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https://www.readbyqxmd.com/read/28259369/delayed-hematologic-toxicity-following-rattlesnake-envenomation-unresponsive-to-crotalidae-polyvalent-antivenom
#1
Abby M Bailey, Stephanie Justice, George A Davis, Kyle Weant
North American rattlesnake envenomations are known to produce coagulopathies and thrombocytopenia. However, the occurrence of delayed hematologic toxicity (less than seven days after envenomation) is poorly characterized in the medical literature. While the recurrence of hematologic derangements has been documented following envenomation, it is usually in the absence of clinically significant bleeding. Although commonly recommended to treat delayed coagulopathies, the effectiveness of crotalidae polyvalent immune Fab ovine (CroFab®) in managing this condition remains in question and warrants further investigation and exploration...
February 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28165801/use-of-polyvalent-equine-anti-viper-serum-to-treat-delayed-coagulopathy-due-to-suspected-sistrurus-miliarius-streckeri-envenomation-in-two-children
#2
Kristie L Williams, Megan Woslager, Stephanie L Garland, Roger P Barton, William Banner
BACKGROUND: Western Pygmy Rattlesnake (WPR) envenomation reportedly causes refractory and persistent coagulopathy when treated with CroFab(®) (Crotalidae Polyvalent Immune Fab). We report two cases where polyvalent equine anti-viper serum (AntivipmynTRI(®)) was used to treat recurrent coagulopathy in children. CASE DETAILS: The first patient was a 16-month-old male who was bitten by a confirmed WPR. The patient received a total of 18 vials of CroFab(®). His labs normalized, swelling gradually improved, and the child was discharged to home...
February 6, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28130154/what-killed-karl-patterson-schmidt-combined-venom-gland-transcriptomic-venomic-and-antivenomic-analysis-of-the-south-african-green-tree-snake-the-boomslang-dispholidus-typus
#3
Davinia Pla, Libia Sanz, Gareth Whiteley, Simon C Wagstaff, Robert A Harrison, Nicholas R Casewell, Juan J Calvete
BACKGROUND: Non-front-fanged colubroid snakes comprise about two-thirds of extant ophidian species. The medical significance of the majority of these snakes is unknown, but at least five species have caused life-threatening or fatal human envenomings. However, the venoms of only a small number of species have been explored. METHODS: A combined venomic and venom gland transcriptomic approach was employed to characterise of venom of Dispholidus typus (boomslang), the snake that caused the tragic death of Professor Karl Patterson Schmidt...
April 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27894563/administration-of-crofab-antivenom-by-a-helicopter-emergency-medical-service-team
#4
Michael T Steuerwald, Season R K Gabbard, Gillian A Beauchamp, Matthew K Riddle, Edward J Otten
The case presented here highlights an unconventional use of a helicopter emergency medical service (HEMS) to provide a specialized medication to a critically ill patient when definitive transport was delayed. A 39-year-old man presented to a rural hospital 1 hour after sustaining a copperhead envenomation. He developed severe symptoms and was intubated. Arrangements were made for transfer to a tertiary referral center by HEMS, but because of incoming weather conditions, the team would not be able to make the return flight safely...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/25819372/comparative-venomics-of-the-prairie-rattlesnake-crotalus-viridis-viridis-from-colorado-identification-of-a-novel-pattern-of-ontogenetic-changes-in-venom-composition-and-assessment-of-the-immunoreactivity-of-the-commercial-antivenom-crofab%C3%A2
#5
COMPARATIVE STUDY
Anthony J Saviola, Davinia Pla, Libia Sanz, Todd A Castoe, Juan J Calvete, Stephen P Mackessy
UNLABELLED: Here we describe and compare the venomic and antivenomic characteristics of both neonate and adult Prairie Rattlesnake (Crotalus viridis viridis) venoms. Although both neonate and adult venoms contain unique components, similarities among protein family content were seen. Both neonate and adult venoms consisted of myotoxin, bradykinin-potentiating peptide (BPP), phospholipase A2 (PLA2), Zn(2+)-dependent metalloproteinase (SVMP), serine proteinase, L-amino acid oxidase (LAAO), cysteine-rich secretory protein (CRISP) and disintegrin families...
May 21, 2015: Journal of Proteomics
https://www.readbyqxmd.com/read/25055811/ethical-considerations-in-design-of-a-study-to-evaluate-a-us-food-and-drug-administration-approved-indication-antivenom-versus-placebo-for-copperhead-envenomation
#6
Charles J Gerardo, Eric J Lavonas, Ross E McKinney
BACKGROUND: In 2000, the US Food and Drug Administration approved CroFab(®) Crotalidae Polyvalent Immune Fab, ovine (FabAV), which had received orphan drug designation, for use in patients with minimal to moderate North American crotaline envenomations including copperhead snakes. As existing evidence on the effectiveness of FabAV for this indication is limited, wide practice variation in its use exists. In order to provide more definitive clinical evidence as to the role of this treatment, a new randomized, placebo-controlled trial of FabAV specifically for copperhead bites was initiated...
October 2014: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/24937331/epidemiology-of-the-reported-severity-of-cottonmouth-agkistrodon-piscivorus-snakebite
#7
Frank G Walter, Uwe Stolz, Robert N E French, Peter B Chase, Jude McNally, Farshad Shirazi
OBJECTIVE: The goal of this study was to analyze trends in the annual rates of reported medical outcomes of cottonmouth (Agkistrodon piscivorus) snakebites in the United States, published in the annual reports of the American Association of Poison Control Centers in the course of 29 years. METHODS: This was a retrospective analysis of medical outcomes for cottonmouth snakebite victims who developed fatal, major, moderate, minor, or no effects. The annual rates for these medical outcomes were calculated by dividing the annual number of patients in each outcome category by the total annual number of people reported as being bitten by cottonmouths...
March 2014: Southern Medical Journal
https://www.readbyqxmd.com/read/24888853/management-of-pediatric-snake-bites-are-we-doing-too-much
#8
Jesus A Correa, Sara C Fallon, Andrea T Cruz, Glenda H Grawe, Phong V Vu, Daniel M Rubalcava, Brent Kaziny, Bindi J Naik-Mathuria, Mary L Brandt
BACKGROUND: The optimal management of children with snake bite injuries is not well defined. The purpose of this study was to review the use of antivenom, diagnostic tests, and antibiotics in children bitten by venomous snakes in a specific geographic region (Southeast Texas). METHODS: This is a retrospective single-center review of all patients with snake bite injury from 1/2006 to 6/2012. An envenomated bite was defined as causing edema, discoloration of the skin, necrosis, or systemic effects...
June 2014: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/24507436/long-term-complications-of-rattlesnake-bites-a-telephone-survey-from-central-california
#9
Susanne J Spano, Rais Vohra, Fernando Macias
OBJECTIVE: The purpose of this institutional review board-approved, cross-sectional study was to identify residual symptoms and signs of envenomation reported by snakebite survivors via a telephone survey. METHODS: Victims of rattlesnake bite who were treated at a single hospital center during a 10-year period were contacted through a telephone survey. Study subjects were included through a diagnosis-based retrospective chart review of snakebite victims, and excluded if they did not receive rattlesnake antivenom...
June 2014: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/24463169/intraspecific-venom-variation-in-the-medically-significant-southern-pacific-rattlesnake-crotalus-oreganus-helleri-biodiscovery-clinical-and-evolutionary-implications
#10
Kartik Sunagar, Eivind A B Undheim, Holger Scheib, Eric C K Gren, Chip Cochran, Carl E Person, Ivan Koludarov, Wayne Kelln, William K Hayes, Glenn F King, Agosthino Antunes, Bryan Grieg Fry
UNLABELLED: Due to the extreme variation of venom, which consequently results in drastically variable degrees of neutralization by CroFab antivenom, the management and treatment of envenoming by Crotalus oreganus helleri (the Southern Pacific Rattlesnake), one of the most medically significant snake species in all of North America, has been a clinician's nightmare. This snake has also been the subject of sensational news stories regarding supposed rapid (within the last few decades) evolution of its venom...
March 17, 2014: Journal of Proteomics
https://www.readbyqxmd.com/read/23305624/validating-a-faster-method-for-reconstitution-of-crotalidae-polyvalent-immune-fab-ovine
#11
David Gerring, Thomas R King, Richard Branton
BACKGROUND: Reconstitution of CroFab(®) (Crotalidae Polyvalent Immune Fab [ovine]) lyophilized drug product was previously performed using 10 mL sterile water for injection followed by up to 36 min of gentle swirling of the vial. CroFab has been clinically demonstrated to be most effective when administered within 6 h of snake envenomation, and improved clinical outcomes are correlated with quicker timing of administration. An alternate reconstitution method was devised, using 18 mL 0...
July 2013: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/23055123/the-toxicology-investigators-consortium-case-registry-the-2011-experience
#12
MULTICENTER STUDY
Timothy J Wiegand, Paul M Wax, Tayler Schwartz, Yaron Finkelstein, Rachel Gorodetsky, Jeffrey Brent
In 2010, the American College of Medical Toxicology established its Case Registry, the Toxicology Investigators Consortium (ToxIC). ToxIC is a prospective registry, which exclusively compiles suspected and confirmed toxic exposure cases cared for at the bedside by medical toxicologists at its participating sites. The Registry aims to fulfill two important gaps in the field: a real-time toxicosurveillance system to identify current poisoning trends and a powerful research tool in toxicology. ToxIC allows extraction of information from medical records making it the most robust multicenter database on chemical toxicities in existence...
December 2012: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
https://www.readbyqxmd.com/read/22963729/pygmy-rattlesnake-envenomation-treated-with-crotalidae-polyvalent-immune-fab-antivenom
#13
Andrew M King, William S Crim, Nathan B Menke, Anthony F Pizon
UNLABELLED: Documented envenomations by the pygmy rattlesnake (Sistrurus miliarius barbouri) are rare. While there have been no documented fatalities, several older case reports describe significant morbidity. We describe the first known case of pygmy rattlesnake envenomation that was treated with Crotalidae Polyvalent Immune Fab Antivenom (CroFab®). CASE: A 28-year-old man with no significant past medical history presented after being envenomated on the right hand by his friend's pet pygmy rattlesnake...
December 1, 2012: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/22765769/crotalidae-polyvalent-immune-fab-a-guide-to-its-use-in-north-american-crotaline-envenomation
#14
Gillian M Keating, Katherine A Lyseng-Williamson
Intravenous crotalidae polyvalent immune Fab (CroFab(®)) is effective in patients with minimal, moderate or severe crotaline envenomation, halting the progression of local venom effects and ameliorating haematological and other systemic abnormalities of envenomation. Despite treatment, patients may experience delayed-onset or recurrent venom effects (e.g. coagulopathy). Intravenous crotalidae polyvalent immune Fab is generally well tolerated, with acute hypersensitivity reactions being the most commonly occurring adverse event...
August 1, 2012: Clinical Drug Investigation
https://www.readbyqxmd.com/read/22511193/the-use-and-tolerability-of-crotalidae-polyvalent-immune-fab-ovine-in-pediatric-envenomations
#15
Henry C Farrar, Taylor Grayham, Branson Bolden, Dileep Vyas, James Graham, Laura P James
There are limited data on the use of Crotalidae Polyvalent Immune FAB-Ovine (CroFab) in the management of crotalid envenomations in children. Thus, the primary objective of this retrospective chart review was to evaluate the safety and tolerability of CroFab in a pediatric population. Over an 8-year time period at this institution, there were 204 admissions for snakebite of which 82 received CroFab. Children who received CroFab were more often associated with bites to the hands and fingers and tended to have more significant envenomations as indicated by longer hospital stays, greater tissue injury, and a tendency to require surgery more often...
October 2012: Clinical Pediatrics
https://www.readbyqxmd.com/read/22316194/overview-and-controversies-in-the-medical-management-of-pit-viper-envenomation-in-the-dog
#16
REVIEW
Robert A Armentano, Michael Schaer
OBJECTIVE: To provide a review and update on the medical management of pit viper envenomation in dogs. ETIOLOGY: Pit viper snake (Crotalidae) envenomation in dogs is a common emergency in the United States. At least 50 enzymes contribute to snake venom potency that causes soft tissue damage, vasculotoxicity, coagulopathy, cytotoxicity, and necrosis. DIAGNOSIS: Snakebite envenomation may be identified by fang puncture wounds but primarily as a focal site with a rapid onset of severe swelling, hemorrhage, pain, and potentially necrosis...
October 2011: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/22123554/venomous-snakebites
#17
Dalia Adukauskienė, Eglė Varanauskienė, Agnė Adukauskaitė
More than 5 million people are bitten by venomous snakes annually and more than 100,000 of them die. In Europe, one person dies due to envenomation every 3 years. There is only one venomous snake species in Lithuania--the common adder (Vipera berus)--which belongs to the Viperidae family; however, there are some exotic poisonous snakes in the zoos and private collections, such as those belonging to the Elapidae family (cobras, mambas, coral snakes, etc.) and the Crotalidae subfamily of the Viperidae family (pit vipers, such as rattlesnakes)...
2011: Medicina
https://www.readbyqxmd.com/read/21317694/when-snakes-bite-the-management-of-north-american-crotalinae-snake-envenomation
#18
Jenny Ashton, Stephanie N Baker, Kyle A Weant
There are more than 120 species of snakes indigenous to the United States, 25 of which are venomous. Although snake envenomation carries a relatively low risk of mortality in the United States, it can result in significant morbidity if left untreated. The venom of Crotalinae snakes contains a complex mixture of enzymatic proteins with various clinical implications. Of these complications, the most significant are consumptive coagulopathy, compartment syndrome, and hypovolemic shock. The development of ovine Crotalidae polyvalent immune Fab antivenin (CroFab) has greatly changed the approach to snake envenomation...
January 2011: Advanced Emergency Nursing Journal
https://www.readbyqxmd.com/read/21119141/management-of-venomous-snakebite-injury-to-the-extremities
#19
REVIEW
Adam W Anz, Mark Schweppe, Jason Halvorson, Brandon Bushnell, Michael Sternberg, L Andrew Koman
Pit vipers (subfamily Crotalinae) are responsible for most venomous snakebites in the United States. The mixture of proteins with cytotoxic, proteolytic, and/or neurotoxic enzymes in snake venom varies by species. Treatment in the field consists of safe identification of the species of snake and rapid transport of the patient to the nearest health care facility. Swelling, bruising, and systemic symptoms are seen following snakebite. Most patients respond to elevation of the affected extremity and observation...
December 2010: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/20952098/short-term-outcomes-after-fab-antivenom-therapy-for-severe-crotaline-snakebite
#20
MULTICENTER STUDY
Eric J Lavonas, Jamie Kokko, Tammi H Schaeffer, Sara L Mlynarchek, Gregory M Bogdan, Richard C Dart
STUDY OBJECTIVES: We seek to determine the short-term outcomes associated with the use of Crotalidae polyvalent immune Fab (ovine) (CroFab; FabAV) therapy for severe crotaline snake envenomation and to better define the incidence of hypersensitivity reactions associated with FabAV use. METHODS: We conducted a multicenter observational case series study of patients who received FabAV at 17 US hospitals in 2002 to 2004. A 7-point score incorporating local, systemic, and hematologic venom effects was used to grade envenomation severity before and after FabAV therapy...
February 2011: Annals of Emergency Medicine
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