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Concept: Bite


A 46-year-old farmer presented to the emergency department 3 hours after his penis was bitten by a snake while he was urinating in an open field. Examination revealed stable vital signs, with a grossly swollen penis and formation of hemorrhagic bullae at the puncture sites.

Concepts: Vital signs, Medical signs, Squamata, Penis, Viperidae, Snake, Bite, Dublin


Dog bite studies are typically based on hospital records and may be biased towards bites requiring significant medical treatment. This study investigated true dog bite prevalence and incidence at a community-level and victim-related risk factors, in order to inform policy and prevention.

Concepts: Medicine, Epidemiology, Medical statistics, Cross-sectional study, Geometry, Dog, Bite


The primary objective of this study was to investigate if differences in dog bite characteristics exist amongst legislated and non-legislated dog breeds listed under breed-specific legislation in Ireland (age when bitten, anatomical bite locations, triggers for biting, victim’s relationship with the dog, geographical location and owner presence, history of aggression, reporting bite incident to authorities, medical treatment required following the bite, and type of bite inflicted). A second objective of the current study was to investigate dog control officer’s enforcement and perceptions of current legislation. Data for statistical analyses were collated through a nationally advertised survey, with Pearson Chi-square and Fisher’s Exact Test statistical methods employed for analyses. A total of 140 incident surveys were assessed comprising of non-legislated (n = 100) and legislated (n = 40) dog bite incidents.

Concepts: Statistical tests, Statistics, Injuries, Ronald Fisher, Fisher's exact test, Exact test, Chi-square test, Bite


OBJECTIVE: The aim of this study is to investigate the antioxidant status (TAS), oxidant status (TOS) and oxidative stress index (OSI) in patients with snake envenomation and to learn more about the pathophysiology of snake envenomation. METHOD: Between May 2009 and October 2010, 47 patients were admitted to our emergency department with snake bites, and as a control group 20 healthy volunteers were enrolled in this study. Serum, plasma, and erythrocyte components were prepared for all patients on admission and at the control after 1 month. Serum TOS/TAS levels were measured. RESULTS: No correlation was observed among age, gender and the levels of TAS, TOS and OSI. TAS, TOS and OSI levels were higher in snake envenomation patients upon arrival at the emergency department than in the healthy control group. Upon admission, all levels of patients with snake envenomation were higher than the control levels taken after 1 month. CONCLUSIONS: Serum TAS, TOS and OSI levels increase in snake envenomation patients. The results obtained in this study indicate that the snake bite was associated with a shift to an oxidative state, and oxidative stress plays an important role in the pathophysiology of snake envenomation.

Concepts: Scientific method, Hospital, Antioxidant, Oxidative stress, Oxidative phosphorylation, Snakebite, Viperidae, Bite


In bitemark analysis the extent of distortion of both maxillary and mandibular arches and how one affects the other has not been studied. A single dentition was used to create 49 bites on unembalmed cadavers. Landmarks were placed on digital images of the bitemarks and scanned images of the biting dentition. A sample of 297 randomly acquired dental models was used for comparison purposes. Geometric morphometric techniques were utilized to statistically describe size and shape change, as well as the correlation between the two arches. Results indicate that the predominant distortion seen was in arch width, at 7-28 times as large as measurement error in the biting dentition and roughly 50% of the variation seen in the random population of dentitions. The correlation of arch width distortion between arches was very low (∼0.03). However, the principal patterns of all shape variation did co-vary in the bitemarks produced by the maxillary and mandibular dentition, an effect indicating independence of size and shape distortion. In conclusion, bitemark analysis should be approached with caution when the principal difference between suspects is arch width.

Concepts: Measurement, Skin, Error, Digital photography, Randomness, Bite, Image scanner, Arch


Snake bites are leading causes of morbidity and mortality worldwide, especially in rural areas. Therapeutic plasma exchange has been used in the treatment of many different conditions such as immunologic diseases, toxicologic disorders, and snake envenomation. The aim of this study is to evaluate the efficacy of plasma exchange treatment on clinical status, outcomes, and discharge of patients who were bitten by venomous snakes. The study was conducted retrospectively in the Emergency Department of Gaziantep University from January 2002 to December 2011. Thirty-seven patients were included in the present study. Routine biochemical and hematologic laboratory parameters were studied before and after plasma exchange. Demographic data, clinical status, and outcomes of patients were recorded. Plasma exchange was performed by using centrifugation technology via an intravenous antecubital or subclavian vein catheter access. Human albumin/fresh frozen plasma was used as replacement fluids. A significant correlation was seen between therapeutic plasma exchange and improvement of laboratory results. None of the study patients lost their limbs. Eight patients were sent to the intensive care unit. The mean length of the hospital stay was 12.2days (4-28). All patients were discharged with good recovery. No complications were seen during the 3months following discharge. Plasma exchange appears to be an effective treatment intervention for snake bite envenomations, especially in the management of hematologic problems and in limb preservation/salvage strategies. In addition to traditional treatment methods, plasma exchange should be considered by emergency physicians in cases of snake bite envenomation as a therapeutic approach to facilitate rapid improvement.

Concepts: Medicine, Hospital, Central venous catheter, Subclavian vein, Snakebite, Viperidae, Snake, Bite


Facial injuries caused by dog bites pose a serious problem. The aims of this study were to determine human behavior immediately preceding a dog bite to the face and to assess the effects of victim age and gender and dog sex and size on the location of the bite to the face and the need for medical treatment. Complete data on 132 incidents of bites to the face were analysed. A human bending over a dog, putting the face close to the dog’s face, and gazing between victim and dog closely preceded a dog bite to the face in 76%, 19% and 5% of cases, respectively. More than half of the bites were directed towards the central area of the victim’s face (nose, lips). More than two thirds of the victims were children, none of the victims was an adult dog owner and only adult dogs bit the face. Victim’s age and gender and dog’s sex and size did not affect the location of the bite on the face. People who were bitten by large dogs sought medical treatment more often than people who were bitten by small dogs (P <0.01). Risk factors such as bending over the dog, putting the face close to the dog's face and gazing between human and dog should be avoided, and children should be carefully and constantly supervised when in the presence of dogs.

Concepts: Psychology, Human behavior, Dog, Apex predator, Victim, Skinny Puppy, Bite, The Victim


C. canimorsus and C. cynodegmi are dog and cat commensals which can be transmitted to humans via bites or scratches and can cause sepsis, meningitis, endocarditis, and eye- or wound infections. Recently an additional Capnocytophaga species was identified as part of the oral flora of healthy dogs and was given the name “C. canis”. We previously identified a Capnocytophaga isolate that could not be typed with available diagnostic tests including MALDI-TOF, 16S rRNA sequencing or species-specific PCR. This strain and 21 other Capnocytophaga spp isolated in Sweden from clinical blood- or wound-cultures were subjected to whole genome sequencing using the Illumina platform. Phylogenetic analysis revealed that the previously non-typable isolate belongs to the putative new species “C. canis”. Since this strain was isolated from a wound it also shows that members of “C. canis” have the potential to be pathogenic. In addition, our phylogenetic analysis uncovered an additional species of Capnocytophaga, which can be transmitted from dogs and cats to humans, suggesting a speciation within the Capnocytophaga family that has not been observed before. We propose the name of “C. stomatis” for this putative novel species.

Concepts: DNA, Bacteria, Molecular biology, Species, DNA sequencing, Full genome sequencing, Injuries, Bite


Adjusting one’s behaviour in response to eavesdropping bystanders is considered a sophisticated social strategy, yet the underlying mechanisms are not well studied. Cleaner wrasse, Labroides dimidiatus, cooperate by eating ectoparasites off “client” fishes, or cheat (i.e. bite) and eat client mucus. Image scoring by bystander clients generally causes cleaners from socially-complex (i.e. high cleaner and client abundance; high client species richness) habitats to increase levels of cooperation. However, some individuals may periodically provide tactile stimulation to small resident clients, which attract bystanders close that are bitten, a form of tactical deception. Cortisol injection can reproduce this pattern. Here, we tested whether cleaners from socially-complex versus simple habitats respond differently to cortisol injections in terms of their cleaning interactions with clients. We found that only cleaners from the socially-complex habitat respond to cortisol injection with strategies functioning as tactical deception: i.e. increased tactile stimulation to small clients and increased cheating of large clients relative to small ones. At the socially-simple site, where reputation management is less important, cortisol-treated fish increased their overall levels of cheating, especially of small clients. Thus, strategic adjustments to cooperative behaviour and tactical deception are likely context-dependent, forming part of general reputation management abilities in cleaner wrasse.

Concepts: Fish, Eating, Strategy, Bite, Labridae, Adjustment disorder, Bluestreak cleaner wrasse, Wrasse


Accurate determination of the origin and timing of trauma is key in medicolegal investigations when the cause and manner of death are unknown. However, distinction between criminal and accidental perimortem trauma and postmortem modifications can be challenging when facing unidentified trauma. Postmortem examination of the immersed victims of the Yemenia airplane crash (Comoros, 2009) demonstrated the challenges in diagnosing extensive unusual circular lesions found on the corpses. The objective of this study was to identify the origin and timing of occurrence (peri- or postmortem) of the lesions.A retrospective multidisciplinary study using autopsy reports (n = 113) and postmortem digital photos (n = 3 579) was conducted. Of the 113 victims recovered from the crash, 62 (54.9 %) presented unusual lesions (n = 560) with a median number of 7 (IQR 3 ∼ 13) and a maximum of 27 per corpse. The majority of lesions were elliptic (58 %) and had an area smaller than 10 cm(2) (82.1 %). Some lesions (6.8 %) also showed clear tooth notches on their edges. These findings identified most of the lesions as consistent with postmortem bite marks from cookiecutter sharks (Isistius spp.). It suggests that cookiecutter sharks were important agents in the degradation of the corpses and thus introduced potential cognitive bias in the research of the cause and manner of death. A novel set of evidence-based identification criteria for cookiecutter bite marks on human bodies is developed to facilitate more accurate medicolegal diagnosis of cookiecutter bites.

Concepts: Death, Median, Identification, Autopsy, Embalming, Bite, Death metal, Aviation accidents and incidents