Human injuries and fatalities due to venomous marine snails of the family Conidae.

OBJECTIVE: This paper provides the first compilation in more than 30 years of human injuries and fatalities from envenomation by marine gastropod molluscs of the predominantly tropical family Conidae. It seeks to apply recent advances in knowledge of the physiological effects of conopeptides and molecular genetics to improve our understanding of the human responses to stings by species that normally use their venom peptides to paralyze and overcome prey such as polychaete worms, other gastropod molluscs, and fishes. RESULTS: A database has been constructed for the 139 cases accepted as reliably reporting each human injury. It includes data on the species responsible, the time and place where the stinging occurred and the sting site on the victim's body, the time-course of clinical effects, treatment carried out, if any, and outcome. Members of the hyperdiverse genus Conus caused all the injuries, except for 2 cases involving species from the recently separated genus Conasprella. Death occurred in 36 cases, 57 cases presented with serious symptoms but recovered completely, and in 44 cases victims were only minimally affected. A few cases are listed as tentative because the information in the reports was limited or unverifiable. Many cases have undoubtedly gone unreported and been forgotten. No cases are known for the period between the date of the first reliable report in the 17th century, and the mid-19th century. Knowledge of conopeptide molecular structure and function has recently burgeoned, permitting initial exploration of relationships between the symptoms and outcomes of human injuries and modes of action of these mainly small, very toxic neuroactive peptides. These relationships are reviewed here, especially in regard to the severe and fatal cases, with the aim of making recent knowledge accessible to clinicians and others involved in treating the effects of human stings, which continue to be reported. CONCLUSIONS: Conus geographus, a specialized predator of fishes, which it paralyzes with its venom and swallows whole, is the most dangerous species to humans. It accounts for about half of the known human envenomations and almost all the fatalities. Children succumb more often to C. geographus stings than adults and stings by larger snails are lethal more often than stings from smaller snails, regardless of the victim's age. Other piscivorous Conus species have stung humans, but with nonlethal results. A few species that normally prey on other gastropods have also seriously injured humans, but most of the fatalities reported have not been confirmed. Most species of Conidae prey only on marine worms; 18 of these species are known to have stung humans, with generally mild effects. Research on the treatment of Conus stings has lagged behind that on the application of conopeptides in pharmacological research and in the development of new pharmaceuticals. However, improved communication and availability of medical aid in remote tropical areas has likely contributed to reducing the mortality rate during the last half century.

Candiru--a little fish with bad habits: need travel health professionals worry? A review.

BACKGROUND: Over the last 150 years, a little South American fish with alleged unsavory habits has become the stuff legends are made of. With growing visitor numbers to the Amazon basin, the question of whether the animal poses a threat to the many travelers to the region arises. METHODS: Scientific literature was identified by searching MEDLINE, ScienceDirect, ProQuest, and Google Scholar. The reference lists of all obtained sources served to refine the search, including the original historical writings where obtainable. Nonscientific material was discovered through extensive web searches. RESULTS: First, the current popular understanding of the fish and its interaction with humans are presented followed by an overview of the historical literature on which this understanding is based. Next, the fish and its supposed attraction to humans are introduced. Finally, this review queries the evidence current medical advice utilizes for the prevention of attacks and the treatment of unfortunate hosts. CONCLUSIONS: Until evidence of the fish's threat to humans is forthcoming, there appears to be no need for considering the candiru in health advice for travelers to the Amazon.

[The attempts of Bishop Ivan Sintic (1792-1837) to treat snake and other animal bites: from intuition to scientific dispute]. / Pokusaji krckog Biskupa Ivana Antuna Sintica (1972. -1837.) U lijecenju otrovnih zmijskih i drugih zivotinjskih ujeda i uboda -od intuitivne slutnje do znanstvenog osporavanja.

This manuscript describes an attempt to treat snake and other animal bites using an ointment made of a plant Aster atticus (sternkraut, of the family Aster). The recipe for this ointment had passed from an Istrian Bernardo Alessandri to bishop Ivan Anton Sintic at the end of the 18th century. At the request by the Austrian administration of the Province of Zadar, Sintic published a booklet on how to prepare the plant and use it, and the administration distributed the booklet to local practitioners. Encouraged by the new therapy, physician Srecko Randic of Bakar, took it for the subject of his doctoral dissertation, an published it in Vienna in 1840. However, the efficiency of this therapy was disputed by the new island of Krk physician Ivan Krstitelj Kubic after years of follow up and investigation.

Investigation of Livingstone's curious point.

The explorer and missionary David Livingstone was identified after death by the appearances of his humerus which had been damaged in an encounter with a lion. In his writings Livingstone suggested that the consequences of the lion's attack were not as bad as he might have expected. He wondered if this was due to the fact that he was wearing a tartan jacket when he was attacked and suggested that this curious point should be investigated. This paper looks at some of the dyes used in tartans of the time and investigates their effect on the bacteria that might be present in the mouths of lions.

Struan Sutherland--Doyen of envenomation in Australia.

Struan Sutherland (1936-2002) was the doyen of medical research in the field of envenomation and the ultimate authority on the medical management of envenomated victims in Australia for almost 3 decades. In 1981 as Head of Immunology Research of Commonwealth Serum Laboratories (CSL), he produced an antivenom against the Sydney Funnel-web Spider (Atrax robustus)-an accomplishment that had defied numerous previous attempts. Struan also invented the pressure-immobilisation technique of first-aid for snake bite. This ingenious, simple but safe and effective technique revolutionised first-aid management of snake bite and of some other types of envenomation. It made redundant the use of tourniquets and other dangerous first-aid treatments. Similarly, he helped to develop a snake venom detection kit, which enables doctors working at a victim's bedside to ascertain which snake was responsible and which antivenom should be administered. He had a very wide range of research interests and was a prodigious researcher publishing over 200 scientific and medical articles, numerous chapters in books and the standard Australian medical textbook on the management of envenomation, Australian Animal Toxins. He made major contributions to the understanding of the venoms of Australia's remarkable range of fauna including snakes, spiders, Blue-ringed octopus, ants, jellyfish and stinging fish. Struan served the medical fraternity and the public selflessly. He was always available to doctors, or to anybody, to give advice at any hour of the day or night, on management of envenomated victims. Members of the Australian Venom Research Unit, which he founded in 1994 at The University of Melbourne, now continue this 24-h advisory service.

[Treatment of rabies in man in Vaud and Fribourg before Pateu: therapeutic observations of Drs. Guisan and Schaller in the 19th century]. / Le traitement de la rage chez l'homme dans les campagnes vaudoises et fribourgeoises avant Pasteur: les observations thérapeutiques des Drs Guisan et Schaller au milieu du XIXe siècle.

The picture showing the little Joseph Meister being treated against rabies under Louis Pasteur's eyes, on July 6, 1885, has quickly become a symbol of the triumphant progress of medicine, even though diseases with high mortality like tuberculosis or diphtheria could still not be healed with efficient therapeutic means. But before the discoveries of Pasteur, what was actually, in daily practice, the kind of response an ordinary doctor could give to human rabies? A Swiss physician, Charles-Hector Guisan, developed a therapy based on the use of sodium arsenate, which he published in the columns of the Gazette des Hôpitaux civils et militaires in 1854. This arsenic therapy was to be put into practice on a larger scale in the canton of Fribourg by Dr Jean-Louis Schaller (1816-1880), who meticulously wrote observations in a notebook on the cases of 13 persons wounded by a rabid dog in 1855.

[Dr. Tu Tsung-ming, a famous physician in Taiwan].

Dr. Tu had achieved great successes in the field of snake venom research in the middle of twenty-century in Taiwan. He ushered a new epoch in venomology from the epidemiological studies of the snake-bite to the chemical analysis of the venoms, from the venom harmful disadvantages to the venom beneficial advantages, and from the pharmacological research to the field of toxicological and biochemical research. He established a method for urine examination to detect the morphine residue. This method was then developed as a routine examination for excitant for athletics in later ages. Dr. Tu was the first professor of pharmacology in Taiwan and also a famous educator and historian in medical science with rather high achievement.

Escorpionismo en Girardot Hospital San Rafael: Enero-Junio de 1994

Objetivo: Identificar las principales caracteristicas clínicas de la picadura de escorpion y el manejo médico en nuestro medio, así como el comportamiento de las variables: sexo, edad, sitio y hora de las picaduras. Materiales y metodos: Se revisaron las historias desde enero 1 hasta junio 30 de 1994, partiendo de la base de datos del Hospital San Rafael de Girardot, donde estan clasificadas las enfermedades según el codigo internacional de enfermedades. Los datos fueron tabulados y anlizados independientemente para cada variable. resultados. Se revisaron 25 historias de picadura de escorpión, la cual fue más frecuente en mujeres (56 porciento), y en horas de la noche (73 porciento). Las manos y pies se constituyeron en las zonas del cuerpo más picadas, con 30 y 35 porciento respectivamente. Su variación con los meses no tuvo importancia. Los medicamentos más utilizados fueron los antihistaminicos (88 porciento), los glucocorticoides (32 porciento) y adrenalina (32 porciento). Concluciones: La picadura de escorpion es frecuente en girardot, su tratamiento no fue el más indicado

Resurgence of rabies. A historical perspective on rabies in children.

Wildlife rabies in certain parts of the United States has been increasing. With greater urbanization, many areas have seen an influx of wild animals such as raccoons and foxes that are known wildlife reservoirs of rabies. Rabies encephalitis has been a fatal illness recognized by humans throughout history. The purpose of this review is to examine the history of rabies throughout the world to elucidate the evolution of popular and scientific knowledge of the disease in animals and humans. By examining this development from a pediatric perspective, we gain insight into the prevention and treatment protocols recommended for children today. Pediatricians need to include education about prevention and treatment of rabies exposures in their anticipatory guidance sessions with families.

Antivenom research in Australia.

Australia has the most potent collection of venomous land and sea creatures in the world--something that settlers to this country discovered by bitter experience. Fortunately, today victims of bites from such animals may benefit from more effective and rational treatment than is available in most other countries.