Corneal wasp sting

Corneal wasp sting is an important uncommon tropical ocular disorder. Here, the author presents the discussions and summary on the data of corneal wasp sting from Thailand.     

Corneal wasp sting

Corneal wasp sting is an important uncommon tropical ocular disorder. Here, the author presents the discussions and summary on the data of corneal wasp sting from Thailand.     

Prognosis of corneal wasp sting: case report and review of the literature

Objectives: To report the ocular complications associated with corneal wasp sting and to highlight the importance of eye protection in case of wasp offense.

Methods: This was a retrospective, observational chart review.

Results: A 34-year-old man was referred for severely decreased vision after being stung by a swap to the left cornea. Ophthalmologic examination showed a large corneal epithelial defect, anterior uveitis, and a left relative afferent pupillary defect. Vision was light perception. After treatment with cycloplegic, topical antibiotic, and systemic steroids for 2 weeks, the epithelial defect healed and anterior uveitis subsided; however, bulbous keratopathy and traumatic cataract developed. The visual acuity remained light perception with poor light projections. Twenty additional cases of corneal hymenoptera sting were reviewed from the English language literature, which shared certain characteristics including anterior uveitis, intractable glaucoma, traumatic cataract, toxic optic neuropathy, corneal scarring, and a catastrophic prognosis.

Conclusions: Wasp stings of the cornea may bring disastrous ocular damages. Outdoor works should manage to protect your eyes when confronted with a hymenoptera attack.     

大剂量甲泼尼龙联合血浆置换抢救蜂螫伤急性重度溶血性贫血临床观察

目的观察大剂量甲泼尼龙联合血浆置换（PE）抢救蜂螫伤致急性重度溶血性贫血的疗效。方法对13例蜂螫伤致急性重度溶血性贫血患者,随机分为常规量甲泼尼龙联合血液灌流组（HP组）和大剂量甲泼尼龙联合血浆置换组（PE组）,观察其疗效。结果大剂量甲泼尼龙联合血浆置换组比血液灌流联合常规量甲泼尼龙组疗效好,溶血控制迅速,并发症减少,死亡率下降。结论大剂量甲泼尼龙阻断蜂毒素对红细胞的破坏,抑制体内的炎症反应;血浆置换（PE）能有效清除蜂毒素及红细胞溶解产物,二者联合运用能从不同环节阻碍溶血过程的进行,从而发挥了很好的协同治疗效果,保护脏器功能,是抢救蜂螫伤危重者的有效方法。     

Fatal weeverfish sting

We report a case of fatal weeverfish sting. An 18-year-old man was stung on the left leg by a weeverfish, which he was attempting to capture while snorkelling off the coast of Majorca (Spain). The man felt intense pain, but managed to swim to his boat where he lost consciousness after boarding rapidly. An hour later, when examined by a doctor, the subject was found to be in cardiorespiratory arrest. Reanimation manoeuvres were unsuccessful. The most import post-mortem findings were in the skin and lungs. A puncture wound, which traversed the greater saphenous vein and was covered by an intense haemorrhagic infiltrate, was observed in the skin. The lungs showed haemorrhagic alveolar oedema.     

Acute meningitis owing to phlebotomus fever Toscana virus imported to France

Acute lymphocytic meningitis, seen in France in summer, is often due to enteroviruses. Arboviruses as West Nile and tick-borne encephalitis do exist in Europe, but other viruses are rarely considered in patients unless they have had recent tropical travel. Toscana virus infection, which is endemic, especially in Italy,1-3 has been documented in some European travelers returning from Italy,4-6 but surprisingly was not documented in France until recently.7 We report a case of meningitis caused by Toscana virus imported to France.     

基于胰高血糖素样肽-1的多重受体激动剂的研究进展

胰高血糖素样肽-1(GLP-1)受体激动剂因其独特的作用优势,在降糖及减重领域的市场份额越来越大。但由于肥胖及2型糖尿病等异质性及并发性的病理学特点,以及能量平衡调节的复杂性,其减重效果无法达到预期标准。以GLP-1为基础的单分子多重受体激动剂有望将几种胃肠激素的有益作用整合到同一个分子中,以改善代谢紊乱。在总结市场上各种GLP-1类似物的分子结构及临床表现的基础上,着重介绍各类以GLP-1为基础的单分子多靶向激动剂的研究进展,为治疗肥胖和糖尿病提供新的思路。

     

Fosfomycin resistance among vancomycin-resistant enterococci owing to transfer of a plasmid harbouring the fosB gene

The presence and characterisation of plasmid-mediated fosfomycin resistance determinants were investigated among 45 clinical vancomycin-resistant enterococci (VRE) isolated in Zhejiang Province, China. In total, 19 VRE were resistant to fosfomycin, of which 18 isolates had conjugative fosfomycin resistance and were positive for fosB. No reported fos genes were detected in the remaining isolate. Among the 18 fosB-carrying isolates, the fosB gene was always flanked by tnpA, suggesting the same novel fosB transposon. In 10 of the 18 fosB-carrying isolates, the fosB and tnpA genes were found reversely inserted in the vanA transposon Tn1546. In the remaining eight isolates the fosB and vanA genes were located on different plasmids. These findings indicate that acquisition of the conjugative plasmid harbouring the novel fosB transposon (ISL3-like transposon) and the Tn1546-like transposon (containing vanA and fosB) may explain, at least in part, the recent increase in fosfomycin-resistant Enterococcus faecium in China.     

A case of jellyfish sting

Jellyfish sting may result in a wide range of symptoms from common erythematous urticarial eruptions to the rare box-jelly induced acute respiratory failure. In Taiwan, with the increasing frequency of international travel, cases of jellyfish sting to foreigners are on the rise. We report a case of jellyfish sting with the rare presentation of painless contact dermatitis. A 38-y-o man accidentally stepped on a sea urchin with his right foot during scuba diving in a beach in Thailand. Traditional therapy with vinegar was applied on the lesion. However, when he returned to Taiwan, erythematous patches on the left thigh with linear radiations to the leg were discovered. The skin lesions had bizzare shapes and showed progressive change. No pain or numbness was noticed. Jellyfish stingwas suspected, topical medications were applied, and the patient recovered without complication. Jellyfish stings usually result in a painful erythematous eruption. In this case, though the lesion involved a large surface, there was no pain. Delayed diagnosis of jellyfish sting was due to the atypical presentation and the physician's unfamiliarity to the Thai jellyfish sting. Awareness to the wide spectrum of jellyfish sting symptoms should be promoted.     

Efficacy of serotherapy in scorpion sting: a matched-pair study

BACKGROUND/OBJECTIVE: Although evidence of scorpion antivenin effectiveness in the clinical setting is lacking, scorpion antivenin is generally considered the only specific treatment for scorpion sting irrespective of its clinical severity. We conducted a matched-pair study to assess the efficacy of systematic administration of scorpion antivenin. METHODS: Among 600 stung patients who participated in a study on the efficacy of high-dose hydrocortisone after scorpion sting, 135 (cases) had been treated with 10 to 20 mL intravenous scorpion antivenin (neutralizing 10 LD50 venom/mL). Controls were matched on disease severity on arrival to the emergency department. The severity of envenomation was graded I or II according to the absence (grade I) or the presence (grade II) of systemic manifestations of scorpion envenomation. Assessment of scorpion antivenin efficacy was based on the rate of changing severity grade in both groups (clinical improvement or worsening during an observation period of at least 4 hours). RESULTS: Both groups were similar with respect to clinical severity (36 patients were graded II in each group), age, sex, time-lapse between scorpion sting and ED arrival, and the administration of adjunctive therapy such as hydrocortisone. By the 4-hour evaluation, 50% and 64% of patients initially graded II exhibited a substantial clinical improvement in cases and controls, respectively, suggesting similar effects in cases and controls. There was no difference in preventive effects: 13% and 10% of cases and controls developed systemic manifestations of scorpion envenomation during the 4-hour observation period; 23% of cases and 17% controls were hospitalized by this time. There was no difference in the duration of hospitalization. Three cases developed anaphylactic shock as a consequence of scorpion antivenin administration, while 1 scorpion antivenin-untreated patient died from refractory shock. CONCLUSION: Systematic administration of scorpion antivenin irrespective of clinical severity did not alter the clinical course of scorpion sting. A prospective study is needed concerning the response of the more severe scorpion envenomations.     

Chlorpyrifos exposure reduces reproductive capacity owing to a damaging effect on gametogenesis in the nematode Caenorhabditis elegans

Previous studies have revealed that chlorpyrifos exposure adversely affects the reproductive capacity of male rodents. The present study investigated the reproductive toxicity of chlorpyrifos exposure and possible related mechanisms using the nematode Caenorhabditis elegans. L4 nematode larvae were exposed to chlorpyrifos at concentrations of 0.003, 0.03, 0.3 and 3.0 mg l^?1 for different durations. In addition to decreased brood size, reduced spermatid size, increased percentage of abnormal spermatids, suppressed spermatid activation and motility of sperm, damaged oocyte morphology, increased numbers of apoptotic cells and unfertilized oocytes were observed in nematodes exposed to various concentrations of chlorpyrifos. Moreover, expression patterns of the genes spe‐10, spe‐15, fer‐1, prg‐1, glp‐1, mlh‐1, cyb‐3, ced‐3, ced‐4 and ced‐9 (which are associated with spermatid size, spermatid activation and morphology, oocyte morphology, oocyte function, and apoptosis) were altered after chlorpyrifos exposure. Therefore, chlorpyrifos exposure may adversely affect fertility in nematodes by influencing both spermatogenesis and oogenesis. Alterations in the expression patterns of genes involved in gametogenesis may explain the corresponding changes in gametogenesis in nematodes exposed to chlorpyrifos. Hence, the model organism Caenorhabditis elegans is recommended for assessment of reproductive toxicity relating to gametogenesis. Copyright © 2011 John Wiley & Sons, Ltd.