https://nova.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:4451 Wed 11 Apr 2018 11:42:09 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:7112 Sat 24 Mar 2018 08:34:11 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:2481 38°C were universal in such patients; these features were therefore added. Using these seven clinical features, decision rules (the Hunter Serotonin Toxicity Criteria) were developed. These new criteria were simpler, more sensitive (84% vs. 75%) and more specific (97% vs. 96%) than Sternbach’s criteria. DISCUSSION: These redefined criteria for serotonin toxicity should be more sensitive to serotonin toxicity and less likely to yield false positives.]]> Sat 24 Mar 2018 08:27:43 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:10454 0.05). Median admission plasma-paraquat concentration in patients with peripheral burning (2.67 μg/mL, 95% CI = 0.84–14.2) was significantly higher than in the patients with no peripheral burning (0.022 μg/mL, 95% CI = 0.005–0.78; p < 0.001). Peripheral burning has a sensitivity of 0.72 (95% CI = 0.6–8) and specificity of 0.74 (95% CI = 0.64–0.08) and a positive predictive value of 0.73 (95% CI = 0.6–0.8). Discussion: It is possible that this symptom may help discriminate between patients who have poor chance of survival and those who may potentially benefit from interventions. The mechanism is not clear but could either include a direct concentration-related effect or be a marker of oxidative stress. Conclusion: Presence of burning sensation is associated with high plasma-paraquat concentrations and is strongly predictive of death.]]> Sat 24 Mar 2018 08:08:02 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:4832 Sat 24 Mar 2018 07:18:47 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:30614 Daboia russelii) envenoming is a major health issue in South Asia and causes venom-induced consumption coagulopathy (VICC). Objectives: To investigate the effects of fresh frozen plasma (FFP) and two antivenom doses in correcting VICC. Methods: We undertook an open-label randomized controlled trial in patients with VICC attwo Sri Lankan hospitals. Patients with suspected Russell’s viper bites and coagulopathy were randomly allocated (1 : 1) to high-dose antivenom (20 vials) or low-dose antivenom (10 vials) plus 4 U of FFP. The primary outcome was the proportion of patients with an International Normalized Ratio (INR) of < 2 at 6 h after antivenom administration. Secondary outcomes included anaphylaxis, major hemorrhage, death, and clotting factor recovery. Results: From 214 eligible patients, 141 were randomized: 71 to high-dose antivenom, and 70 to low-dose antivenom/FFP; five had no post-antivenom blood tests. The groups were similar except for a delay of 1 h in antivenom administration for FFP patients. Six hours after antivenom administration, 23 of 69 (33%) patients allocated to high-dose antivenom had an INR of < 2, as compared with 28 of 67 (42%) allocated to low-dose antivenom/FFP (absolute difference 8%; 95% confidence interval - 8% to 25%). Fifteen patients allocated to FFP did not receive it. Severe anaphylaxis occurred equally frequently in each group. One patient given FFP developed transfusion-related acute lung injury. Three deaths occurred in low-dose antivenom/FFP patients, including one intracranial hemorrhage. There was no difference in recovery rates of INR or fibrinogen, but there was more rapid initial recovery of factor V and FX in FFP patients. Conclusion: FFP after antivenom administration in patients with Russell’s viper bites did not hasten recovery of coagulopathy. Low-dose antivenom/FFP did not worsen VICC, suggesting that low-dose antivenom is sufficient.]]> Fri 24 Aug 2018 09:01:46 AEST ]]>