Charles J. Gerardo

Journal Article Toxicon · August 28, 2024 We investigated the hemotoxic effects of three North American pit vipers in healthy human donor blood. Using experiments focusing on platelet and red blood cell activity, we found differential effects of these venoms on these cellular components. Platelet ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Seizures: Approved by the ACEP Board of Directors, April 17, 2024.

Journal Article Ann Emerg Med · July 2024 Full text Link to item Cite

Capacity of community health centers to treat snakebite envenoming in indigenous territories of the Brazilian Amazon.

Journal Article Toxicon · April 2024 INTRODUCTION: The deaths from and morbidities associated with snakebites - amputations, loss of function in the limb, visible scarring or tissue damage - have a vast economic, social, and psychological impact on indigenous communities in the Brazilian Amaz ... Full text Link to item Cite

Scaling up antivenom for snakebite envenoming in the Brazilian Amazon: a cost-effectiveness analysis.

Journal Article Lancet Reg Health Am · January 2024 BACKGROUND: Snakebite envenoming (SBE) affects nearly three million people yearly, causing up to 180,000 deaths and 400,000 cases of permanent disability. Brazil's state of Amazonas is a global hotspot for SBE, with one of the highest annual incidence rate ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Evaluation and Management of Adult Out-of-Hospital or Emergency Department Patients Presenting With Severe Agitation: Approved by the ACEP Board of Directors, October 6, 2023.

Journal Article Ann Emerg Med · January 2024 Full text Link to item Cite

Development and validation of a minimum requirements checklist for snakebite envenoming treatment in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · January 2024 BACKGROUND: Currently, antivenoms are the only specific treatment available for snakebite envenoming. In Brazil, over 30% of patients cannot access antivenom within its critical care window. Researchers have therefore proposed decentralizing to community h ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Acute Ischemic Stroke.

Journal Article Ann Emerg Med · August 2023 Full text Link to item Cite

Clinical Policy: Critical Issues in the Evaluation and Management of Emergency Department Patients With Suspected Appendicitis: Approved by ACEP Board of Directors February 1, 2023.

Journal Article Ann Emerg Med · June 2023 Full text Link to item Cite

Antivenom access impacts severity of Brazilian snakebite envenoming: A geographic information system analysis.

Journal Article PLoS Negl Trop Dis · June 2023 BACKGROUND: Snakebite envenoming (SBE) is a neglected tropical disease capable of causing both significant disability and death. The burden of SBE is especially high in low- and middle-income countries. The aim of this study was to perform a geospatial ana ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Mild Traumatic Brain Injury: Approved by ACEP Board of Directors, February 1, 2023 Clinical Policy Endorsed by the Emergency Nurses Association (April 5, 2023).

Journal Article Ann Emerg Med · May 2023 This 2023 Clinical Policy from the American College of Emergency Physicians is an update of the 2008 “Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting.” A writing subcommittee conducted a systematic ... Full text Link to item Cite

River dataset as a potential fluvial transportation network for healthcare access in the Amazon region.

Journal Article Sci Data · April 6, 2023 Remote areas, such as the Amazon Forest, face unique geographical challenges of transportation-based access to health services. As transportation to healthcare in most of the Amazon Forest is only possible by rivers routes, any travel time and travel dista ... Full text Link to item Cite

"Two Cultures in Favor of a Dying Patient": Experiences of Health Care Professionals Providing Snakebite Care to Indigenous Peoples in the Brazilian Amazon.

Journal Article Toxins (Basel) · March 3, 2023 In the Brazilian Amazon, deaths and disabilities from snakebite envenomations (SBEs) are a major and neglected problem for the indigenous population. However, minimal research has been conducted on how indigenous peoples access and utilize the health syste ... Full text Link to item Cite

Perspectives on snakebite envenoming care needs across different sociocultural contexts and health systems: A comparative qualitative analysis among US and Brazilian health providers.

Journal Article Toxicon X · March 2023 With the advancements in therapeutics and available treatment options, almost all deaths and permanent disabilities from snakebite envenoming (SBE) are preventable. The challenge lies in implementing these evidence-based treatments and practices across dif ... Full text Link to item Cite

Snakebite envenoming in Brazilian children: clinical aspects, management and outcomes.

Journal Article J Trop Pediatr · February 6, 2023 Snakebite envenoming is currently considered a neglected tropical disease, which affects over 5 million people worldwide, and causes almost 150 000 deaths every year, as well as severe injuries, amputations and other sequelae. Snakebite envenoming in child ... Full text Link to item Cite

A global core outcome measurement set for snakebite clinical trials.

Journal Article Lancet Glob Health · February 2023 Snakebite clinical trials have often used heterogeneous outcome measures and there is an urgent need for standardisation. A globally representative group of key stakeholders came together to reach consensus on a globally relevant set of core outcome measur ... Full text Link to item Cite

The BRAVO Clinical Study Protocol: Oral Varespladib for Inhibition of Secretory Phospholipase A2 in the Treatment of Snakebite Envenoming.

Journal Article Toxins (Basel) · December 28, 2022 INTRODUCTION: Snakebite is an urgent, unmet global medical need causing significant morbidity and mortality worldwide. Varespladib is a potent inhibitor of venom secretory phospholipase A2 (sPLA2) that can be administered orally via its prodrug, varespladi ... Full text Link to item Cite

Mapping of clinical management resources for snakebites and other animal envenomings in the Brazilian Amazon.

Journal Article Toxicon X · December 2022 Snakebite envenomings (SBEs) and other envenomings triggered by venomous animals (VAEs) represent a significant disease burden in Brazil, with 29,152 SBEs reported in 2021 alone with nearly half of those occurring in the remote Brazilian Amazon. In 2021, B ... Full text Link to item Cite

A systematic review and meta-analysis of clinical signs, symptoms, and imaging findings in patients with suspected renal colic.

Journal Article J Am Coll Emerg Physicians Open · December 2022 STUDY OBJECTIVE: The objective of this study was to conduct a systematic review and meta-analysis of the diagnostic accuracy of the clinical signs, symptoms, laboratory investigations, and imaging modalities commonly used in patients with clinically suspec ... Full text Link to item Cite

Pregnancy outcomes after snakebite envenomations: A retrospective cohort in the Brazilian Amazonia.

Journal Article PLoS Negl Trop Dis · December 2022 Snakebite envenomations (SBEs) in pregnant women can result in adverse maternal or neonatal effects, such as abortion, placental abruption, preterm labor, fetal malformations, and maternal, fetal or neonatal deaths. Despite the high incidence of SBEs in th ... Full text Link to item Cite

Delayed Recognition of Severe Systemic Envenomation after Copperhead Bite: A Case Report.

Journal Article Clin Pract Cases Emerg Med · August 2022 INTRODUCTION: We report a case of severe systemic copperhead, Agkistrodon contortrix, envenomation that resulted in long-term sequelae. CASE REPORT: A 72-year-old man presented to the emergency department after suffering a copperhead snakebite. He develope ... Full text Link to item Cite

Antivenom Does Not Cause Snakebite Complications, Withholding It Does.

Journal Article Am Surg · June 2022 We read with interest the retrospective chart review "Crotalidae Polyvalent Immune Fab and Cost-Effective Management of Hospital Admission for Snakebites" by Bowden, et al. The efficacy of US snake antivenoms has been well established for decades. A random ... Full text Link to item Cite

Validation of a Culturally Relevant Snakebite Envenomation Clinical Practice Guideline in Brazil.

Journal Article Toxins (Basel) · May 28, 2022 Snakebite envenoming (SBE) is a neglected tropical disease with significant global morbidity and mortality. Even when antivenom is available in low-resource areas, health workers do not receive adequate training to manage SBEs. This study aims to develop a ... Full text Link to item Cite

Control of venom-induced tissue injury in copperhead snakebite patients: a post hoc sub-group analysis of a clinical trial comparing F(ab')2 to Fab antivenom.

Journal Article Clin Toxicol (Phila) · April 2022 INTRODUCTION: Fab antivenom (FabAV) halts progression of tissue injury and improves recovery in copperhead snakebite. It is unknown if F(ab')2AV does as well. The objective of this study was to compare control of tissue injury in copperhead snakebite patie ... Full text Link to item Cite

Patient-level interventions to reduce alcohol-related harms in low- and middle-income countries: A systematic review and meta-summary.

Journal Article PLoS Med · April 2022 BACKGROUND: Disease and disability from alcohol use disproportionately impact people in low- and middle-income countries (LMICs). While varied interventions have been shown to reduce alcohol use in high-income countries, their efficacy in LMICs has not bee ... Full text Link to item Cite

BITES study: A qualitative analysis among emergency medicine physicians on snake envenomation management practices.

Journal Article PLoS One · 2022 INTRODUCTION: Antivenom is currently considered standard treatment across the full spectrum of severity for snake envenomation in the United States. Although safe and effective antivenoms exist, their use in clinical practice is not universal. OBJECTIVE: T ... Full text Link to item Cite

Contextualizing the Impact of Snakebite Envenoming on Patients: A Qualitative Content Analysis of Patient-Specific Functional Scale Activities Using the International Classification of Functioning, Disability and Health.

Journal Article Int J Environ Res Public Health · September 12, 2021 To categorize the Patient-specific Functional Scale (PSFS) activities in snakebite envenoming (SBE) using the International Classification of Function (ICF) model in order to describe the impact of SBE on patients' activities and daily lives and to develop ... Full text Link to item Cite

Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia

Journal Article Annals of Emergency Medicine · January 1, 2021 This clinical policy from the American College of Emergency Physicians is a revision of the 2009 “Clinical Policy: Critical Issues in the Management of Adult Patients Presenting to the Emergency Department With Community-Acquired Pneumonia.” A writing subc ... Full text Cite

Association of a Network of Immunologic Response and Clinical Features With the Functional Recovery From Crotalinae Snakebite Envenoming.

Journal Article Front Immunol · 2021 BACKGROUND: The immunologic pathways activated during snakebite envenoming (SBE) are poorly described, and their association with recovery is unclear. The immunologic response in SBE could inform a prognostic model to predict recovery. The purpose of this ... Full text Open Access Link to item Cite

A SYSTEMATIC REVIEW OF CLINICAL SIGNS AND SYMPTOMS, PREDICTION RULES AND IMAGING MODALITIES IN PATIENTS WITH SUSPECTED RENAL COLIC

Conference JOURNAL OF UROLOGY · 2021 Cite

Alcohol stigma as it relates to drinking behaviors and perceptions of drink drivers: A mixed method study in Moshi, Tanzania.

Journal Article Alcohol · November 2020 BACKGROUND: Alcohol is a leading risk factor for road traffic injury in low- and middle-income countries, such as Tanzania. This research seeks to explore the drinking patterns, perceptions, and stigma of drink driving behavior of injury patients at Kilima ... Full text Link to item Cite

Clinical Policy: Critical Issues Related to Opioids in Adult Patients Presenting to the Emergency Department

Journal Article Annals of Emergency Medicine · September 1, 2020 This clinical policy from the American College of Emergency Physicians addresses key issues in opioid management in adult patients presenting to the emergency department. A writing subcommittee conducted a systematic review of the literature to derive evid ... Full text Cite

Testing for HIV infection in the emergency departments of 2 hospitals in the Southeastern United States

Journal Article JACEP Open · August 1, 2020 Background: In 2006, the Centers for Disease Control and Prevention (CDC) recommended non-targeted, opt-out HIV screening in all healthcare settings, including emergency departments (EDs). Multiple HIV testing programs have been implemented in EDs across t ... Full text Cite

Need for better evidences and methodological aspects of clinical trials in snakebites.

Journal Article Toxicon · April 20, 2020 Full text Link to item Cite

In reply to Dr. Shah and Dr. Beuhler.

Journal Article Clin Toxicol (Phila) · March 2020 Full text Link to item Cite

Patterns of Emergency Care for Possible Acute Coronary Syndrome Among Patients with Chest Pain or Shortness of Breath at a Tanzanian Referral Hospital.

Journal Article Glob Heart · February 6, 2020 BACKGROUND: Acute coronary syndrome (ACS) is thought to be a rare diagnosis in sub-Saharan Africa, but little is known about diagnostic practices for patients with possible ACS symptoms in the region. OBJECTIVE: To describe current care practices for patie ... Full text Open Access Link to item Cite

Recovery from Copperhead Snake Envenomation: Role of Age, Sex, Bite Location, Severity, and Treatment.

Conference J Med Toxicol · January 2020 INTRODUCTION: Few data exist to understand the recovery phase of pit viper envenomation. A recently published placebo-controlled clinical trial affords this opportunity. The purpose of this study is to examine the time course of recovery from copperhead sn ... Full text Link to item Cite

Injury patients' perceptions of drink-driving: A qualitative assessment of drink-driving behavior in Moshi, Tanzania.

Journal Article PLoS One · 2020 BACKGROUND: Globally, about 2.3 billion people are current alcohol drinkers, and 283 million have an alcohol use disorder. Alcohol use while driving is a major contributor to road traffic injuries (RTI). We need to understand the culture and perception of ... Full text Link to item Cite