South American Rattlesnake (Crotalus durissus spp.) Envenomation in Dogs in the Semiarid Region of Brazil

Background:  South American rattlesnake (Crotalus durissus spp.) envenomation is rarely reported in small animals and livestock in Brazil. Minor swelling at the snakebite site, skeletal muscle, and renal damage, and severe neurological signs characterize the crotalic envenomation. This case report aims to present epidemiological, clinical, and pathological data of two cases of Crotalus durissus spp envenomation in dogs in the Northeast of Brazil.Cases: Envenomation by Crotalus durissus spp. was recorded in two dogs in Patos, State of Paraíba, Brazil. In Case 1, the dog presented flaccid paralysis, hyporeflexia, a deficit of cranial nerves, epistaxis, and gingival hemorrhages. Laboratory assay showed proteinuria, myoglobinuria, regenerative thrombocytopenia, and increased serum activities of creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). The dog was medicated with crotalic antivenom and wholly recovered from local and systemic clinical signs. In Case 2, the dog died and was detected fang marks at the ventral region of the left mandible (two small parallel perforations spaced 2.0 cm apart) at the snakebite site. Cyanosis of the oral cavity, congestion, and hemorrhages in several organs were observed at necropsy. Tubular nephrosis, muscular necrosis, hepatocytes swelling were observed. The owners witnessed snakebites, and the rattlesnakes (Crotalus durissus spp.) identified by the rattle at the end portion of the tail in both cases. Discussion: Natural South American rattlesnake envenomation presents complex clinical signs that makes diagnosis a challenge for veterinary practitioners. The criteria for the correct diagnosis and observed in the two dogs include witness of the snakebite, identification of the snake, detection of fang marks, clinical-pathological findings, and therapeutic response to treatment with specific anti-venom. The dog’s owners did not identify the subspecies of rattlesnakes; however, Crotalus durissus cascavella and Crotalus durissus collilineatus are the only species found in the Northeast region of Brazil. Crotoxin is the primary toxic component of South American rattlesnake, which induces neuromuscular blockage, and neurological signs (skeletal muscle flaccid paralysis, apathy, hyporeflexia, cranial nerve deficits). These clinical signs are similar to those observed in the two dogs. Respiratory distress, cyanosis, pulmonary edema, and hemorrhage are secondary to respiratory muscle paralysis and also detected in a dog (Case 2) with crotalic envenomation. Minor local swelling at the snakebite site,  myotoxicity observed in both dogs (high serum activities of CK and AST - Case 1), degeneration and necrosis of muscle fibers - Case 2), and fang marks observed in Case 2, strengthen the diagnosis of Crotalus durissus envenomation. Nephrotoxicity was also detected in both dogs (increased specific gravity of urine - Case 1 and myoglobin deposition and degeneration of renal epithelial tubular cells - Case 2). Coagulative disorders and hepatotoxicity are infrequently in domestic animals and humans with crotalic envenomation. High serum activities of ALP and ALT in Case 1, and swelling of hepatocytes in Case 2, suggest liver damage associated with the crotalic envenomation. The differential diagnosis of South American rattlesnake envenomation should be included in dogs with acute neuromuscular flaccid paralysis, associated or not with bleeding disorders, myoglobinuria, and acute kidney injury

Direct antiviral therapy for treatment of hepatitis C: A real-world study from Brazil

Introduction and objectives: Direct antiviral agents (DAAs) including sofosbuvir (SOF), daclatasvir (DCV), simeprevir (SIM) and ombitasvir, paritaprevir and dasabuvir were introduced 2015 in Brazil for treatment of hepatitis C virus (HCV) infection. The aims of this study were to assess effectiveness and safety of HCV treatment with DAA in real-life world in a highly admixed population from Brazil. Materials and methods: All Brazilian reference centers for HCV treatment were invited to take part in a web-based registry, prospectively conducted by the Brazilian Society of Hepatology, to assess outcomes of HCV treatment in Brazil with DAAs. Data to be collected included demographics, disease severity and comorbidities, genotype (GT), viral load, DAA regimens, treatment side effects and sustained virological response (SVR). Results: 3939 patients (60% males, mean age 58 ± 10 years) throughout the country were evaluated. Most had advanced fibrosis or cirrhosis, GT1 and were treated with SOF/DCV or SOF/SIM. Overall SVR rates were higher than 95%. Subjects with decompensated cirrhosis, GT2 and GT3 have lower SVR rates of 85%, 90% and 91%, respectively. Cirrhosis and decompensated cirrhosis in GT1 and male sex and decompensated cirrhosis in GT3 were significantly associated with no SVR. Adverse events (AD) and serious AD occurred in 18% and 5% of those subjects, respectively, but less than 1% of patients required treatment discontinuation. Conclusion: SOF-based DAA regimens are effective and safe in the heterogeneous highly admixed Brazilian population and could remain an option for HCV treatment at least in low-income countries

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora