2003
DOI: 10.1016/s0041-0101(02)00336-7
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The clinical significance of venom detection in patients of cobra snakebite

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Cited by 70 publications
(69 citation statements)
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References 14 publications
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“…Based on this retrospective review, patients bitten by snakes of the family Elapidae (neurotoxic venom) required higher antivenom doses and had greater chances for complications, even after antivenom therapy. We found similar epidemiological patterns in previous studies including male predominance (86%), bites on distal extremities of the body (98%) and a large incidence of attacks occurring near the individual residence (57%) (3,4,(7)(8)(9). Correct antivenom administration remains the mainstay of therapy, with a suggested elapsed time from the moment of the bite to the antivenom administration of six to eight hours (10).…”
Section: Discussionsupporting
confidence: 89%
“…Based on this retrospective review, patients bitten by snakes of the family Elapidae (neurotoxic venom) required higher antivenom doses and had greater chances for complications, even after antivenom therapy. We found similar epidemiological patterns in previous studies including male predominance (86%), bites on distal extremities of the body (98%) and a large incidence of attacks occurring near the individual residence (57%) (3,4,(7)(8)(9). Correct antivenom administration remains the mainstay of therapy, with a suggested elapsed time from the moment of the bite to the antivenom administration of six to eight hours (10).…”
Section: Discussionsupporting
confidence: 89%
“…14 A study using an enzyme-linked immunosorbent assay to detect the amount of N atra venom revealed that two to eight vials of antivenin are sufficient to eliminate systemic circulating venom if presentation is early. 6 The efficacy of systemically administrated antivenin to diminish local tissue destruction is still controversial, however, and needs further study. 3 In an animal study, the cytotoxic venom of N atra was shown to bind with high affinity to tissues leading to high levels of local tissue destruction.…”
Section: Discussionmentioning
confidence: 99%
“…5 In contrast, N atra envenomation is associated with more cytotoxic effects. 3,6,7 Although an equine-derived bivalent F(ab)2 antivenin has been produced by the Centers for Disease Control, ROC (Taiwan) to neutralise the venom of N atra, the surgical intervention rate remains high. 1,8 The main objective of this study was to investigate the clinical presentations and predictors for surgery in patients with N atra envenomation.…”
Section: Introductionmentioning
confidence: 99%
“…A definite diagnosis was made by the identification of the culprit snake, which included the examination of the snake, identification of the snake by the patient through a picture, or laboratory testing of the venom by the treating physician. [12][13][14] Patients with typical manifestations, as determined through physical examination, serial wound inspection, a relevant history, and clinical improvement after receiving specific antivenom for N. atra were included in the "clinical case" group (Table 1). 2,3,15 After a careful review of the medical records, patients with snakebites other than those of N. atra (e.g., patients with snakebites of the other five medically important snakes [T. stejnegeri, P. mucrosquamatus, D. acutus, D. siamensis, and B. multicinctus] and less toxic or nonvenomous snakes) and patients with equivocal manifestations and a negative identification of culprit snake were excluded.…”
Section: Methodsmentioning
confidence: 99%