Viperidae snake envenomation from a highly complex hospital in southwestern Colombia.

Background: Snake envenomation is a medical condition with high morbidity and mortality in southwestern Colombia. Objectives: To describe the characteristics of the envenomation caused by Viperidae snakes view in a highly complex hospital in Southwestern Colombia. Methods: A cross-sectional study was carried out. Patients treated for Viperidae snake envenomation from 2001 to 2020 in a Hospital Fundación Valle del Lili, Cali, Colombia, were studied. Results: Twenty-eight patients were included. Envenomation was caused by the genera Bothrops, Bothriechis, Porthidium, and Bothrocophias. The median age was 37.7 (±20.6), and they were predominantly male (19, 68%). Bites occurred on the upper extremities in 16 (57%) patients. Pain (23, 81%) and edema (22, 78%) were the most common clinical symptoms. Thirteen (46%) patients presented coagulopathy. Prolonged prothrombin and activated partial thromboplastin times were common: (22, 78% and 15, 53%, respectively). Twenty (71%) patients were treated with polyvalent antivenom (median dose of 6 (2-15) vials). The median time between the accident and antivenom administration was 9 h (5.5-17). Door-to-needle time was 37.5 (0-62) min. Eighteen (64%) patients were admitted to the intensive care unit. Three (11%) patients had serum sickness. Seven (25%) developed infectious complications, four (14%) had surgery, one (3%) had compartment syndrome, one (3%) underwent amputation of the affected limb, and one (3%) patient died. Conclusions: Local manifestations and coagulopathy were common clinical features. Polyvalent antivenom was an effective treatment for disease control. Significant complications were associated with delays in seeking medical care.

Envenomation by Eyelash Viper Bothriechis schlegelii (Berthold, 1846) in Southwestern Colombia.

INTRODUCTION: Bothriechis schlegelii is a Crotaline viperid species of Central America and Northern South America. The characteristics of its envenomation have not been well established. We present clinical characteristics of human cases evaluated and treated in a hospital in southwestern Colombia. METHODS: We evaluated data from patients who suffered Bothriechis schlegelii envenomation and were seen at Fundación Valle del Lili Hospital, Cali, Colombia between 2011 and 2022. RESULTS: Eight patients were included, with a median age of 24 years. Snakebites occurred in rural areas. Six (75%) patients were bitten on the upper extremities in relation to the arboreal habits of this animal. The most common symptoms were pain and edema (N = 8, 100%), ecchymoses (N = 2, 25%), and paresthesia (N = 2, 25%). The most common systemic findings were hypofibrinogenemia (N = 8, 100%) and prolonged prothrombin time in five patients (N = 5, 62.5%). All were treated with polyvalent antivenom for Colombian snakes, with a good response and outcome. CONCLUSIONS: Most bite sites from B. schlegelii were on the upper limbs. All patients had both local manifestations, including edema, pain, and systemic effects with hypofibrinogenemia, but none had systemic bleeding. Every patient received antivenom and had favorable outcomes.

The Colombian bushmasters Lachesis acrochorda (García, 1896) and Lachesis muta (Linnaeus, 1766): Snake species, venoms, envenomation, and its management.

In Colombia, there are two species of bushmaster snakes, Lachesis acrochorda, which is distributed mainly in the west of the country (in the Choco region), and Lachesis muta in the southeast (in the Amazon and Orinoquia region), whose presence has been reduced due to the destruction of their habitats. Captive maintenance is challenging, making it difficult to obtain their venom for study and antivenom manufacturing. They are the largest vipers in the world. The occurrence of human envenomation is quite rare, but when it occurs, it is associated with high mortality. Bushmaster venom is necrotizing, hemorrhagic, myotoxic, hemolytic, and cardiovascular depressant. Due to the presence of bradycardia, hypotension, emesis, and diarrhea in some patients (Lachesis syndrome), the possibility of a vagal or cholinergic effect is raised. The treatment of envenomation is hindered by the scarcity of antivenom and the need to use high doses. A review of the most relevant biological and medical aspects of bushmaster snakes is presented, mainly for those occurring in Colombia, to facilitate their recognition and raise awareness about the need for special attention to improve their conservation and advance scientific knowledge, in particular, about their venom.

Biological and medical aspects related to the yellow-bellied sea snake Hydrophis platurus (Linnaeus, 1766): A view from Colombia.

In Colombia, 317 species of snakes have been recognized, of which 51 (17%) have medical importance due to the toxicity of their venom. A total of 95% of envenomations are caused by snakes of the family Viperidae and 5% of the family Elapidae. The latter form of envenomation is mainly caused by snakes of the genus Micrurus. The only sea snake described is the yellow-bellied snake (Hydrophis platurus), present in the Pacific Ocean. Although Colombia has approximately 1300 km on the Pacific coast and a significant presence of H platurus, envenomation is rare. As a result of the care of a patient with this type of envenomation and of the donation of a H platurus specimen to our laboratory, we decided to conduct this review on the most relevant biological, epidemiological and clinical aspects of this enigmatic and interesting species.

Pharmacological blockade of KV1.3 channel as a promising treatment in autoimmune diseases.

There are more than 100 autoimmune diseases (AD), which have a high prevalence that ranges between 5% and 8% of the general population. Type I diabetes mellitus, multiple sclerosis, systemic lupus erythematosus and rheumatoid arthritis remain the health problem of highest concern among people worldwide due to its high morbidity and mortality. The development of new treatment strategies has become a research hotspot. In recent years, the study of the ion channels presents in the cells of the immune system, regarding their functional role, the consequences of mutations in their genes and the different ways of blocking them are the subject of intense research. Pharmacological blockade of KV1.3 channel inhibits Ca2+ signaling, T cell proliferation, and pro-inflammatory interleukins production in human CD4+ effector memory T cells. These cells mediated most of the AD and their inhibition is a promising therapeutic target. In this review, we will highlight the biological function of KV1.3 channel in T cells, consequence of the pharmacological inhibition (through anemone and scorpion toxins, synthetic peptides, nanoparticles, or monoclonal antibodies) as well as the possible therapeutical application in AD.

Biomedical applications of snake venom: from basic science to autoimmunity and rheumatology.

Snake venoms have components with diverse biological actions that are extensively studied to identify elements that may be useful in biomedical sciences. In the field of autoimmunity and rheumatology, various findings useful for the study of diseases and potential drug development have been reported. The study of disintegrins, proteins that block the action of integrins, has been useful for the development of antiplatelet agents and principles for the development of immunosuppressants and antineoplastics. Several proteins in snake venoms act on the coagulation cascade, activating factors that have allowed the development of tests for the study of coagulation, including Russell's viper venom time, which is useful in the diagnosis of antiphospholipid syndrome. Neurotoxins with either pre- or postsynaptic effects have been used to study neurogenic synapses and neuromuscular plaques and the development of analgesics, muscle relaxants and drugs for neurodegenerative diseases. Various components act by inhibiting cells and proteins of the immune system, which will allow the development of anti-inflammatory and immunosuppressive drugs. This review summarizes the usefulness of the components of snake venoms in the fields of autoimmunity and rheumatology, which can serve as a basis for diverse translational research.

Clinical syndromes associated with Viperidae family snake envenomation in southwestern Colombia.

BACKGROUND: In southwestern Colombia there is a notable variety of snakes that belong to the Viperidae family (vipers). The particular clinical manifestation related to species is poorly reported. METHODS: Based on a prospective study about envenomation caused by vipers from 2011 to 2019 at the Fundación Valle del Lili Hospital, Cali, in southwest Colombia, we selected cases of admitted patients in which the snakes responsible were fully identified. They were cataloged by clinical syndrome according to prevalent signs (edema-inducing, necrotizing, blister-inducing, procoagulant, anticoagulant or myotoxic) and were related to the species that caused the envenomation. RESULTS: From a cohort of 53 patients, 21 patients (16 males [72.7%]) with an average age of 35 (3-69) y were included. The syndromes associated with envenomation were anticoagulant and necrotizing effects of Bothrops asper (five patients [22.7%]), blister-inducing and anticoagulant effects of Bothrops rhombeatus (five [22.7%]), anticoagulant effects of Bothrops punctatus (three patients [13.6%]), edema-inducing and anticoagulant effects of Bothriechis schlegelii (five [22.7%]), edema-inducing and myotoxic effects of Bothrocophias colombianus (one [4.5%]), edema-inducing and myotoxic effects of Bothrocophias myersi (one [4.5%]) and edema-inducing effects of Porthidium nasutum (one [4.5%]). CONCLUSION: In southwestern Colombia there is notable variety in species of snakes belonging to the family Viperidae (vipers) whose envenomation causes various clinical syndromes.

A morphological, reproductive, and molt phenology database for 379 bird species from the Colombian Tropical Andes.

The Colombian Tropical Andes are one of the regions with highest bird diversity on Earth. However, information on bird morphology, reproductive phenology, and molt is particularly scarce in this region. Also, this region is heavily impacted by deforestation, and it is vulnerable to climate change. Hence, providing baseline information on life history and morphological traits will be essential to support future research on functional diversity, climate change effects, conservation, evolution, and phenology. To fill this gap, we have compiled information on bird distribution, morphology, molt, and reproductive phenology at 52 localities of the Department of Caldas, covering an elevation range between 148 and 3845 m. This compilation comprises a wide range of habitats, including native forests, forestry plantations, croplands, and paramo. Our database presents information for 3,398 records belonging to 379 bird species (representing 23 orders, 53 families, and 258 genera). From those records, 2,843 correspond to information collected in the field between 2008 and 2019, and the remaining 555 records correspond to specimens deposited in the Natural History Museum of the Caldas University, collected between 1969 and 2014. We measured nine morphological traits from all specimens: total culmen, gape, bill width, bill depth, tarsus, wing length, tail length, total length, and mass. We also have reproductive condition information for 257 species and molt information available for 378 species. The information contained in this data set represents ~20% of the Colombian avifauna and ~11% of the bird species richness in South America. This data set is released for non-commercial use only. Credits should be given to this paper (i.e., proper citation), and the products generated with this database should be shared under the same license terms (CC BY-NC-SA).

Papel de la interculturalidad en el control del cáncer en pueblos indígenas

Pese a su importancia, la población indígena se caracteriza por tener mayor pobreza, menor acceso a educación y a salud, lo que conlleva a reducir su expectativa de vida. Otros aspectos como el elevado nivel de desempleo, la precariedad de servicios sociales, la vulneración de Derechos Humanos y la degradación del ambiente, configuran un desfavorable escenario de discriminación, marginación y exclusión. Aunque es bien conocida la necesidad de ofrecer servicios de salud diferenciales, esto aún no logra materializarse, lo que sumado a la ausencia de información y estrategias apropiadas, lleva a la falta de goce efectivo de la población indígena de los servicios para el control del cáncer que son accesibles al resto de la población. Dado lo anterior, es indispensable la reflexión respecto al estado y papel de la interculturalidad en el control del cáncer.

Despite its importance, the indigenous population is characterized by greater poverty, less access to education and health services, which leads to reduced life expectancy. Other facts such as the high rate of unemployment, the precarious social services, the violation of Human Rights and the environment degradation, constitute an unfortunate scenario of discrimination, marginalization and exclusion. Although the need to offer differential health services is well known, this has not yet materialized, in addition, the lack of information and appropriate strategies, leads to indigenous population unable to enjoy effectively the cancer control services. which are accessible to the rest of the population. According to the above mentioned, it is essential to reflect on the condition and role of interculturality in cancer control.

Apesar de sua importância, a população indígena é caracterizada por maior pobreza, menor acesso à educação e à saúde, o que leva a uma redução da expectativa de vida. Outros aspectos, como o alto nível de desemprego, a precariedade dos serviços sociais, a violação dos direitos humanos e a degradação do meio ambiente, constituem um cenário desfavorável de discriminação, marginalização e exclusão. Embora a necessidade de oferecer serviços diferenciais de saúde seja bem conhecida, isso ainda não é uma realidade, o que, somado à falta de informações e estratégias adequadas, leva à falta de aproveitamento efetivo dos serviços de controle de câncer por parte da população indígena, embora tais serviços são acessíveis para o resto da população. Diante do exposto, é essencial refletir sobre o status e o papel da interculturalidade no controle do câncer.

Envenomation by the red-tailed coral snake (Micrurus mipartitus) in Colombia.

BACKGROUND: Although the red-tailed coral snake (Micrurus mipartitus) is widely distributed in Colombia and its venom is highly neurotoxic and life threatening, envenomation by this species is rare. Therefore, this report may shed some light on the clinical presentation of M. mipartitus bites. CASE PRESENTATIONS: Herein, we describe two cases of patients bitten by red-tailed coral snakes, illustrating the clinical presentation of the victims, the outcomes and treatment provided. CONCLUSION: Envenomation caused by M. mipartitus provokes predicable neurotoxicity, and its treatment should be based on respiratory support and use of specific antivenom.

Envenomation by the red-tailed coral snake (Micrurus mipartitus) in Colombia

Background Although the red-tailed coral snake (Micrurus mipartitus) is widely distributed in Colombia and its venom is highly neurotoxic and life threatening, envenomation by this species is rare. Therefore, this report may shed some light on the clinical presentation of M. mipartitus bites. Case presentations Herein, we describe two cases of patients bitten by red-tailed coral snakes, illustrating the clinical presentation of the victims, the outcomes and treatment provided. Conclusion Envenomation caused by M. mipartitus provokes predicable neurotoxicity, and its treatment should be based on respiratory support and use of specific antivenom.(AU)

Envenomation by the red-tailed coral snake (Micrurus mipartitus) in Colombia

Abstract Background Although the red-tailed coral snake (Micrurus mipartitus) is widely distributed in Colombia and its venom is highly neurotoxic and life threatening, envenomation by this species is rare. Therefore, this report may shed some light on the clinical presentation of M. mipartitus bites. Case presentations Herein, we describe two cases of patients bitten by red-tailed coral snakes, illustrating the clinical presentation of the victims, the outcomes and treatment provided. Conclusion Envenomation caused by M. mipartitus provokes predicable neurotoxicity, and its treatment should be based on respiratory support and use of specific antivenom.

Encuesta nacional de analgesia y anestesia obstétrica: ¿Cómo se trabaja entre nosotros? / National survey of analgesia and obstetric anesthesia: How works itself among us?

Esta encuesta fue dirigida a 40 instituciones del país, con el fin de determinar que técnicas son utilizadas para el alivio del dolor en el trabajo de parto y la anestesia en caso de intervención cesárea o parto instrumentado así como para la evaluación de los recursos básicos de la práctica diaria, y diseñar estrategias encaminadas a mejorar la atención del binomio madre feto. Se realizó un estudio descriptivo, prospectivo en 40 centros que prestan atención obstétrica e hicieran parte de una filial de la Sociedad Colombiana de Anestesiología; por medio del método de encuesta, enviada por correo, fax o entregada personalmente. Se empleo el programa Excel para el registro y análisis de los datos, obteniéndose las frecuencias absolutas y relativas de cada variable de manera independiente. El índice de respuesta fue del 67.5 por ciento. El 77.8 por ciento de los centros tienen la disponibilidad de brindar analgesia para el trabajo de parto, el 76.2 por ciento utilizan mezclas analgésicas con concentraciones de Bupivacaina menores de 0.25 por ciento. El 92.6 por ciento utiliza técnica espinal para cesárea. Las técnicas regionales son las de elección tanto para cesárea electiva como urgente. Esta es el primer estudio colombiano tipo encuesta (Survey) que evalúa los recursos y las técnicas básicas empleadas en analgesia / anestesia obstétrica. Palabras Claves: Analgesia, Anestesia obstétrica...