Leslie V Boyer

Interests

Teaching

Toxinology, Immunotherapy Development

Research

Antivenom, Clinical Trials, Snakebite, Scorpion Sting, Venom, Spider Bite, Pharmacokinetics, Toxicokinetics, Pharmacoeconomics

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Barbosa, A. N., Boyer, L., Chippaux, J. P., Medolago, N. B., Caramori, C. A., Paixão, A. G., Poli, J. P., Mendes, M. B., Dos Santos, L. D., Ferreira, R. S., & Barraviera, B. (2017). A clinical trial protocol to treat massive Africanized honeybee (Apis mellifera) attack with a new apilic antivenom. The journal of venomous animals and toxins including tropical diseases, 23, 14.
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  Envenomation caused by multiple stings from Africanized honeybees Apis mellifera constitutes a public health problem in the Americas. In 2015, the Brazilian Ministry of Health reported 13,597 accidents (incidence of seven cases per 100,000 inhabitants) with 39 deaths (lethality of 0.25%). The toxins present in the venom, which include melittin and phospholipase A2, cause lesions in diverse organs and systems that may be fatal. As there has been no specific treatment to date, management has been symptomatic and supportive only.
• Yang, D. C., Dobson, J., Cochran, C., Dashevsky, D., Arbuckle, K., Benard, M., Boyer, L., Alagón, A., Hendrikx, I., Hodgson, W. C., & Fry, B. G. (2017). The Bold and the Beautiful: a Neurotoxicity Comparison of New World Coral Snakes in the Micruroides and Micrurus Genera and Relative Neutralization by Antivenom. Neurotoxicity research, 32(3), 487-495.
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  Coral snake envenomations are well characterized to be lethally neurotoxic. Despite this, few multispecies, neurotoxicity and antivenom efficacy comparisons have been undertaken and only for the Micrurus genus; Micruroides has remained entirely uninvestigated. As the USA's supplier of antivenom has currently stopped production, alternative sources need to be explored. The Mexican manufacturer Bioclon uses species genetically related to USA species, thus we investigated the efficacy against Micrurus fulvius (eastern coral snake), the main species responsible for lethal envenomations in the USA as well as additional species from the Americas. The use of Coralmyn® coral snake antivenom was effective in neutralizing the neurotoxic effects exhibited by the venom of M. fulvius but was ineffective against the venoms of Micrurus tener, Micrurus spixii, Micrurus pyrrhocryptus, and Micruroides euryxanthus. Our results suggest that the Mexican antivenom may be clinically useful for the treatment of M. fulvius in the USA but may be of only limited efficacy against the other species studied.
• Boyer, L. V. (2016). The Reply. The American journal of medicine, 129(6), e31.
• Boyer, L. V., & Ruha, A. M. (2016). Pitviper Envenomation Guidelines Should Address Choice Between FDA-approved Treatments for Cases at Risk of Late Coagulopathy. Wilderness & environmental medicine, 27(2), 341-2.
• Dart, R., Hurlburt, K., & Boyer-Hassen, L. (2016). Lead. I: Dart RC, red. Medical toxicology, 3, 1423--31.
• Nielsen, V. G., & Boyer, L. V. (2016). Iron and carbon monoxide attenuate degradation of plasmatic coagulation by Crotalus atrox venom. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 27(5), 506-10.
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  Hypofibrinogenemia is an important clinical consequence following envenomation by Crotalus species, usually attenuated or prevented by administration of antivenom. It has been determined that iron and carbon monoxide (CO) enhance fibrinogen as a thrombin substrate, likely secondary to conformational changes in molecular structure. We tested the hypothesis that pretreatment of plasma with iron and CO could attenuate the effects of exposure to Crotalus atrox venom. Human plasma was exposed to 0 to 10 μmol/l ferric chloride (iron source) and 0 to 100 μmol/l CO-releasing molecule-2 (CO source) followed by exposure to 0 to 0.5 μg/ml venom for 5 to 20 min. Changes in coagulation kinetics were determined with thrombelastography. Iron and CO significantly attenuated venom-mediated degradation of plasmatic coagulation in terms of onset time, velocity of clot growth and final clot strength. Further preclinical investigation of iron and CO administration as a 'bridge-to-antivenom' to preserve plasmatic coagulation is justified.
• Nielsen, V. G., Boyer, L. V., Matika, R. W., Amos, Q., & Redford, D. T. (2016). Iron and carbon monoxide attenuate Crotalus atrox venom-enhanced tissue-type plasminogen activator-initiated fibrinolysis. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis, 27(5), 511-6.
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  In addition to degrading fibrinogen as a source of consumptive coagulopathy, rattlesnake venom has also been demonstrated to enhance fibrinolysis and degrade alpha-2-antiplasmin. The goals of this investigation was to characterize the kinetic fibrinolytic profile of Crotalus atrox venom in the absence and presence of tissue-type plasminogen activator (tPA), and to also ascertain if iron and carbon monoxide (CO, a positive modulator of alpha-2-antiplasmin) could attenuate venom-enhanced fibrinolysis. Utilizing thrombelastographic methods, the coagulation and fibrinolytic kinetic profiles of human plasma exposed to C. atrox venom (0-2 μg/ml) were determined in the absence or presence of tPA (0-100 IU/ml). Then, either separately or in combination, plasma was exposed to iron (ferric chloride, 10 μmol/l) or CO (carbon monoxide-releasing molecule-2, 100 μmol/l) prior to incubation with venom; the plasma sample was subsequently subjected to thrombelastographic analysis with addition of tPA. Venom exposure in the absence of tPA did not result in detectable fibrinolysis. In the presence of tPA, venom markedly enhanced fibrinolysis. Iron and CO, markedly attenuated venom enhancement of fibrinolysis. C. atrox venom enhances tPA-mediated fibrinolysis, and interventions that enhance/protect alpha-2-antiplasmin activity significantly attenuate venom-enhanced fibrinolysis. Future preclinical investigation is required to determine if iron and CO can attenuate venom-mediated degradation of alpha-2-antiplasmin-dependent fibrinolytic resistance.
• Nielsen, V. G., Boyer, L. V., Redford, D. T., & Ford, P. (2016). Thrombelastographic characterization of the thrombin-like activity of Crotalus simus and Bothrops asper venoms. Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis.
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  Annually, thousands suffer venomous snake-bite from Crotalus simus and Bothrops asper vipers in central and South America. The goals of the present study were to generally characterize the thrombin-like effects of venom from these snakes in human plasma with viscoelastic methods. Human plasma was exposed to the venom of three different C. simus subspecies and venoms obtained from B. asper vipers located in three different locations in Mexico. To characterize the factor X-activating and thrombin-like activity of these venoms, plasma (normal or factor XIII deficient) was pretreated with a variety of additives (e.g., heparin) in the absence or presence of calcium prior to exposure to 2.0 μg/ml of each viper's venom. These profiles were compared with plasma without venom that had contact activation of coagulation. Coagulation kinetics were determined with thrombelastography. All venoms had thrombin-like activity, with C. s. simus creating a slow growing, weak clot that was likely mediated by metalloproteinases. In contrast, B. asper venoms had rapid onset of coagulation and a high velocity of thrombus growth. Further, B. asper venom activity was calcium-independent, activated prothrombin, activated factor XIII, and independently polymerized fibrinogen. The viscoelastic methods used were able to differentiate subspecies of C. simus and specimens of B. asper, and provide insight into the mechanisms by which the venoms acted on plasma. These methods may be useful in the profiling of similar venoms and perhaps can assist in the assessment of interventions designed to treat envenomation (e.g., antivenom).
• Vergara, I., Castillo, E. Y., Romero-Piña, M. E., Torres-Viquez, I., Paniagua, D., Boyer, L. V., Alagón, A., & Medina, L. A. (2016). Biodistribution and Lymphatic Tracking of the Main Neurotoxin of Micrurus fulvius Venom by Molecular Imaging. Toxins, 8(4), 85.
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  The venom of the Eastern coral snake Micrurus fulvius can cause respiratory paralysis in the bitten patient, which is attributable to β-neurotoxins (β-NTx). The aim of this work was to study the biodistribution and lymphatic tracking by molecular imaging of the main β-NTx of M. fulvius venom. β-NTx was bioconjugated with the chelator diethylenetriaminepenta-acetic acid (DTPA) and radiolabeled with the radionuclide Gallium-67. Radiolabeling efficiency was 60%-78%; radiochemical purity ≥92%; and stability at 48 h ≥ 85%. The median lethal dose (LD50) and PLA₂ activity of bioconjugated β-NTx decreased 3 and 2.5 times, respectively, in comparison with native β-NTx. The immune recognition by polyclonal antibodies decreased 10 times. Biodistribution of β-NTx-DTPA-(67)Ga in rats showed increased uptake in popliteal, lumbar nodes and kidneys that was not observed with (67)Ga-free. Accumulation in organs at 24 h was less than 1%, except for kidneys, where the average was 3.7%. The inoculation site works as a depot, since 10% of the initial dose of β-NTx-DTPA-(67)Ga remains there for up to 48 h. This work clearly demonstrates the lymphatic system participation in the biodistribution of β-NTx-DTPA-(67)Ga. Our approach could be applied to analyze the role of the lymphatic system in snakebite for a better understanding of envenoming.
• de Roodt, A. R., Boyer, L. V., Lanari, L. C., Irazu, L., Laskowicz, R. D., Sabattini, P. L., & Damin, C. F. (2016). Venom yield and its relationship with body size and fang separation of pit vipers from Argentina. Toxicon : official journal of the International Society on Toxinology, 121, 22-29.
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  The amount of venom that a snake can inject is related to its body size. The body size is related to head size and to the distance between fangs. To correlate snake body size, distance between fangs and distance between puncture wounds with the venom yield (and consequently with the venom dose potentially injected in a single snakebite), we studied these variables in two species of public health importance in South America, Bothrops (Rhinocerophis) alternatus, and Crotalus durissus terrificus. In all cases a positive correlation was observed between body length, fang separation distance, distance between puncture wounds and venom yield, with a regression coefficient over 0.5 for Bothrops alternatus and over 0.6 for Crotalus durissus terrificus in all cases, being the relation distance between punctures wounds and venom yield of 0.54 and 0.69 respectively. The difference between fang separation and puncture separation was never greater than 30%, with a mean difference around 13%. The strong relationships between body size, fang separation and venom yield may be useful for planning potential venom production in serpentariums. In addition, because puncture mark separation gives an approximate idea of the size of the snake, this provides a rough idea of the size of the snake that produced a bite and the potential amount of venom that could have been injected.
• Benard-Valle, M., Neri-Castro, E., Fry, B., BOYER, L., Cochran, C., Alam, M., Jackson, T., Paniagua, D., Olvera-Rodriguez, F., Koludarov, I., & others, . (2015). Antivenom Research and Development. Venomous Reptiles and Their Toxins: Evolution, Pathophysiology and Biodiscovery, 61.
• Boyer, L. V. (2015). On 1000-Fold Pharmaceutical Price Markups and Why Drugs Cost More in the United States than in Mexico. The American journal of medicine, 128(12), 1265-7.
• Boyer, L. V. (2015). On 1000-Fold Pharmaceutical Price Markups and Why Drugs Cost More in the United States than in Mexico. The American journal of medicine, 128, 1265--1267.
• Boyer, L., Alag{\'o}n, A., Fry, B., Jackson, T., Sunagar, K., & Chippaux, J. (2015). Signs, symptoms, and treatment of envenomation. Venomous Reptiles and Their Toxins: Evolution, Pathophysiology and Biodiscovery, 32.
• Bush, S. P., Ruha, A. M., Seifert, S. A., Morgan, D. L., Lewis, B. J., Arnold, T. C., Clark, R. F., Meggs, W. J., Toschlog, E. A., Borron, S. W., Figge, G. R., Sollee, D. R., Shirazi, F. M., Wolk, R., de Chazal, I., Quan, D., García-Ubbelohde, W., Alagón, A., Gerkin, R. D., & Boyer, L. V. (2015). Comparison of F(ab')2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial. Clinical toxicology (Philadelphia, Pa.), 53(1), 37-45.
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  Crotalidae Polyvalent Immune Fab (Ovine) has been the only antivenom commercially available in the US since 2007 for treatment of Crotalinae envenomation. Late coagulopathy can occur or recur after clearance of Fab antivenom, often after hospital discharge, lasting in some cases more than 2 weeks. There have been serious, even fatal, bleeding complications associated with recurrence phenomena. Frequent follow-up is required, and additional intervention or hospitalization is often necessary. F(ab')2 immunoglobulin derivatives have longer plasma half life than do Fab. We hypothesized that F(ab')2 antivenom would be superior to Fab in the prevention of late coagulopathy following treatment of patients with Crotalinae envenomation.
• Bush, S. P., Ruha, A. M., Seifert, S. A., Sollee, D. R., & Boyer, L. V. (2015). In reply re: "comparison of F(ab')2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial". Clinical toxicology (Philadelphia, Pa.), 53(4), 414-5.
• Bush, S. P., Ruha, A., Seifert, S. A., Morgan, D. L., Lewis, B. J., Arnold, T. C., Clark, R. F., Meggs, W. J., Toschlog, E. A., Borron, S. W., & others, . (2015). Comparison of F (ab’) 2 versus Fab antivenom for pit viper envenomation: a prospective, blinded, multicenter, randomized clinical trial. Clinical Toxicology, 53, 37--45.
• Bush, S. P., Ruha, A., Seifert, S. A., Sollee, D. R., & Boyer, L. V. (2015). In Reply re:“Comparison of F (ab’) 2 versus Fab antivenom for Pit Viper Envenomation: A Prospective, Blinded, Multicenter, Randomized Clinical Trial”. Clinical Toxicology, 53, 414--415.
• B{\'e}nard-Valle, M., Neri-Castro, E., BOYER, L., Jackson, T., Sunagar, K., Clarkson, M., & Fry, B. (2015). Ineffective traditional and modern techniques for the treatment of snakebite. Venomous Reptiles and Their Toxins: Evolution, Pathophysiology and Biodiscovery, 73.
• Chippaux, J. P., Boyer, L. V., & Alagón, A. (2015). Post-exposure treatment of Ebola virus using passive immunotherapy: proposal for a new strategy. The journal of venomous animals and toxins including tropical diseases, 21, 3.
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  Better treatments are urgently needed for the management of Ebola virus epidemics in Equatorial Africa.
• Chippaux, J. P., Massougbodji, A., Diouf, A., Baldé, C. M., & Boyer, L. V. (2015). Snake bites and antivenom shortage in Africa. Lancet (London, England), 386(10010), 2252-3.
• Chippaux, J., Boyer, L. V., & Alag{\'o}n, A. (2015). Post-exposure treatment of Ebola virus using passive immunotherapy: proposal for a new strategy. Journal of Venomous Animals and Toxins including Tropical Diseases, 21, 1.
• Chippaux, J., Massougbodji, A., Diouf, A., Bald{\'e}, C. M., & Boyer, L. V. (2015). Snake bites and antivenom shortage in Africa. The Lancet, 386, 2252--2253.
• FRY, B., HENDRIKX, I., ROWLEY, P., JACKSON, T., VAN DER PLOEG, H., JOHNSON, R., SASA, M., DUNSTAN, N., BARVE, S., LOCK, B., & others, . (2015). MAINTAINING VENOMOUS REPTILE COLLECTIONS. Venomous Reptiles and Their Toxins: Evolution, Pathophysiology and Biodiscovery, 89.
• Nielsen, V. G., & Boyer, L. V. (2015). Iron and carbon monoxide attenuate degradation of plasmatic coagulation by Crotalus atrox venom.. Blood coagulation \& fibrinolysis: an international journal in haemostasis and thrombosis.
• Nielsen, V. G., Boyer, L. V., Matika, R. W., Amos, Q., & Redford, D. T. (2015). Iron and carbon monoxide attenuate Crotalus atrox venom-enhanced tissue-type plasminogen activator-initiated fibrinolysis.. Blood coagulation \& fibrinolysis: an international journal in haemostasis and thrombosis.
• Paniaguaa, D., Vergaraa, I., Boyerb, L., Alag{\'o}na, A., & M{\'e}xico, C. (2015). Role of Lymphatic System on Snake Venom Absorption.
• Aaron, C., Abdel-Rahman, M. S., Abdollahi, M., Abouqal, R., Agarwal, R., Aks, D. S., Alarcon, W. A., Albertson, T., Algren, D. A., Ali, F., & others, . (2014). Reviewer Thank You. J. Med. Toxicol, 10, 118--121.
• De Roodt, A., Clement, H., Dolab, J., Litwin, S., Hajos, S., Boyer, L., & Alag{\'o}n, A. (2014). Protein content of antivenoms and relationship with their immunochemical reactivity and neutralization assays. Clinical Toxicology, 52, 594--603.
• Lanari, L. C., Alagón, A., Olvera, A., Costa de Oliveira, V., Laskowicz, R. D., Boyer, L., Lago, N. R., Alejandro, A., & de Roodt, A. R. (2014). Intraspecific differences in the immunochemical reactivity and neutralization of venom from Argentinean Bothrops (Rhinocerophis) alternatus by specific experimental antivenoms. Toxicon : official journal of the International Society on Toxinology, 85, 31-45.
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  The venoms of Bothrops (Rhinocerophis) alternatus (B.a.) from different regions of Argentina have shown biochemical, toxicological and immunological variations. Considering these variations, we produced nine experimental antisera (rabbit, IgG) against venoms from snakes of nine different regions and a pool of venom, comprised of equal amounts of venoms from each region. The immunologic studies (ELISA, Westernblot) showed significant cross reactivity among all regional antivenoms with all regional venoms, with no significant differences regarding the specificity of the immunogens used for the production of antivenom. Neutralization of hemorrhage was variable (although all the antivenoms neutralized this activity in all venoms) and the neutralization of coagulant and phospholipase activities were evident in all cases. Some antivenoms neutralized toxic activities that were absent or very low in the venoms used as immunogen, on other non-homologous venoms (e.g. thrombin like activity). Despite the different toxic potencies of regional venoms, antivenoms developed using venoms of snakes from a particular region showed high immunochemical reactivity and cross-neutralizing capacity on snake venoms from different and distant regions, in occasions over those of the homologous antivenoms. These findings could be used to improve the generation of pools of venoms for the production of antivenoms.
• Lanari, L. C., Olvera, A., Oliveira, V. C., Laskowicz, R. D., Boyer, L., Lago, N. R., Alag{\'o}n, A., & De Roodt, A. R. (2014). Corrigendum to “Intraspecific differences in the immunochemical reactivity and neutralization of venom from Argentinean Bothrops (Rhinocerophis) alternatus by specific experimental antivenoms”[Toxicon 85 (2014) 31e45]. Toxicon, 88, 138.
• Lanari, L. C., Olvera, A., Oliveira, V., Laskowicz, R. D., Boyer, L., Lago, N. R., Alejandro, A., & Roodt, A. R. (2014). Intraspecific differences in the immunochemical reactivity and neutralization of venom from Argentinean Bothrops (Rhinocerophis) alternatus by specific experimental antivenoms. Toxicon, 85, 31--45.
• Warrick, B. J., Boyer, L. V., & Seifert, S. A. (2014). Non-native (exotic) snake envenomations in the U.S., 2005-2011. Toxins, 6(10), 2899-911.
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  Non-native (exotic) snakes are a problematic source of envenomation worldwide. This manuscript describes the current demographics, outcomes and challenges of non-native snakebites in the United States (U.S.). We performed a retrospective case series of the National Poison Data System (NPDS) database between 2005 and 2011. There were 258 human exposures involving at least 61 unique exotic venomous species (average = 37 per year; range = 33-40). Males comprised 79% and females 21%. The average age was 33 years with 16% less than 20 years old. 70% of bites occurred in a private residence and 86% were treated at a healthcare facility. 35% of cases received antivenom and 10% were given antibiotics. This study is compared to our previous study (1994-2004) in which there was a substantial coding error rate. Software modifications significantly reduced coding errors. Identification and acquisition of appropriate antivenoms pose a number of logistical difficulties in the management of these envenomations. In the U.S., poison centers have valuable systems and clinical roles in the provision of expert consultation and in the management of these cases.
• Warrick, B. J., Boyer, L. V., & Seifert, S. A. (2014). Non-native (exotic) snake envenomations in the US, 2005--2011. Toxins, 6, 2899--2911.
• Armstrong, E. P., Bakall, M., Skrepnek, G. H., & Boyer, L. V. (2013). Is scorpion antivenom cost-effective as marketed in the United States?. Toxicon : official journal of the International Society on Toxinology, 76, 394-8.
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  The purpose of this study was to analyze the cost-effectiveness of scorpion antivenom compared to no antivenom, in the United States, using a decision analysis framework.
• Armstrong, E. P., Bakall, M., Skrepnek, G. H., & Boyer, L. V. (2013). Is scorpion antivenom cost-effective as marketed in the United States?. Toxicon, 76, 394--398.
• Boyer, L. (2013). Editorial: scorpion venom and antivenom. Toxicon : official journal of the International Society on Toxinology, 76, 327.
• Boyer, L. (2013). History of scorpion antivenom: one Arizonan's view. Toxicon : official journal of the International Society on Toxinology, 69, 14-20.
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  This paper was originally presented as the Elsevier Lecture in July, 2012 at the International Society on Toxinology/Venom Week combined meeting in Honolulu, Hawaii. In it, the author addresses the ancient history of venom and immunity, from the Silurian Era to the 1890s; the development of the first antivenoms; the impact of shifting political and economic pressures; the special case of Arizona; the relative stability of the 1960s through 1990s; the transition to regulatory compliance that took place at the time of the author's own research; and concluding thoughts regarding the instability of apparent success.
• Boyer, L. (2013). History of scorpion antivenom: one Arizonan's view. Toxicon, 69, 14--20.
• Boyer, L. V., Chase, P. B., Degan, J. A., Figge, G., Buelna-Romero, A., Luchetti, C., & Alag{\'o}n, A. (2013). Subacute coagulopathy in a randomized, comparative trial of Fab and F (ab′) 2 antivenoms. Toxicon, 74, 101--108.
• Boyer, L. V., Chase, P. B., Degan, J. A., Figge, G., Buelna-Romero, A., Luchetti, C., & Alagón, A. (2013). Subacute coagulopathy in a randomized, comparative trial of Fab and F(ab')2 antivenoms. Toxicon : official journal of the International Society on Toxinology, 74, 101-8.
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  Envenomation by pit vipers is associated with coagulation disorders including hypofibrinogenemia and thrombocytopenia. These abnormalities correct following antivenom treatment during the acute phase of the disease. Delayed or recurrent coagulation abnormalities have been reported following use of Fab antivenom, resulting in risk of hemorrhage or death.
• Boyer, L., Degan, J., Ruha, A. M., Mallie, J., Mangin, E., & Alagón, A. (2013). Safety of intravenous equine F(ab')2: insights following clinical trials involving 1534 recipients of scorpion antivenom. Toxicon : official journal of the International Society on Toxinology, 76, 386-93.
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  The technology of antivenom production has gradually changed since the earliest production of antisera around the turn of the 20th century. Use of early antisera was associated with frequent acute adverse reactions and serum sickness. New F(ab')2 products, manufactured using pepsin degradation of immunoglobulin together with precipitation of unwanted protein and albumin serum fractions, should in concept cause fewer immune reactions in clinical use.
• Boyer, L., Degan, J., Ruha, A., Mallie, J., Mangin, E., & Alag{\'o}n, A. (2013). Safety of intravenous equine F (ab')2: Insights following clinical trials involving 1534 recipients of scorpion antivenom. Toxicon, 76, 386--393.
• Boyer, L., Theodorou, A., Chase, P., Osnaya, N., Berg, M., Mallie, J., Carbajal, Y., Jesus-Hernandez, T., Olvera, F., & Alag{\'o}n, A. (2013). Effectiveness of Centruroides scorpion antivenom compared to historical controls. Toxicon, 76, 377--385.
• Dye, L. (2013). Reviewer Thank You. Journal of medical toxicology, 9, 119.
• Boyer, L., Ruha, M., Degan, J., Mallie, J., & Alag{\'o}n, A. (2012). 185. Safety of Equine F (ab’) 2 Antivenom for Scorpion Envenomation: Results of Prospective Clinical Trials. Toxicon, 60, 190--191.
• Mallie, J. M., Hoopmann, S., Degan, J. A., & Boyer, L. V. (2012). 182. Two Case Studies of Pregnancy Outcomes after Scorpion Envenomation and F (ab') 2 Scorpion Antivenom Treatment. Toxicon, 60, 189.
• McGonigle, A., Jimenez, E., & Boyer, L. V. (2012). Toxicology Summit \& Expo. Toxicology, 2012.
• Paniagua, D., Jim{\'e}nez, L., Romero, C., Vergara, I., Calder{\'o}n, A., Benard, M., Bernas, M., Rilo, H., Roodt, A., D’Suze, G., & others, . (2012). Lymphatic route of transport and pharmacokinetics of Micrurus. Fulvius.(Coral Snake) Venom in Sheep. Lymphology, 45, 144--153.
• Paniagua, D., Jim{\'e}nez, L., Romero, C., Vergara, I., Calder{\'o}n, A., Benard, M., Bernas, M., Sevcik, C., Witte, M., Boyer, L., & others, . (2012). 149. The Role of the Lymphatic System in the Absorption of Micrurus fulvius Venom. Toxicon, 60, 171.
• Soulaymani-Bencheikh, R., Mangin, E. F., Khattabi, A., Fellows, Z. T., & Boyer, L. V. (2012). 181. Evaluation of a Four-Hour Endpoint for Use in Scorpion Envenomation Studies in Morocco. Toxicon, 60, 188--189.
• Aaron, C., Abdel-Rahman, M. S., Abdollahi, M., Abouqal, R., Adirim, T., Agarwal, R., Aks, S. E., Alarcon, W. A., Albertson, T., Algren, D. A., & others, . (2011). Journal of Medical Toxicology Reviewers. J. Med. Toxicol, 7, 1--3.
• Boyer, L. (2010). International Immunopharmacology. Editorial. International immunopharmacology, 10(11), 1317.
• Boyer, L. (2010). International Immunopharmacology. Editorial.. International immunopharmacology, 10, 1317--1317.
• Chippaux, J. P., & Boyer, L. (2010). The 3 + 3 dose escalation design is not appropriate for antivenom dose finding. Toxicon : official journal of the International Society on Toxinology, 55(7), 1408-9; author reply 1410-1.
• Chippaux, J., & Boyer, L. (2010). The 3+ 3 dose escalation design is not appropriate for antivenom dose finding. Toxicon, 55, 1408--1409.
• Hiller, K., Jarrod, M. M., Franke, H. A., Degan, J., Boyer, L. V., & Fox, F. M. (2010). Scorpion antivenom administered by alternative infusions. Annals of emergency medicine, 56(3), 309-10.
• Hiller, K., Jarrod, M. M., Franke, H. A., Degan, J., Boyer, L. V., & Fox, F. M. (2010). Scorpion antivenom administered by alternative infusions. Annals of emergency medicine, 56, 309--310.
• Boyer, L. V., Theodorou, A. A., Berg, R. A., Mallie, J., Ch{\'a}vez-M{\'e}ndez, A., Garc{\'\i}a-Ubbelohde, W., Hardiman, S., & Alag{\'o}n, A. (2009). Antivenom for critically ill children with neurotoxicity from scorpion stings. New England Journal of Medicine, 360, 2090--2098.
• Chase, P., Boyer-Hassen, L., Mcnally, J., Vazquez, H., Theodorou, A. A., Walter, F. G., & Alagon, A. (2009). Serum levels and urine detection of Centruroides sculpturatus venom in significantly envenomated patients. Clinical Toxicology, 47, 24--28.
• Seifert, S. A., Boyer, L. V., Benson, B. E., & Rogers, J. J. (2009). AAPCC database characterization of native U.S. venomous snake exposures, 2001-2005. Clinical toxicology (Philadelphia, Pa.), 47(4), 327-35.
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  Differences in victim demographics, clinical effects, managements, and outcomes among native viperid (rattlesnake, copperhead, and cottonmouth) and elapid (coral snake) species have not been systematically characterized.
• Seifert, S. A., Boyer, L. V., Benson, B. E., & Rogers, J. J. (2009). AAPCC database characterization of native US venomous snake exposures, 2001--2005. Clinical toxicology, 47, 327--335.
• Boyer, L. (2008). Venom week. Journal of Medical Toxicology, 4, 43.
• Hodges, Z., Lambert, Z., Nguyen, M., Armstrong, E., McNally, J., & Boyer, L. (2008). Scorpion envenomations in southern Arizona: a costing study of scorpion stings. Journal of Medical Toxicology, 4, 43--45.
• McNally, J., Boesen, K., & Boyer, L. (2008). Toxicologic information resources for reptile envenomations. Veterinary Clinics of North America: Exotic Animal Practice, 11, 389--401.
• Pearson, E., Esparza, L., Mallie, J., & Boyer, L. (2008). Case Report: vomiting requiring prolonged hospitalization after centruroides sculpturatus envenomation treated with Anascorp [R]. Journal of Medical Toxicology, 4, 44--45.
• Pozarowski, K., Wenger, A., Kanavage, A., McNalley, J., Boyer, L., & Osterhout, J. (2008). High performance liquid chromatography (HPLC) and differential in-gel electrophoresis (DIGE) analysis of snake venoms. Journal of Medical Toxicology, 4, 60--61.
• Seifert, S. A., Oakes, J. A., & Boyer, L. V. (2007). Toxic Exposure Surveillance System (TESS)-based characterization of US non-native venomous snake exposures, 1995--2004. Clinical toxicology, 45, 571--578.
• Audi, J., Seifert, S., Gennaro, J., Skimming, J., Van Mierop, L. H., Kitchens, C., Cardwell, M., Bush, S., Clark, R., Dugan, E., & others, . (2006). From “Snakebites in the new millennium: A state-of-the-art symposium”. Journal of Medical Toxicology, 2, 29--45.
• Kanavage, A. D., Boyer, L. V., McNally, J., & Osterhout, J. J. (2006). Resistance of antivenom proteins to foaming-induced denaturation. Toxicon, 47, 445--452.
• Odegaard, N., Smith, D. R., Boyer, L. V., & Anderson, J. (2006). Use of handheld XRF for the study of pesticide residues on museum objects. Investigation of Solid Phase Microextraction Sampling for Organic Pesticide Residues on Museum Collections Mark Ormsby, Jessica S. Johnson, Susan Heald, Lauren Chang, and Jennifer Bosworth 1 Testing Cultural Material for Arsenic and Interpreting the Results: A Case Study at Carnegie Museum of Natural History Barbara Hamann 13, 20, 42--48.
• Seifert, S., Boyer, L., Bronstein, A., Jacobitz, K., McNally, J., & Meza, J. (2005). Poison center medical error detection, characterization, and reduction. Journal of Toxicology: Clinical Toxicology, 43, 686.
• Seifert, S., Boyer, L., Bronstein, A., Jacobitz, K., McNally, J., & Meza, J. (2005). Reduction of medical error by introduction of a new clinical management protocol in a poison center. Journal of Toxicology: Clinical Toxicology, 43, 767--768.
• Bayona, J. M. (2004). Publishing models and article dates explained. International Journal of Environmental Analytical Chemistry, 84.
• Boyer Hassen, L. (2004). Scorpion envenomation. Medical Toxicology. 3rd ed. Philadwelphia: Lippincott Williams \& Wilkins, p1603--4.
• Boyer, L. V. (2004). Richard Felger. SONORAN HERPETOLOGIST, 17, 13.
• Valdez-Cruz, N. A., D{\'a}vila, S., Licea, A., Corona, M., Zamudio, F. Z., Garc{\'\i}a-Valdes, J., Boyer, L., & Possani, L. D. (2004). Biochemical, genetic and physiological characterization of venom components from two species of scorpions: Centruroides exilicauda Wood and Centruroides sculpturatus Ewing. Biochimie, 86, 387--396.
• Odegaard, N., Boyer, L., Huber, M. J., Kaplan, L., Kunioka, C., Moreno, T., Podsiki, C., Sadongei, A., Smith, D. R., & Zimmt, W. (2003). New ideas for testing, documentation, and storage of objects previously treated with pesticides. Proceedings of the Object Group Session, June 8, 2003, 31st Annual Meeting, Arlington VA, 10, 33--42.
• Seifert, S., Boyer, L., Bronstein, A., Jacobitz, K., & McNally, J. (2003). Poison center medical error detection and prevention. Journal of Toxicology: Clinical Toxicology, 41, 685--686.
• Wallace, S. (2002). The antidote Uncoiling myths surrounding venomous bites. AAP News, 21, 13--13.
• Boyer, L. V., Seifert, S. A., & Cain, J. S. (2001). Recurrence phenomena after immunoglobulin therapy for snake envenomations: Part 2. Guidelines for clinical management with crotaline Fab antivenom. Annals of emergency medicine, 37, 196--201.
• Boyer, L., & McNally, J. (2001). History of Scorpion Sting Treatment in North America and Rationale for the Use in the United States of a Mexican Scorpion-Derived Antivenom. Journal of Venomous Animals and Toxins, 7, 323--323.
• Boyer, L., Heubner, K., McNally, J., & Buchanan, J. (2001). Death from Centruroides scorpion sting allergy. J. Toxicol. Clin. Toxicol, 39, 561--562.
• Boyer, L., McNally, J., Binford, G., Auerbach, P., & others, . (2001). Spider bites.. Wilderness medicine, 807--838.
• Dart, R. C., Seifert, S. A., Boyer, L. V., Clark, R. F., Hall, E., McKinney, P., McNally, J., Kitchens, C. S., Curry, S. C., Bogdan, G. M., & others, . (2001). A randomized multicenter trial of crotalinae polyvalent immune Fab (ovine) antivenom for the treatment for crotaline snakebite in the United States. Archives of internal medicine, 161, 2030--2036.
• Dart, R. C., Seifert, S. A., Boyer, L. V., Clark, R. F., Hall, E., McKinney, P., McNally, J., Kitchens, C. S., Curry, S. C., Bogdan, G. M., & others, . (2001). ORIGINAL INVESTIGATIONS-A Randomized Multicenter Trial of Crotalinae Polyvalent Immune Fab (Ovine) Antivenom for the Treatment for Crotaline Snakebite in the United States. Archives of Internal Medicine, 161, 2030--2036.
• Seifert, S. A., & Boyer, L. V. (2001). Recurrence phenomena after immunoglobulin therapy for snake envenomations: Part 1. Pharmacokinetics and pharmacodynamics of immunoglobulin antivenoms and related antibodies. Annals of emergency medicine, 37, 189--195.
• McRill, C., Boyer, L. V., Flood, T. J., & Ortega, L. (2000). Mercury toxicity due to use of a cosmetic cream. Journal of occupational and environmental medicine, 42, 4.
• Seifert, S. A., Boyer, L. V., Odegaard, N., Smith, D. R., & Dongoske, K. E. (2000). Arsenic contamination of museum artifacts repatriated to a Native American tribe. JAMA, 283, 2658--2659.
• Boyer, L. V., Seifert, S. A., Clark, R. F., McNally, J. T., Williams, S. R., Nordt, S. P., Walter, F. G., & Dart, R. C. (1999). Recurrent and persistent coagulopathy following pit viper envenomation. Archives of internal medicine, 159, 706--710.
• Davis, A., Fields, A., Hill, C., Hanzlick, R., Fagan, T. C., Hunt, R. H., Attia, J., Margetts, P., Guyatt, G., Mann, S. J., & others, . (1999). American Medical Association. ARCH INTERN MED, 159, 636.
• Flood, T., McRill, C., Boyer, L., Ortega, L., & Roe, D. (1998). CLINICAL INVESTIGATION OF MERCURY TOXICITY DUE TO USE OF A BEAUTY CREAM. Journal of Occupational and Environmental Medicine, 40, 1031.
• Grant, K. L., Boyer, L. V., & Erdman, B. E. (1998). Chaparral-induced hepatotoxicity. Integrative Medicine, 1, 83--87.
• Bey, T. A., Boyer, L. V., Walter, F. G., McNally, J., & Desai, H. (1997). Exotic snakebite: envenomation by an African puff adder (Bitis arietans). The Journal of emergency medicine, 15, 827--831.
• Clark, R. F., Williams, S. R., Nordt, S. P., & Boyer-Hassen, L. V. (1997). Successful treatment of crotalid-induced neurotoxicity with a new polyspecific crotalid Fab antivenom. Annals of emergency medicine, 30, 54--57.
• Dart, R. C., Seifert, S. A., Carroll, L., Clark, R. F., Hall, E., Boyer-Hassen, L. V., Curry, S. C., Kitchens, C. S., & Garcia, R. A. (1997). Affinity-purified, mixed monospecific crotalid antivenom ovine Fab for the treatment of crotalid venom poisoning. Annals of emergency medicine, 30, 33--39.
• Seifert, S. A., Boyer, L. V., Dart, R. C., Porter, R. S., & Sjostrom, L. (1997). Relationship of Venom Effects to Venom Antigen and Antivenom Serum Concentrations in a Patient With Crotalus atrox Envenomation Treated With a Fab Antivenom. Annals of emergency medicine, 30, 49--53.
• Yorgin, P. D., Theodorou, A. A., Al-Uzri, A., Davenport, K., Boyer-Hassen, L. V., & Johnson, M. I. (1997). Propylene glycol-induced proximal renal tubular cell injury. American journal of kidney diseases, 30, 134--139.
• Arreola, P., Fowler, C., Schaller, K., Weaver, Z., Neumann, C., & Boyer, L. (1996). Lead-tainted crayons from China. Part 1: Secondary prevention in Arizona. Journal of Environmental Health, 58.
• Arreola, P., Schaller, K., Neumann, C., Fowler, C., & others, . (1996). Lead-tainted crayons from China part I: Secondary prevention in Arizona. Journal of Environmental Health, 58, 6.
• Schmidt, J., & Hassen, L. B. (1996). When Africanized bees attack: what you and your clients should know. Veterinary medicine (1985)(USA).
• Hassen, L., & McNally, J. (1995). Spider bites, Auerbach PS, Wilderness Medicine, ed 3, 1995, 769-786, Mosby, St. Louis, MO.
• Dart, R. C., Hurlbut, K. M., Maiorino, R. M., Mayersohn, M., Aposhian, H. V., & Hassen, L. V. (1994). Pharmacokinetics of meso-2, 3-dimercaptosuccinic acid in patients with lead poisoning and in healthy adults. The Journal of pediatrics, 125, 309--316.
• Dart, R., Siefert, S., CARROL, L., Clark, R., Hall, E., BOYER HASSEN, L., Curry, S., Kitchens, C., & Garcia, R. (1994). Human trial of an affinity purified antibody fragment for snake venom poisoning. Vet. Hum.. Toxicol, 36, 363.
• Sherman, S. J., Boyer, L. V., & Sibley, W. A. (1994). Cerebral infarction immediately after ingestion of hydrogen peroxide solution.. Stroke, 25, 1065--1067.
• Boyer Hassen, L., Dart, R., Arthur, A., & Hurlbut, K. (1992). Subacute toxicity in a family exposed to elemental mercury vapor, and the use of dimercaptosuccinic acid in their treatment. Vet Hum Toxicol, 34, 353.
• Hassen, L. (1990). Reptile and arthropod envenomations.. Occupational medicine (Philadelphia, Pa.), 6, 447--461.
• LACOUTURE, P. G., LESKO, S. M., HASSEN, L. V., RINGER, S., EPSTEIN, M. F., & MITCHELL, A. A. (1989). Adhesive tape remover pads: a risk to the newborn?. American Journal of Diseases of Children, 143, 1391--1391.

Proceedings Publications

• Fry, B., Hendrikx, I., Rowley, P., Jackson, T., Ploeg, H., Johnson, R., Sasa, M., Dunstan, N., Barve, S., Lock, B., & others, . (2015). Maintaining venomous reptile collections: protocols and occupational safety. In Oxford University Press.
• Bush, S., Ruha, A., Seifert, S., Morgan, D., Lewis, B., Arnold, T., Clark, R., Meggs, W., Toschlog, E., Borron, S., & others, . (2014). A prospective, multicenter, double-blind, randomized, controlled, clinical trial comparing Crotalinae Equine Immune F (ab') 2 and Crotalidae Polyvalent Immune Fab (ovine) for the treatment of US Crotalinae envenomation. In CLINICAL TOXICOLOGY, 52.
• Paniagua, D., Vergara, I., Boyer, L. V., & Alag{\'o}n, A. (2014). Role of the lymphatic system on snake venom absorption: review of mechanism and clinical implications. In Springer.
• Paniagua, D., Jimenez, L., Romero, C., Vergara, I., Calderon, A., Benard, M., Bernas, M., Sevcik, C., Witte, M., Boyer, L., & others, . (2013). Understanding PK of Coral Snake Envenomation: Torward Improved Antivenom Therapy. In JOURNAL OF PHARMACOKINETICS AND PHARMACODYNAMICS, 40.
• Benson, B. E., Boyer, L. V., & Seifert, S. A. (2012). Non-native (exotic) snake envenomations in the US, 2005-2011. In CLINICAL TOXICOLOGY, 50.

Others

• Boyer, L., Alagon, A., & Theodorou, A. (2009). Antivenom for Children with Neurotoxicity from Scorpion Stings REPLY.