https://nova.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14548 Wed 11 Apr 2018 14:28:23 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14875 Wed 11 Apr 2018 11:51:58 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:9726 Wed 11 Apr 2018 11:24:03 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:7637 Sat 24 Mar 2018 08:36:01 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10828 6 mg) were identified from a prospective database of poisoning admissions to a regional toxicology service. Data extracted included patient demographics, details of ingestion, clinical features including neurological findings and evidence of dystonias, electrocardiographic parameters (heart rate [HR], QRS, and QT intervals), complications, and medical outcomes including intensive care unit admission. In addition to descriptive statistics, visual inspection of plots of QT-HR pairs compared with the QT nomogram was performed. Results: There were 107 patients with 157 presentations, including 38 patients with 45 risperidone-alone overdoses. Of the 38 patients who ingested risperidone alone, the median age was 25 years (interquartile range [IQR],16-31 years), and 19 (50%) were female. The median dose ingested was 33 mg (IQR, 15-75 mg; range, 8-248 mg). Median length of stay was 16 hours (IQR, 8-18 hours), and none was ventilated or admitted to the intensive care unit. There were 5 cases (11%) with dystonic reactions, 26 (58%) with tachycardia (HR ≥100 beats/min), and no cases with hypotension (blood pressure <90 mm Hg). Only 1 patient (2%) recorded a decreased Glasgow Coma Scale score of 14, and there were no seizures or deaths. On review of electrocardiograms in 41 of the 45 cases where risperidone was ingested alone, there were no acute dysrhythmias. In 4 electrocardiograms (10%), there was an abnormal QT-HR pair, but all bar one were associated with an HR of greater than 110 beats/min. The median maximum QRS width was 80 milliseconds (IQR, 80-80 milliseconds; range, 40-120 milliseconds). Conclusions: Risperidone taken alone in overdose causes minimal effects. Tachycardia and dystonic reactions were the main features of toxicity. Significant cardiac and other neurological features seem to be uncommon.]]> Sat 24 Mar 2018 08:12:50 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:11519 Sat 24 Mar 2018 08:10:23 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:12298 Sat 24 Mar 2018 08:10:08 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19026 7 years) with a redback spider bite and severe pain, with or without systemic effects, were randomized to receive normal saline solution (placebo) or antivenom after receiving standardized analgesia. The primary outcome was a clinically significant reduction in pain 2 hours after trial medication compared with baseline. A second primary outcome for the subgroup with systemic features of envenomation was resolution of systemic features at 2 hours. Secondary outcomes were improved pain at 4 and 24 hours, resolution of systemic features at 4 hours, administration of opioid analgesics or unblinded antivenom after 2 hours, and adverse reactions. Results: Two hours after treatment, 26 of 112 patients (23%) from the placebo arm had a clinically significant improvement in pain versus 38 of 112 (34%) from the antivenom arm (difference in favor of antivenom 10.7%; 95% confidence interval −1.1% to 22.6%; P=.10). Systemic effects resolved after 2 hours in 9 of 41 patients (22%) in the placebo arm and 9 of 35 (26%) in the antivenom arm (difference 3.8%; 95% confidence interval −15% to 23%; P=.79). There was no significant difference in any secondary outcome between antivenom and placebo. Acute systemic hypersensitivity reactions occurred in 4 of 112 patients (3.6%) receiving antivenom. Conclusion: The addition of antivenom to standardized analgesia in patients with latrodectism did not significantly improve pain or systemic effects.]]> Sat 24 Mar 2018 08:05:28 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:28153 Sat 24 Mar 2018 07:36:34 AEDT ]]>