Snakebite envenoming is a public health hazard in some of the Caribbean islands and in the regions of Mexico and Central and South America facing the Caribbean. An international collaborative network was established in the last decade, involving diverse stakeholders in the Caribbean region, with the aim of developing research projects on venoms, envenoming, and antivenoms, improving the clinical management of envenoming, and strengthening public health interventions. Regional workshops have been organized since 2017 in French Guiana, Martinique and Saint Lucia. As a follow up of these developments, a fourth workshop took place at Instituto Clodomiro Picado (University of Costa Rica) in November 2025. This report summarizes the presentations at the workshop and presents the current and future tasks discussed at the workshop to reduce the burden of snakebite envenoming in the region.

BACKGROUND:Snakebite envenoming is a neglected tropical disease with significant morbidity and mortality, particularly in areas with limited resources. Bothrops atrox is the most important snake involved in human envenomings in the Amazon. Its venom induces complex vascular damage that contributes to hemorrhage and systemic complications. This study employs the chicken chorioallantoic membrane (CAM) model to illustrate and quantify the acute vascular toxicity of B. atrox venom. METHODOLOGY/PRINCIPAL FINDINGS:Fertilized chicken eggs at embryonic day 9 were exposed to escalating doses of B. atrox venom (1, 50, and 100 µg/egg) for up to 300 seconds. Vascular alterations were assessed using macroscopic imaging, quantitative analysis with ImageJ and AngioTool, and histological examination. Venom exposure resulted in dose- and time-dependent vascular disruption, mainly vascular rupture and hemorrhage. At low doses, we observed minimal hemorrhage without any significant changes in vascular network architecture. At high doses, histopathology revealed endothelial disorganization, vessel dilation, leukocyte infiltration, and microthrombi formation, consistent with direct cytotoxic and inflammatory effects. CONCLUSIONS/SIGNIFICANCE:B. atrox venom rapidly compromises vascular integrity and triggers an inflammatory response in the CAM model, reflecting key pathophysiological features of envenomation. The severity of these effects was proportional to the duration of exposure and the venom dose used. These findings support the use of CAM assay as a translational tool for screening venom-induced vascular toxicity and underscore the imperative of early antivenom administration.

Ischemia/reperfusion (I/R) injury is a pathological phenomenon involving temporary blood flow restriction (ischemia) followed by a period of reperfusion. This sudden variation induces oxidative stress, inflammation, and mitochondrial dysfunction, leading to severe cellular damage. I/R is a primary driver of organ injury in critically ill patients, particularly in conditions such as myocardial infarction, stroke, cardiac arrest, trauma, cardiac surgery, and various shock states.Remote ischemic conditioning (RIC), a non-invasive strategy involving repeated controlled episodes of ischemia and reperfusion to a distant organ (typically a limb), has emerged as a potential strategy to attenuate I/R injury through systemic protective mechanisms. RIC can be applied at various time points: i) before ischemia (pre-conditioning); ii) during ischemia (per-conditioning); iii) after reperfusion has started (post-conditioning). While preclinical models have consistently demonstrated its efficacy, clinical trials to date have shown mixed results, with limited impact on key clinical outcomes.In this narrative review, we first provide a brief historical overview and outline the molecular and cellular mechanisms underlying RIC. Second, we examine current evidence from both animal studies and human trials on the effect of RIC across several conditions such as myocardial infarction, stroke, cardiac arrest, trauma, cardiac surgery and shock. Finally, we discuss ongoing research efforts aimed at optimizing its delivery and identifying patient populations most likely to benefit from its use.

Background Leptospirosis is a re-emerging zoonosis in French Guiana, with broad and sometimes misleading clinical spectrum. Neurological involvement, referred to as neuroleptospirosis, lacks a consensus definition. Therefore, it is likely underrecognized, raising concerns about missed diagnosis and potentially poor outcomes. This study aimed to characterize the epidemiology, clinical features and outcomes of neuroleptospirosis. Methodology/ Principal findings A multicenter retrospective study was conducted across all public healthcare facilities of French Guiana (2015-2021). Neuroleptospirosis was defined by the combination of (i) neurological symptoms and (ii) objective evidence of neurological involvement based on cerebrospinal fluid (CSF) analysis and/or neuroimaging. Cases were compared with leptospirosis without neurological involvement. Among 146 consecutive hospital-managed cases of leptospirosis, 18 (12%) met criteria for neuroleptospirosis (incidence 0.88 cases/100,000 inhabitants/year; 95% CI 0.52-1.39). Among them, 78% (14/18) presented a meningeal syndrome, 22% (4/18) an encephalitic syndrome, and 17% (3/18) showed paresthesia. Lumbar puncture was performed in 28/146 (19%) patients, with pleocytosis observed in 18/28 (64%) patients; median CSF leukocyte count was 42 cells/mm3 (range 13-240/mm3), with lymphocytic predominance in 8/13 (62%), a slight protein level (median 0.51 g/l, range 0.32-0.88) and no hypoglycorachia. Brain MRI revealed abnormalities in 2/8 (25%) cases of neuroleptospirosis: one cerebral infarct and one pachymeningitis. Compared with patients without neurological involvement, factors associated with a diagnosis of neuroleptospirosis were an age <30 years (p=0.004, 95% CI 1.72-18), no leukocytosis (p=0.042, 95% CI 1.04-10.39) nor thrombocytopenia (p=0.012, 95% CI 1.39-14.32) during hospitalization. Neuroleptospirosis cases had milder disease: they less often progressed to sepsis (OR 0.28; 95% CI 0.10-0.79); none required intensive care admission nor died. Discussion/Conclusions This study provides new insights into the clinical spectrum and outcomes of neuroleptospirosis in French Guiana. Prospective studies incorporating a consensus definition, systematic CSF analysis and microbiological testing are warranted to further characterize the pathophysiology and optimize diagnostic strategies for neuroleptospirosis. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was registered with the Health Data Hub (No. F20220426211656). All patients were informed about their right to object the use of their data. This retrospective study relied exclusively on routinely collected healthcare data and involved no intervention or additional biological sample collection. The study complied with the French reference methodology MR-004 for research using health data not involving direct participation and was declared to the French Data Protection Authority (Commission Nationale de l Informatique et des Libertes, CNIL) under the above registration number. The data used in this study were de-identified prior to their use, and all procedures complied with applicable ethical standards. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript.

Introduction: In 2023, close to Cayenne, French Guiana, a significant attack by africanized honey bees struck a group of 35 tourists on an isolated island, with no available means of rescue. Event Description: The incident resulted in 1 death, 2 critical emergencies, 6 moderate emergencies, and a total of 11 emergency room admissions, involving both adults and children. Discussion: Analysis of challenges encountered that day, particularly in aerial and nautical operations, will help improve our emergency response and healthcare systems in our overseas territories.

The effectiveness of antibiotic-impregnated catheters (AIC) compared to standard catheters (SC) as external ventricular drains (EVD) for preventing EVD-related infections (ERI) is debated. In this study, we aimed to analyze the impact of a shift from AIC to SC, and so a de-escalation strategy, on ERI incidence rate. This is a single-center before-and-after analysis of prospectively recorded data from consecutive patients treated in a French tertiary care hospital neurological intensive care unit from 2015 to 2020. Standard EVD handling procedure remained unchanged over study period, except for the first line drain, which was switched from AIC to SC in 2019. The main outcome was the difference in the incidence of ERI. Data from 510 consecutive patients (348 AIC, 162 SC) were analyzed. AIC use was associated with a lower incidence of ERI (2.6

INTRODUCTION:The severity and clinical consequences of exposure to Datura have been infrequently investigated. No data exist in the French Indies of America. We aimed to describe presentations and outcomes in a mass poisoning attributed to a Datura-contaminated batch of organic buckwheat flour, managed in Martinique. METHODS:All patients who contacted the emergency call center or were treated at Martinique's University Hospital for presumed Datura poisoning in February-March 2019 were included. Data were collected retrospectively from the records. Quantitative parameters are expressed as median, [IQR]. RESULTS:Fifty-one poisoned patients were identified including 31 females (62%) and 20 males (38%), with a median age of 40 years [IQR 30-53 years]. Time to symptom onset was one hour [IQR 1-2 hours]. The most frequent symptoms included dry mouth (67%), vertigo (43%), inebriation (43%) and gastrointestinal disturbances (31%). One patient required intensive care. All patients recovered completely. DISCUSSION:The rapid intervention of the Regional Health Agency, retrieving the incriminated batch and informing the public together with hospital team's engagement, limited the extent of poisonings. CONCLUSION:Martinique's Datura contamination of buckwheat flour resulted in fifty-one poisonings with mild-to-moderate toxicities. A multidisciplinary toxicosurveillance and a rapid public health response are required to limit the extent of population exposure and poisoning severity.

Bothrops atrox is responsible for most snakebite incidents in the Amazon region. Its venom is recognized for causing significant tissue damage and systemic effects. However, its effect on reproductive organs remains poorly explored. This study aimed to investigate the acute effects of B. atrox venom on testes and ovaries of adult mice. Male and female mice were exposed to B. atrox venom (½ LD50) via four administration routes subcutaneous (SC), intramuscular (IM), intravenous (IV), and intraperitoneal (IP), followed by comprehensive assessment of gonadal histology, sperm function, oxidative stress biomarkers, antioxidant enzyme activities, and mRNA expression of inflammatory and apoptotic markers. Following B. atrox venom exposure, ovarian histological architecture remained preserved across all routes, whereas testicular tissue exhibited route-dependent injury ranging from moderate luminal apoptosis after SC and IV administration to severe epithelial disorganization and Sertoli cell vacuolization after IM and IP administration. Sperm motility and viability declined significantly after IP injection, accompanied by increased morphological abnormalities. Oxidative stress markers (Reactive oxygen species, nitric oxide, hydrogen peroxide, lipid hydroperoxides, and malondialdehyde) rose in both sexes, with higher levels in males and maximal induction via the IP route. Antioxidant enzymes (Superoxide dismutase, catalase, and glutathione peroxidase) decreased in testes but increased in ovaries, indicating divergent redox responses. IL-6 and TNF-α mRNA were strongly upregulated by IP exposure in both sexes, revealing a pronounced inflammatory reaction. Bax expression confirmed increased apoptotic signaling, particularly following IP administration. These findings demonstrate that acute B. atrox envenoming can compromise male gonadal integrity while sparing ovarian structure with preservation of antioxidant enzyme activity, highlighting an overlooked dimension of viperid venom pathophysiology.

Introduction La Guyane est située en forêt amazonienne et exposée aux épidémies d’agents pathogènes tropicaux et cosmopolites. Pour améliorer la surveillance des cas hospitalisés l’Agence Régionale de Santé (ARS), Santé publique France (SpF) et le CH Cayenne ont créé en 2010 le poste d’infirmière de santé publique (IDESP) au sein du service des Maladies Infectieuses et Tropicales (UMIT). L’IDESP est chargée de la surveillance épidémiologique hospitalière du CHC et du CH de Kourou pour disposer d’un système de surveillance réactif et exhaustif des cas hospitalisés en rapport avec les maladies infectieuses prioritaires. L’objectif de ce travail est de décrire le rôle original de l’IDESP. Méthodes Les missions de l’IDESP sont pour SpF : la surveillance épidémiologique des arboviroses épidémiques (dengue, Zika, chikungunya), du paludisme, des cas de grippe, Covid-19 et bronchiolite en réanimation et pour l’ARS : la transmission de signaux sanitaires le signalement des cas de maladies à déclaration obligatoire (MDO) et des maladies entériques. L’analyse de ses missions a été réalisée pour la période de janvier 2020 à janvier 2024. L’IDESP travaille de façon autonome à partir des systèmes informatisés des urgences, du laboratoire et du dossier patient. Elle identifie les patients suspects ou atteints des pathologies faisant l’objet d’une surveillance définie. Elle collige les renseignements administratifs, cliniques et biologiques et les critères de gravité et transmet les données à SpF. Les fiches de notifications pour le paludisme et la dengue étaient préalablement classées selon le niveau de gravité par les médecins de l’UMIT avant transmission à SpF. L’IDESP participe aussi à la réunion hebdomadaire de la Plateforme de Veille Sanitaire de l’ARS pour exposer les signaux sanitaires afin que puissent se décider des investigations de terrain et des actions à mener. Elle est aussi en interaction avec l’Institut Pasteur de la Guyane lors des épidémies, pour signaler les cas graves. Résultats Sur la période de l’étude, les patients avec les pathologies suivantes ont été signalés : dengue (n = 470), paludisme (n = 155), et pour cas de réanimation, Covid-19 (n = 519), grippe (n = 29) et bronchiolite (n = 23). Concernant les MDO, 283 signalements ont été réalisés principalement tuberculose (n = 218), légionellose (n = 12), typhoïde (n =1 0) et infections invasives à méningocoque (n = 6). Ce travail prospectif de collecte d’informations a permis à SpF de consolider les indicateurs épidémiologiques dans leurs publications par la description des caractéristiques des patients hospitalisés ainsi que les critères de gravité des épidémies. Discussions et conclusions L’IDESP assure le recueil de données des cas hospitalisés pour les pathologies infectieuses jugées prioritaires en Guyane. Elle a un rôle essentiel dans la transmission de ces informations vers les autorités sanitaires mais aussi vers les cliniciens. Elle assure le lien entre les praticiens hospitaliers, l’ARS et SpF. Son champ d’action évolue en fonction de l’actualité épidémiologique et un renfort est envisagé pour pérenniser ces activités.Les auteurs n’ont pas précisé leurs éventuels liens d’intérêts.

Aeromonas spp. are gram-negative bacilli of the Gammaproteobacteria class and Aeromonadaceae family. These bacteria are a public health challenge, particularly in South America. They harbor chromosomal β-lactamases belonging to classes B, C, and D, whose presence varies among species. This retrospective study aimed to evaluate the minimum inhibitory concentrations (MICs) of piperacillin-tazobactam (PTZ) and cefotaxime (CTX) for clinical strains of Aeromonas spp. A secondary objective was to assess the resistance profile of these strains to cefepime (FEP), aztreonam (AZT), ciprofloxacin (CIP), levofloxacin (LEV), and trimethoprim-sulfamethoxazole (SXT). The study was conducted at the Microbiology Laboratory of Cayenne Hospital (French Guiana) from January 2020 to December 2023. All isolated clinical Aeromonas strains, regardless of species or sample type, were included. In total, 99 strains were analyzed, comprising Aeromonas hydrophila (n = 79), Aeromonas caviae (n = 10), Aeromonas veronii (n = 6), and other Aeromonas spp. (n = 4). The median PTZ MIC was 0.5 mg/L for Aeromonas spp. overall, with six strains (6%) exhibiting MICs of >8 mg/L. For A. hydrophila, the median PTZ MIC was also 0.5 mg/L, lower than the median reported by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) for strains of 4 mg/L. For CTX, the median MIC for all Aeromonas spp. was 0.064 mg/L, with four strains (4%) having MICs of >4 mg/L. The median ceftazidime (CAZ) MIC was 0.125 mg/L. No resistance to AZT was detected, and 3% high-dose susceptibility to FEP was found. Resistance rates to other antibiotics were low: 6% to CIP, 6% to LEV, and 6% to SXT. In conclusion, our study demonstrated low resistance rates in Aeromonas spp. to PTZ (6%), CTX (4%), and CAZ (4%). These findings suggest that PTZ and CTX could be effective against Aeromonas infections, despite the lack of established clinical breakpoints by EUCAST.IMPORTANCEAeromonas spp. are clinically significant, particularly in tropical climates. This study provides essential MIC distribution data for piperacillin-tazobactam and cefotaxime, offering valuable insights for guiding empirical treatment choices. Understanding these susceptibility patterns is crucial for optimizing antimicrobial therapy, particularly in regions with limited resistance surveillance and standardized guidelines. By analyzing a large collection of clinical isolates, our findings contribute to evidence-based decision-making for Aeromonas infections and emphasize the importance of continued surveillance of antimicrobial susceptibility. These findings suggest that PTZ and CTX may be therapeutic options for Aeromonas infections, supporting their potential use in clinical practice.

BackgroundEnvenoming by Bothrops lanceolatus, a viperid endemic to Martinique an island in the Lesser Antilles, induces a unique clinical manifestation, i.e., thrombosis. Pathophysiological signaling leading to thrombotic events remains poorly understood. Among others, proposed mechanisms include increased expression of multimerized forms of von Willebrand factor (VWF). Prothrombotic effects of VWF are regulated by ADAMTS13, a metalloprotease which cleaves VWF multimers. Whether ADAMTS13 activity is reduced in B. lanceolatus envenoming has not been previously investigated.Methodology/principal findingsADAMTS13 activity was evaluated via chromogenic assay in experimental and clinical studies. Human plasma with known ADAMTS13 activities (0.70 IU/mL) was incubated with increasing doses of B. lanceolatus venom. Incubation with B. lanceolatus venom (concentrations 10-1000 ng/mL) induced a dose-dependent reduction of ADAMTS13 activity. In our series of 46 patients bitten by B. lanceolatus snake, ADAMTS13 activity was determined at admission before antivenom therapy. In these patients, the median plasmatic ADAMTS13 activity was 94% (IQR: 78-122%). Ten patients (22%) displayed ADAMTS13 activity less than 75%. Compared with patients with normal ADAMTS13 activity (n = 36), those with moderately low ADAMTS13 activity (n = 10) were older, had a lower platelet count, and displayed increased concentrations of creatine kinase, fibrinogen and C-reactive protein. Multivariate linear regression retained only grade severity of envenoming as independent predictor of increase length of hospital stay, while reduced ADAMTS13 activity and increased C-reactive protein levels bordered on statistical significance.Conclusions/significanceFor the first time, our study provided evidence suggesting that ADAMTS13 activity is reduced in experimental B. lanceolatus venom exposure and patients with B. lanceolatus envenoming. Thanks to its role on the VWF regulation, it is suggested that reduced ADAMTS13 activity can increase the risk of thrombosis in B. lanceolatus envenoming by favoring the circulation of prothrombotic VWF multimers. Low ADAMTS13 activity was associated with increased length of stay in envenomed patients.

Background Snakebite (SB) envenoming is an acute emergency requiring early care delivery. However, sometimes, patients can take several hours before receiving antivenom (AV). We conducted this study to assess the effectiveness of antivenom in the recovery of clotting parameters in patients consulting tardily after SB envenoming in French Guiana. The primary endpoint of our study was to investigate the time needed from SB to recovery from SB-induced coagulopathy. The secondary endpoint was to investigate the time needed from AV administration to recovery from SB-induced coagulopathy in patients receiving AV (late or very late administration). Methods This prospective observational study was conducted in the Intensive Care Unit (ICU) of Cayenne General Hospital between January 2016 and September 2023. We included all patients hospitalized for SB envenoming who either did not receive AV or received it more than 6 h after SB. We excluded patients who received antivenom in less than 6 h from the SB and those who received incomplete AV doses. Findings We included 58 patients in the No AV group, 51 in the late AV group (6 h <= AV < 12 h), and 50 in the very late AV group (AV >= 12 h). The median age of patients was 42 years (IQR: 29-53), 65.4% were male and 34.6% were female (104 and 55 out of 159 patients) without difference regarding the demographic parameters between groups. Data regarding ethnicity was not available. The median time from SB to AV was 8.5 h (IQR: 6.9-10) in the late AV group and 21.1 h (IQR: 16.7-27.4) in the very late AV group (p < 0.001). The time from SB to normal clotting parameters was shorter in patients receiving late AV than in those receiving very late AV and those not receiving AV. No differences were observed in the time from SB and recovery of fi brinogen and activated partial thromboplastin time (aPTT) between very late AV and no AV. However, the International Normalized Ratio (INR) recovery was shorter in the very late AV group than in the no AV group. On the other hand, the time from AV to normal fi brinogen was shorter in patients receiving very late AV than in patients receiving late AV (Log-Rank = 0.020). Meanwhile, the time from AV to normal INR or normal aPTT was similar in patients receiving very late AV compared to patients receiving late AV (Log-Rank = 0.722 and 0.740, respectively). Interpretation Late AV administration effectively reverses coagulopathic manifestations after SB envenoming. However, very late AV administration did not improve the correction of some clotting parameters when compared to patients not receiving AV. Our fi ndings could be explained by the combination of venom toxicokinetics and the kinetics of the synthesis of clotting factors. Funding No funding. Copyright (c) 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Polysaccharides derived from marine algae are natural polymers with antioxidant, anti-inflammatory, and cytoprotectiveproperties, which make them promising for therapeutic use. In contrast, bromuconazole, a common triazole fungicide used in agriculture, has been associated with adverse effects such as oxidative stress, inflammation, and disruptions in cellular death pathways, raising safety concerns. This study investigates the potential of polysaccharides extracted from the red alga Osmundea pinnatifida (PSOP) to mitigate bromuconazole-induced toxicity. Through a subchronic 30-day exposure, 24 Wistar rats (6 per group) were divided into four groups: a control group, a bromuconazolegroup (32.8 mg/kg/day), a PSOP-only group (200 mg/kg/day), and a co-treatment group receiving both compounds. Bromuconazole exposure led to increased oxidative stress markers such as malondialdehyde (MDA), lipid hydroperoxides (LOOH), and advanced oxidation protein products (AOPP), along with decreased antioxidant defenses including glutathione peroxidase (GPx), reduced glutathione (GSH), non-protein thiols (NP-SH), and superoxide dismutase (SOD) in both liver and kidney tissues. These changes were accompanied by altered plasma biochemical parameters, indicating systemic toxicity. PSOP co-treatment alleviated oxidative stress by normalizing oxidation markers and enhancing antioxidant enzyme activities and non-enzymatic antioxidant defenses. Histopathological analyses confirmed PSOP's role in reducing tissue damage in the liver and kidneys. The HET-CAM assay also demonstrated PSOP's anti-irritant properties and ability to protect the vascular membrane during bromuconazole exposure. These results identify PSOP as an affordable, antioxidant-rich agent with significant biomedical potential,capable of protecting against oxidative damage induced by bromoconazole or xenobiotic.

Introduction During the COVID-19 pandemic, the oil and gas industry had to adopt coping strategies. These changes might contribute to early increased mental health issues among workers. This study aimed to assess the prevalence and associated factors to early post-traumatic stress disorder (PTSD) symptoms among healthy Indonesian oil and gas field workers during the COVID-19 pandemic. Method A cross-sectional study was conducted from November 2020 to January 2021. We investigated healthy field employees working during the pandemic. Data on the subjects' PTSD symptoms were collected using the PTSD Checklist-Civilian (PCL-C) Version. Results A total of 1542 completed forms were analyzed. The prevalence of PTSD symptoms was 44.8%, with 9.1% of very severe forms. Independent factors associated with PTSD symptoms were female gender (p = .013, OR 1.72 [95% CI 1.12-2.63]), change in work system (p = .006, OR 1.37 [95% CI 1.09-1.71]), increased workload (p < .001, OR 2.10 [95% CI 1.63-2.71]), and decreased income (p = .041, OR 1.44 [95% CI 1.02-2.05]). Conclusion The COVID-19 crisis and its impact on working conditions were significant stressors that contributed to a high prevalence of PTSD symptoms among oil and gas company workers. Therefore, implementing well-being programs is essential during acute challenges that lead to changes in work systems.

Bothrops atrox envenoming causes significant hematotoxicity, yet the contribution of oxidative stress in red blood cells (RBCs) damage remains incompletely defined. We investigated the oxidative mechanisms of B. atrox venom on RBCs using complementary in vitro and in vivo model, with attention to sex-specific responses. For this, Human RBCs were incubated with 0.1-1 μg venom for 1-24h. Hemolysis, methemoglobin, oxidative stress markers and antioxidant status were quantified. For in vivo analysis mice received intravenous dose of venom (½ LD50) and plasma and RBCs oxidative parameters were measured after 24h. In vitro, venom induced dose- and time-dependent hemolysis reaching 708 % and 647 % over controls in RBCs from male and female donors, after 24h at 1 μg. Similarly, methemoglobin increased by 925 % (male) and 687 % (female). Oxidant parameters significantly increased and antioxidants decreased in RBCs from both sexes. Microscopy revealed echinocytes and spherocytes after venom exposure. In vivo, envenoming increased ROS in (+157.6 % in males, +89.2 % in females), NO (+84.8 %; +82.4 %), and ONOO- (+93.1 %; +135.5 %) in RBCs compared to controls. Similar changes were also observed in mice plasma with marked decrease in antioxidant capacity mainly in males. In conclusion, B. atrox venom causes severe RBCs damage, with oxidative stress serving as one of the key contributing factors. The resulting changes lead to hemolysis and loss of membrane function. In additions, our results show that RBC oxidative damages are from endogenous and exogenous origin. Greater susceptibility in males point to sex-specific redox vulnerability. These findings support exploring antioxidant-based adjunctive therapies in B. atrox envenomings.

Introduction Les cathéters veineux centraux (CVC) sont utilisés chez 60 % des patients de réanimation, or ils sont associés à des infections liées aux cathéters (ILC) à la morbidité importante. Les connaissances actuelles sur le microbiote suggèrent que la dysbiose favorise l’émergence de pathogènes et peut être associée à des états pathologiques. Le déséquilibre du microbiote cutané en réanimation pourrait-il être un facteur favorisant les ILC ? Méthodes Nous avons réalisé une étude prospective descriptive du microbiote cutané des patients de réanimation porteurs d'un CVC au Centre hospitalier de Cayenne. Des écouvillons cutanés au site d'insertion étaient réalisés avant la pose, pendant toute la durée de vie du cathéter, à la sortie de réanimation, puis mis en culture avec identification par MALDI-TOF. Le critère de jugement principal était la variation des proportions de différentes populations bactériennes. La survenue d'événement positif (ILC bactériémiante ou cathéter positif en culture) était rapportée. Résultats De juin 2023 à janvier 2024, nous avons inclus 60 patients. La durée médiane des CVC étaient 6,5 jours (3-10). Deux-cent sept écouvillons cutanés ont été réalisés. À la pose, les staphylocoques à coagulase négative (SCN), les bacilles à Gram négatifs (BGN), et les non fermentants (NF) représentaient 62, 6,9 et 0 % respectivement, contre 48,4, 17, et 9,7 % respectivement au retrait. Les variations de proportions des BGN et NF étaient significatives. Il y a eu 4 ILC bactériémiante et 9 colonisations de cathéters. La variation de proportion de BGN entre la pose et l'ablation du CVC était associés significativement avec la survenue d'un événement positif (p = 0,0019). Conclusion Nous avons montré qu'il existe une variation significative de la composition du microbiote cutané au site d'insertion des CVC, et que l'augmentation de la proportion de BGN est associée à la survenue d'un événement positif.Une étude métagénomique sur les mêmes prélèvements, en cours, viendra compléter ces résultats.Les auteurs n’ont pas précisé leurs éventuels liens d’intérêts.

Introduction La leptospirose, anthropozoonose bactérienne ubiquitaire, est plus fréquente dans les régions tropicales et la mortalité peut atteindre jusqu’à 50 % dans les formes graves. L’objectif de ce travail est de décrire l'épidémiologie et le devenir des patients atteints de leptospirose grave hospitalisés en réanimation dans les départements français d’Amérique (DFA), ainsi que les facteurs associés à la mortalité. Méthodes Il s’agit d’une étude rétrospective réalisée dans les trois réanimations de référence des DFA, du 1er janvier 2013 au 31 décembre 2023, incluant tous les patients majeurs, admis en réanimation pour une leptospirose grave. Résultats Deux cent soixante-quinze patients ont été inclus, dont 226 de sexe masculin (82 %), et d’âge médian (Q1, Q3) 56 ans (46–65). Le score IGSII médian était de 48 (35-63), le score SOFA médian était de 12 (8-15). Le délai médian entre le premier symptôme et l’admission en réanimation était de 5 jours (3-6). Les principales défaillances d'organes observées étaient : hématologique (88 %), hépatique (85 %) et rénale (82 %). Il y avait aussi une élévation des troponines (91 %). Tous les patients ont reçu des antibiotiques, principalement des céphalosporines de troisième génération (93 %). Une réaction de Jarisch-Herxheimer a été documentée dans 41,7% des cas. Le taux de mortalité était de 16% dont 1/3 dans les 48 premières heures. Les défaillances hémodynamique (p = 0,041, OR 9,13 [IC à 95 % 1,09–76,02]), respiratoire (p = 0,006, OR 8,98 [IC à 95 % 1,89–42,75]) et neurologique à l'admission en réanimation (p < 0,001, OR 4,89 [IC 95 % 2,01–11,92]), étaient indépendamment associées à la mortalité. Conclusion Les clusters cliniques de leptospirose grave dans les DFA comprennent la triade de Weil, les atteintes hémodynamique, respiratoire ou neurologique. Les facteurs indépendamment associés au décès sont les défaillances hémodynamique, respiratoire et neurologique à l'admission en réanimation.Les auteurs n’ont pas précisé leurs éventuels liens d’intérêts.

Exposure to environmental pesticides can have significant adverse effects on reproductive health. Using the Wistar rat model, this study assessed the possible protective effect of polysaccharides isolated from the Tunisian green alga Bryopsis plumosa against flupyradifurone-induced reproductive toxicity. For this purpose, animals were divided into four groups: control, flupyradifurone (62.5 mg/kg) as the intoxicated group, flupyradifurone+polysaccharides (100 mg/kg of alimentation) co-treated group, and polysaccharides treated group. Our study showed that flupyradifurone injection induced severe disorders in sperm parameters, accompanied by antioxidant imbalance and histological changes, as confirmed by increased apoptotic and inflammatory genes. However, the administration of polysaccharides attenuated testicular damage via antioxidant, anti-inflammatory, and antiapoptotic pathways. The computational findings supported the in vivo results and showed that DSPE compounds bound HIF-1 alpha and IGF1 with acceptable affinities. These findings showed, for the first time, the adverse effect of flupyradifurone on sperm quality and testicular function in rats and the potential protective effect of polysaccharides against reproductive toxicity.