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1.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(2, cont.): e2406, jul-dez. 2021. tab, ilus
Article in English | ID: biblio-1352311

ABSTRACT

The Elapidae family comprises 35 snake species in Brazil, with Micrurus ibiboboca being widely distributed in the northeast of the country. Despite the high number of Micrurus species in Brazil, there are few cases of human envenomation in literature. This study describes a clinical report of envenomation due to the bite of M. ibiboboca in the State of Pernambuco, Northeast Brazil, that took place in 2017. The patient presented symptoms of muscle paralysis and sweating. He was admitted to the intensive care unit. A total of 10 ampoules of anti-elapidic serum were administered. The patient complained of local pain that extended through the arm, paresthesia in the lower limbs, headache, and chest pain. Changes in the visual, respiratory, and neurological systems were not observed. This clinical case report on coral snake poisoning is useful for increasing the knowledge on the toxicological action of snake poison and its effect on injured individuals, thereby helping in the clinical evaluation and treatment.(AU)


A família Elapidae compreende 35 espécies de serpentes no Brasil, com Micrurus ibiboboca amplamente distribuída no Nordeste. Apesar do elevado número de espécies de Micrurus no Brasil, são poucos os casos de envenenamento humano na literatura. Descrevemos aqui um relato clínico de envenenamento por picada de M. ibiboboca no Estado de Pernambuco, Nordeste do Brasil, ocorrido em 2017. O paciente apresentava sintomas de paralisia muscular e sudorese. Ele foi internado na Unidade de Terapia Intensiva. Um total de 10 ampolas de soro anti-elapídico foi administrado. O paciente queixava-se de dor local que se estendia pelo braço, parestesia em membros inferiores, cefaleia e dor torácica. Não foram observados alterações nos sistemas de visão, respiratório e neurológico. Este relato de caso clínico de intoxicação por cobra coral é útil para aumentar o conhecimento sobre a ação toxicológica da peçonha da serpente e seu efeito sobre os acidentados, auxiliando na avaliação clínica e no tratamento.(AU)


La familia Elapidae comprende 35 especies de serpientes en Brasil como la Micrurus ibiboboca ampliamente distribuidas en el Noreste. A pesar de lo alto número de especies de Micrurus en Brasil, hay pocos casos de envenenamiento humano en la literatura. Describimos aquí un informe clínico de envenenamiento por mordedura de M. ibiboboca en el estado de Pernambuco, Noreste de Brasil, ocurrido en 2017. El paciente presentaba síntomas de parálisis muscular y sudoración. Fue ingresado en la unidad de cuidados intensivos. Se administraron un total de 10 ampollas de suero antielapídico. El paciente se quejaba de dolor local que se extendía por el brazo, parestesias en las extremidades inferiores, cefalea y dolor torácico. No se observaron cambios en los sistemas visual, respiratorio y neurológico. Este informe de caso clínico sobre la intoxicación por serpiente coral es útil para aumentar el conocimiento sobre la acción toxicológica del veneno de serpientes y su efecto en los individuos lesionados, ayudando así en la evaluación clínica y el tratamiento.(AU)


Subject(s)
Animals , Poisoning , Snake Bites , Coral Snakes
2.
Arch. argent. pediatr ; 119(1): e80-e83, feb. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1147283

ABSTRACT

La intoxicación por mordedura de serpiente es un problema de salud pública global. En la población pediátrica, la intoxicación por mordedura de serpiente presenta características diferentes que en los pacientes adultos. La Bungarus multicinctus es una especie de elápido sumamente venenoso. Las presentaciones clínicas documentadas después de la intoxicación por mordedura de Bungarus multicinctus son reacciones locales mínimas, insuficiencia respiratoria, dolor generalizado e hiponatremia potencialmente mortal. Presentamos el caso de una intoxicación por mordedura de Bungarus multicinctus en una niña con manifestaciones clínicas atípicas, incluidas necrosis tisular grave y trombocitopenia con coagulopatía.


Snakebite envenoming is a global public health problem. The pediatric population poisoned by snakebite envenoming has different features than adult patients. Bungarus multicinctus is a highly venomous species of the elapid snake. The documented clinical presentations following Bungarus multicinctus envenoming are minimal local reactions, respiratory failure, general pain, and life-threatening hyponatremia. We present an uncommon case of Bungarus multicinctus envenomation in a girl with unusual clinical findings, including severe tissue necrosis and thrombocytopenia with coagulopathy.


Subject(s)
Humans , Female , Child , Snake Bites , Necrosis , Poisoning , Thrombocytopenia , Blood Coagulation Disorders , China , Bungarus
3.
Rev. Ciênc. Plur ; 7(1): 72-87, jan. 2021. tab, graf
Article in Portuguese | LILACS, BBO | ID: biblio-1147669

ABSTRACT

Introdução: Acidentes causados por animais peçonhentos são considerados um problema de saúde pública, sendo responsáveis por considerável número de agravos à população mundial. Estudos acerca do tema são escassos no Maranhão, havendo a necessidade de investigação dos casos, visto que são de fundamental importância para as ações de vigilância epidemiológica e ambiental. Objetivo: Descrever o perfil epidemiológico dos acidentes com animais peçonhentos no Estado do Maranhão, Brasil. Metodologia: Trata-se de estudo ecológico, descritivo com abordagem quantitativa. Os dados foram coletados no Sistema de Informação de Agravos de Notificação/Departamento de Informática do Sistema Único de Saúde ocorridos no período de 01 janeiro de 2009 a 31 de dezembro 2019 dos casos notificados de acidentes com animais peçonhentos. Resultados: Constou-se maior incidência de notificações de acidentes em 2019,nos meses de Fevereiro (10,14%), Março (9,96%) e Maio (9,89%). No que tange ao perfil das vítimas houve uma predominância no sexo masculino (68,16%), adultos jovens de 20 a 39 anos (36,24%) e autodeclarados pretos (75,03%). No que diz respeito à gestação a imensa maioria não se aplica a categoria gestante (77,71%). Em relação as características do acidente destacou-se o acidente escorpiônico (55,97%), seguido pelos acidentes com aranhas (30,66%) e ofídicos (4,09%). O tempo decorrido entre o acidente e o atendimento foi predominante no intervalo de 1 a 3 horas após o acidente (34,37%). Dos acidentes ocorridos 61,31% foram classificados como leves, 82,02% evoluíram clinicamente com cura e 0,6% para óbito. Conclusões: Os acidentes causados por animais peçonhentos são de relevância para que haja um planejamento com medidas intersetoriais de vigilância epidemiológica junto a outros órgãos ambientais para minimizar o número de mortes (AU).


Introduction:Acidents caused by venomous animals are considered a public health problem, being responsible for a considerable number of injuries to the world population. Studies on the theme are scarce, with the need to investigate the cases,since they are of fundamental importance for the actions of epidemiological and environmental surveillance.Objective:To describe the epidemiological profile of accidents with venomous animals in the state of Maranhão, Brazil. Methodology:This is an ecological, descriptive study with a quantitative approach. Data were collected at Information System for Notifiable Diseases / Informatics Department of the Unified Health System from January 1, 2009 to December 31, 2019 of the reported cases of accidents with venomous animals. Results:There was a higher incidence of accident notifications in 2019 and in the months of February (10.14%), March (9.96%) and May (9.89%). Regarding the profile of the victims, there was a predominance of males (68.16%), young adults aged 20 to 39 years (36.24%) and self-declared blacks (75.03%). With regard to pregnancy, the vast majority does not apply to the pregnant category (77.71%). Regarding the characteristics of the accident, the scorpionic accident stood out (55.97%), followed by accidents with spiders (30.66%) and snakebites (4.09%). The time elapsed between the accident and the assistance was predominant in the interval from 1 to 3 hoursafterthe accident (34.37%). Of the accidents that occurred, 61.31% were classified as mild, 82.02% progressed clinically with cure and 0.6% died. Conclusions:Accidents caused by venomous animals are relevant for planning intersectoral measures for epidemiological surveillance with other environmental agencies to minimize the number of deaths (AU).


Introducción: Los accidentes ocasionados por animales venenosos son considerados un problema de salud pública, siendo responsable de un número considerable de lesiones a la población mundial. Los estudios sobre el tema son escasos,con la necesidad de investigar los casos, ya que son de fundamental importancia para las acciones de vigilancia epidemiológica y ambiental. Objetivo: Describir el perfil epidemiológico de accidentes con animales venenosos en el estado de Maranhão, Brasil. Metodología:Se trata de un estudio ecológico, descriptivo con enfoque cuantitativo. Los datos fueron recolectados en el Sistema de Información de Enfermedades Notificables /Departamento de Informática del Sistema Único de Salud que ocurrieron en el período del 01 de enero de 2009 al 31 de diciembre de 2019 de los casos notificados de accidentes con animales venenosos.Resultados: Hubo una mayor incidencia de notificaciones de accidentes en 2019 y en los meses de febrero (10,14%), marzo (9,96%) y mayo (9,89%). En cuanto al perfil de las víctimas,predominó el sexo masculino (68,16%), adultos jóvenes de 20 a 39 años (36,24%) y negros autodeclarados (75,03%). En cuanto al embarazo, la gran mayoría no aplica a la categoría de embarazadas (77,71%). En cuanto a las características del accidente, destacó el accidente escorpiónico (55,97%), seguido de los accidentes con arañas (30,66%) y las mordeduras de serpientes (4,09%). El tiempo transcurrido entre el accidente y la asistencia fue predominante en el intervalo de 1 a 3 horasposteriores al accidente (34,37%). De los accidentes ocurridos, 61,31% fueron clasificados como leves, 82,02% progresó clínicamente con curación y 0,6% fallecieron. Conclusiones: Los accidentes causados por animales venenosos son relevantes para planificar medidas intersectoriales de vigilancia epidemiológica con otras agencias ambientales para minimizar el número de muertes (AU).


Subject(s)
Humans , Male , Female , Health Surveillance , Bites and Stings , Brazil/epidemiology , Disease Notification , Animals, Poisonous , Snake Bites , Epidemiologic Studies , Data Interpretation, Statistical , Ecological Studies
4.
Rev. Soc. Bras. Med. Trop ; 54: e20200194, 2021. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136927

ABSTRACT

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.


Subject(s)
Humans , Animals , Male , Adult , Snake Bites/complications , Pain , Snakes , Antivenins/therapeutic use , Edema , Hemorrhage
5.
J. venom. anim. toxins incl. trop. dis ; 27: e20200068, 2021. tab, graf
Article in English | ID: biblio-1154772

ABSTRACT

Maintenance of snakes at Butantan Institute started in the last century, intending to produce a different antivenom serum to reduce death caused by snakebites. Through a successful campaign coordinated by Vital Brazil, farmers sent venomous snakes to Butantan Institute by the railway lines with no cost. From 1908 to 1962, the snakes were kept in an outdoor serpentarium, where venom extraction was performed every 15 days. During this period, the snake average survival was 15 days. In 1963, the snakes were transferred to an adapted building, currently called Laboratory of Herpetology (LH), to be maintained in an intensive system. Although the periodicity of venom extraction remained the same, animal average survival increased to two months. With the severe serum crisis in 1983, the Ministry of Health financed remodeling for the three public antivenom producers, and with this support, the LH could be improved. Air conditioning and exhausting systems were installed in the rooms, besides the settlement of critical hygienic-sanitary managements to increase the welfare of snakes. In the early 1990s, snake survival was ten months. Over the years to the present day, several improvements have been made in the intensive serpentarium, as the establishment of two quarantines, feeding with thawed rodents, an interval of two months between venom extraction routines, and monitoring of snake health through laboratory tests. With these new protocols, average snake survival increased significantly, being eight years for the genus Bothrops, ten years for genus Crotalus and Lachesis, and four years for the genus Micrurus. Aiming the production of venoms of good quality, respect for good management practices is essential for the maintenance of snakes in captivity. New techniques and efficient management must always be sought to improve animal welfare, the quality of the venom produced, and the safety of those working directly with the venomous snakes.(AU)


Subject(s)
Animals , Snake Bites , Viperidae , Elapid Venoms/biosynthesis , Animal Welfare , Costs and Cost Analysis
6.
J. venom. anim. toxins incl. trop. dis ; 27: e20210024, 2021. tab, graf, ilus
Article in English | ID: biblio-1340183

ABSTRACT

The Malayan blue coral snake, Calliophis bivirgata flaviceps, is a medically important venomous snake in Southeast Asia. However, the complexity and diversity of its venom genes remain little explored. Methods: To address this, we applied high-throughput next-generation sequencing to profile the venom gland cDNA libraries of C. bivirgata flaviceps. The transcriptome was de novo assembled, followed by gene annotation, multiple sequence alignment and analyses of the transcripts. Results: A total of 74 non-redundant toxin-encoding genes from 16 protein families were identified, with 31 full-length toxin transcripts. Three-finger toxins (3FTx), primarily delta-neurotoxins and cardiotoxin-like/cytotoxin-like proteins, were the most diverse and abundantly expressed. The major 3FTx (Cb_FTX01 and Cb_FTX02) are highly similar to calliotoxin, a delta-neurotoxin previously reported in the venom of C. bivirgata. This study also revealed a conserved tyrosine residue at position 4 of the cardiotoxin-like/cytotoxin-like protein genes in the species. These variants, proposed as Y-type CTX-like proteins, are similar to the H-type CTX from cobras. The substitution is conservative though, preserving a less toxic form of elapid CTX-like protein, as indicated by the lack of venom cytotoxicity in previous laboratory and clinical findings. The ecological role of these toxins, however, remains unclear. The study also uncovered unique transcripts that belong to phospholipase A2 of Groups IA and IB, and snake venom metalloproteinases of PIII subclass, which show sequence variations from those of Asiatic elapids. Conclusion: The venom gland transcriptome of C. bivirgata flaviceps from Malaysia was de novo assembled and annotated. The diversity and expression profile of toxin genes provide insights into the biological and medical importance of the species.(AU)


Subject(s)
Animals , Phospholipases , Snake Bites , Viper Venoms/toxicity , Gene Expression , Elapidae/physiology
7.
Rev. Soc. Bras. Med. Trop ; 54: e00912021, 2021. tab, graf
Article in English | LILACS | ID: biblio-1250836

ABSTRACT

Abstract Introduction: The efficacy of 20-minute whole blood clotting (WBCT20) and the Lee-White clotting time (LWCT) tests in diagnosing coagulation alterations from snakebites were compared. Methods: We evaluated 89 snakebite cases treated at the Hospital Regional do Juruá em Cruzeiro do Sul, Acre, Brazil. Results: WBCT20 results were normal in 33.7% and unclottable in 66.3% of cases, while LWCT results were normal in 23.6% and altered (prolonged or unclottable) in 76.4% of cases, with no significant differences. Conclusions: The WBCT20 is important for rapidly diagnosing coagulation alterations from snakebites. Furthermore, it is efficient, inexpensive, and can be deployed in isolated hospitals.


Subject(s)
Humans , Snake Bites/diagnosis , Blood Coagulation , Brazil , Hospitals
8.
Rev. Esc. Enferm. USP ; 55: e03721, 2021. tab
Article in English | LILACS, BDENF | ID: biblio-1250713

ABSTRACT

ABSTRACT Objective: To understand the epidemiological and clinical profile of snakebite victims in a public teaching hospital. Method: Exploratory, descriptive, cross-sectional study with a quantitative approach conducted in a public hospital in the Triângulo Sul region of Minas Gerais state, Brazil. The data were collected from medical records and compulsory case report forms of patients admitted in the Emergency Service from June 2018 to May 2019. The data were descriptively analyzed and presented in tables. Results: The 137 patients were predominantly male (74.5%), rural workers (33.4%), in their working age (mean of 43.49 years), and in rural areas (87.6%). Bothrops was the most common genus (70.8%), and most occurrences were classified as mild (53.3%). The most performed treatment was snake antivenom administration (73%). Conclusion: Snakebite victims were mostly men in their working age and rural workers. Bothrops bites and mild occurrences were prevalent. Most treatments employed the appropriate snake antivenom. These occurred mostly in rural areas. The prevalent bitten body parts were feet, legs, and hands. Care was provided in less than six hours.


RESUMEN Objetivo: Conocer el perfil epidemiológico y clínico de las víctimas de accidentes ofídicos en un hospital público docente. Método: Estudio exploratorio, descriptivo, transversal, con enfoque metodológico cuantitativo, realizado en un hospital público de la región del Triângulo Sul del estado de Minas Gerais, Brasil. Los datos se recogieron de las historias clínicas y formularios de notificación obligatoria de los pacientes ingresados en los Servicios de Urgencia desde junio de 2018 hasta mayo de 2019. Los datos se analizaron de forma descriptiva y se presentaron en forma de tablas. Resultados: De un total de 137 pacientes, predominaron el sexo masculino (74,5%), los trabajadores rurales (33,4%), los individuos en edad productiva (media de 43,49 años) y la zona de ocurrencia rural (87,6%). El género más implicado en los accidentes fue el Bothrops (70,8%) y la clasificación de la mayoría fue leve (53,3%). El tratamiento más común fue la administración del suero antiofídico (73%). Conclusión: Los accidentes ofídicos se produjeron sobre todo en hombres en edad productiva y en trabajadores rurales. Prevalecieron los accidentes por el género Bothrops y los que se clasifican como leves. La mayoría de los tratamientos utilizaron el antiofídico adecuado. La zona más común de ocurrencia fue la rural. Las zonas corporales más afectadas por las mordeduras fueron los pies, las piernas y las manos, y los tratamientos se realizaron en menos de 6 horas.


RESUMO Objetivo: Conhecer o perfil epidemiológico e clínico das vítimas de acidente ofídico em um hospital público de ensino. Método: Estudo exploratório, descritivo, transversal, de abordagem metodológica quantitativa, realizado em um hospital público do Triângulo Sul de Minas Gerais. A coleta de dados foi realizada em prontuários e fichas de notificação compulsória de pacientes admitidos no Pronto Socorro de junho de 2018 a maio de 2019. Os dados foram analisados descritivamente e apresentados em forma de tabelas. Resultados: De um total de 137 pacientes, foram predominantes o sexo masculino (74,5%), trabalhadores rurais (33,4%), indivíduos em idade produtiva (média de 43,49 anos) e zona de ocorrência rural (87,6%). O gênero mais envolvido nos acidentes foi o Bothrops (70,8%) e a classificação da maioria foi leve (53,3%). O tratamento mais realizado foi a administração do soro antiofídico (73%). Conclusão: Os acidentes ofídicos aconteceram majoritariamente em homens em idade produtiva e trabalhadores rurais. Prevaleceram os acidentes pelo gênero Bothrops e classificados como leves. A maioria dos tratamentos utilizou soro antiofídico adequado. A zona de maior ocorrência foi a rural. As áreas corporais prevalentes de mordedura foram pé, perna e mão e os atendimentos foram realizados em menos de 6 horas.


Subject(s)
Emergency Nursing , Snake Bites , Snake Venoms , Health Profile , Emergency Medical Services
10.
Rev. Soc. Bras. Med. Trop ; 54: e05112020, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155570

ABSTRACT

Abstract INTRODUCTION: Envenomation remains a neglected public health problem in most tropical countries. Epidemiological studies on accidents caused by venomous animals are scarce in the Northeast region of Brazil, mainly in the state of Ceará. The present study aimed to describe the epidemiological features of envenomation cases involving venomous animals in the State of Ceará, Northeastern Brazil, from 2007 to 2019. METHODS: The online Notifiable Diseases Information System was consulted for data on all envenomation cases involving venomous terrestrial animals. Data collected were evaluated for the number of accidents/year, number of accidents/zoological group, antivenom therapy, zone of occurrence, sex, age-group distribution, and deaths. RESULTS: A total of 54,980 cases were recorded, with the highest incidence being that of scorpion stings (67.2%), predominantly in women (52.4%; odds ratio=3.6; 95% confidence interval=3.5-3.8), equally affecting people aged 10-19 years and 40-59 years (21.4%), in the urban areas (odds ratio=10.3; 95% confidence interval=9.9-10.8), especially in the rainy months. Snakebites (16.7%) had an incidence of 8.1/100,000 inhabitants, but the highest case-fatality rates were observed in bee stings (1.3%) and spider bites (0.5%). Regarding therapeutic variables, a small percentage of people had access to serotherapy (5.3%). CONCLUSIONS This study highlights the accidents caused by terrestrial venomous animals as a public health problem that must be monitored in Ceará. Thus, our findings suggest that preventive actions against scorpion and bee stings should be intensified during the months of higher incidence to improve public policies for patient care.


Subject(s)
Animals , Snake Bites/epidemiology , Scorpion Stings/epidemiology , Seasons , Venoms , Brazil/epidemiology , Accidents
11.
Rev. Soc. Bras. Med. Trop ; 54: e0374-2020, 2021. tab
Article in English | LILACS | ID: biblio-1155569

ABSTRACT

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.


Subject(s)
Humans , Animals , Female , Snake Bites/complications , Snake Bites/diagnosis , Snake Bites/epidemiology , Bothrops , Crotalid Venoms , Snakes , Brazil/epidemiology , Antivenins , Risk Factors
12.
Rev. Esc. Enferm. USP ; 55: e03721, 2021. tab
Article in English | LILACS, BDENF | ID: biblio-1287961

ABSTRACT

ABSTRACT Objective: To understand the epidemiological and clinical profile of snakebite victims in a public teaching hospital. Method: Exploratory, descriptive, cross-sectional study with a quantitative approach conducted in a public hospital in the Triângulo Sul region of Minas Gerais state, Brazil. The data were collected from medical records and compulsory case report forms of patients admitted in the Emergency Service from June 2018 to May 2019. The data were descriptively analyzed and presented in tables. Results: The 137 patients were predominantly male (74.5%), rural workers (33.4%), in their working age (mean of 43.49 years), and in rural areas (87.6%). Bothrops was the most common genus (70.8%), and most occurrences were classified as mild (53.3%). The most performed treatment was snake antivenom administration (73%). Conclusion: Snakebite victims were mostly men in their working age and rural workers. Bothrops bites and mild occurrences were prevalent. Most treatments employed the appropriate snake antivenom. These occurred mostly in rural areas. The prevalent bitten body parts were feet, legs, and hands. Care was provided in less than six hours.


RESUMEN Objetivo: Conocer el perfil epidemiológico y clínico de las víctimas de accidentes ofídicos en un hospital público docente. Método: Estudio exploratorio, descriptivo, transversal, con enfoque metodológico cuantitativo, realizado en un hospital público de la región del Triângulo Sul del estado de Minas Gerais, Brasil. Los datos se recogieron de las historias clínicas y formularios de notificación obligatoria de los pacientes ingresados en los Servicios de Urgencia desde junio de 2018 hasta mayo de 2019. Los datos se analizaron de forma descriptiva y se presentaron en forma de tablas. Resultados: De un total de 137 pacientes, predominaron el sexo masculino (74,5%), los trabajadores rurales (33,4%), los individuos en edad productiva (media de 43,49 años) y la zona de ocurrencia rural (87,6%). El género más implicado en los accidentes fue el Bothrops (70,8%) y la clasificación de la mayoría fue leve (53,3%). El tratamiento más común fue la administración del suero antiofídico (73%). Conclusión: Los accidentes ofídicos se produjeron sobre todo en hombres en edad productiva y en trabajadores rurales. Prevalecieron los accidentes por el género Bothrops y los que se clasifican como leves. La mayoría de los tratamientos utilizaron el antiofídico adecuado. La zona más común de ocurrencia fue la rural. Las zonas corporales más afectadas por las mordeduras fueron los pies, las piernas y las manos, y los tratamientos se realizaron en menos de 6 horas.


RESUMO Objetivo: Conhecer o perfil epidemiológico e clínico das vítimas de acidente ofídico em um hospital público de ensino. Método: Estudo exploratório, descritivo, transversal, de abordagem metodológica quantitativa, realizado em um hospital público do Triângulo Sul de Minas Gerais. A coleta de dados foi realizada em prontuários e fichas de notificação compulsória de pacientes admitidos no Pronto Socorro de junho de 2018 a maio de 2019. Os dados foram analisados descritivamente e apresentados em forma de tabelas. Resultados: De um total de 137 pacientes, foram predominantes o sexo masculino (74,5%), trabalhadores rurais (33,4%), indivíduos em idade produtiva (média de 43,49 anos) e zona de ocorrência rural (87,6%). O gênero mais envolvido nos acidentes foi o Bothrops (70,8%) e a classificação da maioria foi leve (53,3%). O tratamento mais realizado foi a administração do soro antiofídico (73%). Conclusão: Os acidentes ofídicos aconteceram majoritariamente em homens em idade produtiva e trabalhadores rurais. Prevaleceram os acidentes pelo gênero Bothrops e classificados como leves. A maioria dos tratamentos utilizou soro antiofídico adequado. A zona de maior ocorrência foi a rural. As áreas corporais prevalentes de mordedura foram pé, perna e mão e os atendimentos foram realizados em menos de 6 horas.


Subject(s)
Snake Bites , Emergency Nursing , Emergency Medical Services , Snake Venoms , Health Profile
13.
Cienc. tecnol. salud ; 8(1): 10-23, 2021. il 27 c
Article in Spanish | LILACS, LIGCSA, DIGIUSAC | ID: biblio-1348245

ABSTRACT

Neurolaena lobata es utilizada tradicionalmente en Centroamérica para tratar la mordedura de serpiente, pero su efectividad para contrarrestar el envenenamiento producido por Bothrops asper ha sido poco estudiada. Se evaluó la capacidad del extracto etanólico de sus hojas para inhibir las actividades proteolítica, fosfolipasa A2 (PLA2; evaluada como hemólisis indirecta) y coagulante del veneno in vitro. El material vegetal fue colectado en Izabal, Guatemala, secado, se hicieron extracciones con etanol y se evaluó la presencia de actividades proteolítica, PLA2 y coagulante in-trínsecas en ensayos de concentración-actividad. Los efectos inhibitorios de la actividad proteolítica y PLA2 del veneno se evaluaron después de pre-incubar concentraciones variables del extracto con concentraciones fijas de veneno. La inhibición de la actividad coagulante del veneno no fue evaluada porque el extracto presentó actividad anticoagulante intrínseca dependiente de la concentración. El extracto inhibió completamente las actividades proteolítica (CE50 = 15.7 µg/µl) y PLA2 (CE50 = 32.5 µg/µl) del veneno. El análisis fitoquímico utilizando ensayos macro y semimicrométricos de cromatografía en capa fina, demostró la presencia de flavonoides, cumarinas, saponinas, taninos, sesquiterpenlactonas y aceites esenciales en el extracto. Su efecto sobre las proteínas del veneno se evaluó por electroforesis SDS-PAGE, mostrando cambios en el patrón electroforético atribuidos a la formación de complejos moleculares con los metabo-litos del extracto. Los resultados indican que el extracto podría inhibir los efectos tóxicos del veneno inducidos por las metaloproteinasas dependientes de zinc (SVMPs) y PLA2s, pero podría afectar las alteraciones en la coagulación, coadyuvando en la desfibrinogenación inducida por el veneno.


Neurolaena lobata has been used by traditional healers in Central America to treat snakebite, but its ability to neutralize Bothrops asper envenomations needs to be proved. This study evaluated the inhibitory potential of the ethanolic extract of the leaves of N. lobata against proteolytic, phospholipase A2 (PLA2) and coagulant activities of the venom in vitro. Leaves were collected in Izabal, Guatemala, dried, extracted with ethanol and concentration-response assays were conducted to detect intrinsic proteolytic, PLA2 (evaluated as indirect hemolysis) and coagulant activities. Assays for anti-proteolytic and anti-PLA2 activities were performed after pre-incubation of several amounts of extract with a fixed concentration of venom. Inhibition assay for the coagulant effect of the venom was not tested because pre-incubation of thrombin with the extract prolonged the clotting time of plasma in a concentration-dependent manner. Proteolytic (EC50 = 15.7 µg/µl) and PLA2 (EC50 = 32.5 µg/µl) activities of the venom resulted completely inhibited by the extract. Phytochemical profiles, determined by micrometric assays and semi microanalysis by thin layer chro-matography, showed the presence of flavonoids, coumarins, saponins, tannins, sesquiterpene lactones and essential oils in the extract. SDS-PAGE was used to assess the action of the extract on the venom proteins. Results showed changes in the electrophoretic profile, probably due to the formation of insoluble complexes with plant specialized metabolites. These findings demonstrated that the extract could be able to inhibit toxic effects triggered by zinc-dependent snake venom metalloproteinases (SVMPs) y PLA2s but might aggravate the alterations induced by the venom in coagulation.


Subject(s)
Humans , Animals , Coagulants/analysis , Bothrops , Phospholipase A2 Inhibitors/supply & distribution , Plants, Medicinal/chemistry , Saponins/chemistry , Snake Bites/therapy , Tannins/chemistry , In Vitro Techniques/methods , Plant Extracts/therapeutic use , Crotalid Venoms/antagonists & inhibitors , Guatemala , Medicine, Traditional/methods
14.
Rev. patol. trop ; 50(4)2021. ilus, tab
Article in English | LILACS | ID: biblio-1353067

ABSTRACT

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.


Subject(s)
Snake Bites , Snakes , Viperidae , Bothrops
15.
Biomédica (Bogotá) ; 40(4): 609-615, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1142427

ABSTRACT

Resumen: Las mordeduras de serpientes son un problema de salud pública en regiones tropicales y subtropicales del mundo. Ocurren, especialmente, en trabajadores rurales, y son una importante fuente de discapacidad y mortalidad. Se presenta el caso de un hombre de 59 años, agricultor de la región del Catatumbo (Colombia), quien sufrió la mordedura de una serpiente Bothrops asper, la cual le produjo una hemorragia cerebral fatal. Se llama la atención sobre el grave trastorno hemorrágico en contraste con los leves cambios en el sitio de la mordedura, así como sobre la necesidad del tratamiento temprano de la intoxicación con el suero antiofídico, incluso, en ausencia de manifestaciones cutáneas significativas.


Abstract: Snake bites are a public health problem in tropical and subtropical regions of the world. They occur especially in rural workers and are an important source of disability and mortality. We present the case of a 59-year-old farmer from the Catatumbo region of Colombia who was bitten by a B. asper snake and suffered a fatal brain hemorrhage after the event. We draw attention to the severe bleeding disorder in contrast with the slight changes at the site of the bite, as well as on the importance of the early treatment of poisoning with antivenom even in the absence of significant skin manifestations.


Subject(s)
Snake Bites , Cerebral Hemorrhage , Bothrops , Viper Venoms , Colombia
16.
Biomédica (Bogotá) ; 40(4): 682-692, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1142434

ABSTRACT

Resumen : Introducción. El envenenamiento por mordedura de serpiente es considerado por la Organización Mundial de la Salud (OMS) una enfermedad tropical desatendida. Si bien los venenos de otras serpientes Bothrops se vienen estudiado ampliamente, poco se conoce del de Bothrops roedingeri. Objetivos. Caracterizar bioquímicamente el veneno total de la serpiente B. roedingeri y evaluar su actividad miotóxica, edematógena y hemorrágica. Materiales y métodos. Se hizo la caracterización enzimática del veneno de B. roedingeri determinando la actividad de la fosfolipasa A2 (PLA2) y de las enzimas proteolíticas, así como su acción fibrinogenolítica mediante electroforesis en gel de poliacrilamida con duodecilsulfato sódico (sodium dodecyl sulfate polyacrylamide gel electrophoresis, SDS-PAGE), y la caracterización tóxica del veneno estableciendo la dosis hemorrágica mínima, la dosis edematógena mínima y el efecto miotóxico local y sistémico. Resultados. La actividad de las PLA2 del veneno total de B. roedingeri fue de 3,45 ± 0,11 nmoles/minuto, la proteolítica, de 0,145 ± 0,009 nmoles/minuto, en tanto que el índice de coagulación del fibrinógeno fue de 6,67 ± 1,33 segundos. Por otro lado, el veneno produjo una dosis hemorrágica mínima de 24,5 µg, una dosis edematógena mínima de 15,6 µg y un pronunciado efecto miotóxico local evidenciado por la elevación de los niveles plasmáticos de creatina cinasa después de la inoculación por vía intramuscular. No se registró miotoxicidad sistémica. Conclusiones. El veneno de B. roedingeri tiene efectos hemorrágicos, edematógenos y miotóxicos locales, así como una elevada actividad de la PLA2, que sería responsable de los efectos miotóxico y edematógeno. También presentó actividad proteolítica, la cual podría afectar la coagulación, dada su capacidad para degradar el fibrinógeno y producir hemorragia por acción de las metaloproteasas.


Abstract : Introduction: Snakebite envenoming is considered by the World Health Organization (WHO) as a neglected tropical disease. Currently, Bothrops snake venoms are being studied intensively, but there is little knowledge about Bothrops roedingeri venom. Objectives: To biochemically characterize B. roedingeri total venom and evaluate its myotoxic, edematogenic, and hemorrhagic activity. Materials and methods: We characterized B. roedingeri venom enzymatic activity by determining the phospholipase A2 and the proteolytic and fibrinogenolytic action using SDS-PAGE electrophoresis while we characterized its venom toxicity by determining the minimum hemorrhagic dose, the minimum edema dose, and the local and systemic myotoxic effects. Results: Bothrops roedingeri venom showed a PLA2 activity of 3.45 ± 0.11 nmoles/min, proteolytic activity of 0.145 ± 0.009 nmoles/min, and a fibrinogen coagulation index of 6.67 ± 1.33 seconds. On the other hand, it produced an minimum hemorrhagic dose of 24.5 µg, an minimum edema dose of 15.6 µg, and a pronounced local myotoxic effect evidenced by the elevation of plasma creatine kinase levels after intramuscular inoculation. The venom showed no systemic myotoxicity. Conclusions: Bothrops roedingeri venom has local hemorrhagic, edematogenic, and myotoxic activity. Enzymatically, it has high PLA2 activity, which would be responsible for the myotoxic and edematogenic effects. It also has proteolytic activity, which could affect coagulation given its ability to degrade fibrinogen, and it causes bleeding through the metalloproteases.


Subject(s)
Snake Venoms , Bothrops , Snake Bites , Neglected Diseases
17.
Rev. epidemiol. controle infecç ; 10(4): 1-10, out.-dez. 2020. ilus
Article in Portuguese | LILACS | ID: biblio-1252780

ABSTRACT

Justificativa e objetivos: apesar dos avanços na área assistencial, os acidentes por animais peçonhentos ainda são um importante problema de saúde pública no Brasil. Entre os anos de 2015 e 2016, a região Sudeste apresentou o maior número de notificações, e Minas Gerais foi o estado com mais ocorrências. O objetivo deste estudo foi descrever as características epidemiológicas dos acidentes por animais peçonhentos notificados entre 2008 e 2017 no município de Patrocínio, Minas Gerais. Métodos: estudo descritivo retrospectivo realizado por meio da análise das informações das fichas de notificação do Sistema de Informação de Agravos de Notificação (SINAN) de vítimas de acidentes por animais peçonhentos ocorridos durante os anos de 2008 a 2017 em Patrocínio. Resultados: foram registrados 1.084 casos, a maioria ocasionada por escorpiões (47,23%), seguida por serpentes (17,07%), aranhas (15,31%) e abelhas (11,07%). Sobre as vítimas, constatou-se o predomínio de homens (63,10%) na faixa etária entre 20 a 39 anos (32,56%). A maior parte dos acidentes foi classificada como leve (89,11%) e a cura ocorreu em 98,80% dos casos; um evoluiu para óbito. Conclusão: embora os acidentes por animais peçonhentos não apresentem altas taxas de letalidade no município estudado, a incidência desse agravo de saúde tem aumentado nos últimos anos. Além disso, informações epidemiológicas atualizadas podem contribuir com ações de políticas públicas e informar a população local sobre os riscos iminentes.(AU)


Background and objectives: despite advances in health care, accidents involving venomous animals are still a major public health problem in Brazil. Between 2015 and 2016, the Southeast region had the highest number of notifications, and Minas Gerais was the state with more occurrences. The objective of this study was to describe the epidemiological characteristics of accidents by venomous animal notified between 2008 and 2017 in the municipality of Patrocínio, Minas Gerais. Methods: this is a retrospective descriptive study conducted by analyzing the information from reporting forms of the Notifiable Diseases Information System for victims of accidents with venomous animals occurred during the years 2008 to 2017 in Patrocínio. Results: in total, 1084 cases were recorded, mostly caused by scorpions (47.23%), followed by snakes (17.07%), spiders (15.31%) and bees (11.07%). There was a predominance of male victims (63.10%), aged between 20-39 years (32.56%). Most accidents were classified as mild (89.11%) and the cure occurred in 98.80% of cases; one evolved to death. Conclusion: although accidents with venomous animals do not have high mortality rates in the municipality studied, the incidence of this health problem has increased in recent years. In addition, this updated epidemiological information may contribute to public policy actions and inform the local population about imminent risks.(AU)


Justificación y objetivos: a pesar de los avances en salud, los accidentes de animales venenosos siguen siendo un importante problema de salud pública en Brasil. Entre 2015 y 2016, la región sudeste tuvo el mayor número de notificaciones y Minas Gerais fue el estado con más casos. El objetivo de este estudio fue describir las características epidemiológicas de los accidentes por animales venenosos notificados entre 2008 y 2017 en el municipio de Patrocínio, Minas Gerais. Métodos: estudio descriptivo retrospectivo llevado a cabo mediante el análisis de la información de los formularios de notificación del Sistema de Información de Enfermedades Notificables de víctimas de accidentes con animales venenosos que ocurrieron durante los años 2008 a 2017 en Patrocínio. Resultados: se registraron 1084 casos, en su mayoría causados por escorpiones (47.23%), seguidos de serpientes (17.07%), arañas (15.31%) y abejas (11.07%). Predominaron las víctimas del sexo masculino (63,10%), con edades entre 20 y 39 años (32,56%). La mayoría de los accidentes se clasificaron como leves (89,11%) y la curación se produjo en el 98,80% de los casos; uno evolucionó hasta la muerte. Conclusiones: aunque los accidentes con animales venenosos no tienen altas tasas de mortalidad en el municipio estudiado, la incidencia de este problema de salud ha aumentado en los últimos años. Además, esta información epidemiológica actualizada puede contribuir a las acciones de política pública e informar a la población local sobre los riesgos inminentes.(AU)


Subject(s)
Humans , Spider Bites/epidemiology , Snake Bites/epidemiology , Scorpion Stings/epidemiology , Animals, Poisonous , Health Profile , Public Health
18.
Rev. salud pública ; 22(3): e202, May-June 2020. tab, graf
Article in English | LILACS | ID: biblio-1150173

ABSTRACT

ABSTRACT Objective To describe the main epidemiological features of snakebites in Colombia during the period 2008 to 2016. Methods A retrospective (quantitative) descriptive analytical empirical study was carried out, based on the official databases of the Public Health Surveillance in the Integral Information System of the Social Protection (SISPRO) and the Surveillance System in Public Health (Sivigila) of the reported cases of snakebites in Colombia for that period. Results In total, 37 066 cases were reported, with annual incidences ranging from 7.0 (2008) to 9.7 (2011 and 2012) cases per 100,000 population. Mortality rates ranged from 0.059 (2013) to 0.091 (2011) deaths per 100 000 population, with case fatality rates ranging from 0.6% (2013) to 1.0% (2010). Indigenous and Afro-Colombian populations were highly affected, and highest incidences occurred in males, and in people living in rural areas. The average age of affected people is 31.7 years (95% CI 28.3 34.5). The regions with higher incidence are Amazonia and Orinoquia. Species of the genus Bothrops are responsible for the highest number of bites (64.5%), owing to their wide distribution in Colombia. Regarding clinical manifestations, pain and edema were observed in 86.9% and 78.8% of patients, respectively. Cellulitis and abscesses were the most frequent local complications of these envenomings. Conclusions Results underscore the relevance of snakebite envenoming in Colombia, and provide information for improving the public health attention to these envenoming.(AU)


RESUMEN Objetivo Describir las principales características epidemiológicas de las mordeduras por serpientes en Colombia durante el período 2008-2016. Métodos Se realizó un estudio retrospectivo (cuantitativo) analítico empírico sobre los reportes de accidentes por mordedura de serpientes en Colombia para el período 2008 a 2016, a partir de las bases de datos oficiales del Sistema Integral de Información de la Protección Social (SISPRO) y del Sistema Nacional de Vigilancia en Salud Pública (Sivigila). Resultados Se reportaron 37 066 casos de mordeduras por serpientes en ese período. Las incidencias anuales oscilaron entre 7,0 (2008) y 9,7 (2011 y 2012) casos por 100,000 habitantes. Las tasas de mortalidad oscilaron entre 0,059 (2013) y 0,091 (2011) muertes por 100 000 habitantes, con tasas de letalidad entre 0,6% (2013) y 1,0% (2010). Los grupos más afectados fueron las poblaciones indígenas y afrocolombianas, y las personas residentes en zonas rurales. La edad promedio de las personas afectadas fue 31,7 años (IC 95% 28,3 34,5). Las regiones con mayor incidencia fueron la Amazonía y la Orino-quía. Especies del género Bothrops fueron responsables del mayor número de casos (64,5%), debido a su amplia distribución en el territorio colombiano. Con relación a las manifestaciones clínicas, se describió dolor y edema en 86,9% y 78,8% de los pacientes, respectivamente. Las complicaciones locales más frecuentes fueron las celulitis y los abscesos. Conclusiones Los resultados muestran la importancia de las mordeduras por serpientes en Colombia y suministran información para mejorar la atención de la salud pública ante estos envenenamientos.(AU)


Subject(s)
Humans , Snake Bites/epidemiology , Public Health Surveillance/methods , Incidence , Retrospective Studies , Colombia/epidemiology , Bothrops
19.
Ciênc. Saúde Colet ; 25(3): 869-878, mar. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1089474

ABSTRACT

Resumo O presente estudo tem como objetivo caracterizar o perfil epidemiológico de vítimas de acidentes escorpiônicos e ofídicos e avaliar a adequação das prescrições de soros antivenenos. Estudo transversal cujas fontes de dados foram as fichas de notificação de acidentes por animais peçonhentos do Sistema de Informação de Agravos de Notificação no município de Vitória da Conquista (BA), Brasil. Foram incluídas as informações de acidentes escorpiônicos ou ofídicos no período entre julho de 2016 e junho de 2017 atendidos no município. Os dados obtidos e as variáveis de interesse foram analisadas de acordo com as perguntas deste estudo. No período observado foram atendidas 293 vítimas de acidentes por animais peçonhentos. Destas, 149 (50,9%) foram homens e 114 (38,9%) possuíam entre 20 a 59 anos. Foram 235 (80,9%) casos de escorpionismo e 58 (19,1%) de ofidismo. Destes, 203 (69,3%) foram classificados como leves e em 200 (68,5%) casos foi prescrita soroterapia para estes pacientes. Quanto à adequação das prescrições, 172 (59,7%) foram julgadas inadequadas e destas, o uso de número de ampolas acima do indicado foi a mais frequente. A prescrição inapropriada de soros antivenenos ocorreu em aproximadamente em 60% dos casos avaliados. Apesar disso, a maioria dos acidentes foi classificada como leve, em homens jovens.


Abstract This study aims to characterize the epidemiological profile of victims of scorpion and snakebite envenomations and to evaluate the adequacy of antivenom sera prescriptions. This is a cross-sectional study whose data sources were the envenomation notification information sheets of the Notifiable Diseases Information System in the city of Vitória da Conquista (BA), Brazil. We included information on scorpion or snakebite envenomations attended in the municipality in the period between July 2016 and June 2017. The data obtained and the variables of interest were analyzed according to the questions of this study. In the observed period, 293 victims of envenomations were treated. Of these, 149 (50.9%) were men, and 114 (38.9%) were 20-59 years old. In total, 235 (80.9%) cases of scorpionism and 58 (19.1%) of ophidism were reported. Of these, 203 (69.3%) were classified as mild, and in 200 (68.5%) cases, serum therapy was prescribed for the patients. Regarding the adequacy of the prescriptions, 172 (59.7%) were considered inadequate, and of these, the use of some vials above than indicated was the most frequent. The inappropriate prescription of antivenom sera occurred in approximately 60% of the evaluated cases. Despite this, most accidents were classified as mild - in young men.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Young Adult , Snake Bites/drug therapy , Scorpion Stings/drug therapy , Immunologic Factors/therapeutic use , Brazil , Antivenins/therapeutic use , Urban Health , Cross-Sectional Studies , Drug Utilization/statistics & numerical data , Emergency Medical Services , Emergency Treatment , Hospitals, Public , Middle Aged
20.
Rev. Soc. Bras. Med. Trop ; 53: e20200151, 2020. graf
Article in English | LILACS, ColecionaSUS, SES-SP | ID: biblio-1136881

ABSTRACT

Abstract Human envenomation by the snakes Colubridae and Dipsadidae are reported in Brazil, and envenomation by the Opisthoglyphous snake Philodryas olfersii could be dangerous. Here, we present the second record of an envenomation by Philodryas olfersii in Pernambuco, northeast Brazil. The male victim presented with mild erythema pain, paraesthesia, local numbness, and swollen lymph nodes. The symptoms were similar to those of a pit viper bite, and disappeared completely after 15 days.


Subject(s)
Humans , Animals , Male , Adult , Snake Bites/diagnosis , Snake Venoms/poisoning , Colubridae
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