biostudies-literaturede Almeida MCFundação de Amparo à Pesquisa do Estado do AmazonasConselho Nacional de Desenvolvimento CientÃfico e TecnológicoInstituto Nacional de Ciência e Tecnologia da Criosferae0013423https://www.ebi.ac.uk/biostudies/studies/S-EPMC12367189biostudies-literatureUnknown19(8)<h4>Background</h4>Bothrops atrox envenomation can cause significant local and systemic effects. Adjunctive therapies, such as cold and heat applications, are proposed to enhance antivenom efficacy, but their clinical value remains unclear.<h4>Methods</h4>This randomized, three-arm clinical trial included 94 patients allocated in a 1:1:1 ratio to Cold Therapy Group (CTG, n = 30), Heat Therapy Group (HTG, n = 31), or Control Group (CG, n = 33). All participants received standard antivenom therapy, with CTG and HTG receiving additional interventions applied for 24 hours post-admission. Primary outcomes included changes in creatine kinase (CK) levels. Secondary outcomes assessed pain intensity, edema, local temperature, and functional recovery using the World Health Organization Disability AsPLoS neglected tropical diseasesLimited efficacy of cold and heat therapy as adjunctive treatments for local and functional outcomes of Bothrops atrox snakebite envenomation: A randomized clinical trial.PMC12367189call AMAZÔNIA+10call No. 017/2023 – PRONEM302662/2017-0call No. 002/2021 PROGRAMA AMAZÔNIDAS – “Mulheres e Meninas na Ciência”311434/2021–5call No. 020/2024 - PROGRAMA PRODUTIVIDADE EM CT&amp;I – EDIÇÃO 2024Mendes YDSde Castro DBSachett JAGOliveira DNMonteiro WAraujo FQCarvalho EDSSartim MAAlmeida-Val FSachett AVissoci JRNde Almeida MCCarvalho KMPfalseLimited efficacy of cold and heat therapy as adjunctive treatments for local and functional outcomes of Bothrops atrox snakebite envenomation: A randomized clinical trial.<h4>Background</h4>Bothrops atrox envenomation can cause significant local and systemic effects. Adjunctive therapies, such as cold and heat applications, are proposed to enhance antivenom efficacy, but their clinical value remains unclear.<h4>Methods</h4>This randomized, three-arm clinical trial included 94 patients allocated in a 1:1:1 ratio to Cold Therapy Group (CTG, n = 30), Heat Therapy Group (HTG, n = 31), or Control Group (CG, n = 33). All participants received standard antivenom therapy, with CTG and HTG receiving additional interventions applied for 24 hours post-admission. Primary outcomes included changes in creatine kinase (CK) levels. Secondary outcomes assessed pain intensity, edema, local temperature, and functional recovery using the World Health Organization Disability As2025-01-01T00:00:00Z2025 Aug2026-04-08T05:07:00.135Z2026-04-07T22:20:46.99ZS-EPMC123671894081172810.1371/journal.pntd.0013423