Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Real-world therapeutic strategies and survival outcomes in advanced HER2 -mutant non-small cell lung cancer.","authors":"Ruei-Lin Sun, Pei-Ya Liao, Ying-Ting Liao, Yi-Chen Yeh, Chi-Lu Chiang, Yuh-Min Chen, Kuo-Hsuan Hsu, Jeng-Sen Tseng, Hsu-Ching Huang, Chia-I Shen, Yen-Han Tseng, Yen-Hsiang Huang, Yung-Hung Luo, Tsung-Ying Yang","doi":"10.1097/JCMA.0000000000001212","DOIUrl":"10.1097/JCMA.0000000000001212","url":null,"abstract":"<p><strong>Background: </strong>Limited information is available regarding the clinical features and outcomes of advanced human epidermal growth factor receptor 2 ( HER2 )-mutant non-small cell lung cancer (NSCLC) in Taiwan, despite expanding treatment options for this distinct subtype. This study aimed to investigate the clinical characteristics and outcomes of HER2-mutant NSCLC in a real-world setting.</p><p><strong>Methods: </strong>Relevant data were collected from patients with advanced or recurrent HER2 -mutant NSCLC who received systemic therapy between 2011 and 2021 and were followed up until 2022 at two medical centers in Taiwan. Clinical features, treatment responses, and survival-related factors were analyzed.</p><p><strong>Results: </strong>This study included 45 patients (median age: 59.7 [range: 41.3-78.7] years). A775_G776insYVMA was the most common HER2 mutation subtype (57.8%), followed by G778_P780dup (11.1%). Approximately 53.3% of the patients received first-line platinum-based chemotherapy (PC) alone, whereas 13.3% received PC combined with an immune checkpoint inhibitor (ICI). The median overall survival (OS) and progression-free survival (PFS) after first-line therapy were 25.8 and 4.4 months, respectively. The objective response rate was generally higher in patients receiving first-line PC + ICI than those receiving PC alone (33.3% vs 12.5%; p = 0.269). Furthermore, patients receiving PC + ICI had longer PFS than those receiving PC alone (9.5 vs 4.4 months; p = 0.131) and those receiving tyrosine kinase inhibitor/ICI monotherapy (9.5 vs 0.5 months; p = 0.015). Compared with patients having other NSCLC subtypes, those carrying HER2 exon 20 insertion mutations had shorter median PFS (17.3 vs 2.9 months; p = 0.043) and OS (not reached vs 19 months; p = 0.031).</p><p><strong>Conclusion: </strong>This study highlights the clinical features and outcomes of advanced HER2 -mutant NSCLC in Taiwan. PC + ICI may be more effective than other regimens as first-line therapy. The prognostic impact of HER2 exon 20 insertion mutations warrants further investigation.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"307-315"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical-radiomics nomogram to predict early neurological deterioration in patients with stroke undergoing intravenous thrombolysis.","authors":"Xiao-Guang Zhang, Shan-Shan Jiang, Dong Zhang, Shu-Hua Chen, Yu-Ming Kong, Yue-Ying Bai, Zhi-Chun Gu, Yun-Hua Yue","doi":"10.1097/JCMA.0000000000001213","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001213","url":null,"abstract":"<p><strong>Background: </strong>Anticipating early neurological deterioration in patients with ischemic stroke undergoing intravenous thrombolysis poses a considerable challenge in clinical practice. This study aimed to develop and validate a diffusion-weighted imaging (DWI)-based clinical-radiomics nomogram for predicting early neurological deterioration in patients with ischemic stroke without large vessel occlusion or hemorrhagic transformation undergoing intravenous thrombolysis.</p><p><strong>Methods: </strong>A total of 273 patients with stroke were randomly divided into training (n = 192) and validation (n = 81) cohorts at a ratio of 7:3. DWI images taken within 24 hours post-intravenous thrombolysis were used to extract radiological features. The t test, least absolute shrinkage, and selection operator algorithm were used for feature selection. These features were used to create a radiomics score (radscore) for each patient. Combined with the clinical features, a logistic regression model was used to select independent risk factors that were used to construct a clinical-radiomics nomogram. The performance of the nomogram was evaluated using the area under the curve (AUC), calibration, discrimination, and decision curve analysis.</p><p><strong>Results: </strong>A total of 1307 radiomics features were extracted from each patient's data. A total of 310 radiomics features were found to be stable after being screened by intraclass correlation coefficients. Seven features were included in the construction of the radscore. The AUC of the clinical-radiomics nomogram was 0.89 (95% CI, 0.83-0.95) in the training cohort and 0.95 (95% CI, 0.90-0.99) in the validation cohort. The calibration curve and decision curve analysis indicated favorable calibration and net clinical benefits of the nomogram.</p><p><strong>Conclusion: </strong>A DWI-based clinical-radiomics nomogram can effectively predict early neurological deterioration in patients with ischemic stroke in the early phase after intravenous thrombolysis.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":"88 4","pages":"273-282"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential risk factors for delayed neurological sequelae and myocardial injury following acute carbon monoxide poisoning: A retrospective study.","authors":"Min-Po Ho, Yuan-Hui Wu, Tsan-Chi Chen, Kuang-Chau Tsai, Chen-Chang Yang","doi":"10.1097/JCMA.0000000000001208","DOIUrl":"10.1097/JCMA.0000000000001208","url":null,"abstract":"<p><strong>Background: </strong>Acute carbon monoxide poisoning (COP) has been a common cause of emergency hospital visits over the past decade. Besides the immediate symptoms of poisoning, carbon monoxide exposure can cause various long-term complications, especially delayed neurological sequelae (DNS) and myocardial injury (MI).</p><p><strong>Methods: </strong>This study retrospectively enrolled 502 patients with COP, including complete collection data, from the Taiwan National Poison Control Center between January 1, 2000, and December 31, 2015. After collecting the relevant clinical and laboratory data, multivariate logistic regression analysis was performed to identify significant risk factors, hazard ratio (HR), and confidence intervals (CI).</p><p><strong>Results: </strong>The cumulative incidence was 12.0% and 19.7% for DNS and MI, respectively. A Glasgow Coma Scale (GCS) score of <9 (OR, 2.55; 95% CI, 1.52-4.27) and rhabdomyolysis (OR, 2.68; 95% CI, 1.59-4.53) were identified as individual indicators of DNS in patients with COP. However, a greater risk for MI was associated with a GCS score of <9 (OR, 2.50; 95% CI, 1.67-3.74), rhabdomyolysis (OR, 4.91; 95% CI, 3.28-7.35), acute renal impairment (OR, 2.43; 95% CI, 1.59-3.71), and leukocytosis (OR, 9.55; 95% CI, 3.88-23.50). Hyperbaric oxygen therapy for patients with COP was more beneficial for DNS (OR, 0.64; 95% CI, 0.34-1.20) than for MI (OR, 1.94; 95% CI, 0.94-4.01).</p><p><strong>Conclusion: </strong>Early differentiation of risk factors for DNS and MI contributes to an effective evaluation of patients with acute COP and the provision of appropriate therapy.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"330-337"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential involvement of trait impulsivity, fluid intelligence, and executive function in creativity among euthymic patients with bipolar disorder.","authors":"Mao-Hsuan Huang, Yi-Hsuan Kuan, Pei-Chi Tu, Yee-Lam E Chan, Tung-Ping Su","doi":"10.1097/JCMA.0000000000001221","DOIUrl":"10.1097/JCMA.0000000000001221","url":null,"abstract":"<p><strong>Background: </strong>While anecdotal evidence suggests a link between bipolar disorder and heightened creativity, empirical studies are scarce, and the underlying cognitive mechanisms remain unclear. This study aimed to explore the association between trait impulsivity, executive function, fluid intelligence, and creativity among euthymic patients with bipolar disorder.</p><p><strong>Methods: </strong>Euthymic outpatients with bipolar disorder and age- and sex-matched healthy controls were enrolled in this cross-sectional study. Creativity was assessed using the Abbreviated Torrance Test for Adults and the Chinese Word Remote Associates Test, which examined divergent thinking and convergent thinking, respectively. Trait impulsivity was measured using the Barratt Impulsiveness Scale, while cognitive flexibility was evaluated using the Wisconsin Card Sorting Test. Fluid intelligence was assessed using Raven's Progressive Matrices. General linear models were used to assess the associations between these cognitive measures.</p><p><strong>Results: </strong>Fifty-seven euthymic patients with bipolar disorder and 56 controls were recruited. Euthymic patients with bipolar disorder exhibited comparable overall creativity to controls but underperformed in convergent thinking. General linear models confirmed a negative association between trait impulsivity and creativity, primarily observed in patients with bipolar disorder. Cognitive flexibility positively correlated with creativity among patients with bipolar disorder, independent of fluid intelligence.</p><p><strong>Conclusion: </strong>Our study showed that euthymic patients with bipolar disorder do not have heightened creativity. The findings underscore the importance of considering trait impulsivity and cognitive factors in understanding creativity in bipolar disorder.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"290-297"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143545252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rise of AI in healthcare education: DeepSeek and GPT-4o take on the 2024 Taiwan Pharmacist Exam.","authors":"Ying-Mei Wang, Tzeng-Ji Chen","doi":"10.1097/JCMA.0000000000001220","DOIUrl":"10.1097/JCMA.0000000000001220","url":null,"abstract":"","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"338-339"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world experience in treatment outcome and genomic insights for metastatic prostate neuroendocrine carcinoma.","authors":"Jiun-I Lai, Yu-Ching Peng, Peter Mu-Hsin Chang, Yen-Hwa Chang, Hsiao-Jen Chung, Yi-Hsiu Huang, Tzu-Ping Lin, William J Huang, Tzu-Chun Wei, Tzu-Hao Huang, Chueh-Chuan Yen","doi":"10.1097/JCMA.0000000000001209","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001209","url":null,"abstract":"<p><strong>Background: </strong>Neuroendocrine prostate cancer (NEPC) (de novo or treatment-related [t-NEPC]) is a rare and deadly variant of prostate cancer. While de novo NEPC is rare, t-NEPC occurs more frequently in patients with castration-refractory prostate cancer. Owing to the rarity of NEPC, no standard treatment has been established, and the outcomes are generally unsatisfactory.</p><p><strong>Methods: </strong>This study retrospectively reviewed NEPC cases at Taipei Veterans General Hospital between 2018 and 2023. Clinical outcomes, treatment modalities, and related genomic profiles were recorded. We also performed a literature review of case series reporting the outcomes of chemotherapeutic regimens for NEPC.</p><p><strong>Results: </strong>From 2158 cases of prostate cancer cases diagnosed during the study period, only 7 had pathologically proven NEPC (0.3%), and the median overall survival was 364 days. Three patients who underwent multigene panel sequencing had mutations in RB1, and delta-like ligand 3 (DLL3) immunohistochemical staining showed a positivity rate of 50%. We performed a literature review on chemotherapy outcomes in patients with NEPC. In six studies with 104 patients, etoposide + platinum treatment was most commonly used. The progression-free survival (PFS) and overall survival ranged from 3.4 to 9.3 and 8.4 to 22.4 months, respectively. The response rates ranged from 44% to 69.2%. These studies were consistent with a dismal overall survival rate, despite a high response rate to the initial chemotherapy regimen.</p><p><strong>Conclusion: </strong>Our study reported poor outcomes with chemotherapy, with a high frequency of retinoblastoma protein (RB) loss and DLL3 positivity. Further clinical developments targeting DLL3 are warranted.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":"88 4","pages":"283-289"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work-related factors of low back pain among Indonesian manufacturing workers in Taiwan.","authors":"Edo Riyandani, Jou-Fang Deng, Ruey-Yu Chen, Chen-Chang Yang","doi":"10.1097/JCMA.0000000000001219","DOIUrl":"10.1097/JCMA.0000000000001219","url":null,"abstract":"<p><strong>Background: </strong>The manufacturing industry, one of the largest employers of migrant workers in Taiwan, reports a high incidence of musculoskeletal disorders, particularly low back pain (LBP), among its workforce overall. Understanding the prevalence and risk factors of LBP among Indonesian migrant workers, who make up a substantial portion of this workforce, is essential for developing effective preventive programs.</p><p><strong>Methods: </strong>This cross-sectional study surveyed Indonesian migrant workers in the manufacturing sector. The Indonesian version of the Oswestry Disability Index was used to assess LBP prevalence and disability levels. The chi-square test was used to evaluate the association between work-related factors and LBP outcomes. Multivariable logistic regression was used to identify the independent factors associated with LBP, adjusted for other variables.</p><p><strong>Results: </strong>According to the LBP disability index, 63.14% of the participants had minimal disability, 29.80% had moderate disability, and 7.05% had severe disability. Mild trunk flexion was associated with a lower risk of LBP disability compared with neutral trunk flexion (odds ratio [OR] [95% CI]: 0.11 [0.03-0.31], p = 0.01). Among women, lifting <25 kg was associated with a lower risk of severe LBP compared with lifting more than 25 kg (OR [95% CI]: 0.01 [0.01-0.61], p = 0.03). In men, whole-body vibration was associated with a lower risk of severe LBP compared with no vibration exposure (OR [95% CI]: 0.41 [0.19-0.88], p = 0.02).</p><p><strong>Conclusion: </strong>Trunk flexion, lifting, and whole-body vibration consistently emerged as significant determinants of LBP disability. More detailed assessments of these factors are necessary to clarify their associations.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"323-329"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital polymerase chain reaction quantification of hematopoietic chimerism by insertion/deletion: A personalized selection for different chimerism status.","authors":"Dai-Yang Li, Pei-Li Xiao, Ye-Mo Li, Lin An, Ning-Juan Wang, Zhi-Yang Yuan, Ke-Ming Du, Zheng Zhong-Zheng","doi":"10.1097/JCMA.0000000000001215","DOIUrl":"10.1097/JCMA.0000000000001215","url":null,"abstract":"<p><strong>Background: </strong>Clinical decision-making after allogeneic stem cell transplantation (HSCT) is partially based on hematopoietic chimerism analysis. Short tandem repeat (STR), the current gold standard for quantitative chimerism analysis, has limited sensitivity. Digital polymerase chain reaction (dPCR) offers precise quantification and high reproducibility with excellent sensitivity (usually ≤0.1%) across a wide measurement range. However, the reported dPCR-based chimerism detection methods were developed in non-Chinese cohorts and may not be directly applicable to the Chinese population.</p><p><strong>Methods: </strong>To improve sensitivity and accuracy, we first screened out 14 insertions/deletions (indel) loci with high individual recognition rates in Asian populations based on literature and NCBI data. Then, we established a dPCR detection system for routine chimerism assessment (\"dPCR-chimerism system\") in Chinese transplant recipients. We compared the concordance between STR and dPCR in patient samples.</p><p><strong>Results: </strong>The newly developed dPCR-chimerism system covers all 12 pairs of autosomes, achieves a sensitivity of 0.01%, and demonstrates excellent linearity from 0.016% to 50%. For dual-donor samples, there was a strong correlation between STR and dPCR-chimerism detection values ( R2 = 0.9974). The R2 of the dPCR results was higher than STR when the theoretical chimerism rate of the single recipient was ≤5%. Clinical validation in 44 HSCT patients showed strong overall concordance between STR and dPCR (mean difference: 0.68%), although discrepancies were noted in some cases.</p><p><strong>Conclusion: </strong>Our newly developed system demonstrates excellent repeatability and sensitivity, particularly in detecting. It is expected to show good applicability in Chinese transplant patients. Selecting between dPCR and STR testing based on individual chimerism status can facilitate sensitive and accurate analysis, enable timely therapeutic intervention, and support effective relapse monitoring in clinical practice.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"298-306"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential beneficial impacts of tadalafil on cardiovascular diseases.","authors":"Tien-Yun Lan, Chih-Hung Chiang, Jaw-Wen Chen, Ting-Ting Chang","doi":"10.1097/JCMA.0000000000001205","DOIUrl":"10.1097/JCMA.0000000000001205","url":null,"abstract":"<p><p>Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor commonly used for the treatment of erectile dysfunction and benign prostatic hyperplasia. Its mechanism of action involves the inhibition of PDE5, leading to increased levels of nitric oxide and cyclic guanosine monophosphate in the corpus cavernosum, which facilitates smooth muscle relaxation. This article reviews studies using tadalafil in the treatment of cardiovascular diseases and emphasizes its potential advantages in conditions such as pulmonary arterial hypertension, atherosclerosis, coronary artery disease, myocardial infarction, heart failure, stroke, diabetic ulcers, and cardiomyopathy. Although tadalafil shows potential efficacy in treating cardiovascular disease, further experimental studies are needed to clarify its pharmacological effects on cardiovascular protection beyond PDE5 inhibition.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"267-272"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three decades of pediatric drug intoxication trends in Taiwan (1985-2020).","authors":"Chih-Wei Lin, Wei-Yu Chen, Yu-Jia Lin, Pei-Chen Tsao, Yu-Sheng Lee, Chien-Chang Juan, Chen-Chang Yang, Mei-Jy Jeng","doi":"10.1097/JCMA.0000000000001217","DOIUrl":"10.1097/JCMA.0000000000001217","url":null,"abstract":"<p><strong>Background: </strong>Pediatric drug intoxication is a significant public health issue worldwide. The present study aimed to delineate the epidemiology, exposure-related conditions, and outcome severity of pediatric drug intoxication cases in Taiwan for over a 36-year period.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed pediatric drug intoxication cases registered in Taiwan Poison Control Center (PCC-Taiwan) database between 1985 and 2020. Data on patient demographics, toxic substances, exposure-related conditions, and outcome severity were extracted and analyzed. Descriptive statistics were used to summarize the findings.</p><p><strong>Results: </strong>Altogether, 19 893 pediatric drug intoxication cases were reported. The majority of cases involved boys (54.7%), and the highest percentage of cases occurred in children aged 0 to 2 years (56.4%), but there is a second, relatively lower peak in adolescents, where female cases outnumbered the male cases. Pharmaceuticals were the predominant toxic substances (70.3%), with most drug intoxication cases being acute (97.2%) and occurring at home (88.8%). Witnesses were present in 62.8% of the cases. The outcomes were mostly asymptomatic (51.0%) or involved mild discomfort (34.1%), with severe complications and mortality occurring in 0.76% and 0.37% of the cases, respectively. Unintentional poisoning accounted for 85.4% of the cases, whereas intentional poisoning was noted in 12.1% of the cases, with the highest rate seen in adolescents aged 15 to 17 years. Intentional cases mainly involved suicide attempts (68.4%) and predominantly occurred in girls (70.7%).</p><p><strong>Conclusion: </strong>This analysis of data obtained from PCC-Taiwan database for over 36 years reveals bimodal trends in pediatric drug intoxication, showing high rates in young children due to unintentional exposures and peaks in intentional poisoning among adolescent girls. Pharmaceuticals were the predominant toxic agents. Future efforts should focus on age- and sex-targeted preventions, public education on medication safety, and age-specific interventions.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"316-322"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}