Pontos de atendimentos para terapia antivenenos, no estado do TOCANTINS, por região de saúde e municípios / Service points for poison therapy in the state of TOCANTINS, by health region and municipalities

Apresenta os 32 municípios com Pontos de Atendimentos para a terapia antiveneno, descritos por região de saúde e município no Estado do Tocantins para ações da vigilância de acidentes por animais peçonhentos.

It presents the 32 municipalities with Service Points for antivenom therapy, described by health region and municipality in the State of Tocantins for actions of surveillance of accidents by venomous animals.

Presenta los 32 municipios con Puntos de Servicio para la terapia antiveneno, descritos por región sanitaria y municipio en el Estado de Tocantins para acciones de seguimiento de accidentes por animales venenosos.

Il présente aux 32 communes des points de service pour la thérapie antivenimeuse, décrits par région sanitaire et commune de l'Etat de Tocantins pour des actions de surveillance des accidents par animaux venimeux.

Niños con mordeduras de animales hospitalizados en un centro de referencia de Uruguay / Children with animal bites hospitalized in a reference center of Uruguay

Resumen: Introducción: Las mordeduras de animales constituyen un problema sanitario. Pueden producir lesiones de diversa gravedad con riesgo de secuelas estéticas, funcionales y complicaciones infecciosas. El objetivo de este estudio fue describir las características clínicas y epidemiológicas, los tratamientos y las complicaciones de las lesiones por mordeduras de animales en niños hospitalizados en un centro de referencia de Uruguay. Métodos: Estudio descriptivo y retrospectivo. Se incluyeron todos los niños hospitalizados por mordeduras de animales entre 2014 y 2017. Se revisaron las historias clínicas y se registraron el animal involucrado, el tipo de lesiones, los tratamientos, las complicaciones y si el caso se notificó al Ministerio de Salud. Resultados: Se hospitalizaron 106 niños (media de edad: 4.5 años). El animal involucrado más común fue el perro (80.2%), seguido de roedores (8.5%), arácnidos (4.7%) y otros (6.5%). Las lesiones fueron en su mayoría únicas (61.3%) y superficiales (80.2%), y la hospitalización se hizo en cuidados moderados en el 91.5% de los casos. Los tratamientos se centraron en higiene (96.2%), sutura (70.8%) y profilaxis antibiótica (81.1%). Se presentaron complicaciones en el 77.4% de los casos. En tres fue posible el aislamiento del agente etiológico más frecuente: Streptococcus pyogenes. El 20.7% de los casos se notificaron al Ministerio de Salud. No se registró letalidad. Conclusiones: Del total de los niños hospitalizados, los más afectados fueron varones menores de 5 años. Predominaron las lesiones en la cabeza y los miembros, mayoritariamente leves y superficiales. En el 77.4% de los casos hubo complicaciones, principalmente infecciosas y estético-funcionales.

Abstract: Background: Animal bites are a health problem that can produce lesions of varying severity, with the risk of aesthetic and functional sequelae and infectious complications. The objective of the study was to describe the clinical, epidemiological, treatment and complications of lesions caused by animal bites in children hospitalized in a reference center in Uruguay. Method: Descriptive, retrospective study. All children hospitalized for animal bites between 2014 and 2017 were included. Medical records were reviewed and data, such as the animal involved, injuries, treatments, complications, and if the case was notified to the Ministry of Health, were recorded. Results: A total of 106 children were hospitalized, with a mean age 4.5 years. The animals involved were dogs (80.2%), rodents (8.5%), arachnids (4.7%), and others (6.5%). The majority of the lesions were superficial (80.2%), and 91.5% of the cases were hospitalized in moderate care. The treatments were hygiene (96.2%), suture (70.8%), and antibiotic prophylaxis (81.1%). There were complications in 77.4% of the cases. In three cases, the isolation of the most frequent etiological agent was possible: Streptococcus pyogenes. Notification to the Ministry of Health occurred in 20.7% of the cases. No lethality was recorded. Conclusions: A total of 106 children were hospitalized due to animal bites. The most affected were males under 5 years old. Most of them were bitten at home or nearby. Dogs and rodents were the most involved animals. There were predominantly head and limb lesions, mostly mild and superficial. Complications occurred in 77.4% of cases, mainly infectious and aesthetic-functional.

Heridas por mordedura animal en la región maxilofacial: revisión de literatura y presentación de casos / Animal bite wounds in the maxillofacial region: a review of the literature and case reports

Las heridas por mordida en la región maxilofacial son relativamentecomunes y se consideran de tratamiento complejo; son contaminadas con una flora oral bacteriana única y, en ocasiones, tienen resultados estéticos devastadores. Las heridas pueden ser ocasionadas por animales domésticos, salvajes y humanos. El clínico debe tener una comprensión multidisciplinaria del manejo de las mismas, incluyendo el abordaje médico, quirúrgico, viral, bacteriológico y la secuencia propia del tratamiento. Se presenta una revisión de la literatura, así como casos clínicos para el tratamiento integral de este tipo de trauma.

Bite wounds in the maxillofacial region are relatively common and are regarded as diffi cult to treat given the associated contamination with what is a unique polymicrobial inoculum. The aesthetic consequences can occasionally prove devastating. The wounds can be caused by both domestic and wild animals, as well as by humans. Clinicians need to have a multidisciplinary understanding of how to manage such wounds, including surgical, medical, virological, and bacteriological aspects, and the proper sequence of treatment. We present a review of the literature and a number of clinical cases for the comprehensive management of this type of trauma.

Soroterapia antiveneno: tratamento das reações adversas / Antivenom serum therapy: treatment of adverse reactions

Soroterapia antiveneno consiste na utilização de soro para neutralizar venenos inoculados após acidente por animal peçonhento. Dados epidemiológicos de 2010 do Hospital João XXIII revelaram que 20% dos atendimentos no Serviço de Toxicologia no hospital foram de- correntes de acidentes com animais peçonhentos. O soro deve ser administrado o mais pre- cocemente possível sendo que a dose administrada em adultos e crianças é igual, uma vez que a função do soro é neutralizar a maior quantidade de veneno circulante, independente do peso do paciente. A aplicação deve ser feita entre 20 e 60 minutos, sob estrita vigilãncia médica e da enfermagem, em sala de emergência. Complicações da soroterapia incluem reações anafilßticas, anafilactoides e a doença do soro. As medicações utilizadas no trata- mento das reações adversas incluem epinefrina, anti-histamínicos (antagonistas H 1 c H2) e corticosteroides. Teste de sensibilidade ao soro e pré-medicação são contraindicados...

Serotherapy antivenom is the use of serum to neutralize poisons inoculated atter an accident by venomous animal. Epidemiological data from the João XXIII Hospital in 2010 revealed that 20% of attendances at the Service of Toxicology ai lhe hospital were due to accidents ioith venomous animals. The serum should be administered as early as possible and lhe dose administered is equal to adults and children, since lhe function of the serum to neutralize the greater amount of venom currenl, independent of patient weight. The application must be made between 20 and 60 minutes under strict medica! supervision anel nursing in lhe emergency room. Complications of antivenom therapy include anaphylactic reactions, anaphylactoid anel serum sickness. Medications used to treat adverse reactions incluede epinephrine. antihistamines (H1and H2 antagonists) and corticosteroids. Sensitioity test to serum and premedication are contraindicated...

Outcome of scorpion sting envenomation after a protocol guided therapy.

OBJECTIVE: Scorpion sting (SS) envenomation is a life threatening emergency in children, though not so severe in adults. Attempt to develop protocol using prazosin and dobutamine and few other drugs to treat SS. METHODS: Children aged 0-13 years with a history of scorpion sting were studied. Clinical features, complications, drug therapy and outcome of the cases for the period 1992-97(N = 186) was collected by the authors and also from the medical records department (RETROSPECTIVE GROUP). Cases treated during 1997-2000 (N = 198) as per the protocol were recorded as PROSPECTIVE GROUP. All the cases were observed for at least for 24 hours. Cases coming within 4 hours of a sting were given a dose of Prazosin (30 mic.gm/Kg/dose) and were observed. Those who came after 4 hours & were asymptomatic received only symptomatic treatment. Cases with signs of envenomation received Prazosin every 6 hourly till recovery. Cases having acute pulmonary edema (APE) were treated with dobutamine and sodium nitroprusside drip. Complicated cases were monitored in PICU as per the protocol. RESULT: Complications associated with excessive parasympathetic and sympathetic stimulation were observed. Myocarditis was observed due to the toxin and excessive catecholamine, which complicated in left ventricular failure (LVF) and APE. Nearly half of the children with acute myocarditis developed APE. Death was mainly due to myocarditis and APE, with or without encephalopathy. Mortality was high in children who received steroid and antihistaminics outside and who came late (> 4 hours). CONCLUSION: Complication rate remained almost same in both the groups. There was a significant reduction in overall mortality (P = < 0.0155) and in deaths associated with APE (P = < 0.0001) after the protocol guided therapy. There was also a reduction in mortality in encephalopathy group though not statistically significant. This treatment protocol and aggressive management of APE reduced the mortality due to SS significantly.

Intravenous ascorbic acid as a treatment for severe jellyfish stings

We report a case of jellyfish envenomation in a 39 year old male. He was stung extensively on both lower limbs by an unidentified jellyfish. This occurred in shallow waters of a beach in the vicinity of Labuan Island, Malaysia. The patient received ambulatory treatment with parenteral and oral ascorbate with remarkable recovery

Acidentes humanos com macacos em relação a tratamentos profiláticos para a raiva, no Município de São Paulo, Brasil / Human accidents with monkeys in relation to prophylactic treatment for rabies, in the Municipal district of Säo Paulo, Brazil

Apesar do Município de São Paulo apresentar a raiva sob controle epidemiológico ( último caso de raiva em humanos foi registrado em 1981) e de 95,4 por cento de sua populaçäo residir na área urbana, se registram casos de acidentes humanos envolvendo animais silvestres e dentre estes, os macacos estäo envolvidos no maior número de casos. No período de 1996 a 1999 foram atendidas 69.967 pessoas vítimas de acidentes com animais, das quais 267 acidentes com macacos. Neste trabalho se estuda a incidência mensal e anual da ocorrência destes acidentes, bem como os tratamentos antirábicos realizados

Centipede (Scolopendra gigantea Linneaus 1758) envenomation in a newborn

The first case of centipede (Scolopendra gigantea Linneaus 1758) envenomation in a newborn is reported. When first examined, approximately 6 hours after the bite, the 28-day-old girl was irritable, with uncontrollable cry and intense local pain, oedema, local hyperthermia, and blood clots at punctures. Uncontrollable crying in neonates should rise the possibility of an insect or arachnid sting

Infección secundaria a mordedura de gato / Secondary infection due to cat bite

Se presenta un caso de mordedura de gato en una persona adulta. Se discuten las principales infecciones secundarias a este tipo de lesiones

Lesiones faciales por mordeduras de humanos y de animales / Facial injuries by human and animal bites

Se presenta una revisión de la literatura así como de la experiencia en el Hospital Central Dr. Ignacio Morones Prieto en el tratamiento de las mordeduras por humanos y por animales. El tratamiento temprano a base de la revisión quirúrgica y cierre primario, así como la antiobioticoterapia adecuada, dan el éxito buscado

Tratamiento de la picadura de alacrán con bromuro de ipratropio / Treatment of the scorpion bite with ipratropio bromide

En el presente estudio se evaluó de manera comparativa la eficacia y seguridad del bromuro de ipratropio en aerosol y la clorfenamina por vía i.v. en el tratamiento de la picadura por alacrán de grado moderado a grave. Los resultados fueron: 1. Ambos tratamientos evitaron la evolución del cuadro a intensidad más grave. 2. Los síntomas de sialorrea y lengua reptante desaparecieron más rápidamente con el bromuro de ipratropio. 3. Los efectos colaterales fueron menores con el bromuro de ipratropio. 4. Aunque se produce somnolencia en ambos grupos, el bromuro de ipratropio no ocasiona confusión mental. 5. La aplicación en aerosol del bromuro de ipratropio es más fácil y menos costosa.

Tratamiento de mordeduras de mamíferos / Treatment of mammal bites

Se estima que cada año en Estados Unidos un millón de niños y adultos requieren tratamiento a causa de mordedura de animales domésticos o salvajes. Aunque la mitad de las lesiones son de poca importancia, algunas son graves (se han informado muertes causadas por mordedura o sus complicaciones). Ante una herida por traumatismo, la consideración más importante es la infección local o general, dado que la flora patógena bucal penetra en desgarres o lesiones profundas; creando fuentes de infección. Luego entonces, considere el cuidado de la herida al igual que la profilaxis y terapéutica antibiótica. Aunque la rabia es rara, el clínico ha de establecer si es o no necesaria la inmunización debido a que dicha enfermedad casi siempre es mortal