Taiwan cobra envenoming: serum venom concentration before and after specific treatment and relationship with debridement of necrotic wound tissue

Background: Bivalent freeze-dried neurotoxic (FN) antivenom has been the primary treatment since the 1980s for Taiwan cobra (Naja atra) envenomation in Taiwan. However, envenomation-related wound necrosis is a significant problem after cobra snakebites. In the present study, we analyzed the changes in serum venom concentration before and after antivenom administration to discover their clinical implications and the surgical treatment options for wound necrosis. Methods: The patients were divided into limb swelling and wound necrosis groups. The clinical outcome was that swelling started to subside 12 hours after antivenom treatment in the first group. Serum venom concentrations before and after using antivenoms were measured to assess the antivenom's ability to neutralize the circulating cobra venom. The venom levels in wound wet dressing gauzes, blister fluids, and debrided tissues were also investigated to determine their clinical significance. We also observed the evolutional changes of wound necrosis and chose a better wound debridement timing. Results: We prospectively enrolled 15 Taiwan cobra snakebite patients. Males accounted for most of this study population (n = 11, 73%). The wound necrosis group received more antivenom doses than the limb swelling group (4; IQR:2-6 vs 1; IQR:1-2, p = 0.05), and less records of serum venom concentrations changed before/after antivenom use (p = 0.0079). The necrotic wound site may release venom into circulation and cause more severe envenomation symptoms. Antivenom can efficiently diminish limb swelling in cobra bite patients. However, antivenom cannot reduce wound necrosis. Patients with early debridement of wound necrosis had a better limb outcome, while late or without debridement may have long-term hospital stay and distal limb morbidity. Conclusions: Antivenom can efficiently eliminate the circulating cobra venom in limb swelling patients without wound necrosis. Early debridement of the bite site wound and wet dressing management are suggestions for preventing extended tissue necrosis and hospital stay.(AU)

The genotype does not influence the establishment of elephantgrass (Pennisetum purpureum Schum)

This study investigated whether genotype influences the establishment of Pennisetum purpureum Schumach. The experimental design was a randomized complete blocks with four treatments and eight replications (n=8). The treatments were four genotypes of P. purpureum, two classified as tall sizes: P. purpureum cv. Elephant B and cv. IRI 381; and two as dwarf types: P. purpureum cv. Mott and Taiwan A-146 2.37. They were planted in a tropical wet and dry region of Brazil. Tall genotypes showed superior field sprouting rates (p < 0.05), ranging between 95-99%, while dwarfs varied between 88-90%, however, Elephant B and IRI 381 produced a much lower average number of tillers (31 and 32 linear m-1, respectively), than Taiwan A-146 2.37 and Mott (56 and 41 linear m-1, respectively) (p < 0.05). Dwarf genotypes produced lower biomass yields (p < 0.05), but this was genotype-dependent and did not impact on their establishment. The levels of non-structural carbohydrates (NSC) (>10%) in the planted stems were associated with satisfactory field sprouting of the elephantgrass genotypes. Despite some variations between the genotypes in terms of sprouting, tillering, and growth rates, the kind of genotype had no major significance on the establishment of the elephantgrass.(AU)

Comparación de los valores de glucosa en caninos obtenidos con glucómetros portátiles y la prueba estándar de laboratorio / Comparação dos valores de glicose em caninos obtidos com glicômetros portáteis e o teste laboratorial padrão / Comparison of glucose values in dogs obtained with portable glucometers and the standard laboratory test

La medición de glucosa en caninos es un procedimiento habitual en la clínica diaria, actualmente este valor se puede obtener mediante dispositivos portátiles y pruebas laboratoriales. Se realizó esta investigación con el fin de aportar mayor conocimiento sobre la importancia de la medición de glucosa, ya que en los últimos años ha perdido valor entre las pruebas hematológicas a considerar debido a que solo se relaciona con determinadas patologías como la diabetes u otras enfermedades metabólicas. El presente trabajo tiene como objetivo comparar los valores de glucosa en caninos obtenidos mediante un glucómetro portátil de uso humano (Accu-chek® Active, Roche Diagnostic, Mannheim, Alemania); veterinario (aLcose® Vet Glu, jjPlus Corporation, New Taipei, Taiwán) y la prueba estándar de laboratorio, esto nos indicará la fiabilidad de los resultados obtenidos mediante estos métodos. Se realizó la toma de muestras de sangre de 50 caninos clínicamente sanos, de los cuales se obtuvo el resultado de glucemia mediante estos tres métodos. Los resultados de nuestra investigación evidenciaron que las tres formas de evaluación de la glucosa sanguínea en perros brindaban resultados estadísticamente diferentes (p < 0.05). Se obtuvo valores de glucosa diferentes entre los tres métodos de medición, teniendo como promedios finales 84.14 mg/dL, 101.12 mg/dL y 91.12 mg/dL correspondientes al glucómetro portátil de uso humano, veterinario y a la prueba estándar de laboratorio respectivamente. En conclusión, los glucómetros portátiles de uso humano subestiman los valores reales de glucosa, mientras que los de uso veterinario lo sobreestiman, comparados con la prueba estándar de laboratorio.

A medição de glicose nos cães é um procedimento habitual realizado no atendimento clínico. Atualmente este valor pode ser obtido por meio de dispositivos portáteis e testes laboratoriais. Esta pesquisa foi realizada com a finalidade de destacar a importância da medição de glicose, visto que nos últimos anos esta avaliação não tem sido muito valorada entre os testes hematológicos, sendo considerada relevante apenas em relação a patologias como a diabetes e outras doenças metabólicas. O presente estudo teve como objetivo comparar os valores de glicose em cães obtidos com glicômetro portátil de uso humano; veterinário e o teste padrão de laboratório. Esta comparação poderá indicar a confiabilidade dos resultados obtidos mediante os métodos avaliados. Foi realizada a amostragem do sangue de 50 caninos clinicamente sadios os quais foram submetidos a avaliação de glicose mediante os três métodos. Os resultados de nossa investigação evidenciaram que as três formas de avaliação da glicose sanguínea têm resultados estatisticamente diferentes (p < 0,05). Os valores de glicose tiveram medias finais de 84,14 mg/dL, 101,12 mg/dL e 91,12 mg/dL para o glicômetro portátil de uso humano (Accu-chek® Active, Roche Diagnostic, Mannheim, Alemanha), veterinário (aLcose® Vet Glu, jjPlus Corporation, Nova Taipei, Taiwan) e o teste padrão de laboratório, respectivamente. Ao concluir, os glicômetros portáteis de uso humano subestimam os valores reais de glicose e os de uso veterinário os superestimam quando comparados com o teste padrão de laboratório.

The measurement of glucose in canines is a common procedure in daily clinical practice. Currently this value can be obtained by use of portable devices and laboratory tests. This research was carried out in order to provide more knowledge about the importance of glucose measurement, since in recent years it has lost value among the hematological tests to be considered because it is only related to certain pathologies such as diabetes or other metabolic diseases. The present study aimed to compare the glucose values in dogs obtained with a portable glucometer for human use, veterinarian use, and the standard laboratory test. This comparison may indicate the reliability of the results obtained through the evaluated methods. A blood sampling of 50 clinically healthy canines was taken and submitted to glucose evaluation using the three methods. Our investigation showed that the three ways of assessing blood glucose have statistically different results (p < 0.05). Glucose values had final averages of 84.14 mg/dL, 101.12 mg/dL, and 91.12 mg/dL for the portable glucometer for human use (Accu-chek® Active, Roche Diagnostic, Mannheim, Germany), veterinary (aLcose® Vet Glu, jjPlus Corporation, New Taipei, Taiwan) and the standard laboratory test, respectively. In conclusion, portable glucometers for human use underestimate the glucose values, and those for veterinary use overestimate them compared to the standard laboratory test.

Beneficial effects of a calf starter versus forage on rumen development and bacteria populations in beef calves / Efeitos benéficos de um concentrado de bezerro versus forragem no desenvolvimento ruminal e na população de bactérias em bezerros

Rumen development depends on the intake of solid food that is fermented into volatile fatty acids that stimulate the development of the rumen papillae in calves. The starter feeding can promote the growth of papillae in the rumen and as a consequence an earlier weaning. We evaluated the effects of calf starter on ruminal development, and productive response of lactating bull calves raised for meat in the tropics. Twelve male Brahman × Swiss American cross beef calves from a dual-purpose system were randomly assigned two treatments with six animals per treatment: milk-fed calves + Taiwan grass (Pennisetum purpureum, MT) and MT + calf starter, (MTS). Feed intake and growth were measured at 7-day intervals throughout until 210 d of age. At 90 days old, three calves from each treatment were harvested, and fluid and ruminal tissues were collected from the cranial, ventral, dorsal, and dorsal blind ruminal sacs for measurements of many papillaes per cm2 (NP), papillae length (LP) and papillae width (WP). Ruminal bacterial genotype identification was determined by amplicon generation with the Illumina platform. Calf starter-improved weight (Live weight, LW) and average weight gain (ADG) and NP, but, LP and WP was similar in both treatments (p 0.05). In calves with starter feed treatment, we observed the bacteria Desulfonauticus autotrophicus sp. nov.that was not previously reported in ruminants. Use of calf starter showed benefit for calves with improved feed intake and rumen development because promoted a greater number of rumen papillae.(AU)

O desenvolvimento do rumen depende da ingestão de alimentos sólidos fermentados em ácidos graxos voláteis que estimulam o desenvolvimento das papilas de rúmen em bezerros. A alimentação inicial pode promover o crescimento das papilas no rúmen e, como consequência, um desmame mais cedo. Avaliamos os efeitos da concentrado de bezerros no desenvolvimento ruminal, e a resposta produtiva dos bezerros lactantes criados para carne nos trópicos. Doze bezerros de carne bovina cruza Brahman × suíço-americano machos de de um sistema de dupla finalidade foram aleatoriamente atribuídos a dois tratamentos, com seis animais por tratamento: bezerros alimentados com leite + grama taiwanesa (Pennisetumpurpureum, MT) e MT+ concentrado de bezerro, (MTS). A ingestão de ração e o crescimento foram medidos. Aos 90 dias de idade, três bezerros de cada tratamento foi amostrado, e foram coletados tecidos fluidos dos sacos ruminais cranianos, ventral, dorsal e dorsal cegos para medições do número de papilas por cm2 (NP), comprimento das papilas (LP) e largura da papila (PM). A identificação do genótipo das bactérias ruminais foi determinada pela geração de amplicon com a plataforma de ilumine. O concentrado de bezerro melhorou o peso (LW) e o ganho diário médio (AGD) e NP, mas, LP e WP foram semelhantes nos dois tratamentos. Bezerros em MTS uma bactéria não encontrada anteriormente em ruminantes Desulfonauticus autotrophicus sp. nov. foi detectado. O uso de concentrado de bezerro mostrou benefício para bezerros com melhor ingestão de ração e desenvolvimento de rúmen, pois promove um maior número de papilas de rúmen.(AU)

Analysis of the ornamental fish exports from the Amazon state, Brazil / Análise das exportações de peixes ornamentais do estado do Amazonas, Brasil

The updated status of the ornamental fish trade from the Amazonas state was analyzed between the years of 2006-2015 (IBAMA database). The trade of ornamental fish from Amazonas state mainly consists of species extracted from nature. A total of 142,552,253 specimens were exported during the studied period. Sales plummeted since 2006, from 26,075,241 specimens exported then to 2,729,846 specimens in 2015 (Jan-Jul). Between 2006 and 2015, a total of US$ 23.0 million in revenue was generated from fish exports destined to 35 countries. Germany, Taiwan, USA and Japan accounted for 75.5% of the volume and 76.7% of the value exported. During this time, 375 species were exported, included Paracheirodon axelrodi, P. simulans, Hemigrammus bleheri, Otociclus affinis and O. hoppei that together represented 84.5% of exports. Thirty are not on the list of IBAMA species released for export, and six are currently on the list of endangered fauna of Brazil, being them: Hopliancistrus tricornis, Leporacanthicus joselimai, Parancistrus nudiventris, Peckoltia compta, Scobinancistrus auratus and S. pariolispos. These results...

O corrente status do comércio de peixes ornamentais exportados do Estado Amazonas foi analisado entre os anos de 2006-2015 (banco de dados IBAMA). Esse comércio está concentrado em espécies extraídas da natureza. Foram exportadas 142.552.253 unidades de exemplares vivos durante o período do estudo. As vendas vêm decrescendo desde 2006, onde foram exportadas 26.075.241 unidades; esse número decaiu para 2.729.846 exemplares em 2015 (jan-jul). O valor total de ingresso de divisas das exportações foi de US$ 23,0 milhões. Dentre os 35 países importadores, destacaram-se a Alemanha, Taiwan, Estados Unidos e Japão que representaram juntos 75,5% do volume e 76,7% do valor das exportações. Nesse período foram comercializadas 375 espécies. As principais foram Paracheirodon axelrodi, P. simulans, Hemigrammus bleheri, Otociclus affinis e O. hoppei que representaram, juntas, 84,5% das exportações. Trinta espécies não estão na lista do IBAMA liberadas para exportação, e seis espécies que aparecem nas exportações atualmente estão na lista da fauna ameaçada de extinção do Brasil, dentre elas Hopliancistrus tricornis...

Analysis of the ornamental fish exports from the Amazon state, Brazil / Análise das exportações de peixes ornamentais do estado do Amazonas, Brasil

The updated status of the ornamental fish trade from the Amazonas state was analyzed between the years of 2006-2015 (IBAMA database). The trade of ornamental fish from Amazonas state mainly consists of species extracted from nature. A total of 142,552,253 specimens were exported during the studied period. Sales plummeted since 2006, from 26,075,241 specimens exported then to 2,729,846 specimens in 2015 (Jan-Jul). Between 2006 and 2015, a total of US$ 23.0 million in revenue was generated from fish exports destined to 35 countries. Germany, Taiwan, USA and Japan accounted for 75.5% of the volume and 76.7% of the value exported. During this time, 375 species were exported, included Paracheirodon axelrodi, P. simulans, Hemigrammus bleheri, Otociclus affinis and O. hoppei that together represented 84.5% of exports. Thirty are not on the list of IBAMA species released for export, and six are currently on the list of endangered fauna of Brazil, being them: Hopliancistrus tricornis, Leporacanthicus joselimai, Parancistrus nudiventris, Peckoltia compta, Scobinancistrus auratus and S. pariolispos. These results...(AU)

O corrente status do comércio de peixes ornamentais exportados do Estado Amazonas foi analisado entre os anos de 2006-2015 (banco de dados IBAMA). Esse comércio está concentrado em espécies extraídas da natureza. Foram exportadas 142.552.253 unidades de exemplares vivos durante o período do estudo. As vendas vêm decrescendo desde 2006, onde foram exportadas 26.075.241 unidades; esse número decaiu para 2.729.846 exemplares em 2015 (jan-jul). O valor total de ingresso de divisas das exportações foi de US$ 23,0 milhões. Dentre os 35 países importadores, destacaram-se a Alemanha, Taiwan, Estados Unidos e Japão que representaram juntos 75,5% do volume e 76,7% do valor das exportações. Nesse período foram comercializadas 375 espécies. As principais foram Paracheirodon axelrodi, P. simulans, Hemigrammus bleheri, Otociclus affinis e O. hoppei que representaram, juntas, 84,5% das exportações. Trinta espécies não estão na lista do IBAMA liberadas para exportação, e seis espécies que aparecem nas exportações atualmente estão na lista da fauna ameaçada de extinção do Brasil, dentre elas Hopliancistrus tricornis...(AU)

Chicken antibodies against venom proteins of Trimeresurus stejnegeri in Taiwan

The venom of bamboo vipers (Trimeresurus stejnegeri - TS), commonly found in Taiwan, contains deadly hemotoxins that cause severe envenomation. Equine-derived antivenom is a specific treatment against snakebites, but its production costs are high and there are some inevitable side effects. The aim of the present work is to help in the development of an affordable and more endurable therapeutic strategy for snakebites. Methods: T. stejnegeri venom proteins were inactivated by glutaraldehyde in order to immunize hens for polyclonal immunoglobulin (IgY) antibodies production. After IgY binding assays, two antibody libraries were constructed expressing single-chain variable fragment (scFv) antibodies joined by the short or long linker for use in phage display antibody technology. Four rounds of biopanning were carried out. The selected scFv antibodies were then further tested for their binding activities and neutralization assays to TS proteins. Results: Purified IgY from egg yolk showed the specific binding ability to TS proteins. The dimensions of these two libraries contain 2.4 × 107 and 6.8 × 107 antibody clones, respectively. An increase in the titers of eluted phage indicated anti-TS clones remarkably enriched after 2nd panning. The analysis based on the nucleotide sequences of selected scFv clones indicated that seven groups of short linkers and four groups of long linkers were identified. The recombinant scFvs showed significant reactivity to TS venom proteins and a cross-reaction to Trimeresurus mucrosquamatus venom proteins. In in vivo studies, the data demonstrated that anti-TS IgY provided 100% protective effects while combined scFvs augmented partial survival time of mice injected with a lethal amount of TS proteins. Conclusion: Chickens were excellent hosts for the production of neutralization antibodies at low cost. Phage display technology is available for generation of monoclonal antibodies against snake venom proteins. These antibodies could be applied in the development of diagnostic kits or as an alternative for snakebite envenomation treatment in the near future.(AU)

Chicken antibodies against venom proteins of Trimeresurus stejnegeri in Taiwan

The venom of bamboo vipers (Trimeresurus stejnegeri - TS), commonly found in Taiwan, contains deadly hemotoxins that cause severe envenomation. Equine-derived antivenom is a specific treatment against snakebites, but its production costs are high and there are some inevitable side effects. The aim of the present work is to help in the development of an affordable and more endurable therapeutic strategy for snakebites. Methods: T. stejnegeri venom proteins were inactivated by glutaraldehyde in order to immunize hens for polyclonal immunoglobulin (IgY) antibodies production. After IgY binding assays, two antibody libraries were constructed expressing single-chain variable fragment (scFv) antibodies joined by the short or long linker for use in phage display antibody technology. Four rounds of biopanning were carried out. The selected scFv antibodies were then further tested for their binding activities and neutralization assays to TS proteins. Results: Purified IgY from egg yolk showed the specific binding ability to TS proteins. The dimensions of these two libraries contain 2.4 × 107 and 6.8 × 107 antibody clones, respectively. An increase in the titers of eluted phage indicated anti-TS clones remarkably enriched after 2nd panning. The analysis based on the nucleotide sequences of selected scFv clones indicated that seven groups of short linkers and four groups of long linkers were identified. The recombinant scFvs showed significant reactivity to TS venom proteins and a cross-reaction to Trimeresurus mucrosquamatus venom proteins. In in vivo studies, the data demonstrated that anti-TS IgY provided 100% protective effects while combined scFvs augmented partial survival time of mice injected with a lethal amount of TS proteins. Conclusion: Chickens were excellent hosts for the production of neutralization antibodies at low cost. Phage display technology is available for generation of monoclonal antibodies against snake venom proteins. These antibodies could be applied in the development of diagnostic kits or as an alternative for snakebite envenomation treatment in the near future.(AU)

Full-Length Genomic Characterization of Chicken Anemia Virus in Turkey

Chicken infectious anemia (CIA) is an immune-suppressive disease caused by chicken anemia virus (CAV). It is characterized by lymphoid atrophy, aplastic anemia, especially in chicks. In this study, full-length genomic characterization of CAV DNA from the broiler flocks in Turkey and phylogenetic analysis were aimed. In the study, CAV DNA were found positive for 37 (53%) flocks with PCR studies from thymus tissues of each 70 broiler flocks. And 17 purified CAV DNA PCR products from these 37 CAV isolates were full length sequenced with the NGS method (Illumina MiSeq). Also with the phylogenetic analyses, full length PCR products of 17 purified CAV isolates have been determined as 2298bp genome size and 99% similarity with each other. The highest similarity (99%) has been detected with the isolates from China and Taiwan. Furthermore, a 97-98% similarity has been detected with vaccine strains (Cux-1, 26P4 and Del Ros) and also 88-90 % similarity has been detected with GyV4 and GyV3 isolates. As a result, in the study full length genomic characterization of CAV DNA from the 7 regions of Turkey were determined. And also all Turkish CAV isolates and vaccine strains were in group 2 according to the phylogenetic tree were obtained. But these isolates and vaccine strains were not found in the same group with GyV3 and GyV4 strains. Besides, these CAV isolates were showed more similarity to the isolates reported from Taiwan and China than the vaccine strains.(AU)

Full-Length Genomic Characterization of Chicken Anemia Virus in Turkey

Chicken infectious anemia (CIA) is an immune-suppressive disease caused by chicken anemia virus (CAV). It is characterized by lymphoid atrophy, aplastic anemia, especially in chicks. In this study, full-length genomic characterization of CAV DNA from the broiler flocks in Turkey and phylogenetic analysis were aimed. In the study, CAV DNA were found positive for 37 (53%) flocks with PCR studies from thymus tissues of each 70 broiler flocks. And 17 purified CAV DNA PCR products from these 37 CAV isolates were full length sequenced with the NGS method (Illumina MiSeq). Also with the phylogenetic analyses, full length PCR products of 17 purified CAV isolates have been determined as 2298bp genome size and 99% similarity with each other. The highest similarity (99%) has been detected with the isolates from China and Taiwan. Furthermore, a 97-98% similarity has been detected with vaccine strains (Cux-1, 26P4 and Del Ros) and also 88-90 % similarity has been detected with GyV4 and GyV3 isolates. As a result, in the study full length genomic characterization of CAV DNA from the 7 regions of Turkey were determined. And also all Turkish CAV isolates and vaccine strains were in group 2 according to the phylogenetic tree were obtained. But these isolates and vaccine strains were not found in the same group with GyV3 and GyV4 strains. Besides, these CAV isolates were showed more similarity to the isolates reported from Taiwan and China than the vaccine strains.

Clinical and laboratory features distinguishing between Deinagkistrodon acutus and Daboia siamensis envenomation

Background:There are 6 species of venomous snakes in Taiwan. Two of them, Deinagkistrodon acutus (D. acutus) and Daboia siamensis (D. siamensis), can cause significant coagulopathy. However, a significant proportion of patients with snakebites cannot identify the correct snake species after envenomation, which hampers the application of antivenom. Hence, the differential diagnosis between the two snakebites by clinical presentations is important. This study aims to compare their clinical and laboratory features for the purpose of differential diagnosis between the two snakebites.Methods:We retrospectively reviewed the medical records of patients who arrived at the emergency department due to D. acutus or D. siamensis envenomation, between 2003 and 2016, in one medical center in eastern Taiwan. Since these snakebites are rare, we also included 3 cases reported from another hospital in central Taiwan.Results:In total, 15 patients bitten by D. acutus and 12 patients by D. siamensis were analyzed. Hemorrhagic bulla formation and the need for surgical intervention only presented for D. acutus envenomation cases (Both 53.3% vs. 0.0%, P= 0.003). As to laboratory features, lower platelet counts (20.0 × 103/μL [interquartile range, 14-66 × 103/μL] vs. 149.0 × 103/μL [102.3-274.3 × 103/μL], P = 0.001), lower D-dimer level (1423.4 μg/L [713.4-4212.3 μg/L] vs. 12,500.0 μg/L [2351.4-200,000 μg/L], P = 0.008), higher proportion of patients with moderate-to-severe thrombocytopenia (platelet count < 100 × 103/μL) (80% vs. 16.7%, odds ratio (OR) = 20.0, 95% CI, 2.77-144.31; P = 0.002), and lower proportion of patients with extremely high D-dimer (> 5000 ng/mL) (16.7% vs. 66.7%, adjusted OR = 0.1 (95% CI, 0.01-0.69; P = 0.036) were found a...(AU)

Clinical and laboratory features distinguishing between Deinagkistrodon acutus and Daboia siamensis envenomation

There are 6 species of venomous snakes in Taiwan. Two of them, Deinagkistrodon acutus (D. acutus) and Daboia siamensis (D. siamensis), can cause significant coagulopathy. However, a significant proportion of patients with snakebites cannot identify the correct snake species after envenomation, which hampers the application of antivenom. Hence, the differential diagnosis between the two snakebites by clinical presentations is important. This study aims to compare their clinical and laboratory features for the purpose of differential diagnosis between the two snakebites. Methods: We retrospectively reviewed the medical records of patients who arrived at the emergency department due to D. acutus or D. siamensis envenomation, between 2003 and 2016, in one medical center in eastern Taiwan. Since these snakebites are rare, we also included 3 cases reported from another hospital in central Taiwan. Results: In total, 15 patients bitten by D. acutus and 12 patients by D. siamensis were analyzed. Hemorrhagic bulla formation and the need for surgical intervention only presented for D. acutus envenomation cases (Both 53.3% vs. 0.0%, P= 0.003). As to laboratory features, lower platelet counts (20.0 × 103/µL [interquartile range, 14-66 × 103/µL] vs. 149.0 × 103/µL [102.3-274.3 × 103/µL], P = 0.001), lower D-dimer level (1423.4 µg/L [713.4-4212.3 µg/L] vs. 12,500.0 µg/L [2351.4-200,000 µg/L], P = 0.008), higher proportion of patients with moderate-to-severe thrombocytopenia (platelet count < 100 × 103/µL) (80% vs. 16.7%, odds ratio (OR) = 20.0, 95% CI, 2.77-144.31; P = 0.002), and lower proportion of patients with extremely high D-dimer (> 5000 ng/mL) (16.7% vs. 66.7%, adjusted OR = 0.1 (95% CI, 0.01-0.69; P = 0.036) were found among cases of D. acutus envenomation compared to D. siamensis envenomation. The combination of hemorrhagic bulla, thrombocytopenia, and a lack of extremely high D-dimer had good discriminatory power (area under the curve (AUC) = 0.965; 95% CI, 0.904-1.00) for distinguishing D. acutus from D. siamensis envenomation. Conclusions: The presentation of moderate to severe thrombocytopenia (platelet count < 100 × 103/µL) and hemorrhagic bulla formation may indicate D. acutus envenomation. However, the envenomed patient with extremely high D-dimer levels may indicate a D. siamensis envenomation. These findings may help diagnose and select the right antivenom in patients with unknown snakebites who present significant coagulopathy.(AU)

Deinagkistrodon acutus envenomation: a report of three cases

Abstract Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6 to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.

Envenoming by Viridovipera stejnegeri snake: a patient with liver cirrhosis presenting disruption of hemostatic balance

Abstract Background In most cases of envenoming by the green habu Viridovipera stejnegeri in Taiwan coagulopathy is not observed. Case presentation Herein, we describe the case of a patient with liver cirrhosis who developed venom-induced consumptive coagulopathy after V. stejnegeri bite. Laboratory investigation revealed the following: prothrombin time > 100 s (international normalized ratio > 10), activated partial thromboplastin time > 100 s, fibrinogen 50 mg/dL, and fibrin degradation product > 80 g/mL. The patient recovered after administration of bivalent hemorrhagic antivenom, vitamin K, fresh frozen plasma and cryoprecipitate. Conclusion The liver, directly involved in the acute phase reaction, is the main responsible for neutralization of animal toxins. Any patient with history of liver cirrhosis bitten by a venomous snake, even those whose venoms present low risk of coagulopathy, should be very carefully monitored for venom-induced consumptive coagulopathy (VICC), since the hemostatic balance may be disrupted.

Deinagkistrodon acutus envenomation: a report of three cases

Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6- to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.(AU)

Deinagkistrodon acutus envenomation: a report of three cases

Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6- to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.(AU)

Envenoming by Viridovipera stejnegeri snake: a patient with liver cirrhosis presenting disruption of hemostatic balance

Background In most cases of envenoming by the green habu Viridovipera stejnegeri in Taiwan coagulopathy is not observed. Case presentation Herein, we describe the case of a patient with liver cirrhosis who developed venom-induced consumptive coagulopathy after V. stejnegeri bite. Laboratory investigation revealed the following: prothrombin time > 100 s (international normalized ratio > 10), activated partial thromboplastin time > 100 s, fibrinogen < 50 mg/dL, and fibrin degradation product > 80 μg/mL. The patient recovered after administration of bivalent hemorrhagic antivenom, vitamin K, fresh frozen plasma and cryoprecipitate. Conclusion The liver, directly involved in the acute phase reaction, is the main responsible for neutralization of animal toxins. Any patient with history of liver cirrhosis bitten by a venomous snake, even those whose venoms present low risk of coagulopathy, should be very carefully monitored for venom-induced consumptive coagulopathy (VICC), since the hemostatic balance may be disrupted.(AU)

Envenoming by Viridovipera stejnegeri snake: a patient with liver cirrhosis presenting disruption of hemostatic balance

Background In most cases of envenoming by the green habu Viridovipera stejnegeri in Taiwan coagulopathy is not observed. Case presentation Herein, we describe the case of a patient with liver cirrhosis who developed venom-induced consumptive coagulopathy after V. stejnegeri bite. Laboratory investigation revealed the following: prothrombin time > 100 s (international normalized ratio > 10), activated partial thromboplastin time > 100 s, fibrinogen < 50 mg/dL, and fibrin degradation product > 80 μg/mL. The patient recovered after administration of bivalent hemorrhagic antivenom, vitamin K, fresh frozen plasma and cryoprecipitate. Conclusion The liver, directly involved in the acute phase reaction, is the main responsible for neutralization of animal toxins. Any patient with history of liver cirrhosis bitten by a venomous snake, even those whose venoms present low risk of coagulopathy, should be very carefully monitored for venom-induced consumptive coagulopathy (VICC), since the hemostatic balance may be disrupted.(AU)

ASPECTOS PRODUTIVOS, MORFOFISIOLÓGICOS E NUTRICIONAIS DE GENÓTIPOS DE CAPIM-ELEFANTE DE DIFERENTES PORTES CONSORCIADOS COM CUNHÃ

Objetivou-se avaliar aspectos produtivos, morfofisiológicos e nutricionais de genótipos de capim-elefante (Cenchrus purpureus Schum. Syn. Pennisetum purpureum Schum.) de diferentes portes, sob monocultivo, e de seus respectivos consórcios com a cunhã (Clitoria ternatea L.). Os genótipos Elefante B e IRI-381 (porte alto), Mott e Taiwan A-146 2.37 (anões) e a leguminosa foram avaliados em 2019 e 2020. Maior acúmulo de forragem anual (P < 0,0001) ocorreu na colheita do Elefante B em monocultivo (19,3 t ha-1 ano-1 MS). A maior estabilidade de acúmulo de forragem ocorreu no consórcio Mott + cunhã (i 2= 0,10), enquanto o Elefante B sob monocultivo foi menos estável (i 2 = 5,59). Os maiores índices de competitividade da cunhã ocorreram nos consórcios com o Mott (3,31) e o Taiwan A-146 2.37 (3,14). As forragens colhidas do Taiwan A-146 2.37 em monocultivo e consorciado com a cunhã tiveram os melhores perfis proteicos, com maiores proporções (P < 0,0001) de proteína solúvel verdadeira (610 e 621 g kg-1 PB, respectivamente) e menores de proteína insolúvel em detergente ácido (41 e 43 g kg-1 PB, respectivamente). Na forragem colhida do Mott e do Taiwan A-146 2.37, em monocultivo, foram observados maiores (P = 0,0148) coeficientes de digestibilidade in vitro da matéria seca (755 e 745 g kg-1, respectivamente), enquanto as forragens obtidas via consórcio tiveram menor digestibilidade. Nos dosséis do genótipo Mott foram observados maiores coeficientes de extinção luminosa (0,47), índice de área foliar (3,82) e maiores teores de carboidratos não-fibrosos (CNF) na forragem (181 g kg-1 MS). Maiores teores de CNF também foram encontrados na forragem obtida via consórcio com a cunhã (178 g kg-1 MS). O genótipo Elefante B, de porte alto, apresenta características morfológicas que favorecem a produção de forragem. Os genótipos anões Mott e Taiwan A-146 2.37 apresentam características morfológicas que melhoram o valor nutritivo. A inclusão da cunhã no sistema aumenta a estabilidade para acúmulo de forragem. O consórcio da cunhã com genótipos de capim-elefante incrementa teores de proteína bruta com boa proporção de proteínas digestíveis, ao passo que reduz a digestibilidade da forragem. A composição morfológica e as características estruturais do genótipo anão Mott favorecem a síntese de carboidratos não-fibrosos nos tecidos vegetais. A inclusão da cunhã no sistema não reduz a eficiência do uso de luz pelas plantas e não compromete a penetração da radiação fotossinteticamente ativa até a base do dossel.

This study aimed to evaluate productive, morphophysiological and nutritional aspects of elephant grass genotypes (Cenchrus purpureus Schum. Syn. Pennisetum purpureum Schum.), with different sizes, under monocropping and from their intercrops with the butterfly pea (Clitoria ternatea L.). Elephant B and IRI-381 (tall-sized genotypes), besides the dwarf Mott and Taiwan A-146 2.37 and the forage legume were assessed in 2019 and 2020. Greater annual herbage accumulation (P < 0.0001) was observed in the harvesting of Elephant B under monocropping (19.3 t ha-1 year-1). The greatest yield stability occurred in the Mott + butterfly pea intercropping (i2 = 0.10), while the Elephant B under monocropping was less stable (i 2 = 5.59). Greater butterfly peas competitiveness indexes were observed in the intercrops with dwarf Mott (3.31) and Taiwan A-146 2.37 (3.14). Forage harvested from Taiwan A-146 2.37 under monocropping and that one from its intercropping with the butterfly pea showed greater proportions (P < 0.0001) of true soluble protein (610 and 621 g kg-1 CP, respectively) and lower ones of acid detergent insoluble protein (41 and 43 g kg-1 CP, respectively). In the forage harvested from dwarf Mott and Taiwan A-146 2.37, under monocropping, there were greater (P = 0.0148) coefficients of in vitro digestible dry matter (755 and 745 g kg-1, respectively), while the forages obtained from the intercrops had lower digestibility. Greater coefficients of light extinction (0.47), leaf area index (3.82) and non-fiber carbohydrates content (NFC) (181 g kg-1 DM) were observed in the dwarf Mott canopies. Greater NFC content also was found in the forage obtained from the intercrops (178 g kg-1 DM). Elephant B, a tall-sized genotype, presents morphological traits that favor the forage production. Dwarf Mott and Taiwan A-146 2.37 show morphological characteristics that favor the forage nutritional value. Butterfly peas inclusion in the system improves the stability for herbage accumulation. Butterfly peas inclusion enhances the crude protein content with a great proportion of digestible proteins, and reduces the forage digestibility. Both the morphological composition and structural traits of the dwarf Mott favor the synthesis of non-fiber carbohydrates in the vegetal tissue. Butterfly peas inclusion into the system does not reduce the light-use efficiency by plants, neither reduces the penetration of photosynthetically active radiation until the canopy basis.

FUBÁ DE MILHO COMO ADITIVO NA ENSILAGEM DE GENÓTIPOS DE CAPIM- ELEFANTE [Cenchrus purpureus (Schumach.) Morrone] CONSORCIADOS COM CUNHÃ (Clitoria ternatea L.)

A pesquisa foi conduzida com o objetivo de avaliar o efeito da adição de fubá de milho sobre as perdas por gases e efluentes, valor nutritivo e a estabilidade aeróbica de silagens de dois genótipos de capim elefante [Cenchrus purpureus (Schumach.) Morrone] consorciados com cunhã (Clitoria ternatea L.). O experimento foi desenvolvido sob delineamento inteiramente casualizado, seguindo arranjo fatorial 2 x 2 composto por dois genótipos de capim-elefante (Taiwan A-146 2.37 e IRI-381), ambos consorciados com cunhã, colhidos aos 75 dias de rebrotação, com e sem aditivo, com quatro repetições. As silagens foram confeccionadas em silos experimentais de PVC, que permaneceram fechados por 60 dias. Maiores valores de perda por gases (1,2% MS) ocorreram nas silagens do genótipo Taiwan A-146 2.37. As silagens aditivadas apresentaram menor perda total de matéria seca (MS) e maior com recuperação de MS, com valores de 16,5% MS e de 83,5% respectivamente. A presença do aditivo também promoveu maior concentração de carboidratos solúveis em água remanescente (2,22 mg/g MS). Maiores valores de pH (4,2) e menor concentração de etanol foram observados nas silagens do Taiwan A-146 2.37. Embora não tenha sido observado diferença entre as concentrações de ácidos orgânicos, presume-se que todas as silagens apresentaram bom perfil fermentativo, tendo em vista a alta concentração de ácido lático (103 g/Kg MS) e reduzida concentração de ácido butírico (0,3 g/Kg MS). Maiores teores de matéria mineral, menores teores de matéria orgânica e fibra insolúvel em detergente ácido foram observados nas silagens confeccionadas de Taiwan A-146 2.37. As silagens aditivadas apresentaram maiores teores de MS (221 g/Kg MS), digestibilidade in vitro da matéria seca, menores teores de fibra em detergente neutro (584 g/Kg MS), ácido (357 g/Kg MS), celulose (305 g/Kg MS) e hemicelulose (229 g/Kg MS). Houve interação (P < 0,05) genótipo × aditivo para proteína bruta (PB), com maior valor para a silagem de Taiwan A-146 2.37 (116 g/Kg MS). Todas as silagens perderam a estabilidade aeróbica após 45 horas da abertura dos silos. A adição de fubá de milho não resultou em aumento nas concentrações de ácido lático, porém observou-se melhoria no perfil fermentativo das silagens e baixas concentrações de ácido butírico. Outros parâmetros fermentativos (pH e nitrogênio amoniacal) também indicaram que não ocorreu fermentação secundária nas silagens. De maneira geral, não foram observadas diferenças relevantes no valor nutritivo das silagens dos genótipos avaliados. A presença da cunhã não influencia negativamente no perfil fermentativo de silagens de capim- elefante. A adição de 5% de fubá de milho promove menores perdas e maior recuperação de matéria seca e valor nutritivo de silagens de capim-elefante.

The research was conducted to evaluate the effect of cornmeal addition on gas and effluent losses, nutritional value and aerobic stability of silages of two elephant grass genotypes [Cenchrus purpureus (Schumach.) Morrone] intercropped with butterfly pea (Clitoria ternatea L.). The experiment was carried out under a completely randomized design, following a 2 x 2 factorial arrangement composed of two elephant grass genotypes (Taiwan A-146 2.37 and IRI-381), both intercropped with butterfly pea and harvested at 75 days of regrowth, with and without additive on four repetitions. The silages were made in experimental PVC silos, which remained closed for 60 days. Higher gas loss values (1.2% DM) occurred in the Taiwan A-146 genotype silages 2.37. Additive silages showed lower total loss of dry matter (DM) and higher with DM recovery, with values of 16.5% DM and 83.5%, respectively. The presence of the additive also promoted a higher concentration of soluble carbohydrates in remaining water (2.22 mg/g DM). Higher pH values (4.2) and lower ethanol concentration were observed in Taiwan A-146 2.37 silages. Although no difference of organic acids concentration was observed it is assumed that all silages had good fermentative profile, considering the lactic acid high concentration (103 g/Kg MS) and low concentration of butyric acid (0. 3 g/kg MS). Higher mineral matter content, lower organic matter content, and acid detergent insoluble fiber were observed in silages made from Taiwan A-146 2.37. The additive silages had higher DM contents (221 g/Kg DM), in vitro digestibility of dry matter, lower levels of fiber on neutral detergent (584 g/Kg DM), acid (357 g/Kg DM), cellulose (305 g/kg MS), and hemicellulose (229 g/kg MS). There was interaction (P < 0.05) genotype × additive for crude protein (CP), with the highest value for the Taiwan A-146 2.37 silage (116 g/Kg MS). All silages lost aerobic stability 45 hours after opening the silos. The addition of cornmeal did not result in an increase in lactic acid concentrations, but there was an improvement in the fermentative profile of the silages and low concentrations of butyric acid. Other fermentative parameters (pH and ammonia nitrogen) also indicated that there was no secondary fermentation in the silages. In general, no relevant differences were observed in the nutritional value in the silages of the evaluated genotypes. The presence of butterfly pea does not negatively influence the fermentation profile of elephant grass silages. The addition of 5% cornmeal promotes lower losses and greater recovery of dry matter and nutritive value of elephant grass silages.