Transactions of the Royal Society of Tropical Medicine and Hygiene
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Trans. R. Soc. Trop. Med. Hyg. · Sep 2006
Muscle cell injury, haemolysis and dark urine in children with falciparum malaria in Papua New Guinea.
During a prospective study of red cell variants and severe malaria in children, a surprising observation was the occurrence of dark urine. Children were grouped according to urine findings: 22 had dark urine that contained a haem protein (Group I), 93 had urine of normal colour that contained a haem protein (Group II) and 236 had normal urine (Group III). To investigate the cause of dark urine, haemolysis and muscle cell injury were assessed. ⋯ It is likely that both haemoglobin and myoglobin contributed to dark urine. The association between muscle cell injury and coma suggests sequestration of parasitized red cells as a common underlying pathology. In malaria, hyperlactataemia may result directly from breakdown of muscle protein as well as tissue hypoxia.
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Trans. R. Soc. Trop. Med. Hyg. · Sep 2006
Randomized Controlled TrialA randomized, double-blind, placebo-controlled trial of antivenom for local effects of green pit viper bites.
Although systemic administration of antivenom can promptly reverse coagulopathy, efficacy on local effects of viper venom remains to be determined. Currently, there has been no proven specific treatment for snakebite patients with severe local effects. This study is a randomized, double-blind, placebo-controlled trial. ⋯ The plasma venom levels were not different at presentation but lower in the antivenom group 24h after intervention (P = 0.033). These data suggest that intravenous antivenom could accelerate local oedema resolution in humans. However, the degree is not clinically significant, and, therefore, general use is not recommended.