This review presents the main species of venomous and poisonous arthropods, with commentary on the clinical manifestations provoked by the toxins and therapeutic measures used to treat human envenomations. The groups of arthopods discussed include the class Arachnida (spiders and scorpions, which are responsible for many injuries reported worldwide, including Brazil); the subphylum Myriapoda, with the classes Chilopoda and Diplopoda (centipedes and millipedes); and the subphylum Hexapoda, with the class Insecta and the orders Coleoptera (beetles), Hemiptera (stink bugs, giant water bugs, and cicadas), Hymenoptera (ants, wasps, and bees), and Lepidoptera (butterfl ies and moths).

Injuries caused by fi sh are common in marine and freshwater environments. Catfi sh of the Ariidae and Pimelodidae families cause about 80% of those injuries. One of the complications of injuries caused by fi sh is the retention of fragments of the stinger in the wounds. Here we report fi ve cases (of a total of 127 injuries caused by catfi sh in the Brazilian coast) in which the retained fragments were detected by radiological examination. Retained fragments should be considered in patients stung by catfi sh. A simple X-ray is suffi cient to detect fragments of stingers in the wounds.

No abstract

To describe costs and outcomes of phacoemulsification for cataracts performed by ophthalmology residents. Methods: We obtained medical records from patients operated on in 2011 by third year residents (R3) using phacoemulsification (n=576). Our expenses estimation included professionals' and hospital costs (fees, materials, medications, and equipment). The study outcomes included spectacle-corrected visual acuities before and six months after the operation, rate of intraoperative complications, and total number of postoperative visits. We compared outcome variables with those from extracapsular cataract extraction procedures (n=274) performed by R3 residents in 1997. Results: The mean total cost for phacoemulsification was US$ 416, while an overall estimation indicated the extracapsular cataract extraction cost at US$ 284 (as of December 30, 2011). The mean preoperative spectacle-corrected visual acuity was worse for eyes scheduled for extracapsular cataract extraction (1.73 ± 0.62), than for eyes scheduled for phacoemulsification (0.74 ± 0.54 logMAR) (p<0.01); the mean postoperative visual acuity was better for phacoemulsification (0.21 ± 0.36 logMAR), than for extracapsular cataract extraction (0.63 ± 0.63 logMAR) (p<0.01). Most patients undergoing phacoemulsification (85%) achieved postoperative spectacle-correc ted visual acuities ≥0.30 logMAR, while only 45% of those undergoing extracapsular cataract extractions achieved the same postoperative visual acuity (p<0.01). The rate of intraoperative complications was significantly higher after extracapsular cataract extractions (21%) than it was after phacoemulsifications (7.6%) (p<0.01), and the mean number of postoperative visits was also higher after extracapsular cataract extractions (5.6 ± 2.3) than after phacoemulsifications (4.5 ± 2.4) (p<0.01). Conclusion: These data indicate that cataract surgery performed by in-training ophthalmologists using phacoemulsification is expensive, but compared to extracapsular cataract extraction results, teaching phacoemulsification leads to an approximate three-fold lower complication rate, smaller number of postoperative visits and, most importantly, better visual acuities.