Deinagkistrodon acutus envenomation: a report of three cases.

BACKGROUND: Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. CASE PRESENTATION: Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. CONCLUSION: Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6- to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.

Deinagkistrodon acutus envenomation: a report of three cases

Abstract Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6 to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.

Deinagkistrodon acutus envenomation: a report of three cases

Background Deinagkistrodon acutus envenomation is associated with severe hematological and wound complications but is rarely described. Case presentation Herein, we report three cases of victims bitten by D. acutus and indicate that rapid-onset severe coagulopathy and thrombocytopenia are distinct features of D. acutus snakebite, which are not observed in other crotaline snakebites (i.e., Trimeresurus stejnegeri and Protobothrops mucrosquamatus) in Taiwan. The toxic effects could occur as early as 2 to 3 h following D. acutus envenomation and persist if the administration of specific antivenom is delayed or even not commenced. Based on our findings, 2 to 4 vials of specific antivenom as the first dose should be administered to victims and repeated at 6 to 8 h intervals if coagulopathy or thrombocytopenia persists. Fresh frozen plasma or platelet replacement is probably safe as an adjunct therapy for D. acutus bite in the presence of venom-induced consumptive coagulopathy. Conclusion Severe coagulopathy and thrombocytopenia could occur as early as 2 to 3 h after D. acutus envenomation. The current recommendation for antivenom is 2 to 4 vials as the first dose and repeated every 6- to 8 h if coagulopathy or thrombocytopenia persists. These cases studied may be helpful to first-line medical personnel in the early diagnosis and management of D. acutus envenomation among other crotaline snakebites in Taiwan.(AU)

Development of Screen-Printed Texture-Barrier Paste for Single-Side Texturization of Interdigitated Back-Contact Silicon Solar Cell Applications.

Continuous cost reduction of silicon-based solar cells is needed to lower the process time and increase efficiency. To achieve lower costs, screen-printed texture-barrier (SPTB) paste was first developed for single-side texturization (ST) of the interdigitated back-contact (IBC) for silicon-based solar cell applications. The SPTB paste was screen-printed on silicon substrates. The SPTB paste was synthesized from intermixed silicate glass (75 wt %), a resin binder (ethyl cellulose ethoce: 20 wt %), and a dispersing agent (fatty acid: 5 wt %). The silicate glass is a necessity for contact formation during firing. A resin binder and a dispersing agent determine the rheology of the SPTB paste. In this work, by modulating various parameters, including post SPTB firing, alkali texturing, and removal of the SPTB, the ST of IBC silicon solar cells was achieved. Since the advantages of the SPTB paste include low toxicity and prompt formation of the texture-barrier, SPTB is potentially suited for simple fabrication at low-cost for solar cell applications. The cost of the SPTB is around $100/kg which is lower than the SiH4/NH3 gas ambient used in plasma-enhanced chemical vapor deposition (PECVD). Thus, the expensive Si3N4 film deposited by PECVD using SiH4 and NH3 gas ambient for silicon solar cells can be replaced by this SPTB.