Systemic Toxicity after Rattlesnake Envenomation in Patients Using Angiotensin Converting Enzyme Inhibitors: A North American Snakebite Registry Study.

Background: Some North American rattlesnake venoms and angiotensin converting enzyme inhibitor (ACEI) medications each increase bradykinin levels in humans, with clinical effects attributable to bradykinin described in exposed populations. Influence of ACEI exposure on persons with snake envenomation has not been studied. We used data from the ACMT North American Snakebite Registry (NASBR) to determine if use of ACEI medications at the time of rattlesnake envenomation is associated with increased rate of systemic toxicity.

Successful Amendment of an Existing Hepatitis B Screening Programme by a Guideline Recommended Hepatitis D Screening in the Primary Care Setting.

Background: Despite European guidelines recommending anti-hepatitis D virus (HDV) screening for all hepatitis B surface antigen (HBsAg)-positive cases, screening rates remain insufficient.

Aims: We analysed anti-HDV screening rates in primary care and implemented prospective HDV screening in HBsAg-positive cases identified in the preventive medical examination from the age of 35 ("Check-Up 35+").

Methods: From 2012 to 2021, we reviewed anti-HDV and HDV RNA test rates in HBsAg-positive patients at 11 sites of a large German laboratory group.

A Case Report of Crotalidae Immune F(ab')-associated Coagulopathy Recurrence in a Preschool-age Child.

Introduction: Pit viper envenomation may cause coagulopathy. The coagulopathy has been treated with crotalidae polyvalent immune fragment antigen-binding (Fab) ovine antivenom for the last few decades in the United States and usually corrects the acute coagulopathy within hours. Days after receiving Fab, coagulopathy may recur in approximately half of the patients.