Haemodynamic patterns in patients with scorpion envenomation

Karnad, Dilip R.

doi:10.1136/hrt.79.5.485

Cited by 66 publications

(59 citation statements)

References 22 publications

(31 reference statements)

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“…Às vezes, estão presentes arritmias, hipertensão arterial sistêmica transitória 11 , hipotensão arterial e até choque circulatório, geralmente cardiogênico 7,8,11 . A convivência deles com a população torna o risco do incidente muito alto 3,4 .…”

Section: Introductionunclassified

Analysis of variables related to fatal outcomes of scorpion envenomation in children and adolescents in the state of Minas Gerais, Brazil, from 2001 to 2005

Guerra¹,

Carvalho²,

Colosimo³

et al. 2008

J Pediatr (Rio J)

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ResumoObjetivos: Descrever e avaliar os acidentes escorpiônicos notificados no estado de Minas Gerais, em crianças e adolescentes, no período de 2001 a 2005, e calcular incidência e mortalidade e identificar fatores relacionados à evolução para óbito.Métodos: Estudo de 14.406 fichas de notificação obrigatória do escorpionismo em Minas Gerais, de pacientes de 0 a 19 anos. Após análise univariada, com fatores relacionados a mortalidade (p < 0,25), foi realizada regressão logística para análise multivariada. Resultados:Houve aumento das notificações dos acidentes escorpiônicos ao longo dos anos. A faixa etária em que mais ocorreu acidente foi de 5 a 9 anos. Dor local esteve presente em 95% dos casos. A maioria dos casos foi classificada como leve (60%), com utilização do soro em 42% dessa população. A letalidade média foi de 0,7%. O município de maior ocorrência do acidente foi a capital Belo Horizonte. O atraso de cada 1 hora até o primeiro atendimento representou aumento de 9% na razão de chance de evolução para óbito, que foi 46 vezes maior no grupo grave do que nos grupos moderado e leve. Para cada ano a menos na idade do paciente houve um aumento de 13% na razão de chance de evolução para óbito. Conclusões:Houve aumento do número de notificações ao longo dos anos estudados. Foram identificados como fatores com maior razão de chance de evoluir para óbito: atraso para o primeiro atendimento, ser classificado como grave e menor idade.J Pediatr (Rio J). 2008;84(6):509-515: Escorpionismo, envenenamento, epidemiologia, picada por escorpião, adolescente, criança. AbstractObjectives: To describe and evaluate notified scorpion envenomation incidents in children and adolescents in the Brazilian state of Minas Gerais between 2001 and 2005, and to calculate the incidence and mortality and identify factors related to fatal outcomes.Methods: Analysis of 14,406 mandatory notifications of scorpion envenomation involving patients aged 0 to 19 years in Minas Gerais. After performing a univariate analysis of factors related to mortality (p < 0.25), multivariate analysis was carried out using logistic regression. Results:The number of notifications of accidents involving scorpions increased over the period. The age group that suffered most accidents was 5 to 9 years. Local pain was reported in 95% of cases. The majority of cases were classified as mild (60%) and antivenom was given to 42% of this population. The mean mortality rate was 0.7%. The state capital, Belo Horizonte, was the municipality with the greatest occurrence of incidents. Each hour's delay before receiving first medical care was associated with a 9% increase in the odds ratio for the likelihood of death, which was 46 times greater in the severe group than in the moderate and mild groups. A decrease of 1 year in patient age was associated with a 13% increase in the odds ratio for the likelihood of death. Conclusions:There was an increase in the number of notifications over the period studied. The following factors were identified as linked with a higher odds ratio...

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Section: Introductionunclassified

Analysis of variables related to fatal outcomes of scorpion envenomation in children and adolescents in the state of Minas Gerais, Brazil, from 2001 to 2005

Guerra¹,

Carvalho²,

Colosimo³

et al. 2008

J Pediatr (Rio J)

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“…Stimulation of both branches of the autonomic system leads to sweating, salivation, vomiting, fasciculation, hypotension, hypertension, bradycardia or tachycardia, ventricular premature contraction, cool extremities, pulmonary edema, shock, and priapism in men. The majority of envenomation symptoms are due to a massive release of catecholamines, which play an important role in the pathogenesis of scorpion sting; they are released from the adrenal glands and postganglionic nerve Hyperkalemia and hyperglycemia are other symptoms which may occur as a consequence of the autonomic storm in the victim (19,21,22,(25)(26)(27).…”

Section: In Vivo and In Vitro Effectsmentioning

confidence: 99%

“…Such effects could be related to the scorpion species and its feeding state; the venom structure and amount; the number of stings; sensitivity, age and weight of the patient; the time of admission to the hospital; and the climate of the region (20,22,38).…”

Section: Clinical Aspectmentioning

confidence: 99%

“…Scorpion toxins can change neuronal action potentials and cause the release of neurotransmitters from cholinergic and adrenergic neurons (4,(19)(20)(21)(22)(23)(24). Neurotoxins also disrupt synaptic vesicles, leading to the cessation of acetylcholine (ACh) release and to the blockage of neuromuscular transmission (18,23,25).…”

Section: In Vivo and In Vitro Effectsmentioning

confidence: 99%

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In vivo and in vitro effects of scorpion venoms in Turkey: a mini-review

Adiguzel¹

2010

J. Venom. Anim. Toxins incl. Trop. Dis

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“…Mortality is related to development of myocarditis and pulmonary edema. [2][3][4][5] The treatment of patients with hypotension and pulmonary edema in particular is not clear 6 .…”

Section: Introductionmentioning

confidence: 99%