[Curarizing action of the venom of Elapidae].
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Seven hundred and thirty accidents by Bothrops snake bite attended at Hospital Vital Brazil-Instituto Butantan (HVB-IB) were studied: 411 of in 1983/84 (group A) and 319 in 1986 (group B). All the patients were seen in the Hospital 6 hours after the bite. As an average, all the 411 patients of the group A and the 319 patients of the group B received antivenom capable of neutralizing 215 mg and 117 mg of Bothrops jararaca, respectively. Both groups were similar concerning to: sex and age of the patients; anatomic region bitten; frequency of incision and tourniquet use at the site bite; time in between of the accident and the admission at HVB-IB; classification of B. jararaca either young or adult; frequency of the coagulation impairment. There was no difference in the evolution of the local envenoming manifestations and there were no cases of death.
A methodological approach to infant mortality estimation in Brazil based on vital information provided by Ministry of Health systems is presented. The study evaluated the available data to establish criteria for identifying municipalities with serious data deficiencies, proposing an adequacy index. All municipalities were classified in strata according to geographic region and adequacy of information. To estimate infant mortality by macro-geographic region, in 1998, direct calculation was performed in strata with adequate information. The United Nations model was used in the other geographic strata. The Brazilian North presented the most deficient information, with 63% of the municipalities presenting inadequate reporting (35% of the regional population), followed by the Northeast (29% of the population). In the South, only 1% of the population showed inadequate information. For the whole country, 12% of the population presented serious problems in completeness of death reports. The adequacy index varied from -28% in Maranhão to 94% in Rio de Janeiro. The infant mortality rate was estimated in the interval 30.7-32.6 per 1,000 live births and the completeness of infant deaths from 61.8% to 65.6%.
OBJECTIVE: Studies on the evolution of infant mortality rate are very relevant. Nevertheless, lack of vital statistics in Brazil limits the temporal and spatial analysis of this indicator. This study aims to investigate the possible use of the Brazilian Hospital Information System as an alternative information source for stillbirth and neonatal mortality rates by age group. METHODS: A new method to estimate the stillbirth and neonatal mortality rates is proposed. It was applied in a set of selected Brazilian states in the year of 1995. For comparative purposes, the Brazilian Death Information System was assessed to estimate the mortality rates under study, after adjusting the registered number of live births by using a demographic tool. RESULTS: By assessing the Hospital Information System a larger number of fetal and early neonatal deaths were observed when compared to data given by the death information system of the Northeastern states. Besides, in the Southern and Southeastern states, where death records are more thorough, the mortality rates calculated using both information sources were very similar. CONCLUSIONS: The results suggest that the proposed methodology could greatly contribute to the analysis of the spatial-time evolution of stillbirth and neonatal death rates in recent years in Brazil, as data on death registration in the majority of the Brazilian states are less thorough than those from the hospital information system.
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The authors report an injury caused by a spiny dogfish (Squalus sp) in a professional fisherman that was got hurt in the left hand for a spine in the dorsal fin of the fish and felt excruciating local pain for 6 h and manifested local edema and erythema. The sharks of the Squalus gender, in a similar way to the gender Heterodontus, present two spines in position previous to the dorsal fins, with channels presenting a whitish mass, composed of great and vacuolated cells that produce venom. The Squalus gender has a complex taxonomy, with five nominal species mentioned in Brazil: S. acanthias, S. blainvillei, S. cubensis, S. megalops and S. mitsukurii. The species associated to the injury belongs to the group 'megalops/cubensis'. A detailed study on the taxonomy and toxinology of the Squalus gender in Brazil would be of vital importance in the resolution of those problems and it would serve as subsidy for any other works involving their representatives, besides with aspects of envenoming that this gender can cause and that has rare citations in the literature.
In rat isolated atria, Androctonus australis (Aa), Leiurus quinquestriatus quinquestriatus (Lqq), and L. q. hebraceus (Lqh) venoms produced intense contracture, alterations in the force and frequency of the spontaneous atrial contractions, and delayed afterdepolarizations (DAD). It was shown by means of tetrodotoxin-induced blockade of neurotransmitter release that the contracture and DAD were produced by the action of the venoms on the atrial cell membrane (direct action) while alterations in the force and frequency of the spontaneous atrial contractions were caused by acetylcholine and norepinephrine released by the venoms (indirect action). The irregularities in the spontaneous contractions and DAD were suppressed by magnesium and lidocaine which, however, caused only a small reduction in the intensity of the atrial contracture. The venom-induced DAD was also abolished by ryanodine and intensified by an increase in [Ca2+]0. In anesthetized rats, Aa, Lqq, and Lqh venoms induced hypertension, arrhythmias, and T wave inversion. The arrhythmias included bradycardia, ventricular and supraventricular extrasystoles, unsustained and sustained ventricular tachycardia with torsade de pointes episodes. Magnesium and lidocaine abolished them, and magnesium also counteracted the hypertension. These results suggest that magnesium and lidocaine, particularly magnesium, may be useful in the treatment of the arrhythmias, hypertension, and other disorders associated with Buthinae scorpion envenomation.
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Vibrio cholerae is an important human pathogen and the cause of cholera. Since genetic variation and antibiotic resistance of strains have implications for effective treatment of the disease, we examined the genetic diversity and antibiotic resistance profile in 92 clinical strains (serogroup O1) and 56 environmental strains (O1 antigen, 42 strains; non-O1 antigen, 14 strains) isolated in Brazil between 1991 and 1999. Clinical and environmental O1 strains showed greater drug resistance compared to environmental non-O1 strains. Nearly all clinical O1 strains were resistant to one or more antibiotics while half of the environmental O1 and non-O1 strains were resistant to one or more antibiotics. No plasmids or class 1 integrons were detected in the strains by PCR analysis. Multilocus enzyme electrophoresis analysis (MLEE) suggests most of the O1 strains belong to a single (South American) clone that is related but different to seventh-pandemic strains isolated from other parts of the world. Our results show that there is a close genetic relationship between clinical and environmental O1 strains and that many serogroups and the environment can be a reservoir for antibiotic resistance.
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