https://nova.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:22780 Wed 11 Apr 2018 11:03:40 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:38297 10,000 U/L)]. The odds of (mild or severe) myotoxicity was lower in patients that received early antivenom (within 6 hours post-bite) compared to those that received late or no antivenom (odd ratio was 0.186; 95% confidence interval, 0.052 – 0.664). A population pharmacokinetic-pharmacodynamic (PKPD) model was developed to describe the relationship between the time course of venom (a mixture of toxins) and effect (elevated CK). In addition, a kinetic-pharmacodynamic (KPD) model was developed to describe the relationship between time course of a theoretical toxin and effect. Model development and parameter estimation was performed using NONMEM v7.3. No single set of parameter values from either the PKPD or KPD models were found that could accurately describe the time course of different levels of severity of myotoxicity. The predicted theoretical toxin half-life from the KPD model was 11 ± 3.9 hours compared to the half-life of venom of 5.3 ± 0.36 hours. This indicates that the putative causative toxin’s concentration-time profile does not parallel that of venom.]]> Thu 16 Nov 2023 12:21:29 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:14431 12) and median highest aPTT was 54 s (46 – 72 s; Range: 35 – 170 s). There was low fibrinogen [median: 1.3 g/L;1, – 1.8 g/L; Range: < 0.2 – 2.9], low factor VIII levels [median: 23%; 16 – 37%] and low factor V levels [median: 43%; 23 – 74%]. D-Dimer concentrations [median: 3.4 mg/L; 2 – 7.4 mg/L] were slightly elevated. Factors II, VII and X and vWF antigen concentrations were normal. Discussion and Conclusions: Hump-nosed pit viper bites result in a mild coagulopathy which is usually not detected by a WBCT20. It is characterised by mild elevation of INR, low fibrinogen and Factors V and VIII which may be consistent with the venom containing a thrombin-like enzyme.]]> Sat 24 Mar 2018 08:21:03 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10169 Sat 24 Mar 2018 08:12:31 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10025 Sat 24 Mar 2018 08:12:18 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:20541 Sat 24 Mar 2018 08:02:39 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:28154 Denisonia maculata) using enzyme immunoassays. Case: A 9-year old boy was bitten by an identified Ornamental Snake. He developed nausea, vomiting, local pain, and swelling. He had a leucocytosis (white cell count, 20.8 x 10⁹/L), an elevated international normalised ratio (INR) of 1.6, but otherwise normal blood tests including D-Dimer and activated partial thromboplastin time. He was treated with Australian Black Snake antivenom because the commercial venom detection kit was positive for Black snake. He was admitted for 36 h with continuing local pain and swelling requiring parenteral analgesia. Materials and methods: Blood samples were collected with informed consent for measurement of venom and antivenom concentrations. Venom-specific enzyme immunoassays were developed using the closely related D. devisi venom with Rabbit anti-Notechis (Tiger Snake) and anti-Tropidechis (Rough-scaled Snake) IgG antibodies to detect venom in serum. Standard curves for measured venom versus actual venom concentrations were made to interpolate Denisonia venom concentrations. In vitro procoagulant and anticoagulant activity of venom was assayed. Results: Denisonia venom was detected in the pre-antivenom sample as 9.6 ng/mL D. devisi venom. No antigenic venom components were detected in post-antivenom samples and there were high antivenom concentrations. D. devisi venom had mild in vitro procoagulant activity with a minimum concentration required to clot after 5 min of 2.5-5 μg/mL and even weaker anticoagulant activity. Conclusions: Denisonia bites appear to cause local effects and possibly mild systemic envenoming (with only non-specific systemic symptoms and leucocytosis), confirmed by detection of antigenic venom components in blood. A significant coagulopathy does not appear to occur.]]> Sat 24 Mar 2018 07:36:34 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:27224 Sat 24 Mar 2018 07:32:23 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:24767 Pseudechis porphyriacus) causes non-specific systemic symptoms, anticoagulant coagulopathy, myotoxicity and local effects. Current management for systemic envenoming includes administration of one vial of tiger snake antivenom within 6 h of the bite to prevent myotoxicity. We present a case of severe rhabdomyolysis in a 16 year old male which developed despite early administration of one vial of tiger snake antivenom. Free venom was detected after the administration of antivenom concurrent with rapidly decreasing antivenom concentrations. The case suggests that insufficient antivenom was administered and the use of larger doses of antivenom need to be explored for red-bellied black snake envenoming.]]> Sat 24 Mar 2018 07:14:08 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:34877 Mon 23 Sep 2019 12:38:08 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:30363 Bungarus spp.) and taipans (Oxyuranus spp.) suggest that antivenom does not reverse established neurotoxicity, but early administration may be associated with decreased severity or prevent neurotoxicity. Small studies of snakes with mainly post-synaptic neurotoxins, including some cobra species (Naja spp.), provide preliminary evidence that neurotoxicity may be reversed with antivenom, but placebo controlled studies with objective outcome measures are required to confirm this.]]> Fri 18 Sep 2020 15:18:23 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18589 Fri 13 Jul 2018 15:49:03 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:17286 Fri 09 Sep 2016 16:17:26 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:45713 Fri 04 Nov 2022 10:27:59 AEDT ]]>