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      Epidemiological study of scorpion stings in the Rio Grande do Norte State, Northeastern Brazil

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          ABSTRACT

          This communication is a retrospective epidemiological study of the scorpion sting cases recorded from 2007 to 2014 in the Rio Grande do Norte State, Northeastern Brazil. The data was collected from the Injury Notification Information System database of the Health Department of Rio Grande do Norte State. A total of 20,555 cases were studied. The cases were distributed over all months of the period studied and occurred mainly in urban areas. Victims were predominantly 20-29 year-old women. Most victims were stung on the foot and received medical care within 1-3 h after being stung. The cases were mostly classified as mild and progressed to cure. Scorpion stings in Rio Grande do Norte State are an environmental public health problem that needs to be monitored and controlled throughout the year.

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            Acidentes por animais peçonhentos e sistemas nacionais de informação

            Neste trabalho foram analisados, sob a ótica da vigilância epidemiológica dos acidentes por animais peçonhentos, quatro sistemas nacionais de informação, o SINAN (Sistema de Informações de Agravos de Notificação), o SINITOX (Sistema Nacional de Informações Tóxico-Farmacológicas), o SIH-SUS (Sistema de Informações Hospitalares do Sistema Único de Saúde) e o SIM (Sistema de Informações sobre Mortalidade). Concluiu-se que esses sistemas possuem características próprias, foram criados para atender demandas diferentes e apesar de produzirem um grande volume de dados, não conseguem, ainda que analisados em conjunto, dar conta da dimensão real desses acidentes.
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              Clinical consequences of Tityus bahiensis and Tityus serrulatus scorpion stings in the region of Campinas, southeastern Brazil.

              Scorpion stings account for most envenomations by venomous animals in Brazil. A retrospective study (1994-2011) of the clinical consequences of Tityus scorpion stings in 1327 patients treated at a university hospital in Campinas, southeastern Brazil, is reported. The clinical classification, based on outcome, was: dry sting (no envenoming), class I (only local manifestations), class II (systemic manifestations), class III (life-threatening manifestations, such as shock and/or cardiac failure requiring inotropic/vasopressor agents, and/or respiratory failure), and fatal. The median patient age was 27 years (interquartile interval = 15-42 years). Scorpions were brought for identification in 47.2% of cases (Tityus bahiensis 27.7%; Tityus serrulatus 19.5%). Sting severity was classified and each accounted for the following percentage of cases: dry stings - 3.4%, class I - 79.6%, class II - 15.1%, class III - 1.8% and fatal - 0.1%. Pain was the primary local manifestation (95.5%). Systemic manifestations such as vomiting, agitation, sweating, dyspnea, bradycardia, tachycardia, tachypnea, somnolence/lethargy, cutaneous paleness, hypothermia and hypotension were detected in class II or class III + fatal groups, but were significantly more frequent in the latter group. Class III and fatal cases occurred only in children <15 years old, with scorpions being identified in 13/25 cases (T. serrulatus, n = 12; T. bahiensis, n = 1). Laboratory blood abnormalities (hyperglycemia, hypokalemia, leukocytosis, elevations in serum total CK, CK-MB and troponin T, bicarbonate consumption and an increase in base deficit and blood lactate), electrocardiographic changes (ST segment) and echocardiographic alterations (ventricular ejected fraction <54%) were frequently detected in class III patients. Seventeen patients developed pulmonary edema, 16 had cardiac failure and seven had cardiogenic shock. These results indicate that most scorpion stings involved only local manifestations, mainly pain; the greatest severity was associated with stings by T. serrulatus and in children <15 years old.
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                Author and article information

                Journal
                Rev Inst Med Trop Sao Paulo
                Rev. Inst. Med. Trop. Sao Paulo
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Instituto de Medicina Tropical
                0036-4665
                1678-9946
                07 August 2017
                2017
                : 59
                : e58
                Affiliations
                [1]Universidade Federal de Campina Grande, Centro de Educação e Saúde, Unidade Acadêmica de Saúde, Programa de Pós-Graduação em Biotecnologia e Ciências Naturais, campus Cuité, Paraíba, Brazil
                Author notes
                Correspondence to: Renner de Souza Leite Universidade Federal de Campina Grande, Centro de Educação e Saúde, Unidade Acadêmica de Saúde, Olho D`água da Bica s/n, CEP 58175-000, Cuité, PB, Brazil Tel: +55 83 33721900. E-mail: rennerleite@ 123456yahoo.com.br

                CONFLICT OF INTERESTS

                The authors declare that they have no competing interests.

                Article
                00231
                10.1590/S1678-9946201759058
                5553945
                28793026
                af2aa4cd-a170-449d-91ca-16d8a8477d12

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 2 April 2017
                : 11 May 2017
                Page count
                Figures: 2, Tables: 3, Equations: 0, References: 44, Pages: 1
                Categories
                Original Article

                arachnids,envenomation,public health
                arachnids, envenomation, public health

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