Evidence of venom variability associated with venom extraction interval in the monocled cobra (Naja kaouthia)

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  Evidence of venom variability associated with venom extraction interval in the monocled cobra (Naja kaouthia) Abstract Snake venom variability is a critical factor in antivenom production. Although several influencing factors have been studied, the impact of extraction interval on venom properties remains poorly understood. This study evaluated the effects of various extraction intervals on venom yield, the percentage of dry weight (%Dw), and composition in the monocled cobra ( Naja kaouthia ). Twenty-five captive snakes were randomly allocated to five groups, each undergoing a control extraction followed by a repeated extraction at 1, 4, 7, 10, or 14 days. Venom profiles were characterized using reversed-phase high-performance liquid chromatography (RP-HPLC) and Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS). Results indicated that while fresh venom yield remained stable across all intervals, %Dw significantly decreased in extractions performed between 1 and 10 days, ...

Scorpion Envenomation: An Intensive Care Unit Transfer Prediction Score

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Scorpion Envenomation: An Intensive Care Unit Transfer Prediction Score

ABSTRACT

Background:  Scorpion envenomation frequently requires critical care intervention. Early determination of cases with a higher likelihood of clinical deterioration may allow for resource optimization and improvement of clinical endpoints. In this study, patients from a tertiary hospital with similar clinical characteristics but diverse outcomes were analyzed to propose a clinical deterioration prediction score.

Methods:  Demographic, clinical, laboratory, and imaging findings of patients with scorpion envenomation were retrieved from a database used in a toxicology center based on in-person attendance data from 2019 to 2024. Multivariate models were defined and evaluated using receiver operating characteristic curves. A nomogram was created to estimate the probability of ICU transfer. Optimal cutoff points, sensitivity, and specificity were computed. Multiple imputation was performed using chained equations. Normality of errors in linear regressions was assessed via QQ plots.

Results:  Overall, 146 patients were eligible for enrolment. Sex (p = 0.06), weight (p = 0.30), time-to-serum (p = 0.89), and exposure area (p = 0.49) were comparable between patients admitted to the intensive care unit (ICU) and other inpatients, whereas age (p = 0.006) and initial severity (p < 0.001) displayed significant differences. Logistic regression models displayed area-under-the-curve metrics ranging from 65% to 93%, with high specificity. Hyperamylasemia (p = 0.004), vomiting (p = 0.006), and cardiac dysfunction on echocardiography or point-of-care ultrasound (p < 0.001) were strongly associated with critical care.

Conclusion:  Prognostication of factors leading to ICU transfer from initial clinical and laboratory findings is feasible. The regression model achieved high specificity and moderate sensitivity; being a potentially useful confirmatory test in cases with clinical suspicion.


Silva MHL e, Almeida JS, Reis SVM, Souto LEL, Alves RL de S, Lopes HGA, et al.. Scorpion Envenomation: An Intensive Care Unit Transfer Prediction Score. Rev Soc Bras Med Trop [Internet]. 2026;59:e0052–2026. Available from: https://doi.org/10.1590/0037-8682-0052-2026