Scorpionism is responsible for most accidents involving venomous animals in Brazil, which leads to severe symptoms that can evolve to death. Scorpion venoms consist of complexes cocktails, including peptides, proteins, and non-protein compounds, making separation and purification procedures extremely difficult and time-consuming. Scorpion toxins target different biological systems and can be used in basic science, for clinical, and biotechnological applications. This study is the first to explore the venom content of the unexplored scorpion species Rhopalurus crassicauda, which inhabits exclusively the northernmost state of Brazil, named Roraima, and southern region of Guyana. Here, we pioneer the fractionation of the R. crassicauda venom and isolated and characterized a novel scorpion beta-neurotoxin, designated Rc1, and a monomeric hyaluronidase. R. crassicauda venom and Rc1 (6,882 Da) demonstrated pro-inflammatory activities in vitro and a nociceptive response in vivo. Moreover, Rc1 toxin showed specificity for activating Na v 1.4, Na v 1.6, and BgNa v 1 voltage-gated ion channels. This study also represents a new perspective for the treatment of envenomings in Roraima, since the Brazilian scorpion and arachnid antivenoms were not able to recognize R. crassicauda venom and its fractions (with exception of hyaluronidase). Our work provides useful insights for the first understanding of the painful sting and pro-inflammatory effects associated with R. crassicauda envenomings.

Poster Presentations P141 POSTERSto patients with smoking-related illnesses, we believe they should have a decreased tendency to smoke.Method: A survey instrument was given to OR personnel at the University of Puerto Rico in order to learn the prevalence of smoking among other tobacco use related data. Prevalence for the general population and other healthcare-related populations was investigated using various search engines and compared with our results.Results: A total of 113 individuals completed the survey; 6.19% were found to be current smokers, and 7.96% were found to be past smokers. Data from the Centers for Disease Control show that the prevalence of cigarette smoking among US adults is 20.9%, which is significantly higher than what we found in our population (P = .01). In Puerto Rico, the prevalence of smoking is 10.6%, which is also significantly higher than our study population (P = .05). Among current smokers, (n = 7), 85.7% have tried to quit at least once (P = .02), and all claimed to have knowledge of the possible complications associated with smoking. Conclusion:Smoking tobacco remains the number one cause of preventable death in the United States despite many efforts to educate the general public on the dangers associated with its use. A more visual or hands-on encounter with the effects of smoking may help decrease tobacco burden in the general population. General Otolaryngology Surgical Skills of applicants to Residency in OtolaryngologyMerry E. Sebelik, MD (presenter); Mitchell J. Challis, MD; Ken Lewoczko; Rose Mary S. Stocks, MD, PharmDObjective: 1) Measure baseline competence in the performance of a basic surgical task by 4th-year medical students applying to otolaryngology residency. 2) Determine whether information available in the standardized otolaryngology residency application correlates with competence in performance of the basic surgical task.Method: Applicants to residency in otolaryngology with the University of Tennessee Health Science Center in 2010 and 2011 constituted the study population. During the interview, the applicant was asked to close a simulated incision with sutures. A blinded observer recorded a 15-point Objective Surgical Assessment of Technical Skill score. Results:The OSATS score provided a measure of the suturing skills of individuals applying to residency training in otolaryngology. The OSATS score was incorporated into the calculation of an overall OSCE (Objective Structured Clinical Examination) score modified to focus on surgical skill performance and a professionalism measure. Initial data analysis produced a correlation value (R value) between the OSCE score and data points gleaned from the standardized application (USMLE step I score, prior employment-related surgical experience, hobbies, musical background, athletic background, research experience that includes performance of surgical procedures). Conclusion:In contrast to other high-skill professions such as the airline industry, surgical educators have not universally developed a practice of testing...

This study shows that adenotonsillectomy in children and adolescents with sleep-disordered breathing reduces daytime sleepiness and improves the performance in tests of visual attention.

Objective: To evaluate the performance of children and adolescents in tests of visual attention before and after surgical treatment of upper airway obstruction (adenotonsillectomy). Method: Study group: 27 children (6-17 years) with excessive daytime sleepiness undergoing surgical treatment of upper airways obstruction. Control group: 30 children (same age) without respiratory or sleep-related complaints. TAVIS-3 test was performed at baseline and 60 days after the surgery (patients) or first evaluation (controls). Results: The initial study population was comprised of 60 children, 29 in the treatment group and 31 in the control group. The final analysis included 57 patients, 27 in the treatment group and 30 in the control group. Mean Epworth Sleepiness Scale–Children (ESSC) decreased from 9.9 ± 2.8 to 5.1 ± 2.1 ( P < .001) in patients and from 4.7 ± 1.6 to 4.6 ± 1.7 for controls. Response time, number of action errors, and number of omission errors decreased significantly ( P < .001) between the 2 evaluations in patients when compared to controls. Conclusion: Surgical treatment of upper airway obstruction and resolution of daytime sleepiness promote improvement in visual attention in children and adolescents.

Objective: Airway obstruction caused by adenotonsillar hypertrophy is the main cause of snoring and sleep apnea in children and often associated with several other signs and symptoms, including growth development. The objective of this study was to evaluate the effect of adenotonsillectomy in the production of IGF-1 (insulin-like growth factor-1) in children. Method: A total of 26 children of both sexes with adenotonsillar hypertrophy with formal indication for adenotonsillectomy (study group) and 21 control children (with indication for surgery for other reasons, eg, postectomy) were submitted to evaluation of peripheral blood IGF-1. The samples were taken immediately preoperatively and 30 days after surgery. Results: The preoperative levels of IGF-1 showed values within the normal range for age in both groups. Two children in the study group had values below normal for their age. The comparison of pre- and postoperative levels in children undergoing tonsillectomy showed a statistically significant increase ( P < .01) by Student t test for paired samples. The 2 children with preoperative values below normal for age recovered normal levels of IGF-1 after surgery. Conclusion: The data from our study suggest that adenotonsillar hypertrophy, resulting in snoring and sleep apnea can affect negatively the production of circulating IGF-1, probably related to the disturbances of height and growth development, and demonstrate that adenotonsillectomy contributes to enhancing and restoring the values of IGF-1.