Rattlesnake venom-induced recurrent coagulopathy in first trimester pregnant women - Two Cases.

Delayed or recurrent coagulopathy can occur up to 14 days after North American rattlesnake envenomation in patients that have been treated with Crotalidae Polyvalent Immune Fab (CroFab). There is little data in the literature characterizing the sequelae of North American rattlesnake envenomation in pregnancy and no previously published reports of recurrent coagulopathy in pregnancy. CASE REPORT: We present 2 cases of first trimester pregnant women requiring readmission and retreatment with Crotalidae Polyvalent Immune Fab (CroFab) after developing recurrent/late coagulopathy following North American Rattlesnake Envenomation.

Pancreatic Laceration in a Pediatric Patient: An Unexpected Diagnosis.

Pediatric pancreatic injuries are rare. We present an atypical case that occurred in a 4-year-old male. The child presented with a twenty-four-hour history of vomiting that had progressed to right lower quadrant abdominal pain on examination in the emergency department.

Baclofen Toxicity in a Patient with Hemodialysis-Dependent End-Stage Renal Disease.

Background: Oral baclofen toxicity is extremely rare, but can affect patients with renal disease due to the drug's predominant renal clearance of approximately 69-85%. Patients with severely impaired renal function typically develop symptoms soon after initiating baclofen therapy, even at relatively low doses.

Case Report: A 69-year-old woman with a history of hemodialysis-dependent end-stage renal disease presented to the Emergency Department with encephalopathy, ataxia, and dystonia after the addition of a recent baclofen prescription for back pain (10 mg twice daily).

Mechanistic Insights into the Hydrolysis of Organophosphorus Compounds by Paraoxonase-1: Exploring the Limits of Substrate Tolerance in a Promiscuous Enzyme.

We designed, synthesized and screened a library of analogs of the organophosphate pesticide metabolite paraoxon against a recombinant variant of human serum paraoxonase-1. Alterations of both the aryloxy leaving group and the retained alkyl chains of paraoxon analogs resulted in substantial changes to binding and hydrolysis, as measured directly by spectrophotometric methods or in competition experiments with paraoxon. Increases or decreases in the steric bulk of the retained groups generally reduced the rate of hydrolysis, while modifications of the leaving group modulated both binding and turnover.