https://novaprd-lb.newcastle.edu.au/vital/access/manager/Index ${session.getAttribute("locale")} 5 A Prospective Study of Snakebite in a Tertiary Care Hospital in South-Western Nepal https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:50468 Wed 26 Jul 2023 14:52:32 AEST ]]> Acute human lethal toxicity of agricultural pesticides: a prospective cohort study https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:9577 Wed 11 Apr 2018 17:20:07 AEST ]]> A randomised controlled trial of two infusion rates to decrease reactions to antivenom https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14464 14 y) with snake envenoming in Sri Lanka. Snake identification was by patient or hospital examination of dead snakes when available and confirmed by enzyme-immunoassay for Russell’s viper envenoming. Patients were blindly allocated in a 11 randomisation schedule to receive antivenom either as a 20 minute infusion (rapid) or a two hour infusion (slow). The primary outcome was the proportion with severe systemic hypersensitivity reactions (grade 3 by Brown grading system) within 4 hours of commencement of antivenom. Secondary outcomes included the proportion with mild/moderate hypersensitivity reactions and repeat antivenom doses. Of 1004 patients with suspected snakebites, 247 patients received antivenom. 49 patients were excluded or not recruited leaving 104 patients allocated to the rapid antivenom infusion and 94 to the slow antivenom infusion. The median actual duration of antivenom infusion in the rapid group was 20 min (Interquartile range[IQR]:20–25 min) versus 120 min (IQR:75–120 min) in the slow group. There was no difference in severe systemic hypersensitivity reactions between those given rapid and slow infusions (32% vs. 35%; difference 3%; 95%CI:−10% to +17%;p = 0.65). The frequency of mild/moderate reactions was also similar. Similar numbers of patients in each arm received further doses of antivenom (30/104 vs. 23/94). Conclusions: A slower infusion rate would not reduce the rate of severe systemic hypersensitivity reactions from current high rates. More effort should be put into developing better quality antivenoms.]]> Wed 11 Apr 2018 16:21:45 AEST ]]> Population pharmacokinetics of an Indian F(ab')₂ snake antivenom in patients with Russell's viper (<i>Daboia russelii</i>) bites https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:21161 Daboia russelii) envenoming in Sri Lanka. All patients received Indian F(ab’)₂ snake antivenom manufactured by VINS Bioproducts Ltd. Antivenom concentrations were measured with sandwich enzyme immunoassays. Timed antivenom concentrations were analysed using MONOLIXvs4.2. One, two and three compartment models with zero order input and first order elimination kinetics were assessed. Models were parameterized with clearance(CL), intercompartmental clearance(Q), central compartment volume(V) and peripheral compartment volume(VP). Between-subject-variability (BSV) on relative bioavailability (F) was included to account for dose variations. Covariates effects (age, sex, weight, antivenom batch, pre-antivenom concentrations) were explored by visual inspection and in model building. There were 75 patients, median age 57 years (40-70y) and 64 (85%) were male. 411 antivenom concentration data points were analysed. A two compartment model with zero order input, linear elimination kinetics and a combined error model best described the data. Inclusion of BSV on F and weight as a covariate on V improved the model. Inclusion of pre-antivenom concentrations or different batches on BSV of F did not. Final model parameter estimates were CL,0.078 Lh⁻¹, V,2.2L, Q,0.178Lh⁻¹ and VP,8.33L. The median half-life of distribution was 4.6h (10-90%iles:2.6-7.1h) and half-life of elimination, 140h (10th-90th percentilesx:95-223h). Conclusion: Indian F(ab’)₂ snake antivenom displayed biexponential disposition pharmacokinetics, with a rapid distribution half-life and more prolonged elimination half-life.]]> Wed 11 Apr 2018 16:20:31 AEST ]]> Pralidoxime in acute organophosphorus insecticide poisoning: a randomised controlled trial https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:7937 Wed 11 Apr 2018 15:47:15 AEST ]]> Acute human self-poisoning with imidacloprid compound: a neonicotinoid insecticide https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:7395 Wed 11 Apr 2018 15:21:44 AEST ]]> Immune response to snake envenoming and treatment with antivenom; complement activation, cytokine production and mast cell degranulation https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:14410 Wed 11 Apr 2018 12:23:20 AEST ]]> Venom concentrations and clotting factor levels in a prospective cohort of Russell's viper bites with coagulopathy https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:27369 13), associated with low fibrinogen [median,<0.01g/L;IQR:<0.01-0.9g/L), low factor V levels [median,<5%;IQR:<5-4%], low factor VIII levels [median,40%;IQR:12-79%] and low factor X levels [median,48%; IQR:29-67%]. There were smaller reductions in factors II, IX and VII over time. All factors recovered over 48h post-antivenom. The median INR remained >3 at 6h post-antivenom but had reduced to <2, by 24h. The aPTT had also returned to close to normal (<50sec) at 24h. Factor VII, VIII and IX levels were unusually high pre-antivenom, median peak concentrations of 393%, 307% and 468% respectively. Pre-antivenom venom concentrations and the INR (r=0.20, p=0.02) and aPTT (r=0.19, p=0.03) were correlated (non-parametric Spearman analysis). Conclusions: Russell's viper coagulopathy results in prolonged aPTT, INR, low fibrinogen, factors V, VIII and X which recover over 48h. Severity of clotting abnormalities was associated with venom concentrations.]]> Wed 11 Apr 2018 11:40:46 AEST ]]> Detection of venom after antivenom is not associated with persistent coagulopathy in a prospective cohort of Russell's viper (Daboia russelii) envenomings. https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:19519 Wed 11 Apr 2018 09:27:43 AEST ]]> Urinary microRNAs as non-invasive biomarkers for toxic acute kidney injury in humans https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:43656  17 fold change (p < 0.0001) and receiver operator characteristics area-under-curve (ROC-AUC) > 0.72. Pathway analysis of target mRNAs of these differentially expressed microRNAs showed association with the regulation of different nephrotoxic signaling pathways. In conclusion, human urinary microRNAs could identify toxic AKI early after acute injury. These urinary microRNAs have potential clinical application as early non-invasive diagnostic AKI biomarkers.]]> Tue 27 Sep 2022 14:32:55 AEST ]]> Acute intentional self-poisoning with a herbicide product containing fenoxaprop-P-ethyl, ethoxysulfuron, and isoxadifen ethyl: a prospective observational study https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:7237 40%, propanil >10%, 4-chloro-2-methylphenoxyacetic acid > 5%, and glyphosate >2%. This combination herbicide product appears to be safe in patients with acute self-poisoning, particularly in comparison with other herbicides, and causing few clinical features.]]> Sat 24 Mar 2018 08:33:46 AEDT ]]> A prospective observational study of the clinical toxicology of glyphosate-containing herbicides in adults with acute self-poisoning https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:10617 734 μg/mL). The apparent elimination half-life of glyphosate was 3.1 h (95% CI = 2.7–3.6 h). Conclusions: Despite treatment in rural hospitals with limited resources, the mortality was 3.2%, which is lower than that reported in previous case series. More research is required to define the mechanism of toxicity, better predict the small group at risk of death, and find effective treatments.]]> Sat 24 Mar 2018 08:13:52 AEDT ]]> Serum and urinary biomarkers for early detection of acute kidney injury following Hypnale spp. envenoming https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:48602 Mon 01 May 2023 15:45:16 AEST ]]> Dataset for "Venom concentrations and clotting factor levels in a prospective cohort of Russell’s viper bites with coagulopathy" https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:18589 Fri 13 Jul 2018 15:49:03 AEST ]]> Dataset for "Population pharmacokinetics of an Indian F(ab’)2 snake antivenom in patients with Russell’s viper (Daboia russelii) bites" https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:17286 Fri 09 Sep 2016 16:17:26 AEST ]]> Early identification of acute kidney injury in Russell's viper (Daboia russelii) envenoming using renal biomarkers https://novaprd-lb.newcastle.edu.au/vital/access/manager/Repository/uon:45713 Fri 04 Nov 2022 10:27:59 AEDT ]]>