The Experts below are selected from a list of 285 Experts worldwide ranked by ideXlab platform
Susan P. Jacups - One of the best experts on this subject based on the ideXlab platform.
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Prospective study of Chironex fleckeri and other box Jellyfish Stings in the "Top End" of Australia's Northern Territory.
The Medical journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950 km of coastline; analysis of tidal, weather and seasonal data. All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the "Stinger season" (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occurred while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month's average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the Stinger season.
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Prospective study of Chironex fleckeri and other box Jellyfish Stings in the “Top End” of Australia’s Northern Territory
The Medical Journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:Objective: To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Design: Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950km of coastline; analysis of tidal, weather and seasonal data. Patients: All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Main outcome measures: Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Results: Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the “Stinger season” (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occured while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month’s average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Conclusions: Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the
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prospective study of chironex fleckeri and other box Jellyfish Stings in the top end of australia s northern territory
The Medical Journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:Objective: To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Design: Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950km of coastline; analysis of tidal, weather and seasonal data. Patients: All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Main outcome measures: Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Results: Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the “Stinger season” (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occured while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month’s average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Conclusions: Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the
Angela C. Webster - One of the best experts on this subject based on the ideXlab platform.
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The Cochrane Library - Interventions for the symptoms and signs resulting from Jellyfish Stings
The Cochrane database of systematic reviews, 2013Co-Authors: Richard Mcgee, Geoffrey K. Isbister, Angela C. WebsterAbstract:Background Jellyfish envenomations are common amongst temperate coastal regions and vary in severity depending on the species. Stings result in a variety of symptoms and signs, including pain, dermatological reactions and, in some species, Irukandji syndrome (including abdominal/back/chest pain, tachycardia, hypertension, sweating, piloerection, agitation and sometimes cardiac complications). Many treatments have been suggested for the symptoms and signs of Jellyfish Stings. However, it is unclear which interventions are most effective. Objectives To determine the benefits and harms associated with the use of any intervention, in both adults and children, for the treatment of Jellyfish Stings, as assessed from randomised trials. Search methods We searched the following electronic databases in October 2012 and again in October 2013: the Cochrane Central Register of Controlled Trials (CENTRAL;The Cochrane Library, Issue 9, 2013); MEDLINE via Ovid SP (1948 to 22 October 2013); EMBASE via Ovid SP (1980 to 21 October 2013); and Web of Science (all databases; 1899 to 21 October 2013). We also searched reference lists from eligible studies and guidelines, conference proceedings and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) and contacted content experts to identify trials. Selection criteria We included randomised controlled trials that compared any intervention(s) to active and/or non-active controls for the treatment of symptoms and signs of Jellyfish Sting envenomation. No language, publication date or publication status restrictions were applied. Data collection and analysis Two review authors independently conducted study selection and data extraction and assessed risk of bias using a standardised form. Disagreements were resolved by consensus with a third review author when necessary. Main results We included seven trials with a total of 435 participants. Three trials focused on Physalia (Bluebottle) Jellyfish, one trial on Carukia Jellyfish and three on Carybdea alata (Hawaiian box) Jellyfish. Two ongoing trials were identified. Six of the seven trials were judged as having high risk of bias. Blinding was not feasible in four of the included trials because of the nature of the interventions. A wide range of interventions were assessed across trials, and a wide range of outcomes were measured. We reported results from the two trials for which data were available and reported the effects of interventions according to our definition of primary or secondary outcomes. Hot water immersion was superior to ice packs in achieving clinically significant (at least 50%) pain relief at 10 minutes (one trial, 96 participants, risk ratio (RR) 1.66, 95% confidence interval (CI) 1.01 to 2.72; low-quality evidence) and 20 minutes (one trial, 88 participants, RR 2.66, 95% CI 1.71 to 4.15; low-quality evidence). No statistically significant differences between hot water immersion and ice packs were demonstrated for dermatological outcomes. Treatment with vinegar or Adolph's meat tenderizer compared with hot water made skin appear worse (one trial, 25 participants, RR 0.31, 95% CI 0.14 to 0.72; low-quality evidence). Adverse events due to treatment were not reported in any trial. Authors' conclusions This review located a small number of trials that assessed a variety of different interventions applied in different ways and in different settings. Although heat appears to be an effective treatment for Physalia (Bluebottle) Stings, this evidence is based on a single trial of low-quality evidence. It is still unclear what type of application, temperature, duration of treatment and type of water (salt or fresh) constitute the most effective treatment. In addition, these results may not apply to other species of Jellyfish with different envenomation characteristics. Future research should further assess the most effective interventions using standardised research methodology.
Javier Ruiz - One of the best experts on this subject based on the ideXlab platform.
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portuguese man of war physalia physalis in the mediterranean a permanent invasion or a casual appearance
Scientific Reports, 2015Co-Authors: Laura Prieto, Diego Macias, Alvaro Peliz, Javier RuizAbstract:In 2010, the Mediterranean basin experienced Portuguese Man-of-War (Physalia physalis) swarms that had dramatic consequences, including the region’s first recorded human fatality attributed to a Jellyfish Sting. Despite the impact of Jellyfish on coastal economic activity and the importance of the tourism industry for the Mediterranean region (accounting for 15% of global tourism), no scientific consensus has been achieved regarding the causes of this episode. Here, we analyse the meteorological and oceanographic conditions of the North-East Atlantic Ocean during the months previous to the appearance of P. physalis in the Mediterranean. We simulate the probable drift of Atlantic populations into the Mediterranean basin with a numerical model and compare model results with available observations. We conclude that the summer 2010 P. Physalis swarm was the result of an unusual combination of meteorological and oceanographic conditions during the previous winter and not a permanent invasion favoured by climatic changes.
Bart J. Currie - One of the best experts on this subject based on the ideXlab platform.
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Prospective study of Chironex fleckeri and other box Jellyfish Stings in the "Top End" of Australia's Northern Territory.
The Medical journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950 km of coastline; analysis of tidal, weather and seasonal data. All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the "Stinger season" (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occurred while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month's average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the Stinger season.
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Prospective study of Chironex fleckeri and other box Jellyfish Stings in the “Top End” of Australia’s Northern Territory
The Medical Journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:Objective: To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Design: Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950km of coastline; analysis of tidal, weather and seasonal data. Patients: All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Main outcome measures: Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Results: Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the “Stinger season” (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occured while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month’s average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Conclusions: Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the
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prospective study of chironex fleckeri and other box Jellyfish Stings in the top end of australia s northern territory
The Medical Journal of Australia, 2005Co-Authors: Bart J. Currie, Susan P. JacupsAbstract:Objective: To describe the epidemiology and clinical features of box Jellyfish envenoming in the Top End of the Northern Territory and, in particular, confirmed Stings from the major Australian box Jellyfish, Chironex fleckeri. Design: Prospective collection of clinical data and skin scrapings or sticky-tape tests for nematocyst identification from patients presenting to Royal Darwin Hospital and remote coastal community health clinics in the Northern Territory, spanning 10 950km of coastline; analysis of tidal, weather and seasonal data. Patients: All patients with Jellyfish Sting details recorded between 1 April 1991 and 30 May 2004. Main outcome measures: Demographic and clinical features, use of C. fleckeri antivenom, and associations between weather, seasonal and tidal factors and confirmed C. fleckeri Stings. Results: Of 606 Jellyfish Stings documented, 225 were confirmed to have been caused by C. fleckeri. 37% of C. fleckeri Stings were in children, 92% occurred during the “Stinger season” (1 October to 1 June), 83% occurred in water 1 m or less deep, and 17% occured while victims were entering the water. Stings were least common on outgoing tides (P < 0.001) and commonest between 15:00 and 18:00 (P < 0.001) and on days with wind speed less than that month’s average (P < 0.001). Nearly all victims experienced immediate pain, but this could often be controlled with ice; only 30% required parenteral narcotics and 8% required hospital admission. Cardiorespiratory arrest occurred within several minutes of the Sting in the one fatal case, involving a 3-year-old girl with only 1.2 m of visible tentacle contact. C. fleckeri antivenom was given to another 21 patients, none of whom had life-threatening features at the time they were given antivenom. Conclusions: Most C. fleckeri Stings are not life-threatening; patients who die usually have cardiopulmonary arrest within minutes of the Sting. The potential benefit of antivenom and magnesium under these circumstances remains to be shown, but a protocol with their rapid use is recommended if cardiopulmonary arrest has occurred. Unfortunately, this is unrealistic for many rural coastal locations, and the priority remains prevention of Stings by keeping people, especially children, out of the sea during the
Hiroshi Nagai - One of the best experts on this subject based on the ideXlab platform.
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RESEARCH ARTICLE Length Is Associated with Pain: Jellyfish with Painful Sting Have Longer Nematocyst Tubules than Harmless Jellyfish
2016Co-Authors: Ryuju Kitatani, Mayu Yamada, Michiya Kamio, Hiroshi NagaiAbstract:A large number of humans are stung by Jellyfish all over the world. The Stings cause acute pain followed by persistent pain and local inflammation. Harmful Jellyfish species typically cause strong pain, whereas harmless Jellyfish cause subtle or no pain. Jellyfish Sting humans by injecting a tubule, contained in the nematocyst, the Stinging organ of Jellyfish. The tubule penetrates into the skin leading to venom injection. The detailed morphology of the nematocyst tubule and molecular structure of the venom in the nematocyst has been reported; however, the mechanism responsible for the difference in pain that is caused by harmful and harmless Jellyfish Sting has not yet been explored or explained. Therefore, we hypothesized that differences in the length of the nematocyst tubule leads to different degrees of epithelial damage. The initial acute pain might be generated by penetration of the tubule, which stimulates pain receptor neurons, whilst persistent pain might be caused by injection of venom into the epithelium. To test this hypothesis we compared the lengths of discharged nematocyst tubules from harmful and harmless Jellyfish species and evalu-ated their ability to penetrate human skin. The results showed that the harmful Jellyfish spe-cies, Chrysaora pacifica, Carybdea brevipedalia, and Chironex yamaguchii, causing moderate to severe pain, have nematocyst tubules longer than 200 μm, compared with a Jellyfish species that cause little or no pain, Aurelia aurita. The majority of the tubules of harmful Jellyfishes, C. yamaguchii and C. brevipedalia, were sufficiently long to penetrate the human epidermis and physically stimulate the free nerve endings of Aδ pain receptor fibers around plexuses to cause acute pain and inject the venom into the human skin epithe-lium to cause persistent pain and inflammation
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Length Is Associated with Pain: Jellyfish with Painful Sting Have Longer Nematocyst Tubules than Harmless Jellyfish
PLOS ONE, 2015Co-Authors: Ryuju Kitatani, Mayu Yamada, Michiya Kamio, Hiroshi NagaiAbstract:A large number of humans are stung by Jellyfish all over the world. The Stings cause acute pain followed by persistent pain and local inflammation. Harmful Jellyfish species typically cause strong pain, whereas harmless Jellyfish cause subtle or no pain. Jellyfish Sting humans by injecting a tubule, contained in the nematocyst, the Stinging organ of Jellyfish. The tubule penetrates into the skin leading to venom injection. The detailed morphology of the nematocyst tubule and molecular structure of the venom in the nematocyst has been reported; however, the mechanism responsible for the difference in pain that is caused by harmful and harmless Jellyfish Sting has not yet been explored or explained. Therefore, we hypothesized that differences in the length of the nematocyst tubule leads to different degrees of epithelial damage. The initial acute pain might be generated by penetration of the tubule, which stimulates pain receptor neurons, whilst persistent pain might be caused by injection of venom into the epithelium. To test this hypothesis we compared the lengths of discharged nematocyst tubules from harmful and harmless Jellyfish species and evaluated their ability to penetrate human skin. The results showed that the harmful Jellyfish species, Chrysaora pacifica, Carybdea brevipedalia, and Chironex yamaguchii, causing moderate to severe pain, have nematocyst tubules longer than 200 μm, compared with a Jellyfish species that cause little or no pain, Aurelia aurita. The majority of the tubules of harmful Jellyfishes, C. yamaguchii and C. brevipedalia, were sufficiently long to penetrate the human epidermis and physically stimulate the free nerve endings of Aδ pain receptor fibers around plexuses to cause acute pain and inject the venom into the human skin epithelium to cause persistent pain and inflammation.
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Identification of allergens in the box Jellyfish Chironex yamaguchii that cause Sting dermatitis.
International archives of allergy and immunology, 2015Co-Authors: Takumi Horiike, Hiroshi Nagai, Seiichi KitaniAbstract:Background: Jellyfish Stings cause painful, papular-urticarial eruptions due to the immediate allergic, acute toxic and persistent inflammatory responses. In spite of many marine accidents and their economic impact, modes of first-aid treatment remain conventional and specific allergen and medical treatment are not yet available. The purpose of this study was to define the specific allergen of the box Jellyfish Chironex yamaguchii and to study the precise mechanism of the resulting dermatitis. Methods: We comprehensively studied the immunoglobulin-binding molecules from the box Jellyfish C. yamaguchii with a purification procedure and Western blotting, using sera from 1 patient and from several controls. Results: From the nematocyst wall and spine, we detected IgG-binding acidic glycoprotein (of 66 and 30 kDa) as determined by Western blot and ion-exchange chromatography. In addition, the 66-kDa protein was found to be an asparagine residue-coupled N-linked glycoprotein and the epitope resided in the protein fraction. We found that CqTX-A, the major toxic protein of the nematocyst, is also a heat-stable IgE-binding allergen. This was confirmed as a 45-kDa protein by Western blot from both nematocyst extracts and purified CqTX-A. Conclusions: The detection of these proteins may, in part, explain the combined immediate allergic-toxic and persistent allergic responses. Hopefully, our findings will lead to the development of specific venom immunotherapy for marine professional workers and tourists for Jellyfish-Sting dermatitis and anaphylaxis.