Myocardial Injury and its Association with Venom-induced Coagulopathy following Bothrops atrox Snakebite Envenomation.

Backgound: In Brazil, the highest incidences of snakebite envenomation (SBE) occur in the Amazon region, caused mostly by Bothrops atrox. Among the effects of envenomation, cardiac alterations are not a frequent outcome but are highly linked to severe cases.

Objective: The present study investigated the serum profile of cardiac injury markers (fatty acid binding protein 3 - H-FABP3, N-terminal type B natriuretic peptide - NTproBNP, creatine kinase-MB - CPK-MB, and troponin I) following Bothrops SBEs and their association with venom-induced coagulopathy.

Ability of brazilian Bothrops-Lachesis-Crotalus antivenom in neutralizing some biological activities of Crotalus durissus ruruima rattlesnake venom.

We evaluated the efficacy of freeze-dried Bothrops-Lachesis-Crotalus antivenom and liquid Crotalus antivenoms to neutralize Crotalus durissus ruruima (Cdr) venom (Roraima, Brazil) comparing with C. d. terrificus (Cdt) venom.

Crosstalk of Inflammation and Coagulation in Snakebite Envenoming: Endogenous Signaling Pathways and Pathophysiology.

Snakebite envenoming represents a major health problem in tropical and subtropical countries. Considering the elevated number of accidents and high morbidity and mortality rates, the World Health Organization reclassified this disease to category A of neglected diseases. In Latin America, genus snakes are mainly responsible for snakebites in humans, whose pathophysiology is characterized by local and systemic inflammatory and degradative processes, triggering prothrombotic and hemorrhagic events, which lead to various complications, organ damage, tissue loss, amputations, and death.

Biological characterization of the Bothrops brazili snake venom and its neutralization by Brazilian Bothrops antivenom produced by the Butantan Institute.

We evaluated the ability of the Bothrops antivenom produced by the Butantan Institute to neutralize the lethal, hemorrhagic, myotoxic and phospholipase A activities induced by B. brazili venom from Rondônia state, Brazil, and verified its cross-reactivity against this venom. This antivenom neutralized the cited biological activities.

The 20-minute whole blood clotting test (20WBCT) for snakebite coagulopathy-A systematic review and meta-analysis of diagnostic test accuracy.

Background: The 20-minute whole blood clotting test (20WBCT) has been used to detect coagulopathy following snakebite for almost 50 years. A systematic review and meta-analysis of the 20WBCT was conducted to evaluate the accuracy of the 20WBCT to detect coagulopathy, indicative of systemic envenoming.

Methods And Findings: Databases were searched from inception up to 09/12/2020 to identify studies that compared the 20WBCT and INR/fibrinogen on five or more subjects.

Use of freeze-dried trivalent antivenom to neutralize the toxic activities of Bothrops atrox snake venoms from the Amazon.

In Brazil, antivenom for snakebite is currently formulated in liquid form and requires storage at 4 °C. Here, a new freeze-dried trivalent antivenom, which would enable cold-chain free storage, was determined to have efficacy in neutralizing the biological activities of Bothrops atrox venoms from Manaus (Brazil) and Leticia (Colombia), exhibiting an efficacy similar to those of currently available liquid Bothrops antivenoms. These results indicate that freeze-dried trivalent antivenom may be beneficial for applications in the Brazilian and Colombian Amazon regions.

Neutralization of hemostatic disorders induced by Lachesis muta venom using Brazilian antivenoms.

We characterized the hemorrhagic, coagulant and defibrinogenant activities of Lachesis muta venom and evaluated the capacity of the Brazilian antivenoms in neutralizing these activities. The hemorrhagic activity of L. muta venom was similarly neutralized by Bothrops, Bothrops-Lachesis and Bothrops-Crotalus antivenoms.

Correlating Fibrinogen Consumption and Profiles of Inflammatory Molecules in Human Envenomation's by in the Brazilian Amazon.

Snakebites are considered a major public health problem worldwide. In the Amazon region of Brazil, the snake () is responsible for 90% of the bites. These bites may cause local and systemic signs from acute inflammatory reaction and hemostatic changes, and present common hemorrhagic disorders.

Snakebite envenomation in the Brazilian Amazon: a cost-of-illness study.

Background: Snakebites account for significant morbidity and mortality. Their occurrence in the Brazilian Amazon warrants an analysis that will enable better understanding of their economic impact and thus contribute to their management and prevention. This study aimed to estimate the cost of snakebite envenomation in the Brazilian Amazon in 2015.

"": predicting venom-induced coagulopathy in bites using snake ontogenetic parameters.

Snake venom composition shows significant inter- and intra-species variation. In the case of the viperid species , responsible for the majority of snakebites in the Amazon region, geographical and ontogenetic variables affect venom composition, with ecological and medical implications. Previous studies had shown that venom from neonate and juvenile specimens have a higher coagulant activity.

Low accuracy of microscopic hematuria in detecting coagulopathy from pit viper bites, Brazilian Amazon.

The common lancehead snakes ( are responsible for up to 90% of snakebites in the Amazon, especially in remote areas. The prevalence of microhematuria is similar to that of coagulopathy in envenomation in the Amazon. Thus, this study aimed to assess the reliability of microhematuria as an inexpensive and simple alternative to detect snake-induced consumption coagulopathy.

Factors Associated with Systemic Bleeding in Envenomation in a Tertiary Hospital in the Brazilian Amazon.

snakebites usually present systemic bleeding, and the clinical⁻epidemiological and laboratorial factors associated with the development of this manifestation are not well established. In this study, we assessed the prevalence of snakebites with systemic bleeding reported at the , in Manaus, Amazonas State, Brazil, and the clinical⁻epidemiological and laboratorial factors associated with systemic bleeding. This is an observational, cross-sectional study carried out between August, 2013 and July, 2016.

Predicting acute renal failure in Bothrops snakebite patients in a tertiary reference center, Western Brazilian Amazon.

Acute Kidney Injury (AKI) is the main systemic complication and cause of death in viperid envenomation. Although there are hypotheses for the development of AKI, the mechanisms involved are still not established. The aim of this study was to evaluate the clinical-laboratorial-epidemiological factors associated with AKI in victims of Bothrops sp envenomation.

Accuracy of the Lee-White Clotting Time Performed in the Hospital Routine to Detect Coagulopathy in Envenomation.

Snake envenomation is a major public health problem in Brazil. Systemic complications that may arise from snakebites are mainly related to coagulopathy. The Lee-White clotting time (LWCT) is a simple and inexpensive test and available even in remote health facilities.

Poor efficacy of preemptive amoxicillin clavulanate for preventing secondary infection from Bothrops snakebites in the Brazilian Amazon: A randomized controlled clinical trial.

Background: Secondary bacterial infections from snakebites contribute to the high complication rates that can lead to permanent function loss and disabilities. Although common in endemic areas, routine empirical prophylactic use of antibiotics aiming to prevent secondary infection lacks a clearly defined policy. The aim of this work was to estimate the efficacy of amoxicillin clavulanate for reducing the secondary infection incidence in patients bitten by Bothrops snakes, and, secondarily, identify risk factors for secondary infections from snakebites in the Western Brazilian Amazon.

Experimental Bothrops atrox envenomation: Efficacy of antivenom therapy and the combination of Bothrops antivenom with dexamethasone.

Bothrops atrox snakes are the leading cause of snake bites in Northern Brazil. The venom of this snake is not included in the antigen pool used to obtain the Bothrops antivenom. There are discrepancies in reports on the effectiveness of this antivenom to treat victims bitten by B.

Severe Hemorrhagic Syndrome After Lonomia Caterpillar Envenomation in the Western Brazilian Amazon: How Many More Cases Are There?

Contact with Lonomia caterpillars can cause a hemorrhagic syndrome. In Brazil, Lonomia obliqua and Lonomia achelous are known to cause this venom-induced disease. In the Brazilian Amazon, descriptions of this kind of envenomation are scarce.

Hallux amputation after a freshwater stingray injury in the Brazilian Amazon.

Freshwater stingray injuries are a common problem in the Brazilian Amazon, affecting mostly riverine and indigenous populations. These injuries cause severe local and regional pain, swelling and erythema, as well as complications, such as local necrosis and bacterial infection. Herein, we report a case of bacterial infection and hallux necrosis, after a freshwater stingray injury in the Brazilian Amazon, which eventually required amputation.

Scorpion envenoming caused by Tityus cf. silvestris evolving with severe muscle spasms in the Brazilian Amazon.

Scorpion stings are a public health problem in the Brazilian Amazon. However, detailed clinical characterization with the proper animal identification is scarce. Here we report a confirmed case of envenoming by Tityus cf.

Low Health System Performance, Indigenous Status and Antivenom Underdosage Correlate with Spider Envenoming Severity in the Remote Brazilian Amazon.

Background: A better knowledge of the burden and risk factors associated with severity due to spider bites would lead to improved management with a reduction of sequelae usually seen for this neglected health problem, and would ensure proper use of antivenoms in remote localities in the Brazilian Amazon. The aim of this study was to analyze the profile of spider bites reported in the state of Amazonas in the Western Brazilian Amazon, and to investigate potential risk factors associated with severity of envenomation.

Methodology/principal Findings: We used a case-control study in order to identify factors associated with spider bite severity in the Western Brazilian Amazon from 2007 to 2014.

Comparison of phylogeny, venom composition and neutralization by antivenom in diverse species of bothrops complex.

In Latin America, Bothrops snakes account for most snake bites in humans, and the recommended treatment is administration of multispecific Bothrops antivenom (SAB--soro antibotrópico). However, Bothrops snakes are very diverse with regard to their venom composition, which raises the issue of which venoms should be used as immunizing antigens for the production of pan-specific Bothrops antivenoms. In this study, we simultaneously compared the composition and reactivity with SAB of venoms collected from six species of snakes, distributed in pairs from three distinct phylogenetic clades: Bothrops, Bothropoides and Rhinocerophis.