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2.
Science ; 367(6485)2020 03 27.
Article in English | MEDLINE | ID: mdl-32217702

ABSTRACT

Marine food-reliant subsistence systems such as those in the African Middle Stone Age (MSA) were not thought to exist in Europe until the much later Mesolithic. Whether this apparent lag reflects taphonomic biases or behavioral distinctions between archaic and modern humans remains much debated. Figueira Brava cave, in the Arrábida range (Portugal), provides an exceptionally well preserved record of Neandertal coastal resource exploitation on a comparable scale to the MSA and dated to ~86 to 106 thousand years ago. The breadth of the subsistence base-pine nuts, marine invertebrates, fish, marine birds and mammals, tortoises, waterfowl, and hoofed game-exceeds that of regional early Holocene sites. Fisher-hunter-gatherer economies are not the preserve of anatomically modern people; by the Last Interglacial, they were in place across the Old World in the appropriate settings.


Subject(s)
Diet , Neanderthals , Animal Shells , Animals , Archaeology , Atlantic Ocean , Birds , Caves , Fishes , Mammals , Nuts , Pinus , Portugal , Seafood , Turtles
3.
Ramanujan J ; 49(2): 421-449, 2019.
Article in English | MEDLINE | ID: mdl-31258382

ABSTRACT

We study Fourier-Bessel series on a q-linear grid, defined as expansions in complete q-orthogonal systems constructed with the third Jackson q-Bessel function, and obtain sufficient conditions for uniform convergence. The convergence results are illustrated with specific examples of expansions in q-Fourier-Bessel series.

4.
J. venom. anim. toxins incl. trop. dis ; 17(1): 66-73, 2011. ilus, graf
Article in English | LILACS | ID: lil-576884

ABSTRACT

Freshwater sponges are abundant in the Amazon region and they have been known to cause dermatitis (acute inflammation) since the beginning of the 20th century. To determine whether additional constituents, besides their body spicules, cause dermatological reactions in humans, an experimental study was developed and carried out using mice and Drulia uruguayensis prepared in three different forms: intact sponges (IS), macerated sponges (MS) or isolated spicules - megascleres (ISM). The cells most commonly involved in inflammatory reactions (mast cells, eosinophils and neutrophils), as well as intraepithelial lymphocytes and degranulated mast cells, were counted so that they could be used as parameters to determine which of the sponge preparations induced the greatest reaction. The effects of the sponge on the skin were then determined by histological analysis. The results obtained showed that IS caused the greatest inflammatory reaction (p = 0.000005), activating mainly mast cells (p = 0.0018). The histopathological analysis revealed a slight loss of continuity of the epidermis when ISM or IS were applied. These findings allow us to conclude that a structurally intact sponge can cause a greater inflammatory reaction in the first contact because of its ability to perforate the skin and allow inflammatory agents to enter. Other proteins present in dried sponge bodies could induce allergic but not toxic responses (in contact with the entire sponge, a large number of pharmacologically inert proteins may be introduced, with a potential allergen).


Subject(s)
Animals , Female , Badiaga/adverse effects , Badiaga/toxicity , Dermatitis , Amazonian Ecosystem , Mice
5.
Rev. bras. plantas med ; 13(3): 359-366, 2011. tab
Article in Portuguese | LILACS | ID: lil-601044

ABSTRACT

O uso milenar de plantas medicinais mostrou ao longo dos anos, que determinadas plantas apresentam substâncias potencialmente perigosas. Do ponto de vista científico, algumas pesquisas mostraram que muitas dessas plantas possuem substâncias agressivas e por essa razão devem ser utilizadas com cuidado, respeitando seus riscos toxicológicos. Os efeitos mais preocupantes do uso indiscriminado de plantas medicinais são embriotóxico, teratogênico e abortivo, uma vez, que os constituintes da planta podem atravessar a placenta, chegar ao feto e gerar um desses efeitos. Este estudo objetiva fornecer uma listagem das principais plantas medicinais que tenham efeitos embriotóxicos, teratogênicos e abortivos comprovados, conhecendo as partes da planta utilizadas e seus respectivos nomes científicos, com a finalidade de alertar gestantes quanto aos riscos de seu uso. Realizou-se buscas nas bases eletrônicas de dados SciELO, PubMed, MEDLINE, LILACS, CAPES e Google acadêmico. Nos resultados encontrados, plantas como Arnica (Arnica montana), Artemísia (Artemisia vulgaris), Arruda (Ruta chalepensis/ Ruta graveolens), Barbatimão (Stryphnodendron polyphyllum), Boldo (Vernonia condensata) dentre outras, podem vir a gerar um desses efeitos. A partir deste estudo comprova-se que para a maioria das plantas medicinais não há dados a respeito da segurança de seu uso durante a gravidez.


The ancient use of medicinal plants has shown over the years that certain plants have potentially dangerous substances. From a scientific point of view, some studies have shown that many of these plants contain aggressive substances and therefore should be used with caution, respecting their toxicological risks. The most important effects of the indiscriminate use of medicinal plants are embryotoxic, teratogenic and abortifacient since the plant constituents can cross the placenta, reaching the fetus and leading to one of these effects. This study aimed to provide a list of the major medicinal plants that have proven embryotoxic, teratogenic and abortifacient effects, including the used plant parts and their respective scientific names, in order to warn pregnant women about the risks of its use. Searches were carried out in the electronic databases SciELO, PubMed, MEDLINE, LILACS, CAPES and Google Scholar. Results indicated that plants such as mountain arnica (Arnica montana), mugwort (Artemisia vulgaris), fringed rue (Ruta chalepensis / Ruta graveolens), "Barbatimão" (Stryphnodendron polyphyllum) and "Boldo" (Vernonia condensata) are likely to generate such an effect. This study shows that for most medicinal plants there are not data regarding the safety of their use during pregnancy.


Subject(s)
Abortifacient Agents , Plants, Medicinal , Teratogens , Toxic Substances , Embryonic Structures , Fetus/abnormalities , Fetus , Pregnancy
7.
Toxicon ; 52(5): 606-10, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18706923

ABSTRACT

We retrospectively analyzed 98 proven cases of centipede stings admitted to Hospital Vital Brazil, Butantan Institute, São Paulo, Brazil, between 1990 and 2007. Most stings occurred at the metropolitan area of São Paulo city (n=94, 95.9%), in the domiciles of patients (n=67, 68.4%), and during the warm-rainy season (n=60, 61.2%). The mean age of the victims was 32.0+/-18.8-years-old. Cryptops and Otostigmus genera were responsible for most cases. Around 86% of the patients sought medical care within 6h after the sting. Both lower (56.1 %) and upper limbs (41.8 %) were most frequently bitten, especially the feet and hands (89.8%). The most frequent local clinical manifestations were pain (94.9%), erythema (44.9%) and edema (21.4%), and the latter was mainly observed in patients bitten by Otostigmus spp. Supportive treatment was used in only 28.6% of the patients, namely administration of local anesthesia (9.2%) and systemic analgesia (13.3%). No sequels or complications were observed in patients, and the prognostic was benign.


Subject(s)
Arthropods , Bites and Stings/epidemiology , Adolescent , Adult , Animals , Brazil/epidemiology , Female , Hospitals , Humans , Male , Retrospective Studies
8.
Trans R Soc Trop Med Hyg ; 98(9): 529-34, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15251401

ABSTRACT

Bites by many species of venomous snake may result in local necrosis at, or extending from, the site of the bite. The use of prophylactic antibiotics to prevent infection as a complication of local necrotic envenoming is controversial. A double-blind randomized controlled trial was carried out to assess whether antibiotic therapy is effective in this situation. Two hundred and fifty-one patients, with proven envenoming by snakes of the genus Bothrops, admitted to two hospitals in Brazil, between 1990 and 1996, were randomized to receive either oral chloramphenicol (500 mg every six hours for five days) or placebo. One hundred and twenty-two of these patients received chloramphenicol (group 1) and 129 were given placebo (group 2). There were no significant differences between the groups at the time of admission. Necrosis developed in seven (5.7%) patients in group 1 and in five (3.9%) patients in group 2 (P>0.05) while abscesses occurred in six patients (4.9%) in group 1 and in six (4.7%) patients in group 2 (P>0.05). In conclusion, the use of orally-administered chloramphenicol for victims of Bothrops snake bite with signs of local envenoming on admission, is not effective for the prevention of local infections.


Subject(s)
Abscess/prevention & control , Anti-Bacterial Agents/administration & dosage , Bothrops , Chloramphenicol/administration & dosage , Snake Bites/complications , Abscess/epidemiology , Abscess/etiology , Administration, Oral , Adolescent , Adult , Animals , Brazil/epidemiology , Child , Child, Preschool , Double-Blind Method , Female , Humans , Infant , Male , Middle Aged , Necrosis/prevention & control , Snake Bites/drug therapy , Snake Bites/epidemiology , Treatment Outcome
9.
Braz J Med Biol Res ; 36(3): 309-13, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12640494

ABSTRACT

Eighty micrograms red blood cell (RBC) ghosts from patients who had previously exhibited the cutaneous form of loxoscelism (presenting localized dermonecrosis) and the viscerocutaneous form of loxoscelism (presenting dermonecrosis, hemoglobinuria, hematuria, and jaundice) and from controls were incubated with 2.5 microg crude Loxosceles gaucho venom in 5 mM phosphate buffer, pH 7.4, at 37 C. Among all membrane proteins, quantitative proteolysis of the important integral transmembrane protein 3 increased with venom dose and with incubation time from 30 to 120 min, as demonstrated by gel densitometry. Similar quantitative data were obtained for RBC ghosts from patients and from control subjects, a fact that argues against the possibility of genetic factors favoring the hemolytic viscerocutaneous form. These data suggest that the clinical forms may be different types of the same disease, with the viscerocutaneous form being the result of large amounts of intravascularly injected venom and the superficial form being the result of in situ venom action. Since protein 3 is a housekeeping integral membrane protein, whose genetic deficiency leads to hemolytic anemia, it is reasonable to relate it to the hemolysis which occurs in the viscerocutaneous form of loxoscelism. The venom protease responsible for the process was not inhibited after 120-min incubation by 0.2 mM paramethylsulfonyl fluoride or by 0.2 mM N-ethylmaleimide but was inhibited by 25 mM ethylenediaminetetraacetic acid (a calcium-chelating agent) in 5 mM phosphate buffer at pH 7.4, which suggests that the enzyme is a calcium-dependent metalloprotease.


Subject(s)
Erythrocyte Membrane/drug effects , Hemolysis/drug effects , Serine Endopeptidases/pharmacology , Spider Venoms/enzymology , Animals , Case-Control Studies , Densitometry , Electrophoresis, Polyacrylamide Gel , Humans , Hydrolysis , Membrane Proteins/drug effects , Phosphoric Diester Hydrolases , Snake Bites/blood
10.
Braz. j. med. biol. res ; 36(3): 309-313, Mar. 2003. ilus, tab
Article in English | LILACS | ID: lil-329455

ABSTRACT

Eighty micrograms red blood cell (RBC) ghosts from patients who had previously exhibited the cutaneous form of loxoscelism (presenting localized dermonecrosis) and the viscerocutaneous form of loxoscelism (presenting dermonecrosis, hemoglobinuria, hematuria, and jaundice) and from controls were incubated with 2.5 æg crude Loxosceles gaucho venom in 5 mM phosphate buffer, pH 7.4, at 37ºC. Among all membrane proteins, quantitative proteolysis of the important integral transmembrane protein 3 increased with venom dose and with incubation time from 30 to 120 min, as demonstrated by gel densitometry. Similar quantitative data were obtained for RBC ghosts from patients and from control subjects, a fact that argues against the possibility of genetic factors favoring the hemolytic viscerocutaneous form. These data suggest that the clinical forms may be different types of the same disease, with the viscerocutaneous form being the result of large amounts of intravascularly injected venom and the superficial form being the result of in situ venom action. Since protein 3 is a housekeeping integral membrane protein, whose genetic deficiency leads to hemolytic anemia, it is reasonable to relate it to the hemolysis which occurs in the viscerocutaneous form of loxoscelism. The venom protease responsible for the process was not inhibited after 120-min incubation by 0.2 mM paramethylsulfonyl fluoride or by 0.2 mM N-ethylmaleimide but was inhibited by 25 mM ethylenediaminetetraacetic acid (a calcium-chelating agent) in 5 mM phosphate buffer at pH 7.4, which suggests that the enzyme is a calcium-dependent metalloprotease


Subject(s)
Animals , Erythrocyte Membrane , Hemolysis , Metalloendopeptidases , Spider Venoms , Case-Control Studies , Densitometry , Electrophoresis, Polyacrylamide Gel , Hydrolysis , Phosphoric Diester Hydrolases
11.
Trans R Soc Trop Med Hyg ; 97(3): 312-7, 2003.
Article in English | MEDLINE | ID: mdl-15228251

ABSTRACT

The association between the clinical severity of Bothrops jararaca envenoming at admission and serum venom and plasma fibrinogen concentrations before antivenom administration is reported in 137 patients admitted to Hospital Vital Brazil, Instituto Butantan, São Paulo, Brazil, between 1989 and 1990. Other variables such as age, gender, site of the bite, use of tourniquet and the time interval between the bite and start of antivenom therapy, spontaneous systemic bleeding, and the 20 minute whole blood clotting test (20WBCT) at admission showed no association with either severity or serum venom antigen concentration (SVAC). Mean SVAC in patients with mild envenoming was significantly lower than in the group with moderate envenoming (P = 0.0007). Patients with plasma fibrinogen concentrations > 1.5 g/L had a lower mean SVAC than patients with plasma fibrinogen concentrations < or = 1.5 g/L (P = 0.02). Those admitted with a tourniquet in place had significantly higher plasma fibrinogen concentrations than those without a tourniquet (P = 0.002). A multiple logistic regression model showed independent risk factors for severity: bites at sites other than legs or forearms, SVACs > or = 400 ng/mL, and the use of a tourniquet. Rapid quantification of SVAC before antivenom therapy might improve initial evaluation of severity in B. jararaca bites.


Subject(s)
Bothrops/immunology , Crotalid Venoms/immunology , Snake Bites/immunology , Adolescent , Adult , Aged , Animals , Antigens/blood , Antivenins/administration & dosage , Blood Coagulation , Child , Female , Fibrinogen/metabolism , Hospitalization , Humans , Male , Middle Aged , Risk Factors , Severity of Illness Index , Snake Bites/blood , Snake Bites/therapy
12.
Trans R Soc Trop Med Hyg ; 96(3): 275-6, 2002.
Article in English | MEDLINE | ID: mdl-12174777

ABSTRACT

A 4 years old boy died a few hours after he had been stung by a scorpion (Tityus serrulatus). At necropsy, there were multiple foci of coagulative myocytolysis in the myocardium and pulmonary oedema. Myocardial necrosis was probably associated with the sympathetic storm induced by scorpion envenomation, and may have contributed to cardiac failure and death.


Subject(s)
Cardiomyopathies/pathology , Scorpion Stings/pathology , Scorpion Venoms/poisoning , Scorpions , Animals , Cardiomyopathies/etiology , Child, Preschool , Death, Sudden , Fatal Outcome , Humans , Male , Necrosis , Pulmonary Edema/etiology , Scorpion Stings/complications
13.
Rev Inst Med Trop Sao Paulo ; 43(3): 171-2, 2001.
Article in English | MEDLINE | ID: mdl-11452328

ABSTRACT

The authors report five cases of seabather's eruption, a typical dermatitis associated predominantly to the jellyfish Linuche unguiculata (Cnidaria), that causes erythematous and pruriginous papules on areas of the skin of bathers covered by swimsuits. The rash is characteristic and the eruption is commom in the Caribbean, Florida, Mexico and Gulf States of USA. The cases are the first reported in Brazil and larvae of the jellyfish are present in the waters where the accidents happened.


Subject(s)
Dermatitis/etiology , Pruritus/etiology , Scyphozoa , Adolescent , Animals , Brazil , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Seawater
14.
BMJ ; 318(7196): 1451-2, 1999 May 29.
Article in English | MEDLINE | ID: mdl-10346769

ABSTRACT

OBJECTIVE: To investigate the efficacy of the H1 antihistamine promethazine against early anaphylactic reactions to antivenom. DESIGN: Sequential randomised, double blind, placebo controlled trial. SETTING: Public hospital in a venom research institute, São Paulo, Brazil. PARTICIPANTS: 101 patients requiring antivenom treatment after being bitten by bothrops snakes. INTERVENTION: Intramuscular injection of promethazine (25 mg for adults and 0.5/kg for children) or placebo given 15-20 min before starting intravenous infusion of antivenom. MAIN OUTCOME MEASURES: Incidence and severity of anaphylactic reactions occurring within 24 hours after antivenom. RESULTS: Reactions occurred in 12 of 49 patients treated with promethazine (24%) and in 13 of 52 given placebo (25%); most were mild or moderate. Continuous sequential analysis indicated that the study could be interrupted at the 22nd untied pair, without preference for promethazine or placebo. CONCLUSION: Prophylaxis with promethazine does not prevent early reactions. Patients should be observed carefully during antivenom infusion and the subsequent few hours.


Subject(s)
Anaphylaxis/prevention & control , Antivenins/adverse effects , Bothrops , Histamine H1 Antagonists/therapeutic use , Promethazine/therapeutic use , Snake Bites/drug therapy , Adolescent , Adult , Animals , Child , Double-Blind Method , Female , Humans , Infusions, Intravenous , Injections, Intramuscular , Male
15.
Trans R Soc Trop Med Hyg ; 92(5): 546-8, 1998.
Article in English | MEDLINE | ID: mdl-9861376

ABSTRACT

A clinical and epidemiological study of 267 cases of envenomation by Loxosceles spp. (loxoscelism), notified to Centro de Informações Toxicológicas de Florianópolis (Santa Catarina State, Brazil), was conducted between January 1985 and December 1995. Most of the incidents occurred along the coast of the mid-southern region of the state, during the warmest months. L. laeta and L. intermedia were identified as the causative agents. Cutaneous loxoscelism was clinically diagnosed in 232 (86.9%) patients with local pain (86.5%), oedema (80.5%), hyperaemia (79.8%) and necrosis (56.9%). Cutaneous-visceral loxoscelism was detected in 35 patients (13.1%) with intravascular haemolysis, manifested by jaundice (68.6%), oliguria (45.7%), dark urine (28.6%), haemorrhage (25.7%), anuria (8.6%) and shock (2.9%), besides the cutaneous effects. Specific antivenom was given to 125 patients (46.8%) and only 8 (6.5%) had mild reactions. Acute renal failure was observed in 17 cases (6.4%); 4 patients (1.5%) died, all of whom were children under 14 years old.


Subject(s)
Spider Bites/epidemiology , Spider Venoms/poisoning , Acute Kidney Injury/etiology , Adolescent , Adult , Antivenins/adverse effects , Antivenins/therapeutic use , Blister/etiology , Brazil/epidemiology , Child , Female , Humans , Jaundice/etiology , Male , Retrospective Studies , Ulcer/etiology
17.
Rev Inst Med Trop Sao Paulo ; 40(2): 119-20, 1998.
Article in English | MEDLINE | ID: mdl-9755567

ABSTRACT

A case of a 37-week pregnant woman who developed a hemorrhagic syndrome and acute renal failure after contact with Lonomia caterpillars is reported. The accident also initiated labour and the patient gave birth to an alive child. Some pathophysiological aspects of the genital bleeding and of the acute renal failure are discussed.


Subject(s)
Acute Kidney Injury/etiology , Insect Bites and Stings/complications , Moths , Pregnancy Complications/etiology , Uterine Hemorrhage/etiology , Adult , Animals , Female , Humans , Infant, Newborn , Obstetric Labor, Premature/etiology , Pregnancy , Syndrome
18.
Am J Trop Med Hyg ; 58(2): 183-9, 1998 Feb.
Article in English | MEDLINE | ID: mdl-9580075

ABSTRACT

The therapeutic efficacy and the incidence of early antivenom reactions (EARs) were compared in a clinical trial performed in 79 patients bitten by Bothrops sp. in Urabá, Colombia. Patients were randomized into three groups according to the antivenom administered: A (n = 30, Butantan polyspecific, pepsin-digested Bothrops antivenom); B (n = 27, Butantan polyspecific, whole IgG Bothrops antivenom); and C (n = 22, Colombian commercial, monovalent, whole IgG Bothrops antivenom). The groups were comparable in all clinical and epidemiologic aspects; 33 patients had mild, 22 moderate, and 24 severe envenoming. At the doses used (two, four, and six vials [10 ml/vial] for mild, moderate, and severe envenomings, respectively) there were no differences between the antivenoms in restoring normal hemostatic parameters within 24 hr. The evolution of local envenoming was comparable in the three groups. Serum venom/antivenom kinetics determined by ELISA showed a complete clearance of venom levels 1 hr after treatment in mild/moderate envenomings. In severe cases, venom levels remained detectable up to 24 hr and recurrence of antigenemia was observed in some cases. Antivenom concentrations remained at high levels up to 24 hr of treatment. The incidence of EARs was significantly different in the groups: A (36.7%), B (11.1.%), and C (81.8%). There were no life-threatening anaphylactic reactions. We conclude that the efficacy of the three antivenoms was similar in neutralizing human Bothrops envenomings and that the production of whole IgG antivenoms by caprylic acid fractionation is a good alternative for reducing the incidence of EARs.


Subject(s)
Antivenins/therapeutic use , Bothrops , Crotalid Venoms/immunology , Immunoglobulin G/therapeutic use , Snake Bites/therapy , Adolescent , Adult , Aged , Animals , Antivenins/adverse effects , Antivenins/metabolism , Child , Child, Preschool , Colombia , Crotalid Venoms/blood , Double-Blind Method , Fibrinogen/analysis , Humans , Immunoglobulin G/adverse effects , Middle Aged , Pepsin A/metabolism , Snake Bites/physiopathology
19.
Thromb Res ; 87(2): 183-95, 1997 Jul 15.
Article in English | MEDLINE | ID: mdl-9259109

ABSTRACT

Patients bitten by the lancehead snake Bothrops jararaca usually develop systemic bleeding. Our aim was to evaluate platelet function in whole blood of 17 human patients bitten by this snake in São Paulo State, Brazil. Bleeding occurred in 71% of these patients, and thrombocytopenia in 53% of them. On admission, most of the patients presented with hypoaggregation to 50 microM ADP and 1.2 mg/ml ristocetin, and only 35% of them to 5 micrograms/ml collagen. Abnormal plasma levels of fibrinogen and fibrin(ogen) degradation products (FDP/fdp) were also observed. Twenty-four hours of finishing serumtherapy, bleeding had already ceased, fibrinogen and FDP/fdp levels returned to hemostatic levels, and values for platelet aggregation returned to the reference range of controls, except for ADP that still remained decreased. These findings evidence that disturbances of platelet function are also an important factor for the development of bleeding in Bothrops envenomation, as well as other known hemostatic disturbances that occur concomitantly.


Subject(s)
Bothrops , Crotalid Venoms , Platelet Aggregation , Snake Bites/blood , Adolescent , Adult , Aged , Animals , Female , Humans , Male , Middle Aged
20.
QJM ; 90(5): 323-34, 1997 May.
Article in English | MEDLINE | ID: mdl-9205667

ABSTRACT

The jararacuçu, one of the most dreaded snakes of Brazil, southern Bolivia, Paraguay and northeastern Argentina, is a heavily-built pit viper which may grow to a length of 2.2 m. Up to 1000 mg (dry weight) of highly-lethal venom may be milked from its venom glands on a single occasion. It has accounted for 0.8% to 10% of series of snake bites in São Paulo State, Brazil. We examined 29 cases of proven jararacuçu bites recruited over a 20-year period in two São Paulo hospitals. Severe signs of local and systemic envenoming, (local necrosis, shock, spontaneous systemic bleeding, renal failure) were seen only in patients bitten by snakes longer than 50 cm; bites by shorter specimens were more likely to cause incoagulable blood. Fourteen patients developed coagulopathy, six local necrosis (requiring amputation in one) and five local abscesses. Two became shocked and four developed renal failure. Three patients, aged 3, 11 and 65 years, died 18.75, 27.75 and 83 h after being bitten, with respiratory and circulatory failure despite large doses of specific antivenom and intensive-care-unit management. In two patients, autopsies revealed acute renal tubular necrosis, cerebral oedema, haemorrhagic rhabdomyolysis at the site of the bite and disseminated intravascular coagulation. In one survivor with chronic renal failure, renal biopsy showed bilateral cortical necrosis; the patient remains dependent on haemodialysis. Effects of polyspecific Bothrops antivenom were not impressive, and it has been suggested that anti-Bothrops and anti-Crotalus antivenoms should be given in combination.


Subject(s)
Bothrops , Snake Bites/therapy , Adult , Aged , Animals , Antivenins/administration & dosage , Blood Coagulation Disorders/etiology , Brazil , Child , Child, Preschool , Crotalid Venoms/analysis , Fatal Outcome , Female , Humans , Kidney Failure, Chronic/etiology , Male , Prospective Studies , Retrospective Studies , Rhabdomyolysis/etiology , Snake Bites/mortality , Snake Bites/pathology
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