores associados a biologia das espécies ou com as atividades humanas relacionados com a distribuição temporal, estando assim o risco de acidente com aracnídeos durante todo o ano.