Abstract:
STUDY OBJECTIVE:The antivenom currently available for treatment of systemic black widow envenomation (latrodectism) is composed of equine whole immunoglobin. Although considered effective, it has been associated with anaphylaxis and 2 reported fatalities. We test the efficacy and safety of new equine antivenom composed of purified F(ab')2 antibody fragments. METHODS:A randomized, double-blind, placebo-controlled trial was conducted at 16 sites across the United States. Subjects aged 10 years or older with moderate to severe pain because of black widow spider envenomation received F(ab')2 antivenom or placebo. The primary outcome measure was treatment failure, which was defined as failure to achieve and maintain clinically significant reduction in pain for 48 hours posttreatment. Secondary measures of pain intensity differences and summed pain intensity difference were computed. Adverse events were recorded. RESULTS:Sixty patients were treated (29 antivenom and 31 placebo). The mean age was 39 years and 68% were male. There were 15 treatment failures in the antivenom group and 24 in the placebo group (P=.019). Differences in pain intensity difference between groups were lower at each postbaseline point, and the mean summed pain intensity difference was greater for the antivenom group (difference 2,133; 95% confidence interval 177 to 4,090). No deaths or serious drug-related adverse events were detected. CONCLUSION:The F(ab')2 antivenom met the predefined primary outcome of reduced treatment failures. Secondary outcomes of pain intensity difference and summed pain intensity difference also supported efficacy. The rate of symptom improvement in the placebo group was higher than expected, which may be related to enrollment criteria or placebo effect.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Dart RC,Bush SP,Heard K,Arnold TC,Sutter M,Campagne D,Holstege CP,Seifert SA,Lo JCY,Quan D,Borron S,Meurer DA,Burnham RI,McNally J,Garcia-Ubbelohde W,Anderson VEdoi
10.1016/j.annemergmed.2019.02.007subject
Has Abstractpub_date
2019-09-01 00:00:00pages
439-449issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(19)30109-Xjournal_volume
74pub_type
杂志文章,多中心研究,随机对照试验abstract::We present the case of a 6-year-old boy with reactive airway disease who developed cervical lung herniation resulting in compression of the trachea and audible stridor. This association has never been reported in the pediatric age group, and a review of the literature revealed that lung herniation is a rare condition ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81574-4
更新日期:1990-08-01 00:00:00
abstract:STUDY OBJECTIVE:We characterize the quantity and quality of data tables and figures in reports of randomized controlled trials (RCTs) submitted to the British Medical Journal (BMJ) and published in peer-reviewed journals. We investigate how the peer review process affected table and figure quality. METHODS:We reviewed...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2006.06.017
更新日期:2006-12-01 00:00:00
abstract:STUDY OBJECTIVE:To identify the arterial and mixed venous blood gas changes caused by different ventilatory strategies during resuscitation from ventricular fibrillation in a pig model of closed-chest cardiac compression. METHODS:A prospective randomized animal study was performed using 27 domestic pigs (body weight, ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70203-3
更新日期:1998-05-01 00:00:00
abstract::A prospective study of emergency physician whole body and extremity exposure to ionizing radiation during trauma resuscitation over a three-month period was conducted. Radiation film badges and thermoluminescent dosimeter finger rings were permanently attached to leaded aprons worn by emergency medicine residents duri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)81797-4
更新日期:1990-02-01 00:00:00
abstract::A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Em...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(98)70045-9
更新日期:1998-11-01 00:00:00
abstract::A double-blind prospective study of 98 patients was carried out, but 57 (58%) returned for follow-up and form the basis of this report. Wound irrigation and debridement were found to be important in reducing infection. Hand wounds were most likely to become infected; face and scalp wounds were at low risk. Puncture wo...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(80)80153-3
更新日期:1980-08-01 00:00:00
abstract::Ethanol disrupts the physical structure of cell membranes. The most fluid membranes, including those that are low in cholesterol, are the most easily disordered by ethanol. Although the membrane-disordering effect is small, there is pharmacological, temporal, and genetic evidence that it is important. Animals that are...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(86)80120-2
更新日期:1986-09-01 00:00:00
abstract::In order to develop a rapid, simple test to differentiate toxic naphthalene from the less toxic mothball ingredient paradichlorobenzene, both types of mothballs were dissolved in isopropyl alcohol, ethanol, methanol, and turpentine. Twenty-five naphthalene and 25 paradichlorobenzene mothballs were weighed, randomly gr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(85)80731-9
更新日期:1985-01-01 00:00:00
abstract:STUDY OBJECTIVES:By evaluating the efficacy of metoclopramide alone and in combination with ibuprofen versus placebos, this study was designed to both evaluate the efficacy of metoclopramide and elucidate its mechanism of action in the treatment of migraine headache. DESIGN:The study was conducted over a two-year peri...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)80201-x
更新日期:1993-02-01 00:00:00
abstract::Epiglottitis in adults, while uncommon, is certainly not rare. Despite the increasing reports of the disorder in the literature, it continues to be misdiagnosed in emergency departments. The first step in the diagnosis of acute epiglottitis is for the emergency physician to think of it. The literature concerning the e...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80463-5
更新日期:1981-01-01 00:00:00
abstract::Sexually transmitted bowel and rectal diseases are common in gay men and are caused by a wide variety of infectious agents. Each of the entities implicated in the gay bowel syndrome is considered separately and epidemiologic considerations responsible for the appearance of such a syndrome are examined. The emergency p...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(80)80310-6
更新日期:1980-09-01 00:00:00
abstract:STUDY OBJECTIVE:The emergency department is a problem-focused environment in which routine screening for intimate partner violence (IPV) is difficult. We hypothesized that screening for IPV during computer-based health-risk assessment would be acceptable to patients and improve detection. METHODS:We performed a descri...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.127181
更新日期:2002-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine if intramedullary aspirate from intraosseous needle placement can be used as a source for evaluating blood compatibility. DESIGN:A prospective, nonrandomized, crossover study. SETTING/PARTICIPANTS:Patients admitted to the hematology/oncology service undergoing bone marrow aspiration for m...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82661-7
更新日期:1992-04-01 00:00:00
abstract:STUDY OBJECTIVE:Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. DESIGN:Randomized, double-blind, prospective clinical trial. SETTING:Urban emergency department. TYPE OF PARTICIPANTS:Ninety-one adult patients with simple linear lacerations were enrolled. Patients wit...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)82603-4
更新日期:1990-12-01 00:00:00
abstract::A young woman presented with acute abdominal pain, anemia, and a positive pregnancy test. At surgery a large retroperitoneal hematoma secondary to a ruptured right kidney was found. Pathological examination revealed a hematogenic necrosis of a choriocarcinoma of the kidney. The patient tolerated subsequent chemotherap...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(87)80432-8
更新日期:1987-12-01 00:00:00
abstract::After recent terrorist attacks, new attention has been focused on health care facility decontamination practices. This article reviews core issues related to the selection of appropriate personal protective equipment for health care facility decontamination personnel, with an emphasis on respiratory protection. Existi...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(03)00447-5
更新日期:2003-09-01 00:00:00
abstract::The use of flumazenil, a benzodiazepine antagonist, was studied in two patients with coma of unknown etiology. One patient ingested 20.5 mg alprazolam before crashing his truck into parked automobiles. The patient was awakened by flumazenil administration, and the severity of his injuries was evaluated reliably. A sec...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/s0196-0644(05)82054-2
更新日期:1990-03-01 00:00:00
abstract::Olfactory and gustatory hallucinations are not often encountered in the acute care setting but may represent the subtle presenting features of a significant underlying disease process. We describe a patient whose most striking presenting symptoms were of olfactory and gustatory hallucinations and in whom the diagnosis...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2010.02.020
更新日期:2010-10-01 00:00:00
abstract:STUDY OBJECTIVES:We assessed the validity and completeness of data in the past medical history (PMH) obtained electronically from parents and examined effects of the human-computer interface and sociodemographic variables on electronic parental report. METHODS:We compared parents' electronic report of PMH data with a ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(00)70052-7
更新日期:2000-04-01 00:00:00
abstract:STUDY OBJECTIVE:To define the rate of complications of adult varicella, including pneumonia, and to determine the association of such complications with pregnancy. METHODS:Retrospective, descriptive case series of consecutive adult emergency department patients with primary varicella seen over a 31-month period in an ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70057-4
更新日期:1996-08-01 00:00:00
abstract::Interstitial pregnancy is a rare and dangerous form of ectopic pregnancy that can be mistaken for a normal intrauterine pregnancy on ultrasonography, leading to catastrophic results. Increasingly, emergency physicians are using ultrasonography to diagnose intrauterine pregnancy. Emergency physicians should be aware of...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1067/mem.2002.125426
更新日期:2002-07-01 00:00:00
abstract::Recent animal and clinical data require a reevaluation of the traditional approach to the patient exposed to carbon monoxide. Unfortunately, these new data are inconclusive and generate controversies regarding the indications and value of neuropsychologic testing, cause of carbon monoxide toxicity, and indications (if...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(94)70136-9
更新日期:1994-08-01 00:00:00
abstract::Experimental data have suggested that pneumatic external counterpressure improves outcome in intra-abdominal hemorrhage by either a tamponade effect and/or elevation in central systemic blood pressure. As a result, the empiric use of the pneumatic antishock garment (PASG) has become a standard of care, even to the poi...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(87)80064-1
更新日期:1987-06-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the feasibility of Pap screening and follow-up of urban emergency department patients and the prevalence of cervical dysplasia and carcinoma in this group. DESIGN:During a four-month period, Pap smears were added to pelvic examinations performed in the ED. Follow-up, including repeat Pap ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(05)82931-2
更新日期:1992-08-01 00:00:00
abstract::In more than 15 years of paramedic operation, fewer than 15 prehospital studies have been undertaken on the pharmacologic intervention by paramedics. Many of these studies suffer from inadequate sample size or deficient study design. There is no evidence that any medication given by the prehospital care provider is be...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/s0196-0644(89)80113-1
更新日期:1989-02-01 00:00:00
abstract::We investigated the compliance of emergency department health care workers with barrier precaution policies adapted from the Centers for Disease Control's "Recommendations for Prevention of HIV Transmission in Health-Care Settings." One hundred sixty-nine health care worker encounters with 97 patients were observed. O...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(89)80522-0
更新日期:1989-06-01 00:00:00
abstract:STUDY OBJECTIVE:We evaluate the effectiveness and safety of an outpatient clinical care pathway for the initial treatment of acute proximal lower-extremity deep venous thrombosis (DVT) with low molecular weight heparin (LMWH) managed by the emergency department of 2 affiliated community hospitals. METHODS:This observa...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1067/mem.2001.113703
更新日期:2001-03-01 00:00:00
abstract::Colchicine overdose is an uncommon but serious problem that may be missed or ignored unless the physician is aware of the significant potential for, and the various stages of, toxicity. We report two fatal cases in which the potential for lethal complications was not initially realized. Both patients developed multipl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80239-9
更新日期:1981-07-01 00:00:00
abstract:STUDY OBJECTIVE:This study seeks to examine whether the finding of an abnormal estimated glomerular filtration rate (eGFR) in the emergency department (ED) was associated with acute coronary syndrome in the population of patients presenting for investigation of chest pain. METHODS:We used prospectively collected data ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2013.01.011
更新日期:2013-07-01 00:00:00
abstract:STUDY OBJECTIVE:Preoxygenation is important to prevent oxygen desaturation during emergency airway management. The purpose of this study is to describe the use of end tidal oxygen (eto2) during rapid sequence intubation in the emergency department. METHODS:This study was carried out in 2 academic centers in Sydney, Au...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.annemergmed.2019.01.038
更新日期:2019-09-01 00:00:00