https://nova.newcastle.edu.au/vital/access/manager/Index ${session.getAttribute("locale")} 5 https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:36897 Wed 15 Jul 2020 18:00:41 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:42150 Wed 13 Mar 2024 19:12:06 AEDT ]]> https://nova.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 ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:14472 Wed 11 Apr 2018 13:49:04 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:14410 Wed 11 Apr 2018 12:23:20 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:22597 Wed 11 Apr 2018 12:04:22 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:25046 Wed 11 Apr 2018 11:07:39 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:51073 Wed 06 Mar 2024 15:55:53 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:43012 Wed 06 Mar 2024 15:18:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:21860 Tue 26 Sep 2017 14:05:54 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:46271 Hypnale spp.) bites. Thrombotic microangiopathy (TMA) is increasingly recognized in association with AKI in cases of Hypnale spp envenomation. We investigated AKI in a cohort of cases of Hypnale envenomation, its association with TMA and the early diagnostic value of common biomarkers for AKI occurring. Materials and methods: We conducted a prospective observational study of suspected viper bites and included 103 confirmed cases of Hypnale envenomation, based on venom specific enzyme immunoassay of blood. AKI was defined using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Thrombotic microangiopathy was diagnosed based on thrombocytopenia (platelet count < 150,000 x 10³/μL) and microangiopathic haemolytic anaemia (MAHA). We investigated the diagnostic performance of creatinine, platelet count and INR for AKI within 4 h and 8 h post-bite by area under the receiver operator characteristic curve (AUC-ROC). Results: Ten patients developed AKI: seven AKI stage 1 and three AKI stage 3. Ten patients (10%) developed thrombocytopaenia while 11 (11%) had MAHA. All three AKI stage 3 had thrombocytopaenia and MAHA fulfilling the criteria for TMA. Two of them presented with oliguria/anuria and all three required haemodialysis. Serum creatinine within 4 h post-bite was the best predictor of AKI with AUC-ROC of 0.83 (95% CI: 0.67-0.99) and was no better within 8 h of the bite. Conclusions: We found that AKI is uncommon in Hypnale spp. envenomation, but an important serious complication. Severe AKI was associated with TMA. A creatinine within 4 h post-bite was the best predictor of AKI.]]> Tue 15 Nov 2022 09:04:53 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:47067 Tue 13 Dec 2022 16:07:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:39298 Thu 16 Nov 2023 12:19:07 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:34838 Thu 16 May 2019 15:04:51 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:53747 Thu 11 Jan 2024 12:16:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:35056 Thu 09 Dec 2021 11:01:32 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:31156 Naivety, Humility and Hope amongst the Rubble, encompassed five subordinate themes. These reveal an integral struggle experienced by Western practitioners unprepared for a culturally different lens. Conclusion: Teaching Playback Theatre in post-war Sri Lanka for these practitioners exposed the gap between the desire to help cross-culturally and their experienced reality. Over time, the collision of Western naivety with good intent facilitated an integral and humble search to be wiser humanitarians cross-culturally in these participants.]]> Sat 24 Mar 2018 08:45:11 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:31596 Sat 24 Mar 2018 08:45:00 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:9524 Sat 24 Mar 2018 08:35:32 AEDT ]]> https://nova.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 ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:17530 Sat 24 Mar 2018 08:03:55 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:5957 Sat 24 Mar 2018 07:46:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:48420 Mon 29 Jan 2024 18:34:27 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:26251 Mon 23 Sep 2019 11:01:06 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:52296 Mon 09 Oct 2023 10:09:52 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:39103 Mon 09 May 2022 15:34:40 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:31503 Fri 22 Apr 2022 10:23:28 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:37583 16 years), who presented with a confirmed snakebite from August 2013 to October 2014 were recruited from Anuradhapura Hospital. Demographic data, information on the circumstances of the bite, first aid, health-seeking behaviour, hospital admission, clinical features, outcomes and antivenom treatment were documented prospectively. There were 742 snakebite patients [median age: 40 years (IQR:27–51; males: 476 (64%)]. One hundred and five (14%) patients intentionally delayed treatment by a median of 45min (IQR:20-120min). Antivenom was administered a median of 230min (IQR:180–360min) post-bite, which didn’t differ between directly admitted and transferred patients; 21 (8%) receiving antivenom within 2h and 141 (55%) within 4h of the bite. However, transferred patients received antivenom sooner after admission to Anuradhapura hospital than those directly admitted (60min [IQR:30-120min] versus 120min [IQR:52-265min; p<0.0001]). A significantly greater proportion of transferred patients had features of systemic envenoming on admission compared to those directly admitted (166/212 [78%] versus 5/43 [12%]; p<0.0001), and had positive clotting tests on admission (123/212 [58%] versus 10/43 [23%]; p<0.0001). Sri Lankan snakebite patients present early to hospital, but there remains a delay until antivenom administration. This delay reflects a delay in the appearance of observable or measurable features of envenoming and a lack of reliable early diagnostic tests. Improved early antivenom treatment will require reliable, rapid diagnostics for systemic envenoming.]]> Fri 19 Feb 2021 15:58:55 AEDT ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:42788 Fri 02 Sep 2022 14:02:24 AEST ]]> https://nova.newcastle.edu.au/vital/access/manager/Repository/uon:51341 1.5 (Incomplete VICC = INR>1.5 and complete VICC = ≥3.0). Results: A total of 272 confirmed snakebites (Russell’s viper[76], hump-nosed viper[89], non-venomous snakes[51] and unidentified bites[56]) were recruited (median age: 42 y [interquartile range: 30- 53 y]; 189 males [69%]). On admission, 82 (30%) had incomplete VICC (INR >1.5 and <3) and 77 (28%) had complete VICC (INR ≥3). Sixteen (6%) developed clinically apparent bleeding. The WBCT-15 had the best sensitivity of 47% for detecting VICC and 68% for complete VICC. The sensitivities of the WBCT-20, WBCT-25, CBCT-5 and CBCT-10 was 30–35%. The sensitivities of all tests were better in detecting complete VICC, VICC in Russell’s viper bites and more than 2 h post-bite. The WBCT-15 test had a sensitivity of 76% for VICC in confirmed Russell’s viper bites. For detection of VICC, CBCT-t had an an excellent sensitivity of 97%, but a poor specificity of 35% for an optimal cut-off of >6.25 min. Conclusion: WBCTs are poorly diagnostic for VICC in Russell’s viper and hump-nosed viper envenoming, missing up to two-thirds of patients for some tests. The WBCT-15 was the best test, improving for more severe VICC and greater than 2 h post-bite.]]> Fri 01 Sep 2023 13:35:05 AEST ]]>