Journal of Medical Toxicology最新文献_第5页

ACMT Practice Statement: Duration of Intravenous Acetylcysteine Therapy Following Acetaminophen Overdose (2026 Update). ACMT实践声明： 对乙酰氨基酚过量后静脉乙酰半胱氨酸治疗的持续时间（2026年更新）。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-04-01 Epub Date: 2026-03-17 DOI: 10.1007/s13181-026-01130-y

Jonathan W Meadows, Robert G Hendrickson, Andrew I Stolbach

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Combined Medical Toxicology and Addiction Medicine Training: A Fellow's Perspective. 综合医学毒理学和成瘾医学培训：一个研究员的观点。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-04-01 Epub Date: 2026-03-02 DOI: 10.1007/s13181-026-01119-7

Anthony Spadaro

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National Poison Center Trends in GLP-1 Receptor Agonist Exposures Following FDA Approval for Weight Loss. FDA批准减重后GLP-1受体激动剂暴露的趋势。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2026-04-01 Epub Date: 2026-02-03 DOI: 10.1007/s13181-026-01121-z

Jordan Miller, Robert Miller, Shawn M Varney, David Han

{"title":"National Poison Center Trends in GLP-1 Receptor Agonist Exposures Following FDA Approval for Weight Loss.","authors":"Jordan Miller, Robert Miller, Shawn M Varney, David Han","doi":"10.1007/s13181-026-01121-z","DOIUrl":"10.1007/s13181-026-01121-z","url":null,"abstract":"Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are therapies for type 2 diabetes whose use expanded sharply after semaglutide's 2021 approval for obesity. Although gastrointestinal effects are well described, national patterns of acute GLP-1 RA exposures are poorly characterized. This study evaluated trends in GLP-1 RA exposures reported to U.S. poison centers, focusing on demographic shifts, exposure circumstances, and clinical outcomes before and after the 2021 FDA approval.Methods: We analyzed human GLP-1 RA exposures reported to the National Poison Data System from 2012 to 2023, using July 1, 2021, to define pre- and post-approval periods. Demographics, exposure characteristics, therapies, and medical outcomes were compared using standardized statistical tests. Quarterly call counts were modeled with segmented Poisson regression to assess changes in reporting trajectory.Results: A total of 10,033 exposures were identified (3,113 pre-approval; 6,920 post-approval). Semaglutide predominated post-approval (64.2%). The exposed population shifted younger and more female. Most cases were unintentional therapeutic errors with mild gastrointestinal symptoms. The proportion managed in or referred to a health care facility increased from 23.0% to 33.5% (RR = 1.46, [95% CI: 1.36, 1.57], p < 0.001). Segmented Poisson modeling demonstrated a significant inflection in call volume, with semaglutide exposures increasing an additional 9.9% per quarter after approval.Conclusions: GLP-1 RA exposures rose sharply following semaglutide's weight-loss approval, accompanied by increased health care utilization despite generally mild clinical effects. Although multiple factors likely contributed to these trends, improved patient counseling and clearer poison center guidance may help reduce preventable therapeutic errors and unnecessary emergency evaluation.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"275-285"},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Welcome to the 2026 ACMT Annual Scientific Meeting. 欢迎参加2026年ACMT年度科学会议。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2026-04-01 Epub Date: 2026-03-25 DOI: 10.1007/s13181-026-01126-8

Joseph E Carpenter, Jennifer Love, Maryann Mazer-Amirshahi, Alyssa Falise, Lucinda Gonzales, Kim Aldy, Stephanie Abston

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2026 ACMT Annual Scientific Meeting Abstracts - Boston, Massachusetts. 2026年ACMT年度科学会议摘要-波士顿，马萨诸塞州。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2026-04-01 DOI: 10.1007/s13181-026-01123-x

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Appreciation for Journal of Medical Toxicology (JMT) 2025 Peer Reviewers. 感谢医学毒理学杂志（JMT） 2025同行评审。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-03-10 DOI: 10.1007/s13181-026-01124-w

Howard A Greller, Mark B Mycyk

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Articles You Might Have Missed. 你可能错过的文章。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-03-02 DOI: 10.1007/s13181-026-01125-9

Chanell Davis, Natalia Swiatowiec, Michael Nelson

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Dissociative-like Neurotoxicity Following Analytically Confirmed Exposure To Hexahydrocannabinol (HHC). 分析证实暴露于六氢大麻酚（HHC）后的解离样神经毒性。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-01-01 Epub Date: 2025-11-12 DOI: 10.1007/s13181-025-01102-8

Shaun L Greene, Rebecca Fawcett, Jared Castle, Zeff Koutsogiannis

{"title":"Dissociative-like Neurotoxicity Following Analytically Confirmed Exposure To Hexahydrocannabinol (HHC).","authors":"Shaun L Greene, Rebecca Fawcett, Jared Castle, Zeff Koutsogiannis","doi":"10.1007/s13181-025-01102-8","DOIUrl":"10.1007/s13181-025-01102-8","url":null,"abstract":"Introduction: Hexahydrocannabinol (HHC) is a semi-synthetic hydrogenated derivative of delta-9-tetrahydrocannabinol (THC). HHC emerged within global markets in 2021and has been detected within unregulated cannabis products.Case report: A 32-year-old male presented to hospital 1.5 h following ingestion of a single gummy, which had been sold as a THC product. Symptoms included nausea, vomiting, slurred speech, a subjective feeling of whole-body numbness, and an inability to move his head. Examination revealed an apparent dissociative state, sinus tachycardia (118 beats per minute), mydriasis, confusion, and tachypnoea (24 breaths per minute). There was no objective focal neurological deficit. Investigations including haematology and biochemistry were normal. Management was supportive and symptoms resolved within eight hours of ingestion. Serum analysis revealed the HHC isomers 9R-hexahydrocannabinol (9R-HHC) and 9 S-hexahydrocannabinol (9 S-HHC). No other pharmaceutical or psychoactive substance was detected.Discussion: HHC can be manufactured using cannabidiol as a precursor and can be administered via inhalation, orally and sublingually. The 9R-HHC isomer is the primary psychoactive component. HHC is rapidly absorbed, crosses the blood-brain-barrier and is hepatically metabolised. User reports of HHC adverse effects include anxiety, nausea, and \"paralysing effects\". Cases of HHC exposure reported in the literature describe palpitations, chest tightness, 'respiratory pause', seizures, dysarthria, dyskinesia, hallucinations, mydriasis, myalgias and acute psychosis. This case of analytically confirmed HHC exposure describes multi-system toxicity including gastrointestinal effects, and dissociative-like neurological effects, and serves as a reminder of the dangers of unregulated products sold within the illicit drug market.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"77-80"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ACMT Position Statement: ACMT Responds to the Acetaminophen and Autism Controversy. ACMT立场声明：ACMT回应对乙酰氨基酚和自闭症争议。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.1007/s13181-025-01116-2

American College Of Medical Toxicology

引用次数: 0

Can Albumin Trap Salicylate? An In Vitro Exploration of Salicylate Overdose Scenarios. 白蛋白能捕获水杨酸盐吗？水杨酸过量的体外研究。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-01-01 Epub Date: 2025-12-18 DOI: 10.1007/s13181-025-01113-5

Ryan Feldman, David Gummin, Mark Hawi, John Lyneis, Ehab Abourashed

{"title":"Can Albumin Trap Salicylate? An In Vitro Exploration of Salicylate Overdose Scenarios.","authors":"Ryan Feldman, David Gummin, Mark Hawi, John Lyneis, Ehab Abourashed","doi":"10.1007/s13181-025-01113-5","DOIUrl":"10.1007/s13181-025-01113-5","url":null,"abstract":"Background: Salicylate toxicity remains a significant cause of morbidity and mortality. At therapeutic levels, most salicylic acid (SA) is albumin-bound, but in overdose, the free fraction rises, driving toxicity. Albumin supplementation has been hypothesized as a strategy to reduce free SA, yet quantitative data are limited.Methods: An in vitro model was developed to assess albumin's binding capacity for salicylic acid across overdose-relevant concentrations. Solutions of SA (SA30 ≈30 mg/dL, SA50 ≈50 mg/dL, SA100 ≈100 mg/dL, SA120 ≈120 mg/dL) were combined with albumin ranging from 1-8 g/dL, representing subphysiologic to supraphysiologic concentrations. One solution (SA120-A) was prepared at pH 7.0 to evaluate binding in acidic environments. Free SA was quantified in each sample.Results: Increasing albumin reduced free salicylate under all conditions. From 1-8 g/dL, free SA decreased by 38.56 mg/dL (95% CI [37.62, 39.49] at SA50, 38.49 mg/dL (95% CI [37.77, 39.20] at SA100, 38.83 mg/dL (95% CI [37.85, 39.81] at SA120 (pH 7.4), and 52.77 mg/dL (95% CI [51.54, 54.01] at SA120 (pH 7.0). Correction of hypoalbuminemia (1-4 g/dL) reduced free SA by 11.33 mg/dL (95% CI [11.14, 11.53] at SA30, 21.07 mg/dL (95% CI [20.19, 21.94] at SA50, 18.40 mg/dL (95% CI [18.12, 18.68] at SA100, 18.27 mg/dL (95% CI [16.93, 19.61] at SA120 (pH 7.4), and 21.40 mg/dL (95% CI [21.00, 21.80] at SA120-A (pH 7.0). Increasing albumin further to 8 g/dL reduced free SA by an additional 17.49 mg/dL (95% CI [17.42, 17.56] at SA50, 20.09 mg/dL (95% CI [19.62, 20.55] at SA100, 20.57 mg/dL (95% CI [20.18, 20.95] at SA120 (pH 7.4), and 31.37 mg/dL (95% CI [30.12, 32.62] at pH 7.0. SA30 fell below quantification beyond 5 g/dL.Conclusion: Albumin addition reduced free salicylate, supporting its potential as a \"protein sink\" in salicylate toxicity. Further research is needed to determine the clinical relevance and safety of this theoretical intervention.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"29-38"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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