Alternative therapy improves hematological profiles of captive snakes from northeastern Brazil / Efeitos positivos de uma terapia alternativa nos perfis hematológicos de serpentes cativas no nordeste brasileiro

Objective: Evaluate the effects of alternative therapy on the hematological profiles of different families of captive snakes. Methodology: Captive snakes at NUROF-UFC were submitted to a clinical and hematological evaluation before and after applying an alternative treatment, including systematic sunbathing and hydration by soaking bathes twice a week for five weeks. The biometric, clinical, and hematological data were compared by multivariate analysis of variance and investigated for possible causal relationships by general linear models. Results: A significant difference was observed between erythrograms and global leukograms in the three families of snakes evaluated before and after treatment. The significant reduction in the heterophil: lymphocyte ratio in the Family Colubridae after treatment was noteworthy. Discussion: The results were most likely due to stress level reduction by improving thermoregulation and conversion of vitamin D during sunbathing, oral rehydration and refreshing in soaking baths, and general metabolic rates due to physical exercise. Conclusion: The results confirm the initial hypothesis, assuming that a simple but systematic treatment that included sunlight exposure and immersion hydration was efficient in reducing stress rates.

Objetivo: Avaliar a influência de banhos de sol e de imersão em água nos perfis hematológicos de serpentes cativas, antes e após a aplicação deste tratamento alternativo. Metodologia: Serpentes cativas no NUROF-UFC foram submetidas à avaliação clínica e hematológica, depois submetidas ao tratamento alternativo por cinco semanas, sendo novamente avaliadas após. Os dados obtidos foram submetidos à análise estatística multivariada (NPMANOVA e GLM) para investigação de possíveis relações causais entre o tratamento e os perfis hematológicos. Resultados: Foi observada diferença significativa entre os eritrogramas e leucogramas nas três famílias de serpentes avaliadas antes e após o tratamento. Ressalta-se a redução significativa na razão heterófilos:linfócitos na Família Colubridae após o tratamento. Discussão: A diferença estatística deveu-se provavelmente à redução nos níveis de estresse, possibilitada por aquecimento e aumento de conversão da vitamina D durante a exposição solar; reidratação oral e refrescância nos banhos de imersão, e ao recondicionamento pelo exercício físico. Conclusão: Os resultados confirmaram a hipótese inicial, admitindo que um tratamento alternativo, simples mas aplicado sistematicamente, que incluiu exposição à luz solar e hidratação por imersão em água foi eficiente em reduzir as taxas de estresse em serpentes cativas.

Towards better antivenoms: navigating the road to new types of snakebite envenoming therapies

Abstract Snakebite envenoming is a significant global health challenge, and for over a century, traditional plasma-derived antivenoms from hyperimmunized animals have been the primary treatment against this infliction. However, these antivenoms have several inherent limitations, including the risk of causing adverse reactions when administered to patients, batch-to-batch variation, and high production costs. To address these issues and improve treatment outcomes, the development of new types of antivenoms is crucial. During this development, key aspects such as improved clinical efficacy, enhanced safety profiles, and greater affordability should be in focus. To achieve these goals, modern biotechnological methods can be applied to the discovery and development of therapeutic agents that can neutralize medically important toxins from multiple snake species. This review highlights some of these agents, including monoclonal antibodies, nanobodies, and selected small molecules, that can achieve broad toxin neutralization, have favorable safety profiles, and can be produced on a large scale with standardized manufacturing processes. Considering the inherent strengths and limitations related to the pharmacokinetics of these different agents, a combination of them might be beneficial in the development of new types of antivenom products with improved therapeutic properties. While the implementation of new therapies requires time, it is foreseeable that the application of biotechnological advancements represents a promising trajectory toward the development of improved therapies for snakebite envenoming. As research and development continue to advance, these new products could emerge as the mainstay treatment in the future.

Phylogeography of cliff racer (Platyceps rhodorachis Jan, 1865) from Punjab, Pakistan / Filografia de penhasco (Platyceps rhodorachis Jan, 1865) de Punjab, Paquistão

The present study reports the existence of cliff racer, Platyceps rhodorachis from the plains of Punjab, Pakistan. A total of 10 specimens were captured during the field surveys from June to September, 2018 from different sites of Punjab. Platyceps rhodorachis was identify on the basis of morphology and confirmed through COI gene sequences. The obtained DNA sequences have shown reliable and exact species identification. Newly produced DNA sequences of Platyceps rhodorachis were submitted to GenBank and accession numbers were obtained (MK936174.1, MK941839.1 and MT790210.1). N-J tree based on COI sequences of Platyceps rhodorachis clearly separated as out-group with other members of family Colubridae based on p-distance. The intra-specific genetic variation ranges from 12% to 18%. The DNA sequences of Platyceps rhodorachis kashmirensis, Platyceps rhodorachis ladacensis, Platyceps ventromaculatus, Platyceps ventromaculatus bengalensis and Platyceps ventromaculatus indusai are not available at NCBI to validate their taxonomic positions. In our recommendations, a large scale molecular based identification of Pakistan’s herpetofauna is required to report more new or subspecies from country.

O presente estudo relata a existência de um corredor de penhasco, Platyceps rhodorachis, das planícies de Punjab, Paquistão. Um total de 10 espécimes foi capturado durante os levantamentos de campo de junho a setembro de 2018 em diferentes locais de Punjab. Platyceps rhodorachis foi identificada com base na morfologia e confirmada por meio de sequências do gene COI. As sequências de DNA obtidas mostraram identificação de espécies confiável e exata. Sequências de DNA de Platyceps rhodorachis recém-produzidas foram submetidas ao GenBank e os números de acesso foram obtidos (MK936174.1, MK941839.1 e MT790210.1). Árvore N-J baseada em sequências COI de Platyceps rhodorachis claramente separadas como out-group com outros membros da família Colubridae com base na distância-p. A variação genética intraespecífica varia de 12% a 18%. As sequências de DNA de Platyceps rhodorachis kashmirensis, Platyceps rhodorachis ladacensis, Platyceps ventromaculatus, Platyceps ventromaculatus bengalensis e Platyceps ventromaculatus indusai não estão disponíveis no NCBI para validar suas posições taxonômicas. Em nossas recomendações, uma identificação de base molecular em grande escala da herpetofauna do Paquistão é necessária para relatar mais novas ou subespécies do país.

Accidente ofídico como problema de salud pública serpientes en la ciudad / Ophidian accident as a public health problem snakes in the city

En todo el planeta ocurren mordeduras por serpiente tanto en humanos, como animales; sin embargo, muchos pueblos carecen de recursos para prestar atención sanitaria, administrar suero antiofídico o mantener seguimiento desde lo multidisciplinario al paciente que quedó con secuelas. Objetivo: Establecer alertas tempranas sobre migración o emigración de serpientes hacia la ciudad, respecto al accidente ofídico como problema de salud pública. Materiales y métodos: La investigación es monográfica de tipo documental y muestra pertinencia social. Resultados: Es indispensable abordar tempranamente a la víctima, así como, registrar causas coadyuvantes o desencadenantes del accidente, ya que, dejó de ser exclusivamente rural y se registra en zonas urbanizadas e incluso en la ciudad. El alcance y magnitud de la investigación, sobrepasa lo académico de fortalecer áreas de conocimiento en carreras científicas del pregrado y trasciende a carreras relacionadas, afines y de postgrado, relacionadas indirectamente al problema. Conclusión: Garantizar seguridad del humano y su entorno requiere disposición para la prevención; no obstante, la migración o emigración de ésta biodiversidad revela un problema socio-ambiental, dependiente de entender la gestión académica y alertas tempranas que anuncian que, las serpientes han llegado a la ciudad(AU)

All over the planet snake bites occur in both humans and animals; however, many towns lack the resources to provide health care, administer antivenom serum or maintain multidisciplinary follow-up of the patient with sequelae. Objective: To establish early alerts on the migration or emigration of snakes to the city, regarding the ophidian accident as a public health problem. Materials and methods: The research is monographic documentary type and shows social relevance. Results: It is essential to address the victim early, as well as to record contributing causes or triggers of the accident, since it is no longer exclusively rural and is recorded in urbanized areas and even in the city. The scope and magnitude of the research goes beyond the academic of strengthening areas of knowledge in undergraduate scientific careers and transcends related, related and postgraduate careers, indirectly related to the problem. Conclusion: Ensuring the safety of humans and their environment requires provision for prevention; however, the migration or emigration of this biodiversity reveals a socio-environmental problem, dependent on understanding the academic management and early warnings that announce that the snakes have arrived in the city(AU)

Achyrocline satureioides (Lam) DC extracts acting as enzyme modulators: digestion, inflammation, and hemostasis / Extratos de Achyrocline satureioides (Lam) DC atuando como moduladores enzimáticos: digestão, inflamação e hemostasia

Achyrocline satureioides is popularly known for its richness in phenolic compounds and medicinal properties (anti-inflammatory, analgesic, and hepatoprotective). The present study aimed at broadening the knowledge about the pharmacological potential exerted by the aqueous and ethanolic extracts of A. satureioides. These extracts were characterized by HPLC and tested for their modulatory action on phospholipases A2 and proteases of snake venoms. In addition, they were tested on the activities of digestive enzymes. Snake venoms were used as tools since they have enzymes with high functional and structural homology to human enzymes. The results demonstrate that the extracts of A. satureioides act as enzymatic inhibitors or potentiators, interfering in processes related to the hemostasis, such as coagulation and thrombus dissolution. In addition, the anti-genotoxic activity and inhibitions exerted on digestive enzymes suggests their potential use in the prevention and/or treatment of several pathologies. New studies could provide information on how the compounds present in the extracts and the different enzymes interact.

A Achyrocline satureioides é popularmente conhecida por sua riqueza em compostos fenólicos e por suas propriedades medicinais (anti-inflamatória, analgésica e hepatoprotetora). No presente estudo, com o objetivo de ampliar o conhecimento sobre o potencial farmacológico exercido por esses extratos, os extratos aquoso e etanólico de A. satureioides foram caracterizados por HPLC e testados quanto à sua ação modulatória sobre as fosfolipases A2 e proteases de peçonhas de serpentes. Além disso, também foram testados em atividades de enzimas digestivas. As peçonhas de serpentes foram usadas como ferramentas por apresentarem enzimas com alta homologia funcional e estrutural às humanas. Os resultados demonstram que os extratos de A. satureioides atuam como inibidores ou potencializadores enzimáticos, interferindo em processos relacionados à hemostasia, como coagulação e dissolução do trombo. Além do mais, destacam seu potencial antigenotóxico e as inibições exercidas sobre as enzimas digestivas direcionando seu potencial de uso na prevenção e/ou tratamento de diversas patologias. Novos estudos poderão fornecer informações sobre os mecanismos de interação entre os compostos presentes nos extratos e as diferentes enzimas.

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.

Características clínico - epidemiológicas de los accidentes ofídicos en un hospital de la Amazonía del Perú / Clinico-epidemiologic characteristics of ophidic accidents in a hospital of the amazonia of Peru

Introducción: En el Perú, los accidentes ofídicos son un importante problema de salud pública, debido a una amplia distribución territorial de diferentes tipos de serpientes. Objetivo: Describir las características clínico - epidemiológicas y el manejo de los accidentes ofídicos registrados en un hospital de Perú. Métodos: Estudio de serie de casos, realizado entre enero del 2011 a diciembre 2015 en el Hospital Santa Rosa de Puerto Maldonado. Se revisaron 256 historias clínicas de pacientes con diagnóstico definitivo de ofidismo. Se analizaron variables sociodemográficas, clínicas y evolución de los pacientes. Resultados: El 78,5 por ciento de pacientes fueron varones, el grupo de edad más afectado fueron los adultos. La mayoría de los accidentes ocurrieron en el mes de marzo (12,5 por ciento). Un 39 por ciento de los pacientes se dedicaba al trabajo agrícola. Entre las 16:00 y 19:59 horas se produjeron 35,2 por ciento de los accidentes, 71,1 por ciento reportó como causante del accidente a la serpiente Bothrops atrox. El 71,5 por ciento de las mordeduras se presentaron en miembros inferiores. La mayoría de pacientes recibió tratamiento específico con antibotrópico polivalente (90,6 por ciento). Conclusiones: En la población estudiada, el sexo más afectado es el masculino con una edad entre 27 a 59 años. La serpiente más frecuente causante de los accidentes fue la Bothrops atrox, más conocida entre los pobladores como "jergón". En la mayoría de los casos se administró como tratamiento específico el suero antiofídico(AU)

Introduction: In Peru, ophidian accidents are an important public health problem due to a wide territorial distribution of different types of snakes. Objective: To describe the clinical-epidemiological characteristics and the management of ophidian accidents registered in a hospital in Peru. Methods: Case series study carried out between January 2011 to December 2015 at the Santa Rosa Hospital in Puerto Maldonado, 256 medical records of patients with a definitive diagnosis of ophidism were reviewed. Sociodemographic and clinical variables and the evolution of the patients were analyzed. Results: A total of 78.5 percent of patients were men, the age group most affected were adults. Most of the accidents occurred in March (12.5 percent). 39 percent of the patients were engaged in agricultural work. Between 4:00 p.m. and 7:59 p.m., 35.2 percent of the accidents occurred. 71.1 percent reported the Bothrops atrox snake as the cause of the accident. 71.5 percent of the bites occurred on the lower limbs. Most patients received specific treatment with polyvalent anti-botropic (90.6 percent). Conclusions: In the studied population, the most affected sex is the male with an age between 27 and 59 years. The most frequent snake causing the accidents was the Bothrops atrox, better known among the inhabitants as "jergón". In most cases, antivenom was administered as a specific treatment(AU)

Development of a species-specific PCR assay for authentication of Agkistrodon acutus based on mitochondrial cytochrome b gene

BACKGROUND: Agkistrodon acutus, a traditional Chinese medicine, clinically used in the treatment of rheumatism, tumor, and cardiovascular and cerebrovascular diseases. Due to the unique medicinal value and the difficulty of artificial breeding of Agkistrodon acutus, the supply of Agkistrodon acutus on the market exceeds the demand, and a large number of its adulterants are found on the market. In this study, the cytb gene sequences of Agkistrodon acutus and 9 snakes were compared and analyzed, specific primers were designed, and specific PCR methods were established to detect Agkistrodon acutus medicinal samples on the market. RESULTS: This method was successfully applied to distinguish the snake from other adulterated species, and tested 18 Agkistrodon acutus samples randomly purchased from six cities. Twelve samples were counterfeit and six were genuine. The standard reference material of Agkistrodon acutus was cloned by molecular cloning and sequencing, and the gene sequence difference with other species was significant. It shows that the region could be used as the fingerprint region of the target species. CONCLUSIONS: The proposed method can be used as a species-specific marker and can be highly distinguished from other adulterated snake species, which is helpful to effectively avoid the problem of false sale of Agkistrodon acutus.

King Cobra and snakebite envenomation: on the natural history, human-snake relationship and medical importance of Ophiophagus hannah

King Cobra (Ophiophagus hannah) has a significant place in many cultures, and is a medically important venomous snake in the world. Envenomation by this snake is highly lethal, manifested mainly by neurotoxicity and local tissue damage. King Cobra may be part of a larger species complex, and is widely distributed across Southeast Asia, southern China, northern and eastern regions as well as the Western Ghats of India, indicating potential geographical variation in venom composition. There is, however, only one species-specific King Cobra antivenom available worldwide that is produced in Thailand, using venom from the snake of Thai origin. Issues relating to the management of King Cobra envenomation (e.g., variation in the composition and toxicity of the venom, limited availability and efficacy of antivenom), and challenges faced in the research of venom (in particular proteomics), are rarely addressed. This article reviews the natural history and sociocultural importance of King Cobra, cases of snakebite envenomation caused by this species, current practice of management (preclinical and clinical), and major toxinological studies of the venom with a focus on venom proteomics, toxicity and neutralization. Unfortunately, epidemiological data of King Cobra bite is scarce, and venom proteomes reported in various studies revealed marked discrepancies in details. Challenges, such as inconsistency in snake venom sampling, varying methodology of proteomic analysis, lack of mechanistic and antivenomic studies, and controversy surrounding antivenom use in treating King Cobra envenomation are herein discussed. Future directions are proposed, including the effort to establish a standard, comprehensive Pan-Asian proteomic database of King Cobra venom, from which the venom variation can be determined. Research should be undertaken to characterize the toxin antigenicity, and to develop an antivenom with improved efficacy and wider geographical utility. The endeavors are aligned with the WHO´s roadmap that aims to reduce the disease burden of snakebite by 50% before 2030.(AU)

A case report of human intoxication due to a snakebite by the opisthoglyphous dipsadid Thamnodynastes lanei Bailey, Thomas & Silva-Jr, 2005

Abstract We present a case of human intoxication due to a snakebite by the opisthoglyphous dipsadid Thamnodynastes lanei. A 26-year-old man was bitten on the right hand and was not medicated. Bleeding lasted a few seconds, while paresthesia, chills, and headache persisted for up to 10 hours. The pain disappeared after a week, and the edema, itching, and prickling persisted for another 3 days. Although this patient's symptoms were typical of bites by South American opisthoglyphous snakes, they persisted longer than those of bites by some congeneric species. Our report adds a species to the list of medically relevant snakes.

Ultrasonographic characterization of the organs in the middle third and caudal coelomic cavity of snakes in the Boidae Family / Caracterização ultrassonográfica dos órgãos do terço médio e caudal da cavidade celomática de serpentes da família Boidae

The aim of this study was the ultrasonographic evaluation of the organs in the middle third and caudal coelomic cavity of healthy snakes in the Boidae family. For such, 15 adult snakes from five species were evaluated: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi and Epicrates crassus. The animals were physically restrained for examination. After the application of acoustic gel over the scales the transducer was positioned in the frontal plane of the coelomic cavity. Microconvex and linear transducers at 10MHz were used. The ultrasound examination was conducted in the craniocaudal direction, with longitudinal and transversal sections to assess syntropy, echogenicity and echotexture of the organs. The liver was bilobulated, hyperechoic, homogeneous echotexture, hyperechoic capsule, with a hepatic lobe measuring 1.15±0.64cm wide, and the presence of a central hepatic vein, measuring 0.44±0.21cm in diameter. The gallbladder was characterized as an anechoic structure with echogenic walls and dimensions of 2.91±1.18cm x 1.38±0.84cm (length x width). The stomach showed a pleated and linear texture, echogenic, with hypoechoic walls measuring 0.3±0.07cm wide. The splenopancreas was a circular and echogenic structure, homogeneous echotexture and measuring 1.18±0.62cm in width and 1.56±0.88cm in length. The kidneys were characterized by elongated, lobulated, hypoechoic structures, an echogenic capsule and an echogenic central line, measuring 1.05±0.7cm in width. The testis were characterized by fusiform, hypoechoic structures, homogeneous echotexture, measuring 2.31±0.79cm in length and 0.6±0.23cm in width. Ovarian follicles were seen in different stages, 0.67±0.39cm wide and 0.73±0.38cm long. No differences were found between species of syntropy, echogenicity and echotexture of the organs of the coelomic cavity. The ultrasound examination proved to be a safe, non-invasive and efficient technique for characterizing the organs of the coelomic cavity of snakes.(AU)

O objetivo do estudo foi realizar a avaliação ultrassonográfica de órgãos do terço médio e caudal da cavidade celomática de serpentes hígidas da família Boidae. Para isto, foram avaliadas 15 serpentes adultas de cinco espécies: Boa constrictor amarali, Boa constrictor constrictor, Eunectes murinus, Epicrates assisi e Epicrates crassus. Os animais foram contidos fisicamente para a realização do exame. Após aplicação de gel acústico sobre as escamas, o transdutor foi posicionado no plano frontal da cavidade celomática. Foram utilizados transdutores microconvexo e linear em 10MHz. O exame ultrassonográfico foi conduzido no sentido craniocaudal, com cortes longitudinais e transversais para avaliar sintopia, ecogenicidade e ecotextura dos órgãos. O fígado se apresentou bilobulado, hiperecoico, ecotextura homogênea, cápsula hiperecoica, com lobo hepático medindo 1,15±0,64cm de largura, e presença de uma veia central hepática, medindo 0,44±0,21cm de diâmetro. A vesícula biliar foi caracterizada como uma estrutura anecoica de paredes ecogênicas e dimensões de 2,91±1,18cm x 1,38±0,84cm(comprimento x largura). O estômago apresentou-se com o aspecto pregueado e linear, ecogênico, com paredes hipoecoicas medindo 0,3±0,07cm de largura. O esplenopâncreasse apresentou como uma estrutura circular e ecogênica, ecotextura homogênea e medindo de 1,18±0,62cm de largura e 1,56±0,88cm de comprimento. Os rins se caracterizaram por estruturas alongadas, lobuladas, hipoecoicas, cápsula ecogênica e uma linha central ecogênica, medindo 1,05±0,7cm de largura. Os testículos foram caracterizados por estruturas fusiformes, hipoecoicas, ecotextura homogênea, medindo 2,31±0,79cm de comprimento e 0,6±0,23cm de largura. Foram visualizados folículos ovarianos em diferentes estágios, de 0,67±0,39cm de largura e 0,73±0,38cm de comprimento. Não foram encontradas diferenças entre espécies de sintopia, ecogenicidade e ecotextura dos órgãos da cavidade celomática. O exame ultrassonográfico demonstrou-se uma técnica segura, não invasiva e eficiente para caracterização dos órgãos da cavidade celomática de serpentes.(AU)

Hemostatic evaluation of rabbits envenomed with Bothrops alternatus treated with anti-bothropic serum, desmopressin and tranexamin acid / Avaliação hemostática de coelhos envenenados com Bothrops alternatus e tratados com soro antibotrópico, desmopressina e ácido tranexâmico

In Brazil, snakes from the Bothrops genus are responsible for thousands of accidents, and their venoms are mainly composed of proteolytic enzymes. Although the antibothropic serum produced by the Brazilian Institutes is remarkably efficient, more studies are necessary, especially in veterinary medicine. The venom contain enzymes and non-enzymatic proteins that interfere with hemostasis leading to hemorrhage or even thrombosis. Possible treatment associations with known bothropic antivenom were the reason for the development of the present study. The aim of this study was to evaluate hemostasis alterations caused by Bothrops alternatus venom in rabbits followed by treatments with anti-bothropic serum, tranexamic acid and desmopressin. Twenty New Zealand rabbits were distributed into five groups (n=4) that were experimentally envenomed with 150mcg/kg of B. alternatus venom via intramuscular injection and treated as follow: Group 1 (G1) was the positive control and received venom and PBS/BSA; Group 2 (G2) was treated with tranexamic acid; Group 3 (G3) with desmopressin; Group 4 (G4) with tranexamic acid and anti-bothropic serum; and Group 5 (G5) with anti-bothropic serum and desmopressin. Blood samples were collected before venom administration, and one, four, eight and 12 hours after, for Partial activated partial thromboplastin time, Prothrombin Time, Thrombin Time and fibrinogen evaluation. Thrombin generation (TG) test was carried out with a pool of samples from final times (8 and 12h). At the end of 12h, all animals were euthanized and necropsy was conducted. Samples from muscle tissue, heart, lungs and kidney were analyzed. Classic coagulation tests showed no significant differences amongst groups and times. However, TG indicated that the venom causes a hypocoagulability state, which was not reversed by proposed treatments. Histology showed muscle inflammation, hemorrhage and necrosis, as well as hemorrhage in other tissues with no differences amongst groups. B. alternatus envenomation causes hypocoagulability detected by TG assay, but not through classical coagulation tests. The use of tranexamic acid and desmopressin for hemostasis stabilization after inoculation of the venom did not show advantage in coagulation restoration.(AU)

No Brasil, as serpentes do gênero Bothrops são responsáveis por milhares de acidentes, e seus venenos são compostos principalmente de enzimas proteolíticas. Embora o soro antiofídico produzido pelos institutos brasileiros seja notavelmente eficiente, mais estudos são necessários, especialmente na medicina veterinária. O veneno contem enzimas e proteínas não-enzimáticas que interferem com a hemostasia levando a hemorragias ou trombose. A associação de outros tratamentos ao soro antibotrópico foi a razão para o desenvolvimento do presente estudo. O objetivo deste estudo foi avaliar as alterações da hemostasia causadas pelo veneno de Bothrops alternatus em coelhos, após tratamento com soro antibotrópico, ácido tranexâmico e desmopressina. Vinte coelhos da Nova Zelândia foram distribuídos em cinco grupos (n = 4) que foram submetidos a experimentos com 150mcg/kg de veneno de B. alternatus por injeção intramuscular. O Grupo 1 (G1) foi o controle positivo e recebeu veneno e PBS / BSA, enquanto o Grupo 2 (G2) foi tratado com ácido tranexâmico, o Grupo 3 (G3) com desmopressina, o Grupo 4 (G4) com ácido tranexâmico e soro antibotrópico, e o Grupo 5 (G5) com soro antibotrópico e desmopressina. As amostras de sangue foram coletadas antes da administração do veneno, e uma, quatro, oito e 12 horas após os tratamentos para realização de tempo de tromboplastina parcial ativada parcial (TTPa), tempo de protrombina (TP), tempo de trombina (TT) e mensuração de fibrinogênio. Para o ensaio de geração de trombina (TG) foi realizado com um pool de amostras nos tempos finais (8 e 12h). Ao final das 12h, todos os animais foram sacrificados e a necropsia foi realizada. Amostras de tecido muscular, coração, pulmões e rins foram analisadas. Os testes TTPa, TP, TT e fibrinogênio não mostraram diferenças significativas entre os grupos e os tempos. No entanto, o TG indicou que o veneno causa um estado de hipocoagulabilidade, que não foi revertido pelos tratamentos propostos. Na histologia, foram observadas inflamação muscular, hemorragia e necrose, além de hemorragia em outros tecidos, sem diferenças entre os grupos. O envenenamento por B. alternatus causa hipocoagulabilidade detectada mais precocemente pelo teste de geração de trombina. O uso de ácido tranexâmico e desmopressina para estabilização da hemostasia após a inoculação do veneno não mostrou vantagem na restauração da coagulação.(AU)

Epidemiological aspects of snakebites in the state of Amazonas, Brazil, from 2007 to 2017

This study comprises a retrospective analysis of snakebites in the State of Amazonas, Brazil, from 2007 to 2017. Data were collected from the Notifiable Diseases Information System (NDIS). 17,056 snakebites were recorded in Amazonas between 2007 and 2017. During the study period, the Rio Negro and Tefé micro-regions had the highest accumulated incidence, while small municipalities such as São Gabriel da Cachoeira, Uarini and Alvarães presenting a high incidence rate during the same period. Snakes in the genera Bothrops and Lachesis caused 69.5% and 20.3% snakebites. Snakebites occurred more frequently in the Amazonian winter, between January and April, and most of the snakebite victims (78.6%) were men. The most affected individuals were between 20 and 39 years of age (59.4%). The time elapsed between snakebites and medical assistance varied from one to six hours (51.4%). 7,705 of the snakebite cases, were classified as moderate, 7,328 as mild, and 1,299 as severe. Of the 104 deaths that occurred in the period, Bothrops genus caused the highest mortality (68.3%). The State of Amazonas recorded both high numbers of snakebites in the period 2007-2017 and the time elapsed between snakebite and medical assistance, which may affect the clinical status of patients.

Severe tissue complications in patients of Bothrops snakebite at a tertiary health unit in the Brazilian Amazon: clinical characteristics and associated factors

Abstract INTRODUCTION: Snakebites in the Brazilian Amazon are caused mostly by snakes from the Bothrops genus and envenomated patients may suffer from tissue complications. METHODS: This study aimed to identify risk factors for severe tissue complications (STC) in patients with Bothrops snakebite in the Amazonas state, Brazil. RESULTS: Snakebites that were classified as severe and affected female patients with comorbidities presented greater risks of developing STCs. In addition, hospitalizations of patients with STC exceeded 5 days. CONCLUSIONS: Clinical and epidemiological characteristics can prove essential for assessing the evolution of STC and clinical prognosis of patients with Bothrops snakebites.

Therapeutic effect of long-snake moxibustion combined with western medication on diarrhea type irritable bowel syndrome of spleen and kidney / 中国针灸

OBJECTIVE@#To compare the therapeutic effect between long-snake moxibustion combined with western medication and simple medication on diarrhea type irritable bowel syndrome (IBS-D) of spleen and kidney @*METHODS@#A total of 60 patients with IBS-D of spleen and kidney @*RESULTS@#Compared before treatment, the symptom scores of abdominal pain, defecation frequency, mucous stool and appetite reduction were decreased (@*CONCLUSION@#Long-snake moxibustion combined with western medication can effectively treat the IBS-D of spleen and kidney

Bile acid derivatives-focused chemical profiling in snake bile / 中国中药杂志

As a precious traditional Chinese medicine(TCM), snake bile has been widely used in numerous Chinese medicine prescriptions. Bile acid(BA) derivatives have been demonstrated as the primary chemical family in snake bile. In-depth chemical characterization of BAs is of great importance towards the establishment of quality standards and clarification of the effective material basis for snake bile. This study firstly employed ~1H-NMR to preliminarily analyze the chemical profiles of snake bile, an automated fraction collector was subsequently implemented to obtain the fractions-of-interest. The fraction was then concentrated and re-analyzed by LC-MS. Based on ~1H-NMR, BAs were found to be the main components of snake bile, and six BAs including CDCA, CA, TCDCA, TCA, TDCA and GCA were tentatively identified from the representative spectrum with the assistance of literature and reference compounds. Whereas the content of TCA in snake bile was too great, resulting in a great obstacle for the detection of trace components, the automated fraction collector was subsequently implemented to obtain the fractions-of-interest for LC-MS analysis. According to matching MS/MS information and retention time with reference compounds as well as database retrieval, a total of 57 BAs were detected and annotated. Because of the combination of ~1H-NMR and LC-MS platforms, the findings are beneficial for the in-depth characterization of BAs in snake bile, which provides references for the establishment of quality control and evaluation methods of snake bile.

Effect of environmental parameters on squamate reptiles in an urban forest fragment in central Amazonia

The increasing urbanization of the Amazonian biome has promoted the creation of several forest fragments surrounded by an urban matrix, but the relationship of animal assemblages to the urban environment, especially in forest fragments, is poorly known. Here we aimed to 1) determine the composition of the squamate fauna of the largest urban forest fragment from central Amazonia, in the Brazilian city of Manaus, and 2) evaluate the influence of environmental parameters on assemblage diversity. We sampled 10 standardized riparian plots through visual search in six surveys between 2008/09 and 2015, totaling 360 observer-hours. We found 15 species of lacertoids (lizards and amphisbaenians) and seven species of snakes through active search. After considering occasional encounters and search in museum collections, we recorded a total of 24 lacertoid and 22 snake species. Multiple regression models indicated that species richness and abundance of individuals increased with the distance from the edge of the fragment, while other structural parameters of the environment did not affect the assemblage. We conclude that this forest fragment 1) consists of a subset of the regional species pool, and 2) undergoes reduction of species richness and abundance of individuals from the center to the borders. This and additional urban forest fragments should be continually monitored in order to evaluate their long-term role in maintaining the tropical biodiversity. (AU)

Distribution update, conservation status and color in life of the rare Amazonian snake, Eutrachelophis papilio Zaher and Prudente 2019 (Serpentes: Xenodontini)

The rare Amazonian snake Eutrachelophis papilio is known from only five individuals, from four localities, belonging to its type-series, the more recent collected over 10 years ago. Here, we expand its distribution and describe its color in life for the first time. We also provide an estimate of its distribution area using the minimum convex polygon method and identify the values of anthropic pressure within its known distribution range with the Human Footprint Index. The new occurrence is located 291 km from the nearest known locality and its distribution is associated with pristine forests. Considering its rarity, and the absence of demographic and biological data, we suggest that the species should be classified as Data Deficient by IUCN criteria. (AU)

Incidência de acidentes ofídicos por gêneros de serpentes nos biomas brasileiros / Incidence of venomous snakebite accidents by snake species in Brazilian biomes

Resumo O aporte de insumos para o tratamento de acidentes ofídicos, bem como o treinamento da equipe assistencial devem ser orientados de acordo com a frequência e riscos por áreas geográficas. O objetivo deste artigo é analisar a tendência da taxa de incidência de acidentes ofídicos segundo gênero de serpentes nos biomas brasileiros no período de 2003 a 2012. Estudo ecológico de tendência da taxa de incidência dos acidentes ofídicos por serpentes dos gêneros Bothrops, Crotalus, Lachesis e Micrurus para os biomas no período de 2003-2012, por meio de regressão de Prais-Winsten. O número de acidentes passou de 26.082 em 2003 para 27.870 em 2012, com aumento de demanda por insumos. A análise de tendência da taxa de incidência mostrou tendência estacionária, exceto para o gênero Crotalus com tendência ascendente no agregado do Brasil. Tendência ascendente foi verificada no Cerrado para o gênero Crotalus, Lachesis e Micrurus, no Pampa também para Crotalus, na Caatinga para o gênero Lachesis e na Mata Atlântica para o gênero Micrurus. A tendência estacionária verificada para os acidentes ofídicos no Brasil decorre da maioria destes (87%) serem causados por serpentes do gênero Bothrops. No entanto, destaca-se aumento do risco para acidentes com serpentes dos gêneros Crotalus, Lachesis e Micrurus.

Abstract The supply of antidotes for the treatment of venomous snakebite accidents, as well as the training of the care team, should be structured according to the frequency and risks by geographical areas. The scope of this article is to analyze the trend of the incidence of snakebite accidents in Brazilian biomes between 2003 and 2012. It involved the ecological study by means of Prais-Winsten regression of the incidence of snakebites by the Bothrops, Crotalus, Lachesis and Micrurus species for the Brazilian biomes in the period from 2003 to 2012. The research revealed that the number of accidents increased from 26,082 in 2003 to 27,870 in 2012 with an increased demand for antidotes. The trend analysis of the incidence showed a stationary trend, except for the Crotalus species with an upward trend in the Brazilian aggregate. An upward trend was found in the Cerrado for the Crotalus, Lachesis and Micrurus species: in the Pampa for Crotalus; in the Caatinga for Lachesis and in the Atlantic Forest for Micrurus. The conclusion drawn is that the stationary trend observed for snakebite accidents in Brazil is due to the fact that the majority of these (87%) are caused by snakes of the Bothrops species. However, it should be stressed that there is an increased risk of accidents with snakes of the Crotalus, Lachesis and Micrurus species.