Journal of Medical Toxicology最新文献_第7页

ACMT and AACT Position Statement: Preventing Occupational Opioid Exposure to Emergency Responders. ACMT和AACT立场声明：防止职业阿片类药物暴露给紧急救援人员。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-01-01 Epub Date: 2025-10-16 DOI: 10.1007/s13181-025-01101-9

Andrew Stolbach, Jon B Cole, Christopher Hoyte, Emily Kiernan, Maryann Mazer-Amirshahi, Charles McKay, Michael Moss, Lewis S Nelson, Brandon Warrick, Hannah Hays

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Evidence-Based Toxicology-Hypothesis Testing in Randomized Clinical Trials: Part III - Non-Inferiority. 随机临床试验的循证毒理学假设检验：第三部分-非劣效性。

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI: 10.1007/s13181-025-01111-7

Joshua Trebach, Ali Graebner, Mark K Su

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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 : 2025-12-02 DOI: 10.1007/s13181-025-01107-3

Kevin Brandecker, Kayla Kendric, Christopher Raciti, Paul F Ehlers

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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 : 2025-10-02 DOI: 10.1007/s13181-025-01095-4

Amar Chakraborty, Annika Strand, William Bleifuss, Nicholas Hoffmann

引用次数: 0

Comparison of Crotalidae Immune F(ab')2 (Equine) and Crotalidae Polyvalent Immune Fab (Ovine) at Establishing Control of Initial Envenomation Symptoms in Louisiana Agkistrodon Envenomations. Crotalidae免疫F（ab’）2（马）与Crotalidae多价免疫Fab（羊）在路易斯安那蝮蛇中毒初期症状控制中的比较

IF 2.6 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-09-02 DOI: 10.1007/s13181-025-01093-6

Taylor Sanders, Christine Murphy, Greggory Davis, Christina Aspinwall, Lauren Theriot, Christopher McVicker, Thomas Arnold

{"title":"Comparison of Crotalidae Immune F(ab')2 (Equine) and Crotalidae Polyvalent Immune Fab (Ovine) at Establishing Control of Initial Envenomation Symptoms in Louisiana Agkistrodon Envenomations.","authors":"Taylor Sanders, Christine Murphy, Greggory Davis, Christina Aspinwall, Lauren Theriot, Christopher McVicker, Thomas Arnold","doi":"10.1007/s13181-025-01093-6","DOIUrl":"10.1007/s13181-025-01093-6","url":null,"abstract":"Introduction: Copperheads and cottonmouths are responsible for most snake envenomations in Louisiana. While the United States Food and Drug Administration has approved both Crotalidae polyvalent immune Fab (FabAV) and Crotalidae immune F(ab')2 (Fab2AV) for Agkistrodon envenomations, data is limited comparing their efficacies for this indication.Methods: This is a retrospective study comparing FabAV to Fab2AV in the treatment of suspected Agkistrodon envenomations in Louisiana between April 2017 and October 2024. Cases identifying rattlesnakes were excluded. The primary outcome was the need for additional antivenom doses to achieve control after the initial antivenom dose.Results: One hundred fifty-eight patients received FabAV or Fab2AV, with 100 cases meeting inclusion criteria. Fifty-seven patients received FabAV and 43 received Fab2AV. The snake was identified as copperhead in 48 cases, cottonmouth in 23, and unidentified in 29. In the FabAV cohort, the initial number of vials ranged from four to 12 with a median dose of four vials. Nine FabAV cases (16%) required additional vials for initial control after the first dose. In the Fab2AV cohort, all patients received 10 vials initially, with 24 cases (56%) requiring additional vials for initial control after the first dose. There was a significant difference in the percentage of patients requiring additional control vials between FabAV and Fab2AV.Conclusion: In this cohort of suspected Agkistrodon envenomations, control with initial recommended dosing was more often achieved with FabAV compared to Fab2AV (84% vs. 44%). The results suggest potential benefit to hospitals stocking FabAV in Louisiana and possibly other Agkistrodon-predominant regions.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"377-385"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957711","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}

引用次数: 0

Variable Toxicity by β-Blocker Class in Intentional Overdoses Reported To U.S. Poison Centers. 向美国毒物中心报告的故意过量服用β-阻滞剂类别的可变毒性。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-07-31 DOI: 10.1007/s13181-025-01088-3

C James Watson, Michael C Monuteaux, Katherine B Tang, Michele M Burns

引用次数: 0

Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia: A Case Report. 智能手表检测非那吡啶致高铁血红蛋白血症难治性低氧血症1例

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-08-04 DOI: 10.1007/s13181-025-01090-9

Leann N Tulisiak, Mackenzie E Loesing, Alexander Ljungberg, Eric E Kaczor

{"title":"Smartwatch Detection of Refractory Hypoxemia in Phenazopyridine-Induced Methemoglobinemia: A Case Report.","authors":"Leann N Tulisiak, Mackenzie E Loesing, Alexander Ljungberg, Eric E Kaczor","doi":"10.1007/s13181-025-01090-9","DOIUrl":"10.1007/s13181-025-01090-9","url":null,"abstract":"INTRODUCTION: Significant cases of methemoglobinemia will cause a signal interference in traditional dual-wavelength pulse oximetry leading to the classic finding of “refractory hypoxemia”. As smartwatches begin to incorporate pulse oximetry capabilities, it is unclear whether these devices will demonstrate the same type of interference in the presence of methemoglobinemia. This article reports a case where a patient’s Apple Watch© reported a hypoxemia alert in the setting of phenazopyridine induce methemoglobinemia. CASE REPORT: This is a case report of a 71-year-old female whose Apple Watch© reported a hypoxemia alarm in the setting of methemoglobinemia caused by phenazopyridine use. The patient’s smartwatch began signaling hypoxemia alerts the day before she noticed clinical cyanosis. 24 hours after the hypoxemia alerts began, she presented to the Emergency Department (ED) with shortness of breath and blue discoloration of skin. The Apple Watch© recorded oxygen saturation readings between 73% and 86%. Upon arrival to the ED, the patient’s SpO2 was 84% on traditional hospital-grade dual-wavelength pulse oximetry and her methemoglobin level was 19.8%. Her symptoms and methemoglobinemia resolved after administration of 1 mg/kg of IV methylene blue. CONCLUSION: Pulse oximetry used in smartwatch technology can trigger a hypoxemia alarm in the presence of drug-induced methemoglobinemia. If demonstrated to be a reproducible finding, smartwatch technology has the potential to be used as part of an early detection system for clinically significant methemoglobinemia. ","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"430-433"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784475","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}

引用次数: 0

In Response to Comment on "Vasopressor Use, Critical Care Management and Outcomes in Dihydropyridine Calcium Channel Blocker Toxicity". 对“二氢吡啶钙通道阻滞剂毒性的血管加压剂使用、重症监护管理和结果”的评论的回应。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-07-11 DOI: 10.1007/s13181-025-01086-5

Hannah H Spungen, Meghan B Spyres

引用次数: 0

Intranasal Dimethyl Trisulfide: Long-Term Efficacy in an Acutely Lethal Large Swine Model of Cyanide Exposure. 鼻内二甲基三硫化物：氰化物暴露急性致死大型猪模型的长期疗效。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-07-29 DOI: 10.1007/s13181-025-01087-4

Tara B Hendry-Hofer, Carter Severance, Christopher J Haberkorn, Nathan Wetmore, Walker G West, Sharmin Sultana, Dennean S Lippner, Melissa O Rhoomes, Brian A Logue, Gary A Rockwood, Vikhyat S Bebarta

{"title":"Intranasal Dimethyl Trisulfide: Long-Term Efficacy in an Acutely Lethal Large Swine Model of Cyanide Exposure.","authors":"Tara B Hendry-Hofer, Carter Severance, Christopher J Haberkorn, Nathan Wetmore, Walker G West, Sharmin Sultana, Dennean S Lippner, Melissa O Rhoomes, Brian A Logue, Gary A Rockwood, Vikhyat S Bebarta","doi":"10.1007/s13181-025-01087-4","DOIUrl":"10.1007/s13181-025-01087-4","url":null,"abstract":"Introduction: Cyanide poisoning poses an ongoing threat to military personnel and civilian populations. FDA approved antidotes require intravenous administration which can be challenging to accomplish in austere environments. Intranasal (IN) delivery is an innovative approach to developing easy to administer medical countermeasures for field use. Rapid absorption through the nasal mucosa and passage of dimethyl trisulfide across the blood-brain barrier could enhance effectiveness in mitigating cyanide toxicity.Methods: An acutely lethal swine model of cyanide poisoning was used to assess the efficacy of IN dimethyl trisulfide (DMTS) on survival, clinical outcomes, and cognitive function. Swine were anesthetized and instrumented for monitoring of vital signs and blood sampling prior to exposure to potassium cyanide. Cyanide exposure continued until 6 min after apnea occurred. Upon cessation of cyanide exposure IN DMTS (n = 12) or saline control (n = 6) was administered. Six animals from the DMTS treatment group were survived for 7 days post treatment to assess for cognitive deficits following rescue.Results: Prior to experimentation physiological and laboratory characteristics were similar across both study groups. Following treatment, survival in the DMTS group was 75% compared to 0% in the control group (p = 0.0014). Blood lactate concentration in the DMTS group was significantly improved (i.e., lower) compared to controls (p < 0.0001; 6.78 ± 4.58 vs. 17.22 ± 2.56 mmol/L, respectively). Additionally, swine treated with IN DMTS demonstrated no long-term cognitive deficits 7 days post rescue.Conclusion: Treatment with IN DMTS improved survival and clinical outcomes in an acutely lethal porcine model of cyanide poisoning.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"395-403"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742330","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}

引用次数: 0

Efficacy of Treating Nifedipine-Induced Shock with Hydroxocobalamin in a Swine Model. 羟钴胺治疗硝苯地平致休克的猪模型疗效观察。

IF 2 4区医学

Journal of Medical Toxicology Pub Date : 2025-10-01 Epub Date: 2025-08-04 DOI: 10.1007/s13181-025-01089-2

Christine Murphy, Michael Runyon, Michael Gellar, Nigel Rozario, Charity G Patterson, William P Kerns Ii

{"title":"Efficacy of Treating Nifedipine-Induced Shock with Hydroxocobalamin in a Swine Model.","authors":"Christine Murphy, Michael Runyon, Michael Gellar, Nigel Rozario, Charity G Patterson, William P Kerns Ii","doi":"10.1007/s13181-025-01089-2","DOIUrl":"10.1007/s13181-025-01089-2","url":null,"abstract":"Introduction: Calcium channel antagonists contribute to many overdose related deaths each year and treatment options are limited. Hydroxocobalamin has shown promise in reversal of multiple shock states, and we evaluated its use in the treatment of nifedipine-induced shock in a swine model.Methods: Twenty-two swine (39 to 50 kg) were anesthetized, instrumented, and acclimatized. Toxicity was induced by administering a nifedipine infusion at 0.0266 mg/kg/min. Once the toxic end point, defined as a 20% decrease from the initial mean arterial pressure, was reached, all animals received a 20 mL/kg bolus of saline and either 60 mL of saline (NP group) or 150 mg/kg of hydroxocobalamin dissolved in 60 mL of saline (NP + HX group). Hemodynamics were analyzed and compared between the NP and NP + HX groups over time using linear mixed models with Bonferroni correction.Results: Modeling of the hemodynamic data demonstrated an increase in both systolic blood pressure and change in MAP from the nadir. Mean arterial pressure (MAP) and diastolic blood pressure were increased (p < 0.01) in the NP + HX group at multiple time points. There were no differences detected in the time-to-death between groups.Conclusion: Improvements in hemodynamics were noted in the group treated with hydroxocobalamin, but there was no evidence for improvement in mortality. Given this, hydroxocobalamin may serve a role in bridging patients to high dose insulin, vasopressors, extracorporeal membrane oxygenation, or transfer to a higher level of care.","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"386-394"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784474","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}

引用次数: 0