1
|
Vaucel JA, Larréché S, Paradis C, Courtois A, Pujo JM, Elenga N, Résière D, Caré W, de Haro L, Gallart JC, Torrents R, Schmitt C, Chevalier J, Labadie M, Kallel H. French Scorpionism (Mainland and Oversea Territories): Narrative Review of Scorpion Species, Scorpion Venom, and Envenoming Management. Toxins (Basel) 2022; 14:toxins14100719. [PMID: 36287987 PMCID: PMC9611377 DOI: 10.3390/toxins14100719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Sixty-seven scorpion species have been described in France and its territories, where they have been found to be heterogeneously distributed. Indeed, only one species can be found on Réunion Island, while 38 species exist in French Guiana. The number of stings is also heterogenous, with up to 90 stings per 100,000 inhabitants occurring annually. Scorpion species can frequently be determined through simple visual factors, including species of medical importance (i.e., Buthus, Centruroides and Tityus). Scorpion venom is composed of local enzymes and peptides with a cysteine-stabilized α/β motif (NaTxs, Ktxs, Calcines), which allow for venom diffusion and the prey's incapacitation, respectively. Harmful scorpion species are limited to Centruroides pococki in the French West Indies, which can induce severe envenoming, and the Tityus obscurus and Tityus silvestris in French Guiana, which can cause fatalities in children and can induce severe envenoming, respectively. Envenomation by one of these scorpions requires hospital monitoring as long as systemic symptoms persist. Typical management includes the use of a lidocaine patch, pain killers, and local antiseptic. In the case of heart failure, the use of dobutamine can improve survival, and pregnant women must consult an obstetrician because of the elevated risk of preterm birth or stillbirth. France does not have scorpion antivenom, as scorpion stings are generally not fatal.
Collapse
Affiliation(s)
- Jules-Antoine Vaucel
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
- Correspondence: ; Tel.: +33-05-5679-8776
| | - Sébastien Larréché
- Medical Biology Department, Hôpital d’Instruction Des Armées Bégin, 94160 Saint-Mandé, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1144, Université de Paris, 75000 Paris, France
| | - Camille Paradis
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Arnaud Courtois
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Jean-Marc Pujo
- Emergency Department, Centre Hospitalier de Cayenne, 97300 Cayenne, France
| | - Narcisse Elenga
- Pediatric Unit, Centre Hospitalier de Cayenne, 97300 Cayenne, France
| | - Dabor Résière
- Intensive Care Unit, Centre Hospitalier et Universitaire Martinique, 97200 Fort de France, France
| | - Weniko Caré
- Institut National de la Santé et de la Recherche Médicale (INSERM) UMR-S 1144, Université de Paris, 75000 Paris, France
- Paris Poison Control Center, Fédération de Toxicologie (FeTox), Hôpital Fernand Widal, AP-HP, 75000 Paris, France
- Internal Medicine Department, Hôpital d’Instruction des Armées Bégin, 94160 Val-de-Marne, France
| | - Luc de Haro
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | - Jean-Christophe Gallart
- Toulouse Poison Control Centre, Centre Hospitalier et Universitaire de Toulouse, 31000 Toulouse, France
| | - Romain Torrents
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | - Corinne Schmitt
- Marseille Poison Control Centre, Assistance Public des Hôpitaux de Marseille, 13000 Marseille, France
| | | | - Magali Labadie
- Bordeaux Poison Control Centre, Centre Hospitalier et Universitaire Bordeaux Pellegrin, 33000 Bordeaux, France
| | - Hatem Kallel
- Intensive Care Unit, Centre Hospitalier de Cayenne, 97300 Cayenne, France
| | | |
Collapse
|
2
|
Les envenimations scorpioniques en France métropolitaine et d’Outremer : mise au point. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
3
|
Mast Cells Modulate the Immune Response and Redox Status of the Gastrointestinal Tract in Induced Venom Pathogenesis. Inflammation 2021; 45:509-527. [PMID: 34608585 DOI: 10.1007/s10753-021-01562-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 10/20/2022]
Abstract
The pathogenesis of Androctonus autralis hector (Aah) scorpion venom involved cellular and molecular mechanisms resulting in multi-organ dysfunction. However, little is reported about the effects of venom on the gastrointestinal axis. Mast cells (MCs) are known to play a crucial role in modulating immune response of the gut. This study aims to investigate the involvement of this cell type in venom-induced gastric and intestinal disorders in a time course (3 and 24h). The obtained results revealed that Aah scorpion venom induced inflammatory cell infiltration as shown by the increase of the myeloperoxidase and eosinophil peroxidase activities. Overexpression of the c-kit receptor (CD117) severely imbalanced the redox status with depletion of antioxidant systemic accompanied by gastrointestinal tissue damage. Moreover, an increased level of lactate dehydrogenase in the serum was correlated with tissue injuries. Pharmacological inhibition of MCs targeting tyrosine kinase (TK) reduces the generation of reactive oxygen species and normalizes catalase, and gluthation S-transferase activities to their physiological levels. In addition, histopathological alterations were restored after pretreatment with c-kit receptor inhibitor associated with a considerable reduction of MC density. Interestingly, obtained results indicate that MCs might be involved in gastric modulation and intestinal inflammation through c-kit signaling following sub-cutaneous Aah venom injection.
Collapse
|
4
|
Vaucel J, Mutricy R, Hoarau M, Pujo JM, Elenga N, Labadie M, Kallel H. Pediatric scorpionism in northern Amazonia: a 16-year study on epidemiological, environmental and clinical aspects. J Venom Anim Toxins Incl Trop Dis 2020; 26:e202000038. [PMID: 32973890 PMCID: PMC7485965 DOI: 10.1590/1678-9199-jvatitd-2020-0038] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background: The Amazon basin is one of the seven major geographical areas where
scorpionism is recorded. In French Guiana, 90 stings per 100,000 inhabitants
are registered per year. As the severity of cases is higher in children,
descriptive studies are needed to have a better understanding of this
pathology. The aim of the present study is to describe pediatric scorpionism
in French Guiana. Methods: We conducted a monocentric descriptive retrospective study on scorpion
stings in all pediatric patients admitted to Cayenne General Hospital from
January 1, 2002 to December 31, 2018. Results: In this survey, 132 patients were included. Of them, 63% were male. Patients
with general signs of envenomation were younger and lighter (p = 0.04). The
picture was “one sting” (95.3%) by a “big” (47.6%), “black” (60%) and “small
pincer” (58%) scorpion on the extremity of the body (84%). Stings occurred
mainly during the day, while patients changed clothes. There was no
envenomation during night. The monthly evaluation highlights that the number
of stings and percentage of general signs of envenomation were closely
connected to a composite variable including the variation of the level of
rivers (p = 0.005). Cardiac symptoms were recorded in 82% of cases with
general signs of envenomation. The presence of pulmonary; ear, nose, and
throat (ENT); or gastrointestinal symptoms are related to major envenomation
(p = 0.001, p = 0.01, and p = 0.02 respectively). Leukocytosis and glycemia
increased according to the envenomation grade whereas serum potassium and
alkaline reserve decreased. Forty-six patients needed hospitalization and
seven of them required intensive care. No patient died nor presented
sequelae at discharge from the hospital. Conclusion: Pediatric scorpionism in French Guiana is closely associated with child
activities and climatic conditions. Severe envenomation presented most of
the time with cardiac, pulmonary, and gastrointestinal symptoms.
Collapse
Affiliation(s)
- Jules Vaucel
- Poison Control Center (Centre Antipoison) Nouvelle Aquitaine, Centre Hospitalier et Universitaire Pellegrin, Bordeaux 33076, Aquitaine, France.,Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Remi Mutricy
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Maëlle Hoarau
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Jean-Marc Pujo
- Emergency Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Narcisse Elenga
- Emergency Pediatric Department, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| | - Magali Labadie
- Poison Control Center (Centre Antipoison) Nouvelle Aquitaine, Centre Hospitalier et Universitaire Pellegrin, Bordeaux 33076, Aquitaine, France
| | - Hatem Kallel
- Intensive Care Unit, Centre Hospitalier de Cayenne, Cayenne 97300, French Guiana, France
| |
Collapse
|
5
|
Dobutamine in the treatment of severe scorpion envenoming. Toxicon 2020; 182:54-58. [DOI: 10.1016/j.toxicon.2020.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/27/2020] [Accepted: 05/15/2020] [Indexed: 01/27/2023]
|
6
|
Louza GSG, Carmo LLGD, Conceição IM. Effect of Tityus serrulatus scorpion venom on isolated jejunum: A very useful tool to study the interaction between neurons in the enteric nervous system. Auton Neurosci 2020; 227:102676. [PMID: 32464449 DOI: 10.1016/j.autneu.2020.102676] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 04/06/2020] [Accepted: 05/08/2020] [Indexed: 12/24/2022]
Abstract
Scorpion envenomation is a public health problem in tropical and subtropical areas. In Brazil, Tityus serrulatus is the biggest cause of accidents with venomous animals. Tityus serrulatus venom causes symptoms related to a great activation of the autonomic system attributed to a massive release of sympathetic and parasympathetic mediators. This effect is attributed to the presence of toxins acting in Na+ and K+ ion channels, leading to an increase in cell excitability. Although gastrointestinal symptoms, like diarrhoea and sialorrhea, is observed in moderate to severe cases, little attention is given in clinical reports. Gastrointestinal motility is controlled by the enteric nervous system which is composed of a wide variety of interconnected neurons that are influenced by the sympathetic and parasympathetic nervous systems. Thus, this work aimed to characterize the effects of Tityus serrulatus venom on sympathetic and parasympathetic neurotransmission of rat jejunum, as well as to investigate possibles effects on other neurons of the enteric nervous system. To this, we verify the effects of Tityus serrulatus venom on the contractility of isolated rat jejunum through organ-bath experiments. We observed that venom can induce both contraction and relaxation. The contraction was partially inhibited by atropine (1 μM) and by suramin (0.1 mM) through tetrodotoxin-resistant and sensitive mechanisms. The relaxation was completely inhibited by 3 μM propranolol and partially inhibited by 1 μM phentolamine. Suramin induced a slowing of relaxation curve. Tetrodotoxin completely inhibits the relaxation induced by Tityus serrulatus venom, but the contraction curves were only partially reduced in their initial portion. The final part of the curve was largely enhanced by Tetrodotoxin. Atropine blocks almost completely the contraction curve in the presence of Tetrodotoxin. These results indicate that Tityus serrulatus venom induces the release of both excitatory (predominantly acetylcholine) and inhibitory (mainly noradrenaline) neurotransmitters. The effects of Tityus serrulatus venom on organ contractility was quite complex and seem to derive from a diffuse and nonspecific release of mediators from autonomic and enteric nervous systems. Further investigation of venom action and its isolated toxins can reveal important aspects to deepen our knowledge about the enteric nervous system transmission and the interaction between excitatory and inhibitory mediators as well as the physiological role of Na+ and K+ ion channels in gut motility.
Collapse
Affiliation(s)
- Gisele S G Louza
- Unit of Mode of Toxin Action (MATx), Laboratory of Pharmacology, Butantan Institute, São Paulo, Brazil; Department of Pharmacology, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | | | | |
Collapse
|
7
|
Abstract
Scorpion envenomation is common in the tropical and subtropical regions. It poses a major public health problem with some patients having serious clinical manifestations and severe complications including death. Old World and New World scorpions are usually contrasted because of differences in venom composition, clinical presentation and severity, and, accordingly, different therapeutic approaches. The majority of scorpion stings are either dry or result in low amounts of injected venom, thus explaining why up to 95% of scorpion stings ensue only in local signs. For a clinical envenomation to occur, it has been suggested that the interaction between the quantity of venom introduced in the body of the prey and the distribution volume should ensue in a critical threshold of scorpion toxin plasma concentration. In this case, there is a massive release of neurohormonal mediators (mainly catecholamine), with systemic vasoconstrictor effects eliciting a sharp increase in systemic arterial pressure and LV-filling pressure and decreased cardiac output. This early phase of cardiac dysfunction, also called "vascular phase", is followed by a severe cardiomyopathy, a form of Takotsubo cardiomyopathy, involving both ventricles and reversible in days to weeks. The more comprehensive understanding of the disease pathophysiology has allowed for a well-codified symptomatic treatment, thus contributing to a substantial reduction in the death toll of scorpion envenomation over the past few decades. The standard intensive-care treatment (when available) overcomes envenomation's consequences such as acute pulmonary edema and cardiogenic shock. Even though it continues to inspire many evaluative studies, immunotherapy seems less attractive because of the major role held by mediators in the pathogenesis of envenomation, and unfavorable pharmacokinetic properties to existing sera compared to venom. Meta-analyses of controlled trials of immunotherapy in severe scorpion envenomation reached similar conclusions: there is an acceptable level of evidence in favor of the use of scorpion antivenom (Fab'2) against Centruroides sp. in USA/Mexico, while there is still a need for a higher level of evidence for immunotherapy in the Old World envenomation.
Collapse
|
8
|
Ward MJ, Ellsworth SA, Nystrom GS. A global accounting of medically significant scorpions: Epidemiology, major toxins, and comparative resources in harmless counterparts. Toxicon 2018; 151:137-155. [DOI: 10.1016/j.toxicon.2018.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 06/25/2018] [Accepted: 07/05/2018] [Indexed: 01/18/2023]
|
9
|
Bahloul M, Turki O, Chaari A, Bouaziz M. Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients. Ther Adv Endocrinol Metab 2018; 9:199-208. [PMID: 29977498 PMCID: PMC6022972 DOI: 10.1177/2042018818772779] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 04/03/2018] [Indexed: 12/15/2022] Open
Abstract
Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed, hyperglycaemia was associated with the severity of clinical manifestations of severe scorpion envenomation requiring intensive care unit (ICU) admission. In fact, the presence of hyperglycaemia was associated with the presence of respiratory failure, pulmonary oedema, haemodynamic instability, neurological failure, multisystem organ failure, and an increased mortality and ICU length of stay. As a consequence, we think the presence of hyperglycaemia in scorpion-envenomed patients at the emergency department prompts searching for presence of systemic manifestations or cardiorespiratory manifestations. As a consequence, the presence of hyperglycaemia can help screen severe patients at the emergency department. The current management of severe scorpion envenomation involves the admission and close surveillance in the ICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The use of antivenom for scorpion stings remains controversial. All patients with pulmonary oedema should receive prazosin and possibly dobutamine, according the scorpion's species. Mechanical ventilation is usually used in severe cases. Insulin should be reserved for severe cases with confirmed excessive hyperglycaemia (>10 mmol/l).
Collapse
Affiliation(s)
| | - Olfa Turki
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Anis Chaari
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
| | - Mounir Bouaziz
- Service de Réanimation médicale, Hôpital Habib Bourguiba, Sfax, Tunisie
| |
Collapse
|
10
|
Abroug F, Ouanes-Besbes L, Bouchoucha S. Scorpion envenomation: from a neglected to a helpful disease? Intensive Care Med 2018; 45:72-74. [DOI: 10.1007/s00134-018-5226-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 05/10/2018] [Indexed: 01/15/2023]
|
11
|
Chakroun-Walha O, Karray R, Jerbi M, Nasri A, Issaoui F, Amine BR, Bahloul M, Bouaziz M, Ksibi H, Rekik N. Update on the Epidemiology of Scorpion Envenomation in the South of Tunisia. Wilderness Environ Med 2018; 29:29-35. [DOI: 10.1016/j.wem.2017.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/20/2017] [Accepted: 09/22/2017] [Indexed: 01/18/2023]
|
12
|
Clinical and Epidemiological Aspects of Scorpionism in the World: A Systematic Review. Wilderness Environ Med 2017; 27:504-518. [PMID: 27912864 DOI: 10.1016/j.wem.2016.08.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 08/18/2016] [Accepted: 08/20/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Scorpion stings are registered worldwide, but the incidence and the features of the envenomations vary depending on the region. The aim of this review was to summarize the epidemiological, clinical, diagnostic, and therapeutic data worldwide regarding humans stung by scorpions. METHODS A systematic review of the literature was conducted through the online databases of the Virtual Health Library (VHL), which hosts Medline and the Latin American and Caribbean Center on Health Sciences Informational (LILACS) database. We selected articles published between January 1, 2002 and July 31, 2014. RESULTS Scorpion envenomation reports were found throughout the world, mainly in subtropical and tropical regions. The clinical manifestations were sympathetically and parasympathetically mediated, depending on the species of scorpion. Some of the most common severe complications of scorpionism included respiratory distress syndrome, pulmonary edema, cardiac dysfunction, impaired hemostasis, pancreatitis, and multiple organ failure. Scorpion envenomation could be classified as mild, moderate, and severe, and the therapeutic approach was based on the case severity. The treatment comprised 3 components: symptomatic measures, vital functions support, and injection of antivenom. Moreover, the time that elapsed between the sting and administration of the appropriate medical care was extremely important to the patient's prognosis. CONCLUSIONS The large number of scorpion stings worldwide is concerning and reaffirms the need for new prevention measures and policies to reduce the incidence, prevalence, morbidity, and mortality rates from these poisonous arachnids.
Collapse
|
13
|
Abstract
Tityus serrulatus (Ts) is the main scorpion species of medical importance in Brazil. Ts venom is composed of several compounds such as mucus, inorganic salts, lipids, amines, nucleotides, enzymes, kallikrein inhibitor, natriuretic peptide, proteins with high molecular mass, peptides, free amino acids and neurotoxins. Neurotoxins are considered the most responsible for the envenoming syndrome due to their pharmacological action on ion channels such as voltage-gated sodium (Nav) and potassium (Kv) channels. The major goal of this review is to present important advances in Ts envenoming research, correlating both the crude Ts venom and isolated toxins with alterations observed in all human systems. The most remarkable event lies in the Ts induced massive releasing of neurotransmitters influencing, directly or indirectly, the entire body. Ts venom proved to extremely affect nervous and muscular systems, to modulate the immune system, to induce cardiac disorders, to cause pulmonary edema, to decrease urinary flow and to alter endocrine, exocrine, reproductive, integumentary, skeletal and digestive functions. Therefore, Ts venom possesses toxins affecting all anatomic systems, making it a lethal cocktail. However, its low lethality may be due to the low venom mass injected, to the different venom compositions, the body characteristics and health conditions of the victim and the local of Ts sting. Furthermore, we also described the different treatments employed during envenoming cases. In particular, throughout the review, an effort will be made to provide information from an extensive documented studies concerning Ts venom in vitro, in animals and in humans (a total of 151 references).
Collapse
|
14
|
Escalona MP, Batista CV, Cassulini RR, Rios MS, Coronas FI, Possani LD. A proteomic analysis of the early secondary molecular effects caused by Cn2 scorpion toxin on neuroblastoma cells. J Proteomics 2014; 111:212-23. [DOI: 10.1016/j.jprot.2014.04.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 04/20/2014] [Accepted: 04/22/2014] [Indexed: 01/16/2023]
|
15
|
Impact of Hydrocortisone Hemisuccinate Use on Outcome of Severe Scorpion-Envenomed Adult Patients. Am J Ther 2014; 21:e181-8. [DOI: 10.1097/mjt.0b013e3182583bbc] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
16
|
Benmosbah M, Guegueniat P, Mayence C, Egmann G, Narcisse E, Gonon S, Hommel D, Kallel H. Epidemiological and clinical study on scorpionism in French Guiana. Toxicon 2013; 73:56-62. [DOI: 10.1016/j.toxicon.2013.05.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 05/25/2013] [Accepted: 05/30/2013] [Indexed: 11/25/2022]
|
17
|
Severe scorpion envenomation among children: does hydrocortisone improve outcome? A case-control study. Trans R Soc Trop Med Hyg 2013; 107:349-55. [DOI: 10.1093/trstmh/trt028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
18
|
Tiwari AK, Mandal MB, Deshpande SB. Role of serotonergic mechanism in gastric contractions induced by Indian Red Scorpion (Mesobuthus tamulus) venom. Indian J Pharmacol 2011; 41:255-7. [PMID: 20407555 PMCID: PMC2846498 DOI: 10.4103/0253-7613.59923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Revised: 08/24/2009] [Accepted: 12/09/2009] [Indexed: 11/09/2022] Open
Abstract
Aim: Gastric dysfunctions are commonly seen after scorpion envenomation, and the underlying mechanisms are not clear. Therefore, the present study was undertaken to investigate the effect of Indian red scorpion (Mesobuthus tamulus, MBT) venom on gastric fundus muscle contraction and the underlying mechanisms involved. Materials and Methods: In vitro isometric contraction was recorded from gastric fundus muscle strips on a chart recorder. The tissue was exposed to different concentrations of serotonin or crude MBT venom. The contractile responses to venom were expressed as the percentage of maximum contraction produced by serotonin at the beginning of each experiment. The contractile responses to 1.0 μg/ml of crude MBT venom were ascertained in the absence or presence of serotonin antagonist, methysergide. Results: Serotonin produced concentration-dependent fundus contractions (0.004–4.0 μM), and maximum contractile response was observed at 4.0 μM of serotonin. Hence, the contractile response obtained at 4.0 μM of serotonin was taken for normalization. The crude MBT venom (0.1–1.0 μg/ml) produced a concentration-dependent increase in fundus contractions (as % of maximum fundus contraction produced by serotonin at 4.0 μM). The maximum response was observed at 1.0 μg/ml of crude venom and a further increase in the concentration, up to 3.0 μg/ml, did not increase the response. In a separate series of experiments, pre-treatment with methysergide (1.0 μM) significantly attenuated the contractile response elicited by the venom (1.0 μg/ml) (P<0.05) and blocked the serotonin (4.0 μM) response. Conclusion: The results suggest that the crude MBT venom produces gastric fundus contractions by partially involving serotonin.
Collapse
Affiliation(s)
- A K Tiwari
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India
| | | | | |
Collapse
|
19
|
Bahloul M, Chabchoub I, Chaari A, Chtara K, Kallel H, Dammak H, Ksibi H, Chelly H, Rekik N, Ben Hamida C, Bouaziz M. Scorpion envenomation among children: clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg 2010; 83:1084-92. [PMID: 21036842 PMCID: PMC2963974 DOI: 10.4269/ajtmh.2010.10-0036] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2010] [Accepted: 04/19/2010] [Indexed: 11/07/2022] Open
Abstract
Our objective was to characterize both epidemiologically and clinically manifestations after severe scorpion envenomation and to define simple factors indicative of poor prognosis in children. We performed a retrospective study over 13 years (1990-2002) in the medical intensive care unit (ICU) of a university hospital (Sfax-Tunisia). The diagnosis of scorpion envenomation was based on a history of scorpion sting. The medical records of 685 children aged less than 16 years who were admitted for a scorpion sting were analyzed. There were 558 patients (81.5%) in the grade III group (with cardiogenic shock and/or pulmonary edema or severe neurological manifestation [coma and/or convulsion]) and 127 patients (18.5%) in the grade II group (with systemic manifestations). In this study, 434 patients (63.4%) had a pulmonary edema, and 80 patients had a cardiogenic shock; neurological manifestations were observed in 580 patients (84.7%), 555 patients (81%) developed systemic inflammatory response syndrome (SIRS), and 552 patients (80.6%) developed multi-organ failure. By the end of the stay in the ICU, evolution was marked by the death in 61 patients (8.9%). A multivariate analysis found the following factors to be correlated with a poor outcome: coma with Glasgow coma score ≤ 8/15 (odds ratio [OR] = 1.3), pulmonary edema (OR = 2.3), and cardiogenic shock (OR = 1.7). In addition, a significant association was found between the development of SIRS and heart failure. Moreover, a temperature > 39°C was associated with the presence of pulmonary edema, with a sensitivity at 20.6%, a specificity at 94.4%, and a positive predictive value at 91.7%. Finally, blood sugar levels above 15 mmol/L were significantly associated with a heart failure. In children admitted for severe scorpion envenomation, coma with Glasgow coma score ≤ 8/15, pulmonary edema, and cardiogenic shock were associated with a poor outcome. The presence of SIRS, a temperature > 39°C, and blood sugar levels above 15 mmol/L were associated with heart failure.
Collapse
Affiliation(s)
- Mabrouk Bahloul
- Service de Réanimation Médicale, Centre Hospitalo-Universitaire Habib Bourguiba, Sfax Tunisie.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
El-Gawad TAA, . HMI, . SAES, . HAS. Study of Cardiac Changes in Egyptian Children with Scorpion Envenomation Before and After Antivenin Therapy. JOURNAL OF MEDICAL SCIENCES 2006. [DOI: 10.3923/jms.2006.1033.1038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|