Coagulopathy following lethal and non-lethal envenoming of humans by the South American rattlesnake (Crotalus durissus) in Brazil.

The South American tropical rattlesnake (Crotalus durissus subspp) is responsible for approximately 10% of bites from venomous snakes in Brazil. We studied 24 victims of bites by this species over 3 years, in south-eastern Brazil, particularly investigating haemostatic alterations. Thirteen patients were defined as moderately envenomed and 11 as severe. There were two deaths, which were not attributed to venom-induced haemostatic disturbances. However, envenoming by C. durissus is frequently associated with haemostatic disorders, which are probably attributable mainly to the action of the thrombin-like enzyme, with possible additional effects secondary to the powerful myotoxic activity of the venom.

[Intracranial arachnoid cysts. Neuroendoscopic treatment]. / Cistos aracnóides intracranianos. Tratamento pela neuroendoscopia.

The author reports the techniques and results of seven patients with intracranial arachnoid cysts treated surgically, all of them through neuroendoscopic approach. Two carriers of supraselar cysts had undergone several shunt surgeries, and another carrier of a temporal cyst undergone external drainage to treat an associated subdural higroma. Only in this case the endoscopic approach has not resulted in control of the symptoms of the patient. The follow up period extended from one to nine years.

[Cerebrovascular disorders in Uberlandia: I. Mortality]. / Doenças cerebrovasculares em Uberlândia: I. Mortalidade.

We have analyzed 1361 death certificates, during the year of 1982 in Uberlandia (Brazil), all deaths of residents and not deathbirths. In 47% the deaths were assisted by a physician and the cause of death proved. The first basic cause of death found was cardiovascular diseases (23.3%). The second, infectious diseases particularly Chagas' disease (14.9%) and the third traumatic lesions and poisonings (14.4%). Cerebrovascular diseases were the seventh basic cause of death (6.5%) but the third most related disease at the death certificates (12.7%). It is important to stress that the mortality index change considerably if we consider the disease as a basic cause of death or in more than one position in the death certificate. For instance in Uberlandia the index for CVD was 30 and 63/100.000 inab/year, respectively. The carriers of arterial hypertension presented CVD related at death certificate 10 times more than in the not carriers of hypertension.

[Cerebrovascular disorders in Uberlandia: II. Epidemiology and clinic medicine]. / Doenças cerebrovasculares em Uberlândia: II. Epidemiologia e clínica.

We have studied prospectively 157 patients with stroke admitted at University Hospital and Hospital Santa Genoveva in Uberlandia, Brazil at the point of view of clinics and epidemiology. Incidence was 0.8/1000 peoples/year and early letality of stroke victims was 40%, only 30% had returned to work. Complete infarct account for 36.3% of the cases and was predominant in white man among stroke population. Hypertension (in 55% of the cases), Chagas' disease (26.1%), transient isquemic attack (22.7%) and hypercolesterolemia were the main risk factors for stroke in this region.