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"Antidote" OR "Antivenum" OR "Antivenin"

Manon Bonneau, Frédéric Landmann, Pierrick Labbé, Fabienne Justy, Mylène Weill, Mathieu Sicard
Wolbachia are maternally inherited endosymbiotic bacteria, widespread among arthropods thanks to host reproductive manipulations that increase their prevalence into host populations. The most commonly observed manipulation is cytoplasmic incompatibility (CI). CI leads to embryonic death in crosses between i) infected males and uninfected females and ii) individuals infected with incompatible Wolbachia strains. CI can be conceptualized as a toxin-antidote system where a toxin deposited by Wolbachia in the sperm would induce embryonic death unless countered by an antidote produced by Wolbachia present in the eggs...
October 15, 2018: PLoS Pathogens
Michael D Schwartz, Mark E Sutter, Derek Eisnor, Mark A Kirk
ABSTRACTHaving sufficient medical countermeasures (MCMs) available for the treatment of acetylcholinesterase-inhibiting nerve agent poisoned patients following a mass chemical exposure is a challenge for communities. After stockpiles containing auto-injectors are exhausted, communities need to be aware of alternative pharmaceutical options. The Department of Homeland Security Chemical Defense Program convened a federal interagency working group consisting of first responders, clinicians, and experts from the fields of medical toxicology, pharmacology, and emergency management...
October 15, 2018: Disaster Medicine and Public Health Preparedness
Sharon C Reale, Kathryn J Gray, Edward W Boyer, Dominique Y Arce, Michaela K Farber
The anesthetic management of toxic ingestion during pregnancy requires concomitant concerns for both mother and fetus. We describe the management of a parturient at 33 weeks of gestation after a suicide attempt by ingestion of acetaminophen (APAP) and acetylsalicylic acid (ASA). Timing of toxin ingestion must be determined, prompt antidote administration prioritized, and hepatotoxicity-induced hematologic impairment anticipated. Fetal exposure to toxins must also be minimized. The use of point-of-care rotational thromboelastometry in conjunction with standard coagulation testing in such cases facilitates consideration of neuraxial anesthesia and determination of risk for postpartum hemorrhage...
October 11, 2018: A&A practice
Shahin Shadnia, Alireza Ebadollahi-Natanzi, Saeid Ahmadzadeh, Somayyeh Karami-Mohajeri, Yaghoub Pourshojaei, Hamid Reza Rahimi
Paraquat (PQ) poisoning is principally reported in developing countries. However, most fatalities occur elsewhere due to the induction of multi-organ failure. PQ poisoning can hardly be managed by clinical practice, and no specific antidote has come into existence yet. Here three cases, including 17-, 20-, and 23-year-old men, who were poisoned with PQ, have been reported. Furthermore, the literature regarding biological mechanisms, clinical manifestation, and treatment of PQ-induced toxicity was reviewed. Patients who, either intentionally or accidentally, ingested PQ earlier were initially found to be stable at the emergency department (ED)...
September 1, 2018: Toxicology Research
Kazunori Toyoda, Hiroshi Yamagami, Masatoshi Koga
Development of direct oral anticoagulants and their antidotes has led to the need to reconsider the eligibility of acute stroke patients who have been taking oral anticoagulants for intravenous thrombolysis. Officially authorized Japanese guidelines on this issue were revised twice at the time of approval for clinical use of direct oral anticoagulants and idarucizumab, a specific reversal agent for dabigatran. A unique recommendation in the latest Japanese clinical guides was that thrombolysis can be recommended if the time of the last dose of direct oral anticoagulants exceeds 4 hours and if commonly available anticoagulation markers are normal or subnormal, i...
September 2018: Journal of Stroke
Thorsten Steiner, Martin Köhrmann, Peter D Schellinger, Georgios Tsivgoulis
Oral anticoagulant-associated intracerebral hemorrhage (OAC-ICH) accounts for nearly 20% of all ICH. The number of patients with an indication for oral anticoagulant therapy (OAT) increases with increasing age. OAT became less complicate with the introduction of non-vitamin K oral anticoagulants (NOAC) OAT because of easier handling, favorable risk-benefit profile, reduced rates of ICH compared to vitamin K antagonists and no need for routine coagulation testing. Consequently, despite a better safety profile of NOAC the number of patients with OAC-ICH will increase...
September 2018: Journal of Stroke
Bharath A Chhabria, Ashish Bhalla, Nusrat Shafiq, Susheel Kumar, Deba Prasad Dhibar, Navneet Sharma
INTRODUCTION: Organophosphate (OP) poisoning is an important public health concern in South-Asia especially in the farming population. Treatment of OP poisoning has remained unchanged since decades and case fatality is 10-40% despite best supportive care, anticholinergic agents and oximes. A new antidote is the need of the hour. Lipid emulsion being inexpensive, easily available and effective in management of other lipid soluble toxins may be a novel option. However, safety has not been established and efficacy is limited to animal studies and case reports in humans with OP poisoning...
October 11, 2018: Clinical Toxicology
Tara B Hendry-Hofer, Alyssa E Witeof, Dennean S Lippner, Patrick C Ng, Sari B Mahon, Matthew Brenner, Gary A Rockwood, Vikhyat S Bebarta
BACKGROUND: Cyanide is a deadly compound used as a terrorist agent. Current FDA approved antidotes require intravenous administration, limiting their utility in a mass casualty scenario. Dimethyl trisulfide (DMTS), a sulfur-based molecule, binds cyanide converting it to the less toxic by-product thiocyanate. Studies evaluating efficacy in rodents have been performed, but a large, clinically relevant animal model has not been reported. OBJECTIVE: This study evaluates the efficacy of intramuscular DMTS on survival and clinical outcomes in a swine model of acute, severe cyanide toxicity...
October 11, 2018: Clinical Toxicology
Emma Aarnio, Risto Huupponen, Katri Hämeen-Anttila, Merja Merikoski, Jaana Puhakka, Maarit J Korhonen
Direct oral anticoagulants provide an alternative to vitamin K antagonists for the anticoagulation therapy in atrial fibrillation (AF). The availability of several treatment options with different attributes makes shared decision making appropriate for the choice of anticoagulation therapy. The aim of this study was to understand how physicians choose an oral anticoagulant (OAC) for patients with AF and how physicians view patients' participation in this decision. Semi-structured interviews with 17 Finnish physicians (8 general practitioners and 9 specialists) working in the public sector were conducted...
October 10, 2018: Basic & Clinical Pharmacology & Toxicology
Gwynn Curran-Sills, Jenna Kroeker
INTRODUCTION: There are 3 pit viper species in Canada. Limited Canadian literature exists on the epidemiology of venomous snakebites and the treatment patterns with antivenom. This study described the epidemiology, the utilization of antivenom, and estimated expenditures due to forfeited antivenom for pit viper envenomations in Canada. METHODS: A retrospective review of the Health Canada Special Access Program records to generate descriptive statistics. Data are presented as mean±SD (range), as appropriate...
October 3, 2018: Wilderness & Environmental Medicine
V Taune, M Skeppholm, A Ågren, G Gryfelt, R E Malmström, A Wikman, J Van Ryn, H Wallén
BACKGROUND: Rapid determination of the anticoagulant effect of dabigatran is essential in emergency situations. OBJECTIVE: To study a viscoelastic test (rotation thromboelastometry; ROTEM) for rapid determination of dabigatran in whole blood samples. METHOD: ROTEM measurements were performed comparing two triggers (thrombin-based vs commercial tissue factor based trigger Ex-tem) in samples from 10 healthy donors spiked with dabigatran (20-500 ng/mL), and in samples from 35 patients on dabigatran treatment; 10 healthy subjects served as controls...
October 4, 2018: Journal of Thrombosis and Haemostasis: JTH
Diego Castanares-Zapatero, Valérie Dinant, Ilaria Ruggiano, Harold Willem, Pierre-François Laterre, Philippe Hantson
Acute paracetamol poisoning due to a single overdose may be effectively treated by the early administration of N-acetylcysteine (NAC) as an antidote. The prognosis may be different in the case of intoxication due to multiple ingestions or when the antidote is started with delay. The aim of this work was to investigate the outcome of paracetamol poisoning according to the pattern of ingestion and determine the factors associated with the outcome. We performed a retrospective analysis over the period 2007⁻2017 of the patients who were referred to a tertiary hospital for paracetamol-related hepatotoxicity...
September 29, 2018: Toxics
Ryan J Hendrix, Paulo N Martins, Jeffrey S Stoff, Aaron Ahearn, Adel Bozorgzadeh, Babak Movahedi
We report two cases of successful renal transplantation with allografts from donors who suffered anoxic brain injury as the primary cause of death from house fires. Each was treated prophylactically with hydroxocobalamin (Cyanokit) for suspected cyanide toxicity. During organ procurement, gross examination was notable for deep discoloration of the parenchymal tissues. Approximately 6 and 18 months after transplantation, both recipients have excellent renal graft function and remain independent from hemodialysis (HD)...
2018: Case Reports in Transplantation
Arthur Bracey, Wassim Shatila, James Wilson
In optimizing anticoagulation therapy, it is essential to balance treatment efficacy with the major adverse effect of anticoagulant treatment, bleeding risk. This narrative review examines the efficacy and safety of the non-vitamin K antagonist oral anticoagulants (NOACs) dabigatran, rivaroxaban, apixaban, and edoxaban compared with standard anticoagulation or placebo. NOAC therapies provide equivalent to superior protection versus standard therapy, with similar or superior safety, and potential benefits in convenience...
September 30, 2018: Therapeutic Advances in Cardiovascular Disease
Young-Hoon Yoon, Jung-Youn Kim, Sung-Hyuk Choi
Background: According to domestic studies, patients visiting the emergency departments (ED) with acute toxic exposure comprise 0.68%-5.5% of all ED patients, with various causes and motives. The purpose of this study is to investigate the clinical and social characteristics of patients with toxic exposure visiting the ED. Methods: This study spanned a period of five years, from January 1, 2009 to December 31, 2013. The data were extracted using the National Emergency Department Information System (NEDIS) and The Korea Health Insurance Review and Assessment Service (HIRA)...
September 24, 2018: Journal of Korean Medical Science
Chi-Hsin Lee, Sy-Jye Leu, Yu-Ching Lee, Chia-I Liu, Liang-Tzung Lin, Pharaoh Fellow Mwale, Jen-Ron Chiang, Bor-Yu Tsai, Chi-Ching Chen, Ching-Sheng Hung, Yi-Yuan Yang
Traditional, horse-derived antivenin is currently the most efficient treatment against snake bites. However, it is costly and has unpredictable side effects. Thus, alternative, cost-effective strategies for producing antivenin are needed. In this study, we immunized hens with inactivated NNA venom proteins from the cobra Naja naja atra (NNA). Purified yolk IgY antibodies showed specific anti-NNA binding activity comparable to that of the equine-derived antivenin. We used phage display technology to generate two antibody libraries containing 9...
September 21, 2018: Toxins
Mohammad Adil, Syed Suhail Amin, Mohd Mohtashim
N-acetylcysteine is a mucolytic drug which is commonly used as an antidote for acetaminophen toxicity. It is a thiol compound, which acts as a donor of cysteine, leading to replenishment of glutathione and thus acts as an antioxidant. It also has anti-inflammatory effects, alters the levels of neurotransmitters, inhibits proliferation of fibroblasts and keratinocytes and causes vasodilatation. Due to these actions, n-acetylcysteine has found use in several dermatologic conditions in systemic and topical form...
November 2018: Indian Journal of Dermatology, Venereology and Leprology
Vikhyat S Bebarta
No abstract text is available yet for this article.
September 24, 2018: Disaster Medicine and Public Health Preparedness
Matthew R Lewin, José María Gutiérrez, Stephen P Samuel, María Herrera, Wendy Bryan-Quirós, Bruno Lomonte, Philip E Bickler, Tommaso C Bulfone, David J Williams
There is an unmet need for economical snakebite therapies with long shelf lives that are effective even with delays in treatment. The orally bioavailable, heat-stable, secretory phospholipase A₂ (sPLA₂) inhibitor, LY333013, demonstrates antidotal characteristics for severe snakebite envenoming in both field and hospital use. A murine model of lethal envenoming by a Papuan taipan ( Oxyuranus scutellatus ) demonstrates that LY333013, even with delayed oral administration, improves the chances of survival...
September 20, 2018: Toxins
Michael Eddleston
Organophosphorus insecticide self-poisoning is a major global health problem, killing over 100,000 people annually. It is a complex multi-organ condition, involving the inhibition of cholinesterases, and perhaps other enzymes, and the effects of large doses of ingested solvents. Variability between organophosphorus insecticides-in lipophilicity, speed of activation, speed and potency of acetylcholinesterase inhibition, and in the chemical groups attached to the phosphorus-results in variable speed of poisoning onset, severity, clinical toxidrome, and case fatality...
September 19, 2018: Annual Review of Pharmacology and Toxicology
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