ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Bouaziz M, et al., 2008. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: Multivariate analysis of 951 cases. Toxicon 52: 918–926.
-
2.
Bahloul M, et al., 2010. Scorpion envenomation among children: Clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg 83: 1084–1092.
-
3.
Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Ben Hamida C, Kallel H, Bouaziz M, 2013. Pulmonary edema following scorpion envenomation: Mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol 162: 86–91.
-
4.
Bahloul M, Regaieg K, Chabchoub I, Kammoun M, Chtara K, Bouaziz M, 2017. Severe scorpion envenomation: Pathophysiology and the role of inflammation in multiple organ failure. Med Sante Trop 27: 214–221.
-
5.
Abroug F, Ouanes-Besbes L, Tilouche N, Elatrous S, 2020. Scorpion envenomation: State of the art. Intensive Care Med 46: 401–410.
-
6.
Fereidooni R, Shirzadi S, Ayatizadeh SH, Bahloul M, Tavangar A, Zomorodian SA, Roshanshad A, Ardekani A, 2023. Scorpion envenomation-associated myocarditis: A systematic review. PLoS Negl Trop Dis 17: e0011219.
-
7.
Bahloul M, Kallel H, Rekik N, Ben Hamida C, Chelly H, Bouaziz M, 2005. Cardiovascular dysfunction following severe scorpion envenomation. Mechanisms and physiopathology. Presse Med 34: 115–120.
-
8.
Bawaskar H, Patare P, Bawaskar P, 2020. Scorpion sting with ST-segment elevation. JAMA Intern Med 180: 1689–1690.
-
9.
Ramalingam PK, Gayathri K, Santhakumar R, Manjunath BV, Karuppusamy N, Vetriveeran B, Selvamani S, Vishnuram P, Natarajan K, 2016. Transient ST segment elevation following Indian red scorpion sting with non-occlusive right coronary artery disease. J Assoc Physicians India 64: 87–88.
-
10.
Patra S, Satish K, Singla V, Ravindranath KS, 2013. Acute myocardial infarction following scorpion sting in a case with obstructive coronary artery disease. BMJ Case Rep 2013: bcr2013009865.
-
11.
Cupo P, Figueiredo AB, Filho AP, Pintya AO, Tavares Júnior GA, Caligaris F, Marin-Neto JA, Hering SE, Simões MV, 2007. Acute left ventricular dysfunction of severe scorpion envenomation is related to myocardial perfusion disturbance. Int J Cardiol 116: 98–106.
-
12.
Bahloul M, et al., 2004. Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study. Intensive Care Med 30: 461–467.
-
13.
Chakroun-Walha O, et al., 2018. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 37: 580–586.
-
14.
Gueron M, Yaron R, 1970. Cardiovascular manifestations of severe scorpion sting. Clinicopathologic correlations. Chest 57: 156–162.
-
15.
Köse N, Yıldırım T, 2021. Acute coronary syndrome because of a scorpion sting in a patient with chronic coronary syndrome: A case report and review of the literature. Turk Kardiyol Dern Ars 49: 328–333.
-
16.
Gueron M, Margulis G, Sofer S, 1990. Echocardiographic and radionuclide angiographic observations following scorpion envenomation by Leiurus quinquestriatus. Toxicon 28: 1005–1009.
-
17.
Rahav G, Weiss AT, 1990. Scorpion. sting-induced pulmonary edema. Scintigraphic evidence of cardiac dysfunction. Chest 97: 1478–1480.
-
18.
Meki A, Mohamed ZMM, El-Deen HMM, 2003. Significance of assessment of serum cardiac troponin I and interleukin-8 in scorpion envenomed children. Toxicon 41: 129–137.
-
19.
Goyffon M, Vachon M, Broglio N, 1982. Epidemiological and clinical characteristics of the scorpion envenomation in Tunisia. Toxicon 20: 337–344.
-
20.
Katwaroo A, Austin K, Bharat A, Chatoo V, Ramcharan P, Seecheran V, Seecheran R, Giddings S, Seecheran NA, 2024. Scorpion-induced acute coronary syndrome: A stinging complication. J Investig Med High Impact Case Rep 12: 23247096241261255.
-
21.
Baykan AO, Gür M, Acele A, Şeker T, Çaylı M, 2016. Scorpion envenomation-induced acute thrombotic inferior myocardial infarction. Turk Kardiyol Dern Ars 44: 82–86.
-
22.
Figueiredo AB, Cupo P, Pintya AO, Caligaris F, Marin-Neto JA, Hering SE, Simões MV, 2010. Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT. Arq Bras Cardiol 94: 444–451.
-
23.
Sagarad SV, Kerure SB, Thakur B, Reddy SS, Balasubramanya K, Joshi RM, 2013. Echocardiography guided therapy for myocarditis after scorpion sting envenomation. J Clin Diagn Res 7: 2836–2838.
-
24.
Sagarad SV, Thakur BS, Reddy SS, Balasubramanya K, Joshi RM, Kerure SB, 2012. Elevated cardiac troponin (cTnI) levels correlate with the clinical and echocardiographic evidences of severe myocarditis in scorpion sting envenomation. J Clin Diagn Res 6: 1369–1371.
-
25.
Amaral CFS, de Rezende NA, Freire-Maia L, 1993. Acute pulmonary edema after Tityus serrulatus scorpion sting in children. Am J Cardiol 71: 242–245.
-
26.
Cupo P, Jurca M, Azeedo-Marques MM, Oliveira JS, Hering SE, 1994. Severe scorpion envenomation in Brazil. Clinical, laboratory and anatomopathological aspects. Rev Inst Med Trop São Paulo 36: 67–76.
-
27.
Daisley H, Alexander D, Pitt-Miller P, 1999. Acute myocarditis following Tityus trinitatis envenoming: Morphological and pathophysiological characteristics. Toxicon 37: 159–165.
-
28.
Abroug F, Ouanes I, Maatouk M, Golli M, Ouanes-Besbes L, 2018. Inverted Takotsubo syndrome in Androctonus australis scorpion envenomation. Clin Toxicol (Phila) 56: 381–383.
-
29.
Miranda CH, Braggion-Santos MF, Schmidt A, Pazin-Filho A, Cupo P, 2015. The first description of cardiac magnetic resonance findings in a severe scorpion envenomation: Is it a stress-induced (Takotsubo) cardiomyopathy like? Am J Emerg Med 33: e5–e7.
-
30.
Ben Jemaa A, Bahloul M, Kallel H, Turki O, Dlela M, Bouaziz M, 2021. Inverted Takotsubo syndrome due to severe scorpion envenomation: Report of one case. Med Trop Sante Int 1: PWX0-M245.
-
31.
Mohammadi H, Fereidooni R, Mehdizadegan N, Amoozgar H, Naghshzan A, Edraki MR, Tavangar A, 2023. Q wave in paediatric myocarditis: An underinvestigated, readily available prognostic factor. Acta Cardiol 78: 813–822.
-
32.
Babuin L, Jaffe AS, 2005. Troponin: The biomarker of choice for the detection of cardiac injury. CMAJ 173: 1191–1202.
-
33.
Simons M, Downing SE, 1985.Coronary vasoconstriction and catecholamine cardiomyopathy. Am Heart J 109: 297–304.
-
34.
Zeghal K, Sahnoun Z, Guinot M, Richer C, Giudicelli JF, 2000. Characterization and mechanisms of the cardiovascular and haemodynamic alterations induced by scorpion venom in rats. Fundam Clin Pharmacol 14: 351–361.
-
35.
Nouira S, Elatrous S, Besbes L, Boukef R, Devaux C, Aubrey N, Elayeb M, Abroug F, 2005. Neurohormonal activation in severe scorpion envenomation: Correlation with hemodynamics and circulating toxin. Toxicol Appl Pharmacol 208: 111–116.
-
36.
Fukuhara YD, Reis ML, Dellalibera-Joviliano R, Cunha FQ, Donadi EA, 2003. Increased plasma levels of IL-1beta, IL-6, IL-8, IL-10 and TNF-alpha in patients moderately or severely envenomed by Tityus serrulatus scorpion sting. Toxicon 41: 49–55.
-
37.
Klemm P, Warner TD, Hohlfeld T, Corder R, Vane JR, 1995. Endothelin 1 mediates ex vivo coronary vasoconstriction caused by exogenous and endogenous cytokines. Proc Natl Acad Sci USA 92: 2691–2695.
-
38.
Kadokami T, Shimokawa H, Fukumoto Y, Ito A, Takayanagi T, Egashira K, Takeshita A, 1996. Coronary artery spasm does not depend on the intracellular calcium store but is substantially mediated by the protein kinase C mediated pathway in a swine model with interleukin-1 beta in vivo. Circulation 94: 190–196.
-
39.
Bahloul M, Kharrat S, Bouchaala K, Chtara K, Bouaziz M, 2023. Takotsubo cardiomyopathy following scorpion envenomation: A literature review. Am J Cardiovasc Dis 13: 354–362.
-
40.
Ghadri JR, Wittstein IS, Prasad A, Sharkey S, Dote K, Akashi YJ, Cammann VL, 2018. International expert consensus document on Takotsubo syndrome (part I): Clinical characteristics, diagnostic criteria, and pathophysiology. Eur Heart J 39: 2032–2046.
-
41.
Matta AG, Carrié D, 2023. Epidemiology, pathophysiology, diagnosis, and principles of management of takotsubo cardiomyopathy: A review. Med Sci Monit 29: e939020.
-
42.
Bouaziz M, Ben Hamida C, Chelly H, Bahloul M, Kallel H, 2020. Dobutamine in the treatment of severe scorpion envenoming. Toxicon 182: 54–58.
-
43.
Elatrous S, Nouira S, Besbes-Ouanes L, Boussarsar M, Boukef R, Marghli S, Abroug F, 1999. Dobutamine in severe scorpion envenomation: Effects on standard hemodynamics, right ventricular performance, and tissue oxygenation. Chest 116: 748–753.
-
44.
Abroug F, Ouanes-Besbes L, Elatrous S, 2015. Should dobutamine be used in severe scorpion envenomation. Clin Toxicol (Phila) 53: 584.
-
45.
Rizzetto F, Lia M, Widmann M, Tavella D, Zanolla L, Pighi M, Ferrero V, Ribichini FL, 2022. Prognostic impact of antiplatelet therapy in Takotsubo syndrome: A systematic review and meta-analysis of the literature. Heart Fail Rev 27: 857–868.
-
46.
Sukhera J, 2022. Narrative reviews in medical education: Key steps for researchers. J Grad Med Educ 14: 418–419.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 3808 | 3808 | 150 |
| Full Text Views | 91 | 91 | 14 |
| PDF Downloads | 77 | 77 | 8 |
Myocardial Ischemia after Severe Scorpion Envenomation: A Narrative Review
Mabrouk Bahloul
bahloulmab@yahoo.fr
Mabrouk Bahloul
Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Karama Bouchaala
Karama Bouchaala
Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Kamilia Chtara
Kamilia Chtara
Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Sana Kharrat
Sana Kharrat
Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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Mounir Bouaziz
Mounir Bouaziz
Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia
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ABSTRACT.
Myocardial ischemia after severe scorpion envenomation is rarely reported. The aim of this review was to elaborate on a review of myocardial ischemia after severe scorpion envenomation and to detail the mechanism of this myocardial hypoperfusion. We used the PubMed database and entered the following keywords in MeSH research: scorpion envenomation, myocardial ischemia, myocardial perfusion scintigraphy, echocardiography, and troponins. The literature analysis confirmed that severe scorpion envenomation can be complicated by temporary myocardial ischemia, based on electrocardiographic, histopathologic, echocardiographic, myocardial perfusion scintigraphy, and biological studies. The correlation between clinical manifestations, laboratory and electrocardiographic evidence of myocardial damage, echocardiographic studies, perfusion scintigraphy abnormalities, and histopathologic findings are suggestive of lesions of cardiac fibers secondary to myocardial ischemia. Myocardial hypoperfusion may be due to multiple factors. First, catecholamine storms can induce microvascular constriction. On the other hand, the release of catecholamines through a complex neurohormonal interaction with other neuropeptides and cytokine release can produce/induce major coronary microvascular constriction and/or microvascular injury, leading to microvascular acute coronary syndrome with Takotsubo cardiomyopathy. The management of severe scorpion envenomation with severe myocardial failure and pulmonary edema is based on oxygen with invasive or noninvasive ventilator support. Dobutamine improves cardiac function after scorpion envenomation. Antiplatelet therapy is not recommended. In conclusion, severe scorpion envenomation can be complicated by temporary myocardial ischemia, which can be due to multiple factors.
- Supplemental Materials (PDF 216.61 KB)
Author Notes
Authors’ contributions: All authors contributed to the drafting of the manuscript. All authors read and approved the final manuscript.
Current contact information: Mabrouk Bahloul, Karama Bouchaala, Kamilia Chtara, Sana Kharrat, and Mounir Bouaziz, Department of Intensive Care, Habib Bourguiba University Hospital, Sfax University, Sfax, Tunisia, E-mails: bahloulmab@yayoo.fr, karamamnif@gmail.com, kamilia.chtaraelaoud@gmail.com, sanakharrat15@hotmail.com, and mounir.bouaziz@rns.tn.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Bouaziz M, et al., 2008. Epidemiological, clinical characteristics and outcome of severe scorpion envenomation in South Tunisia: Multivariate analysis of 951 cases. Toxicon 52: 918–926.
-
2.
Bahloul M, et al., 2010. Scorpion envenomation among children: Clinical manifestations and outcome (analysis of 685 cases). Am J Trop Med Hyg 83: 1084–1092.
-
3.
Bahloul M, Chaari A, Dammak H, Samet M, Chtara K, Chelly H, Ben Hamida C, Kallel H, Bouaziz M, 2013. Pulmonary edema following scorpion envenomation: Mechanisms, clinical manifestations, diagnosis and treatment. Int J Cardiol 162: 86–91.
-
4.
Bahloul M, Regaieg K, Chabchoub I, Kammoun M, Chtara K, Bouaziz M, 2017. Severe scorpion envenomation: Pathophysiology and the role of inflammation in multiple organ failure. Med Sante Trop 27: 214–221.
-
5.
Abroug F, Ouanes-Besbes L, Tilouche N, Elatrous S, 2020. Scorpion envenomation: State of the art. Intensive Care Med 46: 401–410.
-
6.
Fereidooni R, Shirzadi S, Ayatizadeh SH, Bahloul M, Tavangar A, Zomorodian SA, Roshanshad A, Ardekani A, 2023. Scorpion envenomation-associated myocarditis: A systematic review. PLoS Negl Trop Dis 17: e0011219.
-
7.
Bahloul M, Kallel H, Rekik N, Ben Hamida C, Chelly H, Bouaziz M, 2005. Cardiovascular dysfunction following severe scorpion envenomation. Mechanisms and physiopathology. Presse Med 34: 115–120.
-
8.
Bawaskar H, Patare P, Bawaskar P, 2020. Scorpion sting with ST-segment elevation. JAMA Intern Med 180: 1689–1690.
-
9.
Ramalingam PK, Gayathri K, Santhakumar R, Manjunath BV, Karuppusamy N, Vetriveeran B, Selvamani S, Vishnuram P, Natarajan K, 2016. Transient ST segment elevation following Indian red scorpion sting with non-occlusive right coronary artery disease. J Assoc Physicians India 64: 87–88.
-
10.
Patra S, Satish K, Singla V, Ravindranath KS, 2013. Acute myocardial infarction following scorpion sting in a case with obstructive coronary artery disease. BMJ Case Rep 2013: bcr2013009865.
-
11.
Cupo P, Figueiredo AB, Filho AP, Pintya AO, Tavares Júnior GA, Caligaris F, Marin-Neto JA, Hering SE, Simões MV, 2007. Acute left ventricular dysfunction of severe scorpion envenomation is related to myocardial perfusion disturbance. Int J Cardiol 116: 98–106.
-
12.
Bahloul M, et al., 2004. Evidence of myocardial ischaemia in severe scorpion envenomation. Myocardial perfusion scintigraphy study. Intensive Care Med 30: 461–467.
-
13.
Chakroun-Walha O, et al., 2018. Value of troponin levels in the diagnosis of cardiac dysfunction in moderate scorpion envenomation. Hum Exp Toxicol 37: 580–586.
-
14.
Gueron M, Yaron R, 1970. Cardiovascular manifestations of severe scorpion sting. Clinicopathologic correlations. Chest 57: 156–162.
-
15.
Köse N, Yıldırım T, 2021. Acute coronary syndrome because of a scorpion sting in a patient with chronic coronary syndrome: A case report and review of the literature. Turk Kardiyol Dern Ars 49: 328–333.
-
16.
Gueron M, Margulis G, Sofer S, 1990. Echocardiographic and radionuclide angiographic observations following scorpion envenomation by Leiurus quinquestriatus. Toxicon 28: 1005–1009.
-
17.
Rahav G, Weiss AT, 1990. Scorpion. sting-induced pulmonary edema. Scintigraphic evidence of cardiac dysfunction. Chest 97: 1478–1480.
-
18.
Meki A, Mohamed ZMM, El-Deen HMM, 2003. Significance of assessment of serum cardiac troponin I and interleukin-8 in scorpion envenomed children. Toxicon 41: 129–137.
-
19.
Goyffon M, Vachon M, Broglio N, 1982. Epidemiological and clinical characteristics of the scorpion envenomation in Tunisia. Toxicon 20: 337–344.
-
20.
Katwaroo A, Austin K, Bharat A, Chatoo V, Ramcharan P, Seecheran V, Seecheran R, Giddings S, Seecheran NA, 2024. Scorpion-induced acute coronary syndrome: A stinging complication. J Investig Med High Impact Case Rep 12: 23247096241261255.
-
21.
Baykan AO, Gür M, Acele A, Şeker T, Çaylı M, 2016. Scorpion envenomation-induced acute thrombotic inferior myocardial infarction. Turk Kardiyol Dern Ars 44: 82–86.
-
22.
Figueiredo AB, Cupo P, Pintya AO, Caligaris F, Marin-Neto JA, Hering SE, Simões MV, 2010. Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT. Arq Bras Cardiol 94: 444–451.
-
23.
Sagarad SV, Kerure SB, Thakur B, Reddy SS, Balasubramanya K, Joshi RM, 2013. Echocardiography guided therapy for myocarditis after scorpion sting envenomation. J Clin Diagn Res 7: 2836–2838.
-
24.
Sagarad SV, Thakur BS, Reddy SS, Balasubramanya K, Joshi RM, Kerure SB, 2012. Elevated cardiac troponin (cTnI) levels correlate with the clinical and echocardiographic evidences of severe myocarditis in scorpion sting envenomation. J Clin Diagn Res 6: 1369–1371.
-
25.
Amaral CFS, de Rezende NA, Freire-Maia L, 1993. Acute pulmonary edema after Tityus serrulatus scorpion sting in children. Am J Cardiol 71: 242–245.
-
26.
Cupo P, Jurca M, Azeedo-Marques MM, Oliveira JS, Hering SE, 1994. Severe scorpion envenomation in Brazil. Clinical, laboratory and anatomopathological aspects. Rev Inst Med Trop São Paulo 36: 67–76.
-
27.
Daisley H, Alexander D, Pitt-Miller P, 1999. Acute myocarditis following Tityus trinitatis envenoming: Morphological and pathophysiological characteristics. Toxicon 37: 159–165.
-
28.
Abroug F, Ouanes I, Maatouk M, Golli M, Ouanes-Besbes L, 2018. Inverted Takotsubo syndrome in Androctonus australis scorpion envenomation. Clin Toxicol (Phila) 56: 381–383.
-
29.
Miranda CH, Braggion-Santos MF, Schmidt A, Pazin-Filho A, Cupo P, 2015. The first description of cardiac magnetic resonance findings in a severe scorpion envenomation: Is it a stress-induced (Takotsubo) cardiomyopathy like? Am J Emerg Med 33: e5–e7.
-
30.
Ben Jemaa A, Bahloul M, Kallel H, Turki O, Dlela M, Bouaziz M, 2021. Inverted Takotsubo syndrome due to severe scorpion envenomation: Report of one case. Med Trop Sante Int 1: PWX0-M245.
-
31.
Mohammadi H, Fereidooni R, Mehdizadegan N, Amoozgar H, Naghshzan A, Edraki MR, Tavangar A, 2023. Q wave in paediatric myocarditis: An underinvestigated, readily available prognostic factor. Acta Cardiol 78: 813–822.
-
32.
Babuin L, Jaffe AS, 2005. Troponin: The biomarker of choice for the detection of cardiac injury. CMAJ 173: 1191–1202.
-
33.
Simons M, Downing SE, 1985.Coronary vasoconstriction and catecholamine cardiomyopathy. Am Heart J 109: 297–304.
-
34.
Zeghal K, Sahnoun Z, Guinot M, Richer C, Giudicelli JF, 2000. Characterization and mechanisms of the cardiovascular and haemodynamic alterations induced by scorpion venom in rats. Fundam Clin Pharmacol 14: 351–361.
-
35.
Nouira S, Elatrous S, Besbes L, Boukef R, Devaux C, Aubrey N, Elayeb M, Abroug F, 2005. Neurohormonal activation in severe scorpion envenomation: Correlation with hemodynamics and circulating toxin. Toxicol Appl Pharmacol 208: 111–116.
-
36.
Fukuhara YD, Reis ML, Dellalibera-Joviliano R, Cunha FQ, Donadi EA, 2003. Increased plasma levels of IL-1beta, IL-6, IL-8, IL-10 and TNF-alpha in patients moderately or severely envenomed by Tityus serrulatus scorpion sting. Toxicon 41: 49–55.
-
37.
Klemm P, Warner TD, Hohlfeld T, Corder R, Vane JR, 1995. Endothelin 1 mediates ex vivo coronary vasoconstriction caused by exogenous and endogenous cytokines. Proc Natl Acad Sci USA 92: 2691–2695.
-
38.
Kadokami T, Shimokawa H, Fukumoto Y, Ito A, Takayanagi T, Egashira K, Takeshita A, 1996. Coronary artery spasm does not depend on the intracellular calcium store but is substantially mediated by the protein kinase C mediated pathway in a swine model with interleukin-1 beta in vivo. Circulation 94: 190–196.
-
39.
Bahloul M, Kharrat S, Bouchaala K, Chtara K, Bouaziz M, 2023. Takotsubo cardiomyopathy following scorpion envenomation: A literature review. Am J Cardiovasc Dis 13: 354–362.
-
40.
Ghadri JR, Wittstein IS, Prasad A, Sharkey S, Dote K, Akashi YJ, Cammann VL, 2018. International expert consensus document on Takotsubo syndrome (part I): Clinical characteristics, diagnostic criteria, and pathophysiology. Eur Heart J 39: 2032–2046.
-
41.
Matta AG, Carrié D, 2023. Epidemiology, pathophysiology, diagnosis, and principles of management of takotsubo cardiomyopathy: A review. Med Sci Monit 29: e939020.
-
42.
Bouaziz M, Ben Hamida C, Chelly H, Bahloul M, Kallel H, 2020. Dobutamine in the treatment of severe scorpion envenoming. Toxicon 182: 54–58.
-
43.
Elatrous S, Nouira S, Besbes-Ouanes L, Boussarsar M, Boukef R, Marghli S, Abroug F, 1999. Dobutamine in severe scorpion envenomation: Effects on standard hemodynamics, right ventricular performance, and tissue oxygenation. Chest 116: 748–753.
-
44.
Abroug F, Ouanes-Besbes L, Elatrous S, 2015. Should dobutamine be used in severe scorpion envenomation. Clin Toxicol (Phila) 53: 584.
-
45.
Rizzetto F, Lia M, Widmann M, Tavella D, Zanolla L, Pighi M, Ferrero V, Ribichini FL, 2022. Prognostic impact of antiplatelet therapy in Takotsubo syndrome: A systematic review and meta-analysis of the literature. Heart Fail Rev 27: 857–868.
-
46.
Sukhera J, 2022. Narrative reviews in medical education: Key steps for researchers. J Grad Med Educ 14: 418–419.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 3808 | 3808 | 150 |
| Full Text Views | 91 | 91 | 14 |
| PDF Downloads | 77 | 77 | 8 |