Candiru Catfish Urethral Myth vs Piranha and Pacu Bite Hemostasis and Freshwater Stingray (Potamotrygon) Necrotic Spine¶

Mu misulu ya mayi mimpe ya mu Amerike wa ku Sud (Amazone, Orinoco, Paraná-Paraguay, Essequibo, ne Magdalena basins) ne mu bisuku bia pa buloba bujima, bikandakanda bidi bitamba kuimanyina pa mushipa mukese wa candiru catfish (Vandellia cirrhosa ne Trichomycteric**) udibu babikila ne: candiru catfish) piranhas** (Pygocentrus nattereri). Mu bulelela, malu a masama a mu nzubu ya luondapu ya mu Brésil, Pérou, ne Colombie adi aleja ne: disama dia mu musulu didi ditamba kuenzeka, didi dikengesha bikole ne didi dinyangakaja mifuba didi difumina ku South America freshwater stingray (Family Potamotrygonidae, *Potagon, Potagon, Pagonary Plesiotrygon, ne Heliotrygon). Bishilangane na stingrays ya mu mayi (Dasyatis), idi buanga buayi buenza kanyinganyinga kakole kadi kabuyi buenza bua dikoba dikale dikola, buanga bua Potamotrygon bua mu mayi budi ne bungi bua bungi bua hyaluronidase, metalloproteases, phospholipase A2, ne peptides vasoconstrictive idi ikebesha kanyinganyinga ka lukasa, NE progressive dinyanguka dia kikoba ne mputa ya tshiendelele idi kayiyi ikola mu matuku 7 too ne ku 30, mivula kudi bipese bia mukolo bidi bishale ne disama dia Aeromonas hydrophila. Mu kitatyi kimo, piranhas (Pygocentrus ne Serrasalmus species) ne pacus (Colossoma macropomum ne Piaractus brachypomus) udi udia mamuma udi wenza bipese bia "cookie-cutter" bilenga, bia tshijengu anyi bipese bia minu bidi bikengedibua bua kuela mashi, ne bia lukasa lukasa hemostase direct-pressure ne dilama dia mputa. Shi muntu musumibua kudi nyunyi wa mu mayi mimpe anyi musumibue bikole kudi nyunyi wa piranha anyi pacu, ubikile muaba unudi nomba ya tshimpitshimpi diakamue. Tangila kabidi mikanda yetu ya bana betu pa mionji ya stingray ya mu mayi, misongo ya urchin wa mu mayi, ne buanga bua stonefish, dipatuka dia mashi dikole, ne sepsis ne septic shock.

Tshia kumpala tshiudi ne bua kuenza bua **tshipupu tshia mu mayi matalale (Potamotrygon) ntshia kupatuka mu musulu, kusukula tshilonda ne mayi malenga, kuela dikasa anyi tshikasa mu mayi a kapia ka 42 too ne ku 45 degrés Celsius (108 to ne 113 degrés Fahrenheit) bua minite 30 too ne ku 90 too ne ku dishintuluka dia bufuki disama dia luya ne dinyanguka dia mijilu, ne kuya ku lupitadi bua kuenza dikebulula dia dipanda, diumusha dia tshitupa tshia mubidi tshidi ne buanga, rayons X ya mubidi mupepele, ne anti-Aeromonas antibiotics. Bua piranha anyi pacu bite, ela gauze mu minite 10 anyi 15 bua kuimanyika dipatuka dia mashi, kubandisha tshianza, ne kukanga tshina tshia musulu tshidi ne bukoya nansha kakese.

Enza nunku mpindieu¶

1. Patula muntu udibu bashipe mu musulu pa muelelu wa mâyi anyi pa buatu diakamue, ne ubikile nimero wa lupitadi lua muaba unudi bikalaku mashi a bungi apatuka mu mishipa, disama dia stingray dia mu tshiadi anyi dia mu difu, anyi disama dia mutu. Ela 192/193 mu Brésil, 106 mu Pérou, 123 mu Colombie, mu États-Unis, ne mu Ecuador, ne mu Canada 112 mu matunga masanga a ku Mputu, anyi tangila tshilaminu tshietu tshia buloba bujima tshia nomba ya tshimpitshimpi.
2. Bua tshipupu tshia nyunyi wa mu mayi mimpe (Potamotrygon): sukula tshilonda ne mayi malenga ne ela dikasa mu mayi a kapia a 42 too ne ku 45 degrés Celsius (108 to ne 113 degrés Fahrenheit) munkatshi mua minite 30 to ne 90. Teta kumpala luya lua mayi ne tshianza tshiebe tshidi katshiyi tshitapike bua kubenga kuosha muntu udibu bashipe. Dibueja mu mayi a kapia didi dinyangakaja proteyine ya buanga budi bumvua luya ne didi diunzulula mishipa ya mashi idi mikole idi mua kupangisha dikoba dia oxygène ne kuenza bua Potamotrygon kikoba ikale ne lufu lua lukasa.
3. KUPATUKI mukolo wa stingray udi mubuela munda menemene udi mu tshiadi, mu difu, mu nshingu, anyi mu tshitupa tshia mu nshingu; uleke muaba wende bua kuwumbusha. Pa disama dia pa mutu dia ku makasa, sukula bitekete bitekete nsenga miunzuluke ne nsenga ya nsongo ya nsongo ne mayi mimpe ne tshiamu tshia kuela nabi mishiku, kadi uvuluke ne: mukolo wa Potamotrygon udi wenza mudimu bu tshingoma ne upatula dikoba diende dia pambelu dia munda mua mputa.
4. Bua Piranha (Pygocentrus / Serrasalmus) anyi Pacu (Colossoma) disuma: fina tshilamba tshikole tshia gaze anyi tshilamba tshikezuke buludiludi mu tshina tshia mputa tshidi tshinyunguluke ne utshikuate bikole, katshiyi tshijika munkatshi mua minite 10 anyi 15. Meno a Piranha adi apetangana bu rose wa dipanda ne dilengeja dia dikoba dia tshijengu ne mafuta a muinshi mua dikoba (pa tshibidilu adi afumina ku munu, ku tshikasa anyi ku munu), adi ashiya mishipa ya dikoba idi ipatuka mashi mu mayi a musulu a kapia. Bandisha tshitupa tshia mubidi pa mutu pa mutshima paudi ulama tshikuma.
5. Bua tshintu tshidi katshiyi tshitamba kumueneka tshia Candiru (Vandellia) tshidi tshifila mashi ku dikoba, anyi tshintu tshionso tshidi tshilamakaja tshia nsese ya mu mayi anyi tshia mushipa wa mbuji: KUENA ne tshikisu tshikole pikala mikolo mikanga to. Nansha mudi muyuki muende lumu wa candiru udi wela mu musulu wa mashi mu lupepele kawuyi mua kuenzeka, mushipa mukese Vandellia udi ne cadille misongo ya opercular (gill-cover) idi mitangile kunyima idi mua kukuata tshitupa tshîpi pa mucosa anyi pa dikoba didi dinyanguke padiyi mikuate ku mpukapuka munda mua bilamba bia kuowa nabi mâyi bikole; ela bitekete bitekete anyi ela mâyi malenga ne ukebe bua kuondopa kudi baminganga pikala mutshi wa mukolo mubuela.
6. Umbusha muntu yonso udi ne disama dia stingray wa mu mayi mimpe ne udi ne disama dia deep piranha/pacu ku lupitadi anyi ku lupitadi bua kumupandabu mputa, bua kumupesha manga a tetanus, ne bua kumupesha manga adi anyanga Aeromonas hydrophila. Bishilangane ne stingray ya mu mâyi itu misangu ya bungi iondapa panyima pa dibuela mu mâyi a kapia, ** 60 pa lukama too ne ku 600 ya bantu badi kabayi baondapibue ku Sud Disama dia Potamotrygon dia mu Amerike didi dikola too ne ku dinyanguka dia dikoba ne ku disama dia Aeromonas / Pseudomonas dibidi** pa kumbusha padibu bumbusha tshitupa tshia mubidi tshidi tshipatula buanga kumpala kua dîba.

Mutshi wa dipangadika: Disuma dia musulu wa mu Amerike wa ku Sud, disuma, ne disungula dia bintu bidi mu mayi¶

flowchart TD
    A["Disama dia mu musulu wa mu Amerike wa ku Sud anyi njiwu ya mu tshina tshia mâyi tshia pambelu"] --> B{"Ntapa ya mushindu kayi ivua mienzeke?"}
    B -->|Stepped on buried disc in sand/mud; jagged puncture + excruciating burning pain + grey slime| C["Tshipupu tshia mu mayi malenga (Potamotrygon) tshidi ne mukolo wa nsongo"]
    B -->|Sudden snap in shallow water or while unhooking fish; circular crater plug or crushed digit bleeding briskly| D["Piranha (Pygocentrus / Serrasalmus) anyi Pacu (Colossoma) Bite"]
    B -->|Tiny slender catfish or spiky fish snagged in swimwear or skin orifice| E["Candiru (Vandellia) anyi Cetopsid Catfish Encounter"]
    C --> F["Sukula ne mayi malenga; ela tshitupa tshia mubidi mu mayi a kapia 42 too ne ku 45 C (108 too ne ku 113 F) munkatshi mua minite 30 too ne ku 90"]
    F --> G["Dilama dia mu lupitadi: Dikanga dia mijilu + X-ray/Ultrasound bua bitupa bia mukolo + Dipanda dia tshitupa tshia mubidi + Ciprofloxacin"]
    D --> H["Ela tshiamu tshia gaze tshikole munkatshi mua minite 15 + bandisha tshianza; Lama nsongo ya munu yonso mikosa mu tshilamba tshitoke pa mayi a mashika"]
    H --> I["Dilama dia mu lupitadi: Diela dia mâyi a bungi a mukele; Rayon X bua dinyanguka dia mifuba/mifuba; Lekela tshina tshia tshijengu tshiunzulula bua kuondopibua ku tshipatshila tshibidi + Antibiotics"]
    E --> J["KUKOKA ne tshikisu ku mikolo ya opercular idi panyima to; ela mâyi a mukele; diumusha dia endoscope/urologique muinshi mua sedation pikalabu balame"]

Difuanyikija dia malu a luondapu: Freshwater Stingray vs Piranha vs Pacu vs Candiru Catfish¶

Kutapulula malu a luondapu a mu matunga a mashika ne miyuki ya kale ya mu musulu kudi kuambuluisha benyi, balobi, ne baminganga bua kuteka pa muaba wa kumpala njiwu milelela ya dipanda ne ya masama:

Bishi bia mu mayi malenga (Potamotrygonidae): Pathophysiology, Hot Water Therapy, and Surgical Bridedement¶

1. Bua tshinyi Potamotrygon ututa ne mushindu kayi udi mukolo ufila buanga¶

Nyunyi ya mu mayi mimpe ya mu Amerike wa ku Sud (Potamotrygon motoro, Potamotrygon orbignyi, Potamotrygon falkneri, ne Paratrygon aiereba) ke dîku dimuepele dia nyunyi ya stingray idi milue kuikala anu mu mayi mimpe. Mu tshikondo tshia mashika padi misulu ya Amazone ne ya Pantanal ijika, nyunyi ya stingrays itu misokome muinshi mua 1 anyi 2 centimètres ya nsenga ya luya ku muelelu kua misulu idi kayiyi mikole. 1. The Whip Reflex: Padi wader upuekela buludiludi pa diske dia tshiadi dia stingray, ray udi ubandisha mukila wende wa misunyi muulu, wela mukolo wende wa retroserrate (saw-toothed) vasodentine mu dikasa dia muntu udibu bashipe, mu tshikasa anyi mu tshiadi tshia kuinshi. 2. Ditapuluka dia tshitupa tshia mubidi: Mukolo nkayawu ki mmushindu wa munda to. Pamutu pa nanku, mukolo udi bu mufuba udi mubuikila mu tshilamba tshia pa buadi tshia tshilamba tshia munda tshia mubidi tshiuwule tente ne tuselile tua buanga tudi tupatuka mu mifuba ibidi idi mu bule. Padi mutshi wa mukolo ubuela mu mubidi wa muntu ne ukokibua kunyima, mishiku idi mitangile kunyima idi ipatula tshitupa tshia mubidi eku ipatula tshilamba tshia mukolo tshidi ne buanga tshitoke ne tshiyiteka, pamue ne nsongo ya mukolo idi mitshibuka, munda menemene mua mputa wa muntu. 3. Disama dia mu bitupa bibidi (Disama dia mashi didi dilonda kudi lufu lua mâyi): - Tshitupa 1 (Minute 0 to 12 Hours: The Vasospastic Pain Storm): Mu tusekonde tukese, muntu udibu bashipe udi umvua disama dia 10/10 didi dikuata dikasa dijima too ne ku tshiadi. Biamu bia venom bidi bikuata mijilu ya mu dikoba, bienza bua mputa ikale mitoke (mifike) ne pashishe ikale mitoke bule-bule, misangu ya bungi idi ilondangana ne tuishi, disama dia mutshima, disama dia mutshima, dipanga dia dikisha ne dikankamika. - Tshitupa 2 (Mêba 12 too ne mbingu 3: Difua dia dikoba ne disama dia mputa mikole): Bishilangane ne nyunyi ya mu mâyi, Potamotrygon venom metalloproteases, phospholipase A2, ne hyaluronidase bidi bishipa collagen ne membrane ya selile eku thrombose microvasculaire udi kayi ujika udi wenza bua dikoba dikale ne nzala ya bungi. Bullae hemorrhagic (bipumbishi bia mashi) bidi bipatuka mu meba 24 too ne ku 48, bilonda mu matuku 4 too ne 14 kudi necrose centrale liquefactive et coagulative udi ubuela mu tshitupa tshikole tshidi tshileja mionji ya extensor anyi tendon wa Achille.

================================================================================
   FRESHWATER STINGRAY (POTAMOTRYGON) SPINE ANATOMY & HOT-WATER PROTOCOL
================================================================================

  [Retroserrate Tail Spine]           [Two-Step Emergency Care]
       /\  <-- Sharp tip snaps off     1. HOT WATER IMMERSION (42-45 C / 108-113 F)
      /  \     inside foot/ankle          * Soak foot for 30 to 90 minutes.
     /|  |\                               * Denatures heat-labile pain proteins.
     /|  |\ <-- Backward barbs shred      * Reverses severe arteriole vasospasm
    / |  | \    tissue on withdrawal        (restores blood flow to limit necrosis).
    \ |  | /    & strip off toxic
     \|  |/     grey venom sheath      2. HOSPITAL NERVE BLOCK + DEBRIDEMENT
      |  |  <-- Ventrolateral grooves     * Local/regional bupivacaine nerve block.
      |__|      filled with necrotic      * X-ray / Ultrasound for radiopaque shards.
                proteases & hyaluronidase * Scrub out ALL grey integumentary sheath
================================================================================

2. Dilombola dia kumpala kua lupitadi ne dia lupitadi dia disama dia Potamotrygon¶

1. Dibueja dia lukasa mu mayi a kapia (42 too ne ku 45 degre Celsius [108 too ne 113 degre Fahrenheit]):
2. Sukula mputa diakamue ne mayi malenga (kuyi mayi a mu musulu nansha kakese) bua kumbusha bitotshi ne bintu bia pa mutu bidi ne buanga.
3. Ela dikasa anyi tshianza tshidi tshitapa mu tshibombi anyi mu tshibombi tshia mayi a kapia adibu mua kuosha too ne padiwu mua kuitaba kakuyi kuosha dikoba dia pa tshibidilu (42 too ne ku 45 C / 108 too ne ku 113 F) munkatshi mua minite 30 too ne ku 90.
4. Teta misangu yonso luya lua mayi ne tshianza tshidi katshiyi tshitapike (anyi tshiamu tshia kupima natshi luya) bualu dikasa didibu bashipe ndishintulule mushindu udi muntu umvua ne didi mua kuosha luya lukole padibu badipongolola mâyi a kapia.
5. Bualu bubidi mu Potamotrygon stings: Mâyi a kapia kaena anu apangisha peptide idi ifila kanyinganyinga mu minite 15 anyi 20 to, kadi adi kabidi alengeja vasospasme wa mu mashi adi afumina ku buanga, apingaja mashi adi apita mu dikoba ne apuekesha bikole diamètre wa ndekelu wa disama dia dikoba.
6. Dikanga dia mijilu ya mu lupitadi (kumpala kua dikonkonona dia mputa):
7. Mu lupitadi anyi mu tshibambalu tshia malu a mpukapuka, ela tshintu tshidi tshikanga mijilu (bu mudi: tshibuikidiji tshia kunyima kua tshiadi, tshia sural, tshia saphenous, anyi tshia ku tshiadi tshia pa tshibidilu, anyi dibuela dia mputa ya muaba udibu basombele) ne 0,5% bupivacaine anyi 1% too ne ku 2% lidocaine KUYI ne epinephrine (udi mua kuenza mudimu ne epinephrine * pabuipi ne Pomotagone mputa, bu mudi adrenaline wenza bua disama dia dikoba dinyanguke).
8. Bimfuanyi bia ku radiyo / Ultrason ne dipanda dia mubidi:
9. Angata multi-view plain-film X-rays (mifuba ya vasodentine stingray calcified idi kayiyi imueneka mu 70 too ne ku 80 pa lukama ya bilumbu) anyi ultrason wa ku luseke lua bulalu wa misangu mikole (udi umona 100% ya mikolo ne bishadile bia cartilaginous/sheath).
10. Muinshi mua anesthesie wa mu tshitupa kampanda, kangula njila ya dipanda idi mikole pikalabi bikengela, ela mâyi ne 1 to ne ku 2 litre ya saline normal sterile, ne umbusha bimpe tshitupa tshionso tshia tshilamba tshia mubidi tshidi ne buanga bua gris-black ne nsongo ya mukolo mitshibuka. Kushiya nansha tshitupa tshia 2-millimetre tshia tshibombi tshia buanga anyi tshia mukolo munda mua mafuta a muinshi mua dikoba kudi kujadika granuloma wa tshintu tshikuabu tshidi katshiyi tshijika ne ulcère necrotique progressive.
11. Lekela tshilonda tshiunzulula (tshibuikila bimpe ne tshiamu tshia saline tshidi katshiyi ne disama) bua kupatuka; kuena ne bua kusuika tshilonda tshia stingray tshikole to.
12. Targeted Antibiotic Prophylaxis and Tetanus:
13. Bitotshi bia mu musulu wa mu Amerike wa ku Sud ne Potamotrygon bidi ne Aeromonas hydrophila, Pseudomonas aeruginosa, Morganella morganii, Staphylococcus, ne Clostridium.
14. Udi mua kufila tshintu tshia kukolesha natshi disama dia tetanus (Tdap/Td) ne kufundila ciprofloxacin (500 mg PO misangu ibidi ku dituku mu matuku 7) anyi trimethoprim-sulfamethoxazole (TMP-SMX DS misangu ibidi ku dituku) pamue ne amoxicillin-clavulanate anyi clindaymetrocin/nizomonaleminale* bua kuepuka *FullA disama dia mubidi mupepele.

Piranha (Pygocentrus / Serrasalmus) ne Pacu (Colossoma) Bites: Hemostasis and Crater Care¶

1. Bua tshinyi nyama ya piranha itu isuma bantu (ne kubenga dishima dia "didia dia mifuba")¶

Bishilangane na binjinjimbi bia mu Hollywood mudi muena mayi ulua mufuba mu masekonde 60, binjinjimbi bia malu a luondapu bia mu Brésil, Suriname, ne Guyana (Haddad Jr. & Sazima, Wilderness & Environmental Medicine) bidi bileja ne: pabuipi ne bipupu bionso bia piranha bidi bikuata bantu badi ne muoyo bidi anu bia kudikuba nabi pamutu pa kuluisha: - Padi Piranha uluma: 1. Dilama dia nzubu mu tshikondo tshia mashika mu mayi adi kaayi makole: Mu tshikondo tshia mashika padi mâyi a musulu apueka, nyunyi ya tshifu tshikunze (Pygocentrus nattereri) ne nyunyi ya nkutshi mikunze (Serrasalmus rhombeus) itu iteka mayi mu bisonsa bidi muinshi mua mâyi ku muelelu wa mâyi idi kayiyi mikole ne itu ikuma bua kudikuba (tshiamu tshimue tshia kudimuija) kudi nyunyi yonso udi mua kudimuija bantu udi wenda pabuipi ne tshisuku. 2. Kusukula mishipa ne bintu bia kudia ku tshitudilu tshia kuowa mâyi: Kuela mishipa ya mushipa anyi bintu bia nyama mu miaba ya kuowa mâyi idi kayiyi mikole kudi kuenza bua piranhas ikale mua kukuma padiye utua minu ne minu. 3. Kupatula mishipa ya mu matu: Balobi badi bumbusha mishipa ya piranhas anyi pacus / tambaqui (Colossoma macropomum) batu bapeta dikosa dia minu ne tshianza tshikole padi mishiku mikanga. (Dikebulula dia panyima pa lufu kudi piranhas didi dienzeka anu kudi bantu bakadi bamane kufua mu mâyi bua dikuluka dia buatu, dikuatshika dia maluvu anyi disama dia tshimpitshimpi.) - The "Cookie-Cutter" Crater vs The Pacu Crush: - Piranha (Pygocentrus / Serrasalmus): Udi ne mulongo umua wa meno a nsongo, a nseke isatu adi apetangana bikole bu tshiamu tshia kupanda natshi mifuba. Padi tshiadi tshikanga, tshidi tshipatula tshitupa tshia dikoba ne mafuta a muinshi mua dikoba (pa tshibidilu 1 anyi 3 centimètres mu diamètre) ku munu, ku tshikasa, ku tshitupa tshia Achille anyi ku munu. - Pacu (Colossoma / Piaractus): Balela ba pa muoyo ba piranhas badi bakola too ne ku kilo 20 too ne ku 30 (44 too ne ku 66 paundi) ne badi ne meno a nsongo adi amueneka bu a meno a bantu, bavua bashintuluke bua kutshibula nkunde mikole ya muitu ne ntete. Disuma dia pacu ku tshianza tshia mulobi didi difikisha ku ditshibuka dikole dia phalanges, ditshibuka dia mishiku, ne dikosa dia tshianza tshia ku bianza. Dimanyisha: Miyuki ya mu bikandakanda idi ileja ne: pacus udi usuma bitupa bia mubidi bia bantu ("mushipa wa ball-cutter") idi mianu ya mu tshimenga idi ifumina ku tuseku tudibu batele bibi pa bidi bitangila biakudia biabu bia nkunde; mu bulelela, disuma dia pacu didi dienzeka bikole ku minwe ne bianza bia balobi ne badi badiisha mu tshina tshia mâyi, anyi imue misangu ku minu ya waders.

2. Diambuluisha dia kumpala ne dilama dia mputa ya Piranha ne Pacu¶

1. Diumusha dia lukasa dia mashi (pambelu pa mayi):
2. Patula muntu udibu bashipe mu musulu diakamue (mashi adi apueka mu mayi a kapia adi amueneka manene bikole kupita mudiwu menemene, ne kushala mu mayi adi kaayi makole kudi mua kupeta njiwu ya dikuba dia musangu muibidi).
3. Bu mudi menu a piranha akosa bimpe menemene mu mishipa ya dikoba kayiyi itshibula nsongo ya mishipa (mishipa mishipa idi ikanga, kadi mishipa mipanda ne tshiamu tshia nsongo idi ipatuka mashi lukasa), tshikasa tshia tshijengu anyi tshia ku makasa tshidi tshipatuka mashi tshianana.
4. Funda tshilamba tshikole tshia gaze anyi tshilamba tshikezuke, tshiteke anyi tshifina buludiludi mu tshina tshia tshijengu ne minu ibidi anyi tshianza tshikole munkatshi mua minite 10 anyi 15 mishindame, ne ubandishe dikasa anyi tshianza pa mutu pa mutshima.
5. Diela dia mayi a bungi ne dienza dia bintu bia bungi (Bua tshinyi kuena mua kusuika tshina tshia Piranha):
6. Ela tshilonda bimpe ne 1 anyi 2 litre ya mâyi a mukele anyi mâyi mimpe a kunua bua kumbusha nsenga ya mu musulu ne nsukadi ya mushipa.
7. Mukenji wa dipanda bua bipese bia Piranha: Bualu disuma dia piranha didi diumusha tshitupa tshia mubidi tshidi tshinyunguluke (dijimija dia tshitupa tshijima tshia mubidi) ne didi dinyanguka ne bikunyibua bia mu musulu, kutetshi nansha kakese bua kukoka miaba ya mputa pamue ne bukole bua bungi ne mionji mikole. Kukoka tshilema tshia tshijengu kudi kufikisha ku disama dia dikoba ne kukuata bactérie ya Aeromonas munda. Pamutu pa nanku, enza hemostase (kuenza mudimu ne tshiamu tshia arjan tshia nitrate, tshiponji tshia gelatine tshidi tshikuata, anyi tshiamu tshia figure-of-eight hemostatic suture pa arteriole umue udi upatuka padibi bikengela) ne uvuala tshina tshia mashi ne gauze wa petrole/antiseptique bua **kuondopa ku diambuluisha dia lungenyi luibidi (granulation) mutantshi mule too ne ku 5-7-dituku dia ciprofloxacin anyi trimethoprim-sulfamethoxazole pamue ne amoxicillin-clavulanate.

Candiru Catfish (Vandellia cirrhosa): Kutapulula malu a luondapu ne nkindi ya malu a mashi¶

Banyama bakese mu malu a luondapu lua mu matunga a mashika badi banyunguluka kudi miyuki ya kale mipite bungi kupita candiru (Vandellia cirrhosa ne mishipa mikese ya mu tshisumbu tshia Vandelliinae mu Amazone ne Orinoco basins).

1. Ntshinyi tshidi tshilelela ne tshidi tshishima mu malu a sianse bua Candiru¶

• THE MYTH (Swiming Up an Airborne Stream of Urine): Miyuki ya ngendu ya ku ntuadijilu kua bidimu bia 1800 ne 20 ivua ileja ne: muntu yeye muele mashi padiye muimane mulu anyi wenda mu musulu wa Amazone, mushipa wa candiru udi ununka urea, udi wela mâyi ku musulu bu mudi mushipa wa saumon utuluka mu tshina tshia mâyi, ne uya mu njila wa muntu. Etshi katshiena mua kuenzeka mu malu a mayi ne mu malu a muoyo to. Malonga a tshikebelu avua mumanyi wa malu a mu mayi Stephen Spotte (Candiru: Life and Legend of the Bloodsucking Catfishes, 2002) avua maleje ne: Vandellia cirrhosa katu wandamuna ku mashi a bantu anyi ku ammonia nansha kakese; pamutu pa nanku, udi ulomba muena nzubu wende (mishipa minene ya mu Amazone ne characins) anu ku diambuluisha dia dilonda dia mêsu ne dimona dia mâyi adi anyanguka adi apatuka mu bipese bia mishiku ya mishipa, ne kena mua kuowa mâyi mu musulu mukese wa mâyi adi apueka bilondeshile bukole budi bukokela bintu panshi to.
• THE MEDICAL REALITY (Rare Mechanical Entrapment vs Candiru-Açu):
• Mushipa wa Vandellia mulelela udi udia mashi: Mushipa mukese, mutekete bu wa ngulube (mu bule bua santimetre 2 too ne ku 6, butshiama bua milimetre 3 too ne ku 5) udi pa tshibidilu ubuela munda mua nzubu ya mishiku ya mishipa minene ne wimana **misongo mikole idi mitangile kunyima pa mishiku yabu (mishipa ya pa mutu) padiye uyibuikila bua kuyikosa mushipa wa gill bua kudia mashi. Mu misangu mivule mifunda (mivule idi itangila dibuela dia mu tshina tshia bakaji kudi bakaji badi bowa mâyi, anyi tshilumbu tshimue tshia mu 1997 tshia malu a urologie mu Manaus, mu Brésil), bikala muntu udi wowa mâyi mu mâyi a mu musulu kayi ne bilamba bia kudikuba nabi ne Vandellia mukese ubuela mu mubidi wa muntu ku mpukapuka anyi udi ubuela munda mua bilamba butuku, kukoka mushipa kunyima kudi kufikisha mikolo yende idi mitangile kunyima mu mucosa anyi mu dikoba, kumukanga muaba wende.
• Candiru-Açu / Whale Catfish (Cetopsis coecutiens): A completely different, larger (15 to 25 cm), more blue-grey scavenger catfish also called "candiru" in Amazon. Cetopsis coecutiens i tshintu tshidi tshikuata bitalu bia mu mayi ne bifukibua bidi bienda pa mâyi bidi misangu mikuabu bienza bipupu bia dikoba dia tshijengu kudi badi bowa mâyi ne muoyo, bidi misangu ya bungi bipetangana mu luapolo lua muaba udibu basombele ne bipupu bia piranha anyi bipupu bia Vandellia.

2. Dilama dia malu a luondapu didi dimanyine pa bijadiki pikala mushipa wa mbuji anyi tshintu tshia mu mayi tshikuate¶

1. Kukoki nansha kakese kunyima ku bukole ku mikolo ya opercular anyi ya pectoral:
2. Nansha shi udi wenza mudimu ne Vandellia mukese udi mukuatshike ku mucosa/dikoba anyi ne mushipa munene wa mu mayi mimpe (Pimelodus, Pseudoplatystoma, anyi Corydoras) udi ne mukolo wa tshiadi/wa panyima udi ne meno mu tshianza tshia mulobi, **udi uleja bitupa bia panyima padibu bamukoka.
3. Lupitadi / Mukenji wa dipatula dia bintu ku diambuluisha dia endoscopie:
4. Bua mukolo wa mushipa wa catfish mu tshianza anyi ku dikasa: enza dikanga dia mijilu ya mu tshitupa kampanda, wangate tshiamu tshia X, ne umbusha mukolo pa kupanda njila mubulula kakese anyi kuya kumpala/kupatula mishiku ya panyima kumpala kua kuela mâyi a bungi ne anti-Aeromonas antibiotics.
5. Bua dilama dia mucose anyi dia orifice dia Vandellia mukese didi kadiyi ditamba kumueneka: kuya nende ku lupitadi bua diondopangana/diondopangana ne dimona dia buludiludi dia endoscopie (cystoscopique anyi colposcopique) ku diambuluisha dia forceps mimpe ya endoscopie ne ciseaux bua kufina anyi kukosa mikolo ya opercular ne kupatula tshintu tshidi katshiyi tshinyanguka kakuyi diteta dia mucosacimen.
6. Kuena ne bua kuela mayi a bikunyibua (bu mudi Xagua / Genipa americana mayi a bimuma bia muitu) anyi aside wa tshisuku mu tshina tshia mashi anyi mu tshifu: Malu a bantu adi aleja ne: mayi a Genipa americana adi "anyangakaja" mufuba wa candiru munda mua mubidi adi a dishima ne adi akebesha bipupu bia tshimpitshimpi ne bilonda bia mu tshifu.

Nomba ya tshimpitshimpi ya mu tshijengu ne mikenji ya bibambalu¶

• Brazil (Amazonas, Pará, Mato Grosso, Pantanal, Paraná Basins): Ela 192 (SAMU) bua ambulanse anyi 193 (Corpo de Bombeiros) bua dipandisha dia mu musulu. Londa mikenji ya Ministério da Saúde do Brasil / Instituto Butantan: dibueja dia lukasa mu mayi a kapia (42 too ne ku 45 C) bua stingrays ya mu mayi mimpe (Potamotrygon), dikanga dia mijilu ya mu tshitupa kampanda, dipanda dia tshitupa tshia mubidi tshidi tshifua, dikuba dia disama dia tetanus, ne dienza dia coproxacin/SMTX.
• Peru, Colombia, Ecuador, Bolivia, ne Venezuela: Ela 106 mu Peru, 123 mu Colombia, 911 mu Ecuador ne Venezuela, anyi 160 / 118 mu Bolivia. Bibambalu bia luondapu bia mu musulu bidi biteka pa muaba wa kumpala dibuela mu mayi a kapia ne dikonkonona dia mputa kumpala kua dîba bua kuepuka mputa ya ku makasa idi kayiyi ijika.
• Guyana, Suriname, ne French Guyana: Ela 913 mu Guyana, 115 mu Suriname, anyi 15 / 112 (SAMU) mu French Guyana.
• Ditunga dia États-Unis, Canada, Royaume-Uni, Union européenne, ne Australie (Exotic Aquarium Trade): Ela 911 (US/Canada), 999 (UK), 112 (EU), anyi 000 (Australia), ne ubikile US Poison Control ku 1-800-2222 anyi tshibambalu tshiebe tshia poison. Mu nzubu wa muntu nkayende ne mu zoo bidi bifumina ku Potamotrygon motoro anyi Potamotrygon leopoldi bidi bikengela 45 C wa dibueja mu mayi a kapia, X-ray wa ku bianza, dipanda dia mubidi, ne anti-Aeromonas fluoroquinolone therapy.

Nkonko itubu bela misangu ya bungi¶

Bua tshinyi nyunyi wa stingray wa mu mayi matalale wa mu Amerike wa ku Sud udi mubi kupita ditapa dia stingray wa mu mbuu ku muelelu wa mâyi?¶

Nansha mudi nyunyi ya mu mayi ne ya mu mayi matalale yenza kanyinganyinga kakole ka lukasa padi mayi a kapia ajika, nyunyi ya mu mayi mimpe ya mu Amerike wa ku Sud (mushindu wa Potamotrygon) idi ne buanga budi ne bungi bua bungi bua metalloproteases idi inyanga mifuba, hyaluronidase, phospholipase A2, ne peptides idi ikandika mashi bikole. Mu ma nsa 24 to ne ku 72, disama dia Potamotrygon ditu dilua dikala dia violet ne difiike munkatshi ne dilua disama dia dikoba dia munda menemene ne tshilonda tshidi katshiyi tshijika tshidi mua kuleja mijilu ne kuangata ngondo ya bungi bua kuondopibua anu padibu kabayi batshiondopa ne lukasa ne diunzulula dia mijilu ne mâyi a kapia ne dipanda dia lufu luvuaye mushale nalu.

Mâyi adi ne tshia kuikala ne kapia bungi munyi bua nyunyi wa stingray wa mu mayi mimpe, ne bua tshinyi mayi a kapia adi ambuluisha?¶

Ela dikasa anyi tshianza tshikuma mu mayi malenga adi ne kapia ka 42 too ne ku 45 degre Celsius (108 to ne 113 degre Fahrenheit), adi umvuika bimpe bu diowa dia kapia kadiyi diosha dikoba dia pa tshibidilu, munkatshi mua minite 30 too ne ku 90. Misangu yonso, teta mayi kumpala ne tshianza tshiebe tshidi katshiyi tshitapike bua wewe kubenga kuosha kudi kapia. Mâyi a kapia adi ne midimu ibidi ya mushinga mukole mu tshipupu tshia Potamotrygon: adi anyanga proteyine ya kanyinganyinga idi mu buanga mu minite 15 anyi 20, ne adi avula mishipa ya mashi idi mikanga bikole idi minyunguluke tshilonda, apingaja luya lua oxygène mu dikoba ne akepesha bunene bua tshilonda tshia lufu.

Piranhas udiku mua kukosa muntu udi wenda mu mayi mu tusekonde tukese bu mudibi mu mafilime anyi?¶

Tòo, tshimfuanyi tshia mu filme tshia muena mayi udi ne muoyo mushipa kudi tshisumbu tshia nyunyi ya piranhas ntshia nkindi. Malongesha a mu lupitadi mu Amazone ne Pantanal adi aleja ne: pabuipi ne malu onso adi nyama wa piranha uluisha nyama idi ne muoyo idi yenzeka mu tshikondo tshia mashika padi mâyi makese ne nyama wa mu mâyi udi wenda pabuipi ne tshikumbi tshia nyama wa nyama wa nyama wa piranha anyi udi wela mâyi pabuipi ne tshitudilu tshia mishipa. Disuma dimue adi didi dienza mudimu ne meno a nseke isatu adi ne buitshi bua kupatula tshitupa tshikezuke tshia "cookie-cutter" tshia dikoba ne mafuta a ku tshianza, ku tshikasa anyi ku munu, tshidi tshipatuka mashi lukasa ne tshidi tshilomba dikuma dia tshiamu tshia gaze tshikole munkatshi mua minite 10 anyi 15.

Mputa wa tshijengu wa piranha udi ne tshia kuikala mukanga bikole anyi?¶

Tòo. Bu mudi dikuma dia piranha dikosa tshitupa tshia dikoba ne mafuta (dishiya tshitupa tshidi katshiyi ne tshitupa tshia mubidi) ne didi ne bukoya bua bungi ne tuishi tua mu musulu bu mudi Aeromonas hydrophila, disonga dia ku mpenga pamue bikole kudi kupangisha mashi bua kuya ku mpenga kua dikoba ne kukuata tuishi munda, ne kuenza bua tshipupu tshikole tshikale tshikole. Pamutu pa nanku, baminganga badi bimanyika dipatuka dia mashi ne dikuma dia buludiludi anyi ne tshiamu tshia kuosha natshi, badi bela mâyi mu tshina tshia mâyi ne mâyi a mukele adi kaayi ne disama, bafunda manga adi anyanga bimpe (bu mudi ciprofloxacin ne amoxicillin-clavulanate), ne balekela tshina tshidi tshinyunguluke tshiondopa kumbukila kuinshi too ne kuulu (tshipatshila tshibidi).

Mushipa wa candiru udi mua kuowa mâyi mu musulu wa mashi mu lupepele wewe muele mashi mu musulu wa Amazone anyi?¶

Tòo. Mashinyi a mu mashi ne mateta a bikadilu adi aleja ne: muyuki wa mushipa wa candiru (Vandellia cirrhosa) udi wenda mu musulu wa mashi udi mu lupepele kawena mua kuenzeka to, ne candiru kena ukokibua kudi mashi a bantu nansha kakese. Vandellia i tuishi tukese tua bule bua santimetre 2 too ne ku 5 tudi tubuela mu nzubu ya mishiku ya mishipa minene pa kulonda mâyi adi enda. Nansha mudibu bamanyishe njiwu ya mashinyi idi kayiyi mitamba kuenzeka padi mushipa mukese ukuata ku dikoba anyi ku tshibuelelu tshia mushipa udi mu mâyi ne kukanga mikolo yende idi mitangile panyima, kuvuala bilamba bia kuowa nabi mâyi bia pa tshibidilu padibu mu mâyi a mu musulu adi kaayi malelela kudi kupangisha bua kusambakena.

Mushipa wa pacu udi bushuwa "musuma mafuba," anyi mmushindu kayi udiye wenza?¶

Muyuki wa pa buawu udi wamba ne: mushipa wa pacu wa mu Amerike wa ku Sud (Colossoma macropomum ne Piaractus brachypomus) udi usungula bitupa bia mubidi wa muntu wakatuadija bu tshisekedi tshia mu bikandakanda bua bidia biabu bia nkunde ne ntete ya muitu mikole. Mu mudimu wa buanga, pacus udi ne mishiku mikole mienza ne meno a bantu, ne udi ushipa ne utapa bikole anu ku minu ne ku bianza bia balobi badi babapatula anyi bantu badi babadisha ku bianza mu maziba ne mu nzubu ya mâyi, imue misangu utshibula mifuba ya minu anyi ukosa nsongo ya minu.

Miaba ne buludiki bua mbulamatadi¶

• Ministério da Saúde of Brazil & Instituto Butantan (Brazil): Manual de Diagnóstico et Tratamento de Acidentes por Animais Peçonhentos and Aquaticos: Raias Fluviais (Potamotrygonidae), Piranhas, ne Candirus (Haddad Jr. et al.).
• Wilderness Medical Society (WMS): Piranha Attacks on Humans in Southeast Brazil (Haddad Jr. & Sazima) and Freshwater Stingray Envenomation in the Amazon Basin.
• Toxicon & Journal of Venomous Animals and Toxins: Comparative Biochemistry and Dermonecrotic Activity of Freshwater Stingray (Potamotrygon) Venom vs Marine Stingray Venom (Barbaro et al.).
• Tshisumbu tshia masama a masama a mu Amerike (IDSA, États-Unis): Dilama dia masama a mu mayi mimpe ne dikuba dia Aeromonas hydrophila.
• Experimental Toxicology Reviews: Candiru: Life and Legend of the Bloodsucking Catfishes (Spotte, 2002).

Malu adi apetangana¶

• Nsongo ya stingray ya mu mayi, misongo ya urchin wa mu mayi, ne buanga bua stonefish
• Dipatuka dia mashi dikole, dibuikila dia mputa, ne dienza dia tourniquet
• Dilamakaja dia nkutshi mu dîsu, mu nshingu, anyi mu dikoba ne diumusha dia botfly
• Disama dia sepsis, tshipupu tshia septic, ne disama dia lukasa lukasa
• Nomba ya njiwu bilondeshile ditunga