Dm Disease-A-MonthPub Date : 2025-08-01Epub Date: 2025-06-19DOI: 10.1016/j.disamonth.2025.101972
Matthew C Randall, Ryan Feldman
{"title":"Neuromuscular junction toxins.","authors":"Matthew C Randall, Ryan Feldman","doi":"10.1016/j.disamonth.2025.101972","DOIUrl":"10.1016/j.disamonth.2025.101972","url":null,"abstract":"<p><p>The neuromuscular junction (NMJ) is highly susceptible to neurotoxins due to its lack of protective barriers like the blood-brain barrier. Over time, a wide range of natural toxins have evolved to target the NMJ, derived from animals, plants, and bacteria, alongside modern synthetic compounds developed for use in medicine, insecticides, and warfare. These toxins exert their effects through various mechanisms, such as antagonizing or agonizing nicotinic and muscarinic acetylcholine receptors, or inhibiting neurotransmitter release or breakdown. Despite their diverse origins and actions, NMJ toxins often present clinically with muscle weakness and can lead to respiratory failure if untreated. However, variations in presentation and clinical context are critical for accurate diagnosis and appropriate treatment. Understanding these mechanisms is essential for early recognition, effective management, informed use of current medications, and the development of novel therapeutics.</p>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":" ","pages":"101972"},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dm Disease-A-MonthPub Date : 2025-08-01Epub Date: 2025-06-20DOI: 10.1016/j.disamonth.2025.101970
Alexander J Randall, David J Post
{"title":"A comprehensive review of the treatment options in myasthenia gravis.","authors":"Alexander J Randall, David J Post","doi":"10.1016/j.disamonth.2025.101970","DOIUrl":"10.1016/j.disamonth.2025.101970","url":null,"abstract":"<p><p>The challenge of treating of Myasthenia Gravis (MG) stems from the multiple underlying mechanisms, the varied presentations, the need for chronic immunotherapy, and the long-term consequences of treatment. The disease itself is varied with clinical presentations ranging from droopy eyes to respiratory failure. The underlying etiology may be paraneoplastic or one of several identified antibodies that affect the post-synaptic neuromuscular junction. Treatment strategies vary depending on all of these factors. There are limited medications available for symptomatic treatment of the neuromuscular junction while most treatment focuses on immunotherapy to limit the immune response. Thymectomy is beneficial for most patients with thymoma and many with antibody positive disease. Choosing the right treatments to maximize benefits and limit adverse effects of the medicines is crucial in this chronic disease.</p>","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":" ","pages":"101970"},"PeriodicalIF":4.3,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dm Disease-A-MonthPub Date : 2025-05-24DOI: 10.1016/j.disamonth.2025.101936
Andrew Stolbach MD, MPH , Maryann Mazer-Amirshahi PharmD, MD, MPH, PhD , Jeffrey Brent MD, PhD , Diane P. Calello MD, FACMT, FAAP, FAACT , Nicholas Connors MD, FACEP, FACMT , Michael G. Holland MD, FACEP, FACOEM, FACMT, FAACT , Fiona Garlich Horner MD, FACMT , David M. Greer MD, MA , Michael J. Kosnett MD, MPH , Ken Kulig MD, FACMT, FAACT , Thomas L. Kurt MD, MPH , Jerrold Leikin MD, FACOEM, FACP, FACEP, FACMT, FAACT, FASAM , Charles A. McKay MD, FACMT , Michael J. Moss MD , Mark J. Neavyn MD, FACMT , Lewis S. Nelson MD, MBA , Silas W. Smith MD , Laura M. Tormoehlen MD, FACMT, FAAN, FAACT
{"title":"The American College of Medical Toxicology Position Statements","authors":"Andrew Stolbach MD, MPH , Maryann Mazer-Amirshahi PharmD, MD, MPH, PhD , Jeffrey Brent MD, PhD , Diane P. Calello MD, FACMT, FAAP, FAACT , Nicholas Connors MD, FACEP, FACMT , Michael G. Holland MD, FACEP, FACOEM, FACMT, FAACT , Fiona Garlich Horner MD, FACMT , David M. Greer MD, MA , Michael J. Kosnett MD, MPH , Ken Kulig MD, FACMT, FAACT , Thomas L. Kurt MD, MPH , Jerrold Leikin MD, FACOEM, FACP, FACEP, FACMT, FAACT, FASAM , Charles A. McKay MD, FACMT , Michael J. Moss MD , Mark J. Neavyn MD, FACMT , Lewis S. Nelson MD, MBA , Silas W. Smith MD , Laura M. Tormoehlen MD, FACMT, FAAN, FAACT","doi":"10.1016/j.disamonth.2025.101936","DOIUrl":"10.1016/j.disamonth.2025.101936","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":"71 7","pages":"Article 101936"},"PeriodicalIF":3.8,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dm Disease-A-MonthPub Date : 2025-05-23DOI: 10.1016/j.disamonth.2025.101942
Anthony F. Pizon MD, FACMT , Ziad Kazzi MD, FACMT , Paul Wax MD, FACMT , Andrew I. Stolbach MD, MPH, FACMT
{"title":"Foreword: The American College of Medical Toxicology: Our fourth decade of advancing the toxicological care of patients and populations","authors":"Anthony F. Pizon MD, FACMT , Ziad Kazzi MD, FACMT , Paul Wax MD, FACMT , Andrew I. Stolbach MD, MPH, FACMT","doi":"10.1016/j.disamonth.2025.101942","DOIUrl":"10.1016/j.disamonth.2025.101942","url":null,"abstract":"","PeriodicalId":51017,"journal":{"name":"Dm Disease-A-Month","volume":"71 7","pages":"Article 101942"},"PeriodicalIF":3.8,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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