Acidente crotálico seguido por primeiro episódio psicótico: um folclore clínico / Rattlesnake bite accident followed by first psychotic episode: a clinical folklore / Accidente crotálico seguido de primer episodio psicótico: un folclore clínico

Introdução: Acidentes ofídicos são doenças negligenciadas e constituem uma parcela importante da morbidade de pessoas em idade produtiva que vivem em zonas rurais. A maior parte dos seus efeitos a curto prazo é amplamente conhecida, especialmente aqueles de natureza clínica; no entanto, ainda se observa lacuna importante do conhecimento das consequências a longo prazo de tais agravos, notadamente as de ordem psíquica. Este artigo relata um caso de adoecimento mental subsequente a um acidente crotálico e gera reflexões de âmbito cultural e fisiopatológico a respeito das sequelas de tais eventos. Apresentação do caso: Trata-se de adolescente residente no interior baiano que foi vítima de mordedura por cascavel e teve necessidade de hospitalização em unidade de terapia intensiva. Observou-se que, mesmo após melhora clínica, iniciou com sintomas psicóticos prodrômicos e progrediu para piora mental grave, que culminou em internação psiquiátrica e diagnóstico de esquizofrenia no decorrer dos meses seguintes. Conclusões: Nota-se, neste caso, correlação direta entre esses dois eventos; mas, em razão da escassez de trabalhos científicos que abordem tais questões, depreende-se que é preciso investigar e estudar com maior profundidade possíveis associações entre acidentes crotálicos e psicoses.

Introduction: Snakebites are neglected diseases and constitute an important part of the morbidity of working-age people who live in rural areas. Most of their short-term effects are widely known, especially those of a clinical nature; however, there is still an important gap in the knowledge of the long-term consequences of such injuries, notably those of a psychotic nature. This article aims to report a case of mental illness subsequent to a rattlesnake bite accident and generate cultural and pathophysiological reflections regarding the consequences of such events. Case presentation: An adolescent residing in the interior of the state of Bahia was bitten by a rattlesnake and required hospitalization in an intensive care unit. It was observed that even after clinical improvement, the case started with prodromal psychotic symptoms and progressed to severe mental deterioration that culminated in psychiatric hospitalization and diagnosis of schizophrenia over the following months. Conclusions: In this case, there was a direct correlation between these two events, but because of the scarcity of scientific works that address such issues, it is necessary to investigate and study in greater depth possible associations between snakebite accidents and psychoses.

Introducción: Las mordeduras de serpientes son enfermedades desatendidas y constituyen una parte importante de la morbilidad de las personas en edad laboral que viven en zonas rurales. La mayoría de sus efectos a corto plazo son ampliamente conocidos, especialmente los de carácter clínico; sin embargo, todavía existe un importante vacío en el conocimiento de las consecuencias a largo plazo de este tipo de lesiones, en particular las de carácter psíquico. Este artículo tiene como objetivo informar un caso de enfermedad mental posterior a un accidente crotálico y generar reflexiones culturales y fisiopatológicas sobre las consecuencias de tales eventos. Presentación del caso: Se trata de un adolescente residente en el interior de Bahía que fue mordido por una serpiente cascabel y requirió hospitalización en unidad de cuidados intensivos. Se observó que, aún después de la mejoría clínica, comenzó con síntomas psicóticos prodrómicos y progresó a un deterioro mental severo que culminó con hospitalización psiquiátrica y diagnóstico de esquizofrenia en los meses siguientes. Conclusiones: En este caso, existe una correlación directa entre estos dos eventos pero, debido a la escasez de trabajos científicos que aborden tales cuestiones, parece necesario investigar y estudiar con mayor profundidad posibles asociaciones entre accidentes crotálicos y psicosis.

Fasciotomia em membro superior após síndrome compartimental por acidente ofídico com posterior enxertia e plástica em Z: relato de caso / Fasciotomy in the upper limb after compartment syndrome due to snakebite with subsequent grafting and z-plasty: case report

Este relato de caso aborda o curso clínico de um envenenamento botrópico ocorrido no município de Jarinu, SP, no ano de 2021. O paciente necessitou de fasciotomia em membro superior após síndrome compartimental aguda com enxertia dermoepidérmica em um segundo momento cirúrgico. No pós-operatório tardio, o paciente evoluiu com retração, necessitando de reabordagem cirúrgica com correção de retração de membro superior esquerdo. Discute-se a gravidade do acidente ofídico, efeitos do veneno nos tecidos, complicações, síndrome compartimental aguda, indicação e técnica da fasciotomia descompressiva com base na literatura.

This case study examines the clinical course of a Bothrops snakebite poisoning that occurred in Jarinu, São Paulo, Brazil, in 2021. The patient required a fasciotomy in the upper limb due to acute compartment syndrome, followed by a second surgical procedure involving dermo-epidermal grafting. In the late postoperative period, the patient experienced retraction, leading to a subsequent surgical intervention to correct the retraction in the left upper limb. The severity of the snakebite accident, the effects of venom on tissues, complications, acute compartment syndrome, as well as the indications and techniques for decompressive fasciotomy, are discussed based on the available literature.

Epidemiological profile of accidents involving venomous animals in Maranhão from 2012 to 2021 / Perfil epidemiológico de acidentes envolvendo animais peçonhentos no Maranhão no período de 2012 a 2021 / Perfil epidemiológico de los accidentes con animales venenosos en Maranhão de 2012 a 2021

Background and Objectives: the second greatest cause of human poisoning in Brazil is caused by venomous animals. Thus, this study aimed to analyze clinical and sociodemographic data, in order to outline the epidemiological profile of accidents involving venomous animals in Maranhão. Methods: this is an ecological study with a quantitative approach, carried out from data collection by the Notifiable Diseases Information System (SINAN) of notifications of accidents by venomous animals that occurred in the state of Maranhão from 2012 to 2021. Results: of the 34,808 cases reported, it was found that the highest incidence occurred in 2019 and, in general, January is the month in which most accidents are recorded. When analyzing the sociodemographic profile, it is noted that the majority of victims are represented by male individuals, between 20-39 years old, with an unidentified level of education. In the case of clinical and epidemiological criteria, it was evident that snakes of the genus Bothrops are responsible for the highest incidence, with most cases involving venomous animals occurring within 1-3 hours after the bite. Among the cases identified, 63% were described as mild and 82% progressed to cure. Conclusion: the epidemiological profile described in the study can be used by health agents to plan preventive measures in Primary Health Care, and knowing the profile of victims is essential to prevent and promote quality care.(AU)

Justificativa e Objetivos: a segunda maior causa de envenenamento humano no Brasil é ocasionada por animais peçonhentos. Dessa forma, este estudo visou analisar dados clínicos e sociodemográficos, a fim de traçar o perfil epidemiológico dos acidentes envolvendo animais peçonhentos no Maranhão. Métodos: trata-se de estudo ecológico de abordagem quantitativa, realizado a partir da coleta de dados pelo Sistema de Informações de Agravos de Notificação (SINAN) de acidentes por animais peçonhentos ocorridos no estado do Maranhão no período de 2012 a 2021. Resultados: dos 34.808 casos notificados, constatou-se que a maior incidência ocorreu no ano de 2019 e, em geral, janeiro é o mês em que mais se registram acidentes. Ao analisar o perfil sociodemográfico, nota-se que a maior parte das vítimas é representada por indivíduos do sexo masculino, entre 20 e 39 anos, com grau de escolaridade não identificado. Tratando-se de critérios clínicos e epidemiológicos, evidenciou-se que as serpentes do gênero Bothrops são as responsáveis pela maior incidência, sendo que a maior parte dos atendimentos envolvendo animais peçonhentos ocorreu no intervalo de 1-3 horas após a picada. Entre os casos identificados, 63% foram descritos como leve e 82% evoluíram para a cura. Conclusão: o perfil epidemiológico descrito no estudo pode ser utilizado por agentes de saúde para o planejamento de medidas preventivas na Atenção Primária à Saúde, e conhecer o perfil das vítimas é essencial para prevenir e promover uma assistência de qualidade.(AU)

Justificación y Objetivos: la segunda causa de envenenamiento humano en Brasil es causada por animales venenosos. Así, este estudio tuvo como objetivo analizar datos clínicos y sociodemográficos, con el fin de delinear el perfil epidemiológico de los accidentes con animales venenosos en Maranhão. Métodos: se trata de un estudio ecológico con abordaje cuantitativo, realizado a partir de la recolección de datos por el Sistema de Información de Enfermedades de Declaración Obligatoria (SINAN) de relatos de accidentes por animales ponzoñosos ocurridos en el estado de Maranhão entre 2012 y 2021. Resultados: de los 34.808 casos reportados, se encontró que la mayor incidencia ocurrió en 2019 y, en general, enero es el mes en el que se registran más accidentes. Al analizar el perfil sociodemográfico, se observa que la mayoría de las víctimas están representadas por personas del sexo masculino, entre 20-39 años, y con nivel de escolaridad no identificado. En el caso de los criterios clínicos y epidemiológicos, se evidenció que las serpientes del género Bothrops son las responsables de la mayor incidencia, y la mayoría de los casos que involucran animales venenosos ocurren entre 1 y 3 horas después de la mordedura. Entre los casos identificados, el 63% fueron descritos como leves y el 82% progresó hacia la curación. Conclusión: el perfil epidemiológico descrito en el estudio puede ser utilizado por los agentes de salud para planificar medidas preventivas en la atención básica de salud, y conocer el perfil de las víctimas es fundamental para prevenir y promover una atención de calidad.(AU)

Hide or die when the winds bring wings: predator avoidance by activity shift in a mountain snake.

BACKGROUND: Understanding predator-prey relationships is fundamental in many areas of ecology and conservation. In reptiles, basking time often increases the risk of predation and one way to minimise this risk is to reduce activity time and to stay within a refuge. However, this implies costs of lost opportunities for foraging, reproduction, and thermoregulation. We aimed to determine the main potential and observed predators of Vipera graeca, to infer predation pressure by estimating the incidence and the body length and sex distribution of predation events based on body injuries, and to assess whether and how the activity of V. graeca individuals is modified by predation pressure. RESULTS: We observed n = 12 raptor bird species foraging at the study sites, of which Circaetus gallicus, Falco tinnunculus and Corvus cornix were directly observed as predators of V. graeca. We found injuries and wounds on 12.5% of the studied individuals (n = 319). The occurrence of injuries was significantly positively influenced by the body length of vipers, and was more frequent on females than on males, while the interaction of length and sex showed a significant negative effect. The temporal overlap between predator and viper activity was much greater for the vipers' potential activity than their realised activity. Vipers showed a temporal shift in their bimodal daily activity pattern as they were active earlier in the morning and later in the afternoon than could be expected based on the thermal conditions. CONCLUSION: The time spent being active on the surface has costs to snakes: predation-related injuries increased in frequency with length, were more frequent in females than in males and occurred in shorter length for males than for females. Our results suggest that vipers do not fully exploit the thermally optimal time window available to them, likely because they shift their activity to periods with fewer avian predators.

Exploring the antibacterial potential of venoms from Argentinian animals.

The resistance to antimicrobials developed by several bacterial species has become one of the main health problems in recent decades. It has been widely reported that natural products are important sources of antimicrobial compounds. Considering that animal venoms are under-explored in this line of research, in this study, we screened the antibacterial activity of venoms of eight snake and five lepidopteran species from northeastern Argentina. Twofold serial dilutions of venoms were tested by the agar well-diffusion method and the minimum inhibitory concentration (MIC) determination against seven bacterial strains. We studied the comparative protein profile of the venoms showing antibacterial activity. Only the viperid and elapid venoms showed remarkable dose-dependent antibacterial activity towards most of the strains tested. Bothrops diporus venom showed the lowest MIC values against all the strains, and S. aureus ATCC 25923 was the most sensitive strain for all the active venoms. Micrurus baliocoryphus venom was unable to inhibit the growth of Enterococcus faecalis. Neither colubrid snake nor lepidopteran venoms exhibited activity on any bacterial strain tested. The snake venoms exhibiting antibacterial activity showed distinctive protein profiles by SDS-PAGE, highlighting that we could reveal for the first time the main protein families which may be thought to contribute to the antibacterial activity of M. baliocoryphus venom. This study paves the way to search for new antibacterial agents from Argentinian snake venoms, which may be a further opportunity to give an added value to the local biodiversity.

Conhecimentos sobre o manejo de vítimas do acidente botrópico no serviço de emergência / Knowledge about botropic accident victim management in emergency service / Conocimiento sobre el manejo de víctimas de accidentes botópicos en emergencia

Objetivo: identificar o conhecimento da equipe de enfermagem, no manejo do paciente vítima de acidente botrópico no serviço de emergência. Métodos: estudo descritivo, exploratório e com abordagem qualitativa. Desenvolvido em 2019, com profissionais da equipe de enfermagem do setor de emergência adulto de um Hospital Universitário. Utilizou-se entrevistas semiestruturadas, transcritas e analisadas por meio de estatística descritiva simples e análise de conteúdo. Resultados: participaram do estudo 34 profissionais da equipe de enfermagem, sendo 82% do sexo feminino, com média de idade de 37 anos. A análise de conteúdo revelou três categorias: conhecimento sobre acidentes por animais peçonhentos, trajetória acadêmica e profissional no contexto de animais peçonhentos e manejo da equipe de enfermagem do paciente vítima de acidente botrópico. Conclusão: os resultados demonstram o conhecimento e condutas da equipe de enfermagem frente ao acidente botrópico e evidenciam a necessidade de sensibilizar a equipe de enfermagem quanto ao reconhecimento do acidente ofídico, especialmente com relação às características apresentadas pelo animal peçonhento e as manifestações clínicas apresentadas pelo paciente. (AU)

Objective: to identify the knowledge of the nursing staff in dealing with bothropic accident victims in the emergency service. Methods: descriptive, exploratory study with a qualitative approach. Developed in 2019, with professionals from the nursing staff of the adult emergency sector of a University Hospital. A semi-structured interview was used, transcribed and analyzed using simple descriptive statistics and content analysis. Results: 34 professionals from the nursing team participated in the study, being 82% female, with an average age of 37 years. The content analysis revealed three categories: knowledge about accidents caused by poisonous animals, academic and professional trajectory in the context of poisonous animals and management of the nursing team to the patient victim of bothropic accidents. Conclusão: the results demonstrate the knowledge and behaviors of the nursing staff in face of bothropic accidents and highlight the need to sensitize the nursing staff regarding the recognition of the snakebite accident, especially regarding the characteristics presented by the venomous animal and the clinical manifestations presented by the patient. (AU)

Objetivo: identificar los conocimientos del equipo de enfermería en el manejo del paciente víctima de accidente botópico en el servicio de urgencias. Métodos: estudio descriptivo, exploratorio con abordaje cualitativo. Desarrollado en 2019, con profesionales del personal de enfermería del servicio de urgencias de adultos de un Hospital Universitario. Se utilizó una entrevista semiestructurada, transcrita y analizada mediante estadística descriptiva simple y análisis de contenido. Resultados: participaron en el estudio 34 profesionales del equipo de enfermería, de los cuales el 82% eran mujeres, con una edad promedio de 37 años. El análisis de contenido reveló tres categorías: conocimiento sobre accidentes causados por animales venenosos, trayectoria académica y profesional en el contexto de animales venenosos, y manejo del equipo de enfermería al paciente víctima de accidentes bottrópicos. Conclusión: los resultados demuestran el conocimiento y conducta del equipo de enfermería ante el accidente bottrópico y muestran la necesidad de sensibilizar al personal de enfermería sobre el reconocimiento del accidente de la serpiente, especialmente en lo que respecta a las características que presenta el animal venenoso y las manifestaciones clínicas que presenta el paciente. (AU)

Conservation of Major Satellite DNAs in Snake Heterochromatin.

Repetitive DNA sequences constitute a sizeable portion of animal genomes, and tandemly organized satellite DNAs are a major part of them. They are usually located in constitutive heterochromatin clusters in or near the centromeres or telomeres, and less frequently in the interstitial parts of chromosome arms. They are also frequently accumulated in sex chromosomes. The function of these clusters is to sustain the architecture of the chromosomes and the nucleus, and to regulate chromosome behavior during mitosis and meiosis. The study of satellite DNA diversity is important for understanding sex chromosome evolution, interspecific hybridization, and speciation. In this work, we identified four satellite DNA families in the genomes of two snakes from different families: Daboia russelii (Viperidae) and Pantherophis guttatus (Colubridae) and determine their chromosomal localization. We found that one family is localized in the centromeres of both species, whereas the others form clusters in certain chromosomes or subsets of chromosomes. BLAST with snake genome assemblies showed the conservation of such clusters, as well as a subtle presence of the satellites in the interspersed manner outside the clusters. Overall, our results show high conservation of satellite DNA in snakes and confirm the "library" model of satellite DNA evolution.

Predictors of genomic diversity within North American squamates.

Comparisons of intraspecific genetic diversity across species can reveal the roles of geography, ecology, and life history in shaping biodiversity. The wide availability of mitochondrial DNA (mtDNA) sequences in open-access databases makes this marker practical for conducting analyses across several species in a common framework, but patterns may not be representative of overall species diversity. Here, we gather new and existing mtDNA sequences and genome-wide nuclear data (genotyping-by-sequencing; GBS) for 30 North American squamate species sampled in the Southeastern and Southwestern United States. We estimated mtDNA nucleotide diversity for 2 mtDNA genes, COI (22 species alignments; average 16 sequences) and cytb (22 species; average 58 sequences), as well as nuclear heterozygosity and nucleotide diversity from GBS data for 118 individuals (30 species; 4 individuals and 6,820 to 44,309 loci per species). We showed that nuclear genomic diversity estimates were highly consistent across individuals for some species, while other species showed large differences depending on the locality sampled. Range size was positively correlated with both cytb diversity (phylogenetically independent contrasts: R2 = 0.31, P = 0.007) and GBS diversity (R2 = 0.21; P = 0.006), while other predictors differed across the top models for each dataset. Mitochondrial and nuclear diversity estimates were not correlated within species, although sampling differences in the data available made these datasets difficult to compare. Further study of mtDNA and nuclear diversity sampled across species' ranges is needed to evaluate the roles of geography and life history in structuring diversity across a variety of taxonomic groups.

Cryptosporidium serpentis Surveillance in Free-Ranging Snakes to Inform a Reintroduction Strategy for the Eastern Indigo Snake (Drymarchon couperi).

Understanding risk factors associated with reintroductions is important for making informed decisions within an adaptive framework. Biosecurity measures minimizing the risk of the introduction or spread of transmissible diseases are a priority when considering the release of captive-reared wildlife. Eastern indigo snake (EIS; Drymarchon couperi) reintroductions have been occurring in Alabama since 2010 and in Florida since 2017. During this effort the pathogen Cryptosporidium serpentis was detected, affecting several of the captive breeding snakes. Infected snakes were quarantined and removed from breeding efforts, which reduced snakes available for the reintroduction projects. To make informed management decisions about future reintroduction strategies, 155 free-ranging snakes were sampled at the two release sites and a third site in Georgia to evaluate the natural occurrence of C. serpentis. Additionally, 72 free-ranging EIS and other species incidentally encountered throughout the EIS range were tested opportunistically. All snakes sampled at the three focal sites tested negative, but one opportunistically tested EIS from South Florida tested positive. These results indicate that C. serpentis is present in the environment in at least one location, but at low levels. Our results suggest that, pending additional surveillance, C. serpentispositive snakes should not be included in reintroduction efforts, and that maintaining a high level of biosecurity is important in captive breeding programs.

Completude das notificações dos acidentes por animais peçonhentos no Sistema de Informação de Agravos de Notificação: estudo descritivo, Brasil, 2007-2019 / Completeness of notifications of accidents involving venomous animals in the Information System for Notifiable Diseases: a descriptive study, Brazil, 2007-2019 / Completitud de las notificaciones de accidentes por animales ponzoñosos en el Sistema de Información de Agravamientos de Notificación: estudio descriptivo, Brasil, 2007-2019

Objective: to describe the completeness of notifications of accidents involving venomous animals held on the Notifiable Health Conditions Information System (SINAN), in Brazil and its macro-regions, from 2007 to 2019. Methods: we analyzed essential and non-mandatory fields for snakebite, spider bite and scorpion sting notifications, considering the following completeness categories: Excellent (≤ 5.0% incompleteness), Good (5.0% to 10.0%), Regular (10.0% to 20.0%), Poor (20.0% ≤ 50.0%) and Very Poor (> 50.0%). Proportional change in completeness between 2007 and 2019 was estimated. Results: 1,871,462 notifications were investigated. The "localized manifestations", "systemic manifestations", "case classification", "case progression" and "zone of occurrence" fields had excellent or good completeness. Completeness was regular or poor for the "schooling" and "race/color" fields. The "occupation" field was predominantly poorly or very poorly filled in. There was a proportional worsening in completeness ((VP < 0) in most regions for the "zone of occurrence", "case progression" and "schooling" fields. Conclusion: completeness of most fields improved, although socioeconomic and occupational fields require more attention.

Objetivo: describir la completitud de las notificaciones de envenenamiento por serpientes, arañas y escorpiones en el Sistema de Información de Enfermedades de Declaración - Sinan, en Brasil y regiones, de 2007 a 2019. Métodos: se analizaron campos esenciales y no obligatorios para las notificaciones de ofidismo, aracneismo y escorpionismo, considerando las categorías de completitud: Excelente (≤ 5,0% de incompletitud), Buena (5,0% a 10,0%), Regular (10,0% a 20,0%), Mala (20,0% ≤ 50,0%) y Muy mala (> 50,0%). Se estimó el cambio proporcional en la completitud entre 2007-2019. Resultados: se investigaron 1.871.462 notificaciones. Los campos "manifestaciones locales y sistémicas", "zona de ocurrencia", "clasificación y evolución de casos" presentaron excelente o buena completitud. "Escolaridad" y "raza/color de piel" regular o mala completitud. "Ocupación" fue predominantemente mala/muy mala completitud. "Zona","evolución" y "escolaridad" mostraron empeoramiento proporcional en la completitud en la mayoría de las regiones ((VP < 0). Conclusión: hay mejoría y completitud en la mayoría de los campos, aunque los campos socioeconómico y ocupacional demandan atención.

Objetivo: descrever a completude das notificações de acidentes causados por animais peçonhentos no Sistema de Informação de Agravos de Notificação, no Brasil e macrorregiões, em 2007-2019. Métodos: analisou-se a completude de campos de preenchimento essenciais e não obrigatórios das notificações de ofidismo, araneísmo e escorpionismo, utilizando-se a classificação de "Excelente" (≤ 5,0% de incompletude), "Bom" (5,0% a 10,0%), "Regular" (10,0% a 20,0%), "Ruim" (20,0% e ≤ 50,0%) e "Muito ruim" (> 50,0%); estimou- -se a variação proporcional (VP) da completude. Resultados: foram investigadas 1.871.462 notificações; os campos "manifestações locais", "sistêmicas", "classificação do caso", "evolução do caso" e "zona de ocorrência" apresentaram completude excelente ou boa; "escolaridade" e "raça/cor da pele", completude regular ou ruim; ocupação, completude ruim ou muito ruim; "zona", "evolução do caso" e "escolaridade" apresentaram piora proporcional na completude, na maioria das regiões ((VP < 0). Conclusão: melhorou a completude na maioria dos campos, exceto socioeconômicos e ocupacionais, que demandam maior atenção.

Factors for unfavorable evolution of snakebites in children

Pediatric patients have particularities in the clinical manifestations and complications of snakebite envenomation (SBEs), and few studies have examined this population. The objective of this paper was to study snakebites in a pediatric age group treated at a reference hospital and to evaluate factors associated with unfavorable evolution. A cross-sectional study with a clinical-epidemiological description and identification of the factors related to unfavorable evolution in patients aged <19 years old seen from January, 2018 to November, 2019 was performed. Complications related to the SBE, such as compartment syndrome, secondary infection, extensive necrosis, hemorrhage, and kidney damage, were considered unfavorable evolution. From the 325 patients in the sample, 58 were aged <19 years old; 40 (69%), 0-12 years old; and 18 (31%), 13-18 years old. All patients had local manifestations (mild, moderate, and severe), and 36 (62%) had an unfavorable evolution. Fourteen (24.1%) patients had compartment syndrome, with a significant risk association between 0 and 12 years old (p = 0.019). Two factors significantly contributed to unfavorable evolution: the timing from the bite to medical care being ≥6 hours and additional antivenom therapy needed. We conclude that the younger the patient, the smaller body segment affected, leading to disproportionality between the affected area and the amount of inoculated venom, contribute to more frequent local manifestations and complications in children rather than adults. Because of the relationship between body area and vascular volume in children differs from that in adults, the same volume of venom inoculated by snakes will be disproportionate in these two groups. Therefore, in the treatment of pediatric patients, increasing the volume of antivenom therapy is possibly necessary. Furthermore, as in adults, six hours between the bite to medical care increases the risk of complications and mortality.

Mordeduras de ofidios en mano pediátrica y sus complicaciones locales / Snake bites in pediatric hand and their local complications / Mordidas de serpentes de mão pediátricas e suas complicações locais

Introducción: el envenenamiento por mordedura de ofidios es reconocido como un problema de salud pública según la Organización Mundial de la Salud. La baja incidencia sumada a la diversidad de presentaciones clínicas, edades, topografías afectadas, así como los diferentes protocolos en la bibliografía existente sobre algunos aspectos del tratamiento, hacen difícil el manejo sistematizado de estos pacientes. El objetivo de este trabajo es realizar una revisión sistemática de la literatura sobre mordedura de serpientes en pacientes pediátricos con afectación en mano y miembro superior, haciendo hincapié en la conducta frente las complicaciones loco-regionales. Por importancia y frecuencia destacamos al síndrome compartimental, las flictenas y las infecciones. Metodología: se realizó una búsqueda bibliográfica en MedLine/PubMed con las palabras clave: "Snake Bite hand Children" y "Snake Bite compartimental syndrome". Se incluyeron los artículos publicados en los últimos 10 años (2012 al 2022). Resultados: la búsqueda de artículos ante las palabras "Snake Bite hand Children" resultó en 20 articulos y la busqueda ante las palabras "Snake Bite compartimental syndrome" derivó en 34. Luego de aplicar los criterios de inclusión y exclusión se obtuvieron 30 artículos para el análisis. Conclusiones: la población pediátrica se encuentra más expuesta a las mordeduras por serpientes y a su vez a presentar lesiones más severas. El tratamiento del síndrome compartimental continúa siendo un tema de debate. El veneno inoculado puede simular un síndrome compartimental que puede revertir sin fasciotomías con el tratamiento adecuado. Igualmente, ante síntomas y signos claros de síndrome compartimental se sugiere realizar fasciotomías frente a las graves secuelas potenciales. Ante la aparición de flictenas, el destechado cuidadoso de la misma es un tratamiento adecuado. La mayoría de los autores coinciden con el tratamiento profiláctico con antibioticoterapia.

Introduction: Ophidian bite poisoning is recognized as a public health problem by the World Health Organization. The low incidence added to the diversity of clinical presentations, ages, affected topographies, as well as the different protocols in the existing literature on some aspects of treatment, make the systematized management of these patients difficult. The aim of this work is to carry out a systematic review of the literature on snakebite in pediatric patients with hand and upper limb involvement, with emphasis on the management of loco-regional complications. In terms of importance and frequency, we highlight compartment syndrome, phlyctenas and infections. Methodology: a literature search was carried out in MedLine/PubMed with the keywords: "Snake Bite hand Children" and "Snake Bite compartment syndrome". Articles published in the last 10 years (2012 to 2022) were included. Results: the search for articles with the words "Snake Bite hand Children" resulted in 20 articles and the search for the words "Snake Bite compartment syndrome" resulted in 34 articles. After applying the inclusion and exclusion criteria, 30 articles were obtained for the analysis. Conclusions: the pediatric population is more exposed to snake bites and in turn to present more severe lesions. The treatment of compartment syndrome continues to be a subject of debate. Inoculated venom can simulate a compartment syndrome that can be reversed without fasciotomies with proper treatment. Likewise, in the presence of clear symptoms and signs of compartment syndrome, fasciotomies are suggested because of the serious sequelae generated. In the event of the appearance of phlyctenas, careful unroofing of the phlyctenas would be an appropriate treatment. Most authors agree with prophylactic treatment with antibiotic therapy.

Introdução: O envenenamento por mordidas ofídias é reconhecido como um problema de saúde pública pela Organização Mundial da Saúde. A baixa incidência, juntamente com a diversidade de apresentações clínicas, idades, topografias afetadas, bem como os diferentes protocolos da literatura existente sobre alguns aspectos do tratamento, tornam difícil o gerenciamento sistemático desses pacientes. O objetivo deste trabalho é realizar uma revisão sistemática da literatura sobre mordida de cobra em pacientes pediátricos com envolvimento de mãos e membros superiores, com ênfase no gerenciamento de complicações loco-regionais. Em termos de importância e freqüência, destacamos a síndrome compartimental, as flectenas e as infecções. Metodologia: foi realizada uma pesquisa bibliográfica no MedLine/PubMed com as palavras-chave: "Snake Bite hand Children" e "Snake Bite compartment syndrome". Os artigos publicados nos últimos 10 anos (2012 a 2022) foram incluídos. Resultados: a busca de artigos usando as palavras "Snake Bite hand Children" resultou em 20 artigos e a busca das palavras "Snake Bite compartment syndrome" resultou em 34 artigos. Após a aplicação dos critérios de inclusão e exclusão, foram obtidos 30 artigos para análise. Conclusões: a população pediátrica está mais exposta às picadas de cobra e, por sua vez, a lesões mais graves. O tratamento da síndrome compartimental continua a ser motivo de debate. O veneno inoculado pode simular uma síndrome de compartimento que pode ser revertida sem fasciotomias com tratamento apropriado. Da mesma forma, se houver sinais e sintomas claros de síndrome compartimental, são sugeridas fasciotomias por causa das severas seqüelas. Se as flectenas aparecerem, o desenrolamento cuidadoso das flectenas seria um tratamento apropriado. A maioria dos autores concorda com o tratamento profilático com a antibioticoterapia.

Venomous animals in Pernambuco: children at risk / Animais peçonhentos em Pernambuco: crianças em risco

Abstract Objectives: to analyze the epidemiological and clinical aspects of accidents caused by venomous animals in children under 15 years old. Methods: a cross-sectional study with an analytical component using secondary data from Centro de Informação e Assistência Toxicológica de Pernambuco (CIATox-PE), (Poison Center in Pernambuco)), in 2017 to 2019. Notifications of accidents caused were included in the studied age group and evaluated the characteristics of poisoning (animal classification, exposure zone, place and time of the occurrence and specific use of serum therapy), and of the patient (sociodemographic variables, clinical condition and evolution). The analysis performed in STATA® 13.1 presents frequency distribution tables and Pearson's chi-square for comparison. Results: of the 2678 notifications, 82,8% were scorpionism and 10, 8% snakebite. The age group of1 to 9 years old (70.5%) and being male (54.1%) were predominant. Most of the cases occurred in urban area (80.9%), in Recife (67.3%), inside the victim's residence (83.9%) and at night (47.3%). The majority (87.1%) were classified as 'mild severity', 10% received antivenom therapy and one died (by scorpionism). Two cases of snakebite in the workplace were registered. Conclusion: there was a high frequency of accidents caused in the urban area, which may be related to the lack of urban planning and sanitary education. The accidents caused among children in the household environment and the suspicion of child labor in the age group of 10 to 14 years old were also highlighted which favors the development and habits of the venomous animal.

Resumo Objetivos: analisar aspectos epidemiológicos e clínicos dos acidentes por animais peçonhentos em menores de 15 anos. Métodos: estudo transversal com componente analítico utilizando dados secundários do Centro de Informação e Assistência Toxicológica de Pernambuco (CIATox-PE), no período de 2017 a 2019. Foram incluídas as notificações dos acidentes na faixa etária estudada e avaliadas características do envenenamento (classe do animal, zona de exposição, local/turno da ocorrência e uso soroterapia específica) e do paciente (variáveis sociodemográficas, gravidade clínica e evolução). A análise realizada no STATA® 13.1 apresenta tabelas de distribuição de frequência e qui-quadrado de Pearson para comparação. Resultados: das 2678 notificações, 82,8% foram de escorpionismo e 10,8% de ofidismo. Predominaram na faixa etária de 1a 9 anos (70,5%) e sexo masculino (54,1%);ocorreram principalmente na zona urbana (80,9%),no Recife(67,3%), na residência da vítima (83,9%), durante horário noturno (47,3%). A maioria (87,1%) foi classificada como de gravidade leve, 10% receberam soroterapia e ocorreu um óbito (escorpionismo). Registraram-se dois casos de ofidismo em ambiente de trabalho. Conclusão: ressaltam-se os acidentes intradomiciliares entre crianças e a suspeita de trabalho infantil na faixa etária de 10 a 14anos.Os acidentes ocorreram sobretudo na zona urbana provavelmente associado à falta de planejamento e educação sanitária que favorece o desenvolvimento e hábitos do animal peçonhento.

Horizontal Transposon Transfer and Its Implications for the Ancestral Ecology of Hydrophiine Snakes.

Transposable elements (TEs), also known as jumping genes, are sequences able to move or copy themselves within a genome. As TEs move throughout genomes they often act as a source of genetic novelty, hence understanding TE evolution within lineages may help in understanding environmental adaptation. Studies into the TE content of lineages of mammals such as bats have uncovered horizontal transposon transfer (HTT) into these lineages, with squamates often also containing the same TEs. Despite the repeated finding of HTT into squamates, little comparative research has examined the evolution of TEs within squamates. Here we examine a diverse family of Australo-Melanesian snakes (Hydrophiinae) to examine if the previously identified, order-wide pattern of variable TE content and activity holds true on a smaller scale. Hydrophiinae diverged from Asian elapids ~30 Mya and have since rapidly diversified into six amphibious, ~60 marine and ~100 terrestrial species that fill a broad range of ecological niches. We find TE diversity and expansion differs between hydrophiines and their Asian relatives and identify multiple HTTs into Hydrophiinae, including three likely transferred into the ancestral hydrophiine from fish. These HTT events provide the first tangible evidence that Hydrophiinae reached Australia from Asia via a marine route.

First occurrence of Psammophis (Serpentes) from Europe witnesses another Messinian herpetofaunal dispersal from Africa - biogeographic implications and a discussion of the vertebral morphology of psammophiid snakes.

We here describe abundant new snake material from the late Miocene (MN 13) of Salobreña, Spain. Vertebral morphology suggests a referral of the specimens to the extant psammophiid Psammophis, documenting the first occurrence of this genus in Europe. The diversity and disparity across the vertebral morphology of different psammophiid genera are discussed. We identify vertebral features that could diagnose Psammophis and therefore enable the recognition of the genus in the fossil record. A comparison of the new Spanish form with other taxa is conducted. We provide a detailed review of the psammophiid fossil record. Material previously described from the middle Miocene of Beni Mellal, Morocco is here tentatively referred to as ?Psammophis sp., an action that renders that occurrence as the oldest (probable) record of the genus and Psammophiidae as a whole, providing thus a potential calibration point. On the other hand, Eastern European Pliocene material that had been previously supposedly referred to Psammophis is here discarded as being rather fragmentary, not affording any more precise determination. The two psammophiid genera Psammophis and Malpolon appear almost simultaneously in the European fossil record (MN 13), with the former achieving only a short-lived and apparently geographically limited distribution in the continent, while the latter still exists in its modern herpetofauna. We assess biogeographic implications of the new find, suggesting a direct dispersal event from northwestern Africa to the Iberian Peninsula during the late Miocene, facilitated by the Messinian Salinity Crisis.

Taxonomical review of Prosymnaangolensis Boulenger, 1915 (Elapoidea, Prosymnidae) with the description of two new species.

African Shovel-snout snakes (Prosymna Gray, 1849) are small, semi-fossorial snakes with a unique compressed and beak-like snout. Prosymna occur mainly in the savanna of sub-Saharan Africa. Of the 16 currently recognised species, four occur in Angola: Prosymnaambigua Bocage, 1873, P.angolensis Boulenger, 1915, P.frontalis (Peters, 1867), and P.visseri FitzSimons, 1959. The taxonomical status and evolutionary relationships of P.angolensis have never been assessed due to the lack of genetic material. This species is known to occur from western Angola southwards to Namibia, and eastwards to Zambia, Botswana and Zimbabwe. The species shows considerable variation in dorsal colouration across its range, and with the lower ventral scales count, an 'eastern race' was suggested. In recent years, Prosymna material from different parts of Angola has been collected, and with phylogenetic analysis and High Resolution X-ray Computed Tomography, the taxonomic status of these populations can be reviewed. Strong phylogenetic evidence was found to include the angolensis subgroup as part of the larger sundevalli group, and the existence of three phylogenetic lineages within the angolensis subgroup were identified, which each exhibit clear morphological and colouration differences. One of these lineages is assigned to the nominotypical P.angolensis and the other two described as new species, one of which corroborates the distinct eastern population previously detected. These results reinforce that a considerable part of Angolan herpetological diversity is still to be described and the need for further studies.

ResumoAs cobras-de-focinho-de-pá africanas (Prosymna) são pequenas cobras semi-fossoriais com um focinho único, achatado e em forma de bico, que ocorrem principalmente na savana da África subsaariana. Das 16 espécies actualmente reconhecidas, quatro existem em Angola: Prosymnaambigua Bocage, 1873, P.angolensis Boulenger, 1915, P.frontalis (Peters, 1867), e P.visseri FitzSimons, 1959. O estatuto taxonómico e as relações evolutivas de P.angolensis nunca foram avaliados devido à falta de material genético. A espécie ocorre desde o oeste de Angola, para sul até a Namíbia, e para este em direcção à Zâmbia, Botswana e Zimbábue. Na sua área de ocorrência, esta espécie tem variação principalmente na coloração dorsal, e com base no menor número de escamas ventrais, foi sugerida a existência de uma raça oriental. Recentemente foi amostrado material de Prosymna de várias partes de Angola, e com recurso a análises filogenéticas e a tomografia computadorizada de raios-X de alta resolução, foi possível rever o estatuto taxonómico destas populações. Encontrámos fortes evidências filogenéticas para incluir o subgrupo angolensis como parte do grupo sundevalli. Revelámos a existência de três linhagens filogenéticas no subgrupo angolensis. Atribuímos uma dessas linhagens ao P.angolensis nominotípico, e descrevemos as outras duas como espécies novas, uma das quais corrobora a população oriental previamente detectada. Estes resultados reforçam a ideia de que uma parte considerável da diversidade herpetológica angolana está ainda por descrever, e a necessidade de mais estudos.

Tendência temporal e perfil epidemiológico dos acidentes por animais peçonhentos no Brasil, 2007-2019 / Tendencia temporal y perfil epidemiológico de los accidentes por animales venenosos en Brasil, 2007-2019 / Temporal trend and epidemiological profile of accidents involving venomous animals in Brazil, 2007-2019

Objetivo: Analisar a tendência temporal dos acidentes causados por animais peçonhentos no Brasil, de 2007 a 2019. Métodos: Estudo transversal, realizado com dados do Sistema de Informação de Agravos de Notificação (Sinan). Para a análise temporal, utilizou-se a regressão linear de Prais-Winsten. Foram calculadas as incidências por sexo e faixa etária, risco relativo e letalidade. Resultados: No período de estudo, houve 2.102.657 casos de acidentes por animais peçonhentos. Com exceção do ofidismo, os demais acidentes apresentaram tendência temporal crescente na maioria das macrorregiões nacionais. Escorpionismo, ofidismo e araneísmo foram responsáveis por 86% dos acidentes, principalmente entre pessoas do sexo masculino em idade economicamente ativa. A de letalidade foi mais elevada para acidentes ofídicos (0,4%) e apílicos (0,3%). As crianças foram as principais vítimas de acidentes com abelhas, lagartas e "outros". Conclusão: Os acidentes com animais peçonhentos apresentaram tendência temporal crescente para a maioria dos agravos e diferentes perfis epidemiológicos.

Objetivo: Analizar la tendencia temporal de los accidentes con animales ponzoñosos en Brasil de 2007 a 2019. Métodos: Estudio transversal realizado con datos del Sistema de Información de Enfermedades de Declaración Obligatoria (Sinan). Para el análisis temporal se utilizó la Regresión Lineal de Prais-Wisten. Se calcularon las incidencias por sexo y grupo de edad, riesgo relativo y letalidad. Resultados: Durante el período del estudio hubo 2.102.657 casos de accidentes con animales ponzoñosos. Con excepción de la mordedura de serpiente, los demás accidentes mostraron una tendencia temporal creciente en la mayoría de las regiones del país. El escorpionismo, la mordedura de serpiente y la picadura de araña fueron responsables del 86% de los accidentes, afectando principalmente a personas del sexo masculino en edad laboral. Las tasas de letalidad más altas fueron por accidentes de mordedura de serpiente (0,4%) y picadura de araña (0,3%). Los niños fueron las principales vitimas de los acidentes con abejas, lagartas y "otros". Conclusión: Los accidentes com animales ponzoñosos mostraron una tendencia temporal creciente para la mayoría de las enfermedades y diferentes perfiles epidemiológicos.

Objective: to analyze the temporal trend of accidents involving venomous animals in Brazil from 2007 to 2019. Methods: this was a cross-sectional study carried out with data from the Notifiable Health Conditions Information System (SINAN). Prais-Winsten linear regression was used for the temporal analysis. We calculated incidence rates according to sex and age group, relative risk and case fatality ratio. Results: during the study period there were 2,102,657 cases of accidents involving venomous animals. With the exception of snakebite, the remaining accidents showed a rising temporal trend in most regions of the country. Scorpion stings, snake bites and spider bites were responsible for 86% of accidents, mainly affecting male people of working age. Accidents involving snakes (0.4%) and bees (0.3%) had the highest case fatality ratios. Children were the main victims of accidents involving bees, caterpillars and "others". Conclusion: accidents involving venomous animals showed a rising temporal trend for most conditions, as well as different epidemiological profiles.

Composition and natural history of a snake community from the southern Cerrado, southeastern Brazil.

The natural history of a cerrado snake community in a protected area in southeastern Brazil (Santa Bárbara Ecological Station; SBES) is described. A visual guide and an identification key are also provided to assist researchers and local people in identifying snakes in that region. Sampling was performed through pitfall traps, time-constrained search, accidental encounters, and observations by local people for two years, which corresponded to 240 days of sampling. Among the 388 individuals found in the field, 33 snake species belonging to 21 genera of seven families were recorded. Most species were restricted or found at least once in non-forest vegetation types (campo sujo, campo cerrado, and cerrado sensu stricto) and a few were restricted to forest habitats (cerradão). Our results show that most species (1) occupy open areas; (2) present both diurnal and nocturnal activity; (3) are primarily terrestrial; (4) include lizards, mammals and/or anurans in the diet; (5) present seasonal reproductive activity; and (6) use mainly visually oriented defensive tactics. Despite its small size (3,154 ha), the SBES harbours preserved habitats and a rich and typical Cerrado snake fauna, including threatened species. Furthermore, most of the SBES snakes occur in non-forest environments (54%) and some species are sensitive to habitat disturbance.

Ecological Filtering and Exaptation in the Evolution of Marine Snakes.

AbstractConvergent evolution is often attributed to adaptation of form to function, but it can also result from ecological filtering, exaptation, or nonaptation. Testing among these possibilities is critical to understanding how and why morphological similarities emerge independently in multiple lineages. To address this challenge, we combined multiple preexisting phylogenetic methods to jointly estimate the habitats and morphologies of lineages within a phylogeny. We applied this approach to the invasions of snakes into the marine realm. We utilized a data set for 1,243 extant snake species consisting of newly compiled biome occupancy information and preexisting data on reproductive strategy, body mass, and environmental temperature and elevation. We find evidence for marine clades arising from a variety of aquatic and terrestrial habitats. Furthermore, there is strong evidence of ecological filtering for nonmarine ancestors that were already viviparous, had slightly larger-than-average body sizes, and lived in environments with higher-than-average temperatures and lower-than-average elevations. In aggregate, similarities among independent lineages of marine snakes result from a combination of exaptation and strong ecological filtering. Strong barriers to entry of new habitats appear to be more important than common adaptations following invasions for producing similarities among independent lineages invading a shared, novel habitat.

Molecular phylogeny and morphological comparisons of the genus Hebius Thompson, 1913 (Reptilia: Squamata: Colubridae) uncover a new taxon from Yunnan Province, China, and support revalidation of Hebius septemlineatus (Schmidt, 1925).

We describe a new species of the genus Hebius and provide evidence for the validity of H. septemlineatuscomb. nov. Morphological and molecular analyses of Hebius specimens collected in Yunnan Province, China, revealed three distinct lineages, namely the newly described Hebius weixiensissp. nov., as well as H. octolineatus (Boulenger, 1904), and H. septemlineatuscomb. nov. (Schmidt 1925), which is removed from synonymy with H. octolineatus. Based on mitochondrial genealogy, Hebius weixiensissp. nov. is sister to H. septemlineatuscomb. nov., while H. octolineatus is sister to H. bitaeniatus. The new species and H. septemlineatuscomb. nov. showed considerable genetic divergence from their recognized congeners (uncorrected P-distance ≥3.9%). Furthermore, the new species and H. septemlineatuscomb. nov. can be diagnosed from closely related congeners by a combination of pholidosis characters.