[Distribution of findings of scorpions in Buenos Aires city in the period 2001-2012 and their sanitary implications]. / Distribución de los hallazgos de escorpiones en la Ciudad de Buenos Aires en el período 2001-2012 y sus implicancias sanitarias.

Scorpion stings and their associated mortality increased in the last years in Argentina, with a cumulative record of 73,617 cases and 30 deaths during the period 2001-2012, occurring almost all the deaths in pediatric patients. However, deaths due to severe envenoming by scorpion stings have not been recorded in Buenos Aires city and suburban regions, although the presence of scorpions in this city has been increasingly reported. We studied the temporal and geographical distribution of Tityus trivittatus findings in Buenos Aires city from the database of the Research and Development Area from the National Institute for Production of Biologics of the National Ministry of Health during the period 10/01/2001 to 31/12/2012 in order to correlate these findings with the distribution of health centers in the city. In this period 385 consults with identification of scorpions were recorded. Annual records showed a growing trend. Georeferenced data showed that findings appeared to increase in the surroundings of metro and train stations, mainly at the east of the city with expansion to the west. Although Toxicology services are geographically related to the zones with higher density of finding of scorpions, the accessibility to the centers with antivenom may hinder its application in the recommended time; some measures to avoid possible delays in the application of the treatment are suggested.

En Argentina, las picaduras de alacrán (escorpión) y la mortalidad asociada aumentaron en los últimos años. Durante el período 20012012, se registraron 73 617 accidentes y 30 óbitos, casi todos en pacientes pediátricos. A diferencia de otras latitudes del país, en la Ciudad de Buenos Aires y su Conurbano, no se registraron envenenamientos graves o muertes por estos arácnidos. El objetivo fue describir la distribución temporal y geográfica de los hallazgos de Tityus trivittatus en la Ciudad de Buenos Aires desde el 10/1/2001 al 31/12/2012 y su relación con la distribución de los centros asistenciales. Hubo 385 consultas con identificación de escorpiones. Los registros anuales mostraron una tendencia creciente. El georreferenciamiento mostró áreas con mayor frecuencia de hallazgos y densidad en proximidades de ciertas estaciones de ferrocarril y subterráneos, principalmente al este de la ciudad con expansión hacia el oeste. Si bien los centros con servicios de Toxicología coinciden geográficamente con estas zonas, la accesibilidad a centros que disponen del antiveneno puede dificultar su aplicación en el tiempo recomendado. Se sugieren medidas para prevenir demoras en los tratamientos.

[The toxicity of venom of Bothrops (Rhinocerophris) alternatus in different areas of Cordoba State in Argentina]. / Caracterización tóxica del veneno de Bothrops (Rhinocerophis) alternatus de diferentes regiones de la provincia de Córdoba (Argentina).

Snake venoms can show biochemical and toxicological variability even in specimens from the same specie. The geographical localization of the snakes is one of the factors that can influence those variations. By these reasons the venom from specimens of Bothrops (Rhinocerophis) alternatus ("crucera", "yararágrande"), one of the snakes of highest medical importance in Argentina, from three different regions of Córdoba was studied. Lehtal potency, hemorrhagic, coagulant on plasma and thrombin like activities as well as the electrophoretic patterns of venom from snakes of Calamuchita, Traslasierras and the East of the province were determined. The venom from the snakes of the three regions showed the characteristic activities of the venom of the majority of Bothrops, causing hemorrhage, hemostatic disturbances acting on plasma or directly on fibrinogen with a "thrombin like activity". The different samples were very similar regarding their biochemical characteristics and toxic potencies at difference of previous observations on venoms from the same specie in different regions of other provinces fro Argentina. Bivalent antivenom, the one used by the Provincial Ministry of Health to treat the bothropic accidents, neutralized in all the cases the toxic activities of the venom in very similar range of neutralizing potency.

Los venenos serpientes pueden presentar variabilidad en sus características bioquímicas y toxicológicas aún en ejemplares de una misma especie. La localización geográfica de los ejemplares es uno de los factores que puede influenciar estas variaciones. Por este motivo se estudió el veneno de ejemplares Bothrops (Rhinocerophis) alternatus ("crucera", "yarará grande"), una de las serpientes de mayor importancia médica de Argentina, de tres regiones diferentes de Córdoba. Se estudió la potencia letal, la actividad hemorrágica, coagulante en plasma y trombina símil y el patrón electroforético de ejemplares de Calamuchita, Traslasierras y del Este de la provincia. El veneno de las serpientes de las tres regiones presentó las actividades características de los venenos de la mayoría de las Bothrops, causando hemorragias y alteraciones en el sistema hemostático, afectando tanto al plasma como actuando directamente sobre el fibrinógeno mediante una actividad trombina símil. Las distintas muestras fueron muy similares en cuanto a sus características bioquímicas ya sus potencias tóxicas, a diferencia de lo observado con veneno de ejemplaresB. alternatusde distintas regiones de otras provincias de la Argentina. El antiveneno Bivalente utilizado por el Ministerio de Salud de Córdoba para tratar los accidentes por Bothrops neutralizó, en todos los casos las actividades tóxicas ensayadas en rangos de potencias neutralizantes muy similares.

Caracterización tóxica del veneno de Bothrops (Rhinocerophis) alternatus de diferentes regiones de la provincia de Córdoba (Argentina). / [The toxicity of venom of Bothrops (Rhinocerophris) alternatus in different areas of Cordoba State in Argentina].

Snake venoms can show biochemical and toxicological variability even in specimens from the same specie. The geographical localization of the snakes is one of the factors that can influence those variations. By these reasons the venom from specimens of Bothrops (Rhinocerophis) alternatus ("crucera", "yararágrande"), one of the snakes of highest medical importance in Argentina, from three different regions of Córdoba was studied. Lehtal potency, hemorrhagic, coagulant on plasma and thrombin like activities as well as the electrophoretic patterns of venom from snakes of Calamuchita, Traslasierras and the East of the province were determined. The venom from the snakes of the three regions showed the characteristic activities of the venom of the majority of Bothrops, causing hemorrhage, hemostatic disturbances acting on plasma or directly on fibrinogen with a "thrombin like activity". The different samples were very similar regarding their biochemical characteristics and toxic potencies at difference of previous observations on venoms from the same specie in different regions of other provinces fro Argentina. Bivalent antivenom, the one used by the Provincial Ministry of Health to treat the bothropic accidents, neutralized in all the cases the toxic activities of the venom in very similar range of neutralizing potency.

Caracterización tóxica del veneno de Bothrops (Rhinocerophis) alternatus de diferentes regiones de la provincia de Córdoba (Argentina) / [The toxicity of venom of Bothrops (Rhinocerophris) alternatus in different areas of Cordoba State in Argentina].

Snake venoms can show biochemical and toxicological variability even in specimens from the same specie. The geographical localization of the snakes is one of the factors that can influence those variations. By these reasons the venom from specimens of Bothrops (Rhinocerophis) alternatus ("crucera", "yararágrande"), one of the snakes of highest medical importance in Argentina, from three different regions of Córdoba was studied. Lehtal potency, hemorrhagic, coagulant on plasma and thrombin like activities as well as the electrophoretic patterns of venom from snakes of Calamuchita, Traslasierras and the East of the province were determined. The venom from the snakes of the three regions showed the characteristic activities of the venom of the majority of Bothrops, causing hemorrhage, hemostatic disturbances acting on plasma or directly on fibrinogen with a "thrombin like activity". The different samples were very similar regarding their biochemical characteristics and toxic potencies at difference of previous observations on venoms from the same specie in different regions of other provinces fro Argentina. Bivalent antivenom, the one used by the Provincial Ministry of Health to treat the bothropic accidents, neutralized in all the cases the toxic activities of the venom in very similar range of neutralizing potency.

Envenenamiento de Chelydra serpentina (Reptilia: Testudines) por Tityus trivittatus (Scorpionida: Buthidae) / Envenomation of Chelydra serpentina (Reptilia: Testudines) by Tityus trivittatus (Scorpionida: Buthidae)

Se describe el caso de un ejemplar de tortuga mordedora (Chelydra serpentina) que fue hallada con los miembros tetanizados en extensión, midriasis y poca respuesta a estímulos externos, en cuyo recinto se encontró un ejemplar de escorpión Tityus trivittatus. Ante el claro cuadro de envenenamiento, se trató al quelonio con antiveneno escorpiónico específico retornando a un estado de relajación muscular a las seis horas y encontrándoselo totalmente normal a las 24 horas sin mostrar secuelas posteriores. Este es el primer comunicado sobre el envenenamiento de quelonios por escorpiones. Se discuten algunos aspectos de este envenenamiento escorpiónico y su tratamiento con antiveneno específico.

We report the case of a snapping turtle (Chelydra serpentina) found tetanized, with the limbs in extension, mydriasis and poor response to external stimuli, in whose terrarium was found a Tityus trivittatus scorpion. Based on the clear clinical picture of envenoming, the turtle was treated with a specific scorpion antivenin, returning to a state of muscle relaxation after six hours of treatment and it was found totally normal at 24 hours, without envenoming sequelae. This is the first report on turtle envenomation by scorpion. The scorpion envenomation in reptiles and the treatment with specific antivenom is discussed.

General biochemical and immunological characterization of the venom from the scorpion Tityus trivittatus of Argentina.

Tityus trivittatus is the Argentinean scorpion reported to cause the majority of human fatalities in the country, however no systematic studies have been conducted with the venom of this species. This communication describes a general biochemical and immunological characterization of the venom obtained from T. trivittatus scorpions collected in the city of Buenos Aires and various provinces of Argentina: Catamarca, Cordoba, Entre Rios, La Rioja, Santa Fe and Santiago del Estero. These are places where human accidents were reported to occur due to this scorpion. For comparative purposes two types of samples were assayed: whole soluble venom obtained by electrical stimulation and supernatant from homogenized venomous glands. Two strains of mice (NIH and CF-1) were used for LD(50) determinations by two distinct routes of administration (intravenously and intraperitoneally). Important variations were found that goes from 0.5 to 12 mg/kg mouse body weight. Samples of soluble venom were always more potent than Telson homogenates. More complex pattern was observed in homogenates compared to soluble venom, as expected. This was supported by gel electrophoretic analysis and high performance liquid chromatographic (HPLC) separations. Additionally, the HPLC profile was enriched in proteins resolved at similar elution times as other known toxins from scorpion venoms studied. Immune enzymatic assays were also conducted comparatively, using four different anti-venoms commercially available for treatment of scorpion stings (Argentinean antidote from INPB, two anti-venoms from Butantan Institute of Brazil and Alacramyn from the Mexican Bioclon Institute). Cross-reactivities were observed and are reported among the various venoms and anti-venoms used. Lung, heart, liver and pancreas pathological modifications were observed on tissues of intoxicated mice. It seems that there are important variations on the venom compositions of the various samples studied and reported here, depending on the geographical area where the scorpions were captured. The results reported here are important for the clinical outcome of human accidents.

A new venomous scorpion responsible for severe envenomation in Argentina: Tityus confluens.

In Argentina the scorpions of medical importance belong to the genus Tityus (T.), particularly the species T. trivittatus, the only scorpion whose sting is recognized to be associated with severe human envenoming and death. This genus is distributed from the north of the Patagonian region to the center and some provinces in the north of the country. During the period 2003-2006 four children died following scorpion stings, of which one was certainly and three were probably by T. confluens. In 2006, in the province of Tucumán, a girl died by scorpion envenoming and the scorpion responsible for the death, found in her shoe, was T. confluens. We thus studied the toxicity of venom gland homogenates from T. confluens from the provinces of Jujuy and Catamarca, and of crude venom from specimens from Catamarca and the province of La Rioja. The lethal potencies of the telson homogenates were 7.0 and 18.6microg/g for Jujuy and Catamarca, respectively, while the lethal potency of the crude venom was 0.7microg/g. Injected mice showed generalized congestion and hepatic lesions. Pancreatic damage was observed in some animals. Lungs showed congestion and foci of hemorrhage and mild edema. The heart showed injury in the muscular fibers. The venom showed high reactivity against anti-T. trivittatus antivenom and against two anti-T. serrulatus antivenoms. The anti-T. trivittatus antivenom neutralized the lethal activity of T. confluens venom. In addition, the venom reacted very slightly against an anti-Centruroides antivenom. Therefore, the stings of this scorpion must be considered of risk for humans to the same degree as the stings of T. trivittatus.