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Ugeskrift For Laeger Aug 2020Snakebite envenoming is a neglected tropical disease killing more than 100,000 people every year. Reducing the mortality and morbidity of snakebite envenoming depends on... (Review)
Review
Snakebite envenoming is a neglected tropical disease killing more than 100,000 people every year. Reducing the mortality and morbidity of snakebite envenoming depends on the accessibility of healthcare and antivenom, but also on sufficient knowledge on correct first aid treatment. In this review, we summarise the indications for antivenom treatment and which first-aid measures have proven effective, and which methods should be avoided, since many traditional methods of first-aid treatment of snakebites have been proven to be ineffective or even harmful.
Topics: Antivenins; Humans; Snake Bites
PubMed: 32800051
DOI: No ID Found -
BMJ (Clinical Research Ed.) Jan 2022
Review
Topics: Antivenins; Humans; Practice Guidelines as Topic; Primary Health Care; Snake Bites
PubMed: 34996773
DOI: 10.1136/bmj-2020-057926 -
Emergency Medicine Clinics of North... May 2022This review discusses the distinct envenomation syndromes produced by North American species of snakes and arthropods, specifically the Crotalinae subfamily of snakes,... (Review)
Review
This review discusses the distinct envenomation syndromes produced by North American species of snakes and arthropods, specifically the Crotalinae subfamily of snakes, which includes cottonmouths, copperheads, and rattlesnakes; coral snakes; Latrodectus and Loxosceles species of arachnid; and Centruroides sculpturatus, the only species of North American scorpion capable of producing an envenomation syndrome. The authors discuss the epidemiology, pathophysiology, and presentation of these syndromes and emphasize the varying degrees to which these syndromes can manifest clinically. Finally, the management of each envenomation syndrome is addressed. Special attention is paid to available antivenoms, their indications for use, and their side effects.
Topics: Animals; Antivenins; Arthropods; Humans; North America; Snake Bites; Syndrome
PubMed: 35461625
DOI: 10.1016/j.emc.2022.01.006 -
The Veterinary Clinics of North... Apr 2024Snakebite envenomation (SBE) in horses can have devastating outcomes. Tissue damage, cardiotoxicity, coagulopathy, and neurotoxicity can be concerns with SBE.... (Review)
Review
Snakebite envenomation (SBE) in horses can have devastating outcomes. Tissue damage, cardiotoxicity, coagulopathy, and neurotoxicity can be concerns with SBE. Understanding the actions of venom components is important in developing a successful treatment plan. Antivenom is the mainstay of treatment. Long-term deleterious effects can occur including cardiac dysfunction and lameness.
Topics: Animals; Horses; Snake Bites; Horse Diseases; Antivenins; Blood Coagulation Disorders
PubMed: 37716857
DOI: 10.1016/j.cveq.2023.08.003 -
Emergency Medicine Clinics of North... May 2017Arthropods (phylum Arthopoda) account for a higher percentage of morbidity and mortality to humans than do mammalian bites, snake bites, or marine envenomation. They are... (Review)
Review
Arthropods (phylum Arthopoda) account for a higher percentage of morbidity and mortality to humans than do mammalian bites, snake bites, or marine envenomation. They are ubiquitous in domestic dwellings, caves, and campsites and in wilderness settings such as deserts, forests, and lakes. Although arthropods are most intrusive during warmer months, many are active throughout the winter, particularly indoors. Arthropods are also nocturnal and often bite unsuspecting victims while they are sleeping. Encounters with humans are generally defensive, accidental, or reactive. An individual stung by an insect or bitten by an arachnid may experience pain and local swelling, an anaphylactic reaction, or life-threatening toxicity. This review discusses the clinical presentation and latest treatment recommendations for bites and stings from spiders, scorpions, bees, ants, ticks and centipedes of North America.
Topics: Animals; Antivenins; Arthropods; Bites and Stings; Combined Modality Therapy; Humans; North America
PubMed: 28411932
DOI: 10.1016/j.emc.2017.01.001 -
Toxins Sep 2018Antivenom cross-reactivity has been investigated for decades to determine which antivenoms can be used to treat snakebite envenomings from different snake species.... (Review)
Review
Antivenom cross-reactivity has been investigated for decades to determine which antivenoms can be used to treat snakebite envenomings from different snake species. Traditionally, the methods used for analyzing cross-reactivity have been immunodiffusion, immunoblotting, enzyme-linked immunosorbent assay (ELISA), enzymatic assays, and in vivo neutralization studies. In recent years, new methods for determination of cross-reactivity have emerged, including surface plasmon resonance, antivenomics, and high-density peptide microarray technology. Antivenomics involves a top-down assessment of the toxin-binding capacities of antivenoms, whereas high-density peptide microarray technology may be harnessed to provide in-depth knowledge on which toxin epitopes are recognized by antivenoms. This review provides an overview of both the classical and new methods used to investigate antivenom cross-reactivity, the advantages and disadvantages of each method, and examples of studies using the methods. A special focus is given to antivenomics and high-density peptide microarray technology as these high-throughput methods have recently been introduced in this field and may enable more detailed assessments of antivenom cross-reactivity.
Topics: Animals; Antivenins; Cross Reactions; Peptides; Snake Venoms
PubMed: 30261694
DOI: 10.3390/toxins10100393 -
Intensive Care Medicine Mar 2020Scorpion envenomation is common in the tropical and subtropical regions. It poses a major public health problem with some patients having serious clinical manifestations... (Meta-Analysis)
Meta-Analysis Review
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') 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.
Topics: Animals; Antivenins; Humans; Mexico; Scorpion Stings; Scorpion Venoms; Scorpions
PubMed: 32125457
DOI: 10.1007/s00134-020-05924-8 -
Anaesthesia and Intensive Care Sep 2022
Topics: Animals; Antivenins; Australia; Elapidae; Snake Bites
PubMed: 36076351
DOI: 10.1177/0310057X221108562 -
Nature Biotechnology Apr 2024
Topics: Antivenins
PubMed: 38570693
DOI: 10.1038/s41587-024-02221-3 -
Toxins Jun 2022There are an estimated 5.4 million snakebite cases every year. People with snakebite envenoming suffer from severe complications, or even death. Although some review... (Review)
Review
There are an estimated 5.4 million snakebite cases every year. People with snakebite envenoming suffer from severe complications, or even death. Although some review articles cover several topics of snakebite envenoming, a review of the cases regarding cerebral complications, especially rare syndromes, is lacking. Here, we overview 35 cases of snakebite by front-fanged snakes, including Bothrops, Daboia, Cerastes, Deinagkistrodon, Trimeresurus, and Crotalus in the Viperidae family; Bungarus and Naja in the Elapidae family, and Homoroselaps (rare cases) in the Lamprophiidae family. We also review three rare cases of snakebite by rear-fanged snakes, including Oxybelis and Leptodeira in the Colubridae family. In the cases of viper bites, most patients (17/24) were diagnosed with ischemic stroke and intracranial hemorrhage, leading to six deaths. We then discuss the potential underlying molecular mechanisms that cause these complications. In cases of elapid bites, neural, cardiac, and ophthalmic disorders are the main complications. Due to the small amount of venom injection and the inability to deep bite, all the rear-fanged snakebites did not develop any severe complications. To date, antivenom (AV) is the most effective therapy for snakebite envenoming. In the six cases of viper and elapid bites that did not receive AV, three cases (two by viper and one by elapid) resulted in death. This indicates that AV treatment is the key to survival after a venomous snakebite. Lastly, we also discuss several studies of therapeutic agents against snakebite-envenoming-induced complications, which could be potential adjuvants along with AV treatment. This article organizes the diagnosis of hemotoxic and neurotoxic envenoming, which may help ER doctors determine the treatment for unidentified snakebite.
Topics: Animals; Antivenins; Bungarus; Elapidae; Humans; Snake Bites; Viperidae
PubMed: 35878174
DOI: 10.3390/toxins14070436