Envenomation by Micrurus coral snakes in the Brazilian Amazon region: report of two cases

Two cases of proven coral snake bites were reported in Belém, Pará State, Brazil. The first case was a severe one caused by Micrurus surinamensis. The patient required mechanical ventilation due to acute respiratory failure. The second case showed just mild signs of envenomation caused by Micrurus filiformis. Both patients received specific Micrurus antivenom and were discharged without further complications. Coral snake bites are scarcely reported in the Amazon region and there is a broad spectrum of clinical manifestations, varying from extremely mild to those which may rapidly lead to death if the patient is not treated as soon as possible.Dois acidentes por coral verdadeira são descritos em Belém, Pará. O primeiro caso foi decorrente de envenenamento por Micrurus surinamensis, no qual a vítima necessitou ventilação mecânica por insuficiência respiratória. O segundo, causado por Micrurus filiformis, apresentou apenas manifestações leves. Ambos os pacientes receberam soro antielapídico específico e evoluíram sem complicações. Acidentes por coral verdadeira na região Amazônica são raramente descritos e podem cursar com um largo espectro de alterações, que variam desde quadros de envenenamento muito leves até manifestações com risco de óbito

Delayed healthcare and secondary infections following freshwater stingray injuries: Risk factors for a poorly understood health issue in the Amazon

Introduction: This study aimed to describe the profile of freshwater stingray injuries in the State of Amazonas, Brazilian Amazon, and to identify the associated risk factors for secondary infections. Methods: This cross-sectional study used surveillance data from 2007 to 2014 to identify factors associated with secondary infections from stingray injuries. Results: A total of 476 freshwater stingray injuries were recorded, with an incidence rate of 1.7 cases/100,000 person/year. The majority of injuries were reported from rural areas (73.8%) and 26.1% were related to work activities. A total of 74.5% of patients received medical assistance within the first 3 hours of injury. Secondary infections and necrosis were observed in 8.9% and 3.8%, respectively. Work-related injuries [odds ratio (OR) 4.1, confidence interval (CI); 1.87-9.13] and >24 hours from a sting until receiving medical care (OR; 15.5, CI; 6.77-35.40) were independently associated with the risk of secondary bacterial infection. Conclusions: In this study, work-related injuries and >24 hours from being stung until receiving medical care were independently and significantly associated with the risk of secondary infection. The frequency of infection following sting injuries was 9%. The major factor associated with the risk of secondary bacterial infection was a time period of >24 hours from being stung until receiving medical care. © 2018, Sociedade Brasileira de Medicina Tropical. All rights reserved

Envenomation by Micrurus coral snakes in the Brazilian Amazon region: report of two cases

Two cases of proven coral snake bites were reported in Belém, Pará State, Brazil. The first case was a severe one caused by Micrurus surinamensis. The patient required mechanical ventilation due to acute respiratory failure. The second case showed just mild signs of envenomation caused by Micrurus filiformis. Both patients received specific Micrurus antivenom and were discharged without further complications. Coral snake bites are scarcely reported in the Amazon region and there is a broad spectrum of clinical manifestations, varying from extremely mild to those which may rapidly lead to death if the patient is not treated as soon as possible

The ATLAS fast tracKer system

The ATLAS Fast TracKer (FTK) was designed to provide full tracking for the ATLAS high-level trigger by using pattern recognition based on Associative Memory (AM) chips and fitting in high-speed field programmable gate arrays. The tracks found by the FTK are based on inputs from all modules of the pixel and silicon microstrip trackers. The as-built FTK system and components are described, as is the online software used to control them while running in the ATLAS data acquisition system. Also described is the simulation of the FTK hardware and the optimization of the AM pattern banks. An optimization for long-lived particles with large impact parameter values is included. A test of the FTK system with the data playback facility that allowed the FTK to be commissioned during the shutdown between Run 2 and Run 3 of the LHC is reported. The resulting tracks from part of the FTK system covering a limited η-ϕ region of the detector are compared with the output from the FTK simulation. It is shown that FTK performance is in good agreement with the simulation. © The ATLAS collaboratio

Aspectos clínicos e epidemiológicos dos acidentes por arraias nos distritos de Mosqueiro e Outeiro, Belém-Pará-Brasil

The Marajó Bay waters become fresh waters during the months when the pluviometric precipitation is high. They also become brackish waters in the other period what makes possible to find stingrays of the Potamotrygonidae family and other seawater species. These stingrays have retrossered and sharp stings that once got into the victims they injure the skin which recovers the glandurar cells with venon, exposing the tissues to the toxin, leading them to clinical manifestations. It has been used an observational and descriptive model of prevalence in order to estimate the clinical and epidemiological aspects of 116 stingrays accidents occurend in the Mosqueiro and Outeiro beaches, around Belem, Para, from July 1999 to August 2001. These accidents happened specially in the Mosqueiro beaches (80,2%) with more frequency in the male sex (63,8%) while in the teenager and adult groups it occurs (38,8% and 50,0%) respectively, and during the month of July (37,9%). In all tides there were victims but with less frequency in the high tide (4,3%). The most accidents ocurred in the bottom of a river with sand (49,1 %) and during the afternoon period (62,1 %). The major part of the stingrays caught in the Mosqueiro beaches belongs to the Potamotrygonidae family. The victims helped in the first hour were 79,3% of the cases being the lowest members the part the most affected in 84,5%specially the feet in 75,0%. All the patients appeared with local clinical manifestations, the pain with 99,1% and the cianosis with 42,2% of the cases. The systemic symptoms were present in 14,6% being the dizziness (6,0%) and the sudoresis (5,2%) the most ones found. The blood pressure above the normal was present in 6,0% and the taquicardiac was in 9,5%. The debridment has been the cirurgic behaviour the most used (94,5). Only 18,1% came back to a revaluation whose 33,4% of them evolved to necrosis 28,6% with local infection. There has been no statistic signifecance in the correlationamong the clinical evolution, the treatments used and the time between the accidents and the beginning of the medical service. We concluded that the stingray accidents are an important health injury for the population who despite the local complications and difficulties, the victims don't display a serious healthy state. The brackish waters period seems to have a great influence to increase the number of these accidents.As águas da Baía de Marajó tornam-se doce nos meses de maior precipitação pluviométrica e saloba no outro período, o que torna possível o encontro de arraias da família Potamotrygonidae e exemplares de águas marítimas, as que são providas de ferrões pontiagudos e retrosserrilhados que, ao penetrarem nas vítimas, danificam o tegumento que as células glandulares de veneno, expondo os tecidos a toxina, levando ao aparecimento de manifestações clínicas. Empregou-se um modelo observacional e descritivo da prevalência, para avaliar os aspectos clínicos e epidemiológicos de 116 acidentes por arraias, ocorridos nos Distritos de Mosqueiro e Outeiro, Belém-Pará, no período de julho de 1999 a agosto de 2001. Estes ocorreram, principalmente, em Mosqueiro (80,2%) com maior freqüência no sexo masculino (63,8%), no grupo etário dos adolescentes e adultos (38,8% e 50,0%), respectivamente, no mês de julho (37,9%). Em todas as marés houve vítimas, porém, com menor freqüência na preamar (4,3%). A maioria dos acidentes ocorreu no fundo do rio com areia (49,1%) e no período vespertino (62,1%). As arraias mais capturadas nas praias de Mosqueiro foram da família Potamotrygonidae. As vítimas socorridas na primeira hora em 79,3% dos casos, sendo o membro inferior a região mais atingida em 84,5%, particularmente o pé (75,0%). Todos os pacientes apresentaram manifestações clínicas locais, com dor em 99,1% e cianose em 42,2% dos casos. Os sintomas sistêmicos estiveram presentes em 14,6%, sendo a tontura (6,0%) e a sudorese (5,2%) os mais encontrados. A pressão arterial acima do normal presente em 6,0%, e a taquicardia em 9,5%. O debridamento foi o manejo cirúrgico mais utilizado (94,5%). Retornaram para reavaliação somente 18,1% dos pacientes, dos quais, 33,4% evoluíram com necrose e 28,6% com infecção local. Não houve significância estatística na correlação entre evolução clínica, os tratamentos instituídos e o tempo entre o acidente e o início do atendimento médico. Conclui-se que acidentes por arraias são um importante agravo de saúde para a população que apesar das complicações locais, as vítimas não apresentam quadro grave. O período das águas salobras parece que influencia no aumento dos casos

Scorpions and scorpionism in the metropolitan area and surroundings of Belém, Pará State, Brazil (Chelicerata, Scorpiones)

Ministério da Saúde. Fundação Nacional de Saúde. Instituto Evandro Chagas. Belém, PA, Brasil.Universidade Federal do Pará. Belém, PA, Brasil