Pub Date : 2026-01-01Epub Date: 2025-11-28DOI: 10.1007/s13181-025-01112-6
Keahi M Horowitz, Colleen P Cowdery, Robert G Hendrickson
{"title":"Clinical Features of Paralytic Shellfish Poisoning: a Case Series from the 2024 Oregon Outbreak.","authors":"Keahi M Horowitz, Colleen P Cowdery, Robert G Hendrickson","doi":"10.1007/s13181-025-01112-6","DOIUrl":"10.1007/s13181-025-01112-6","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"39-43"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145634771","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}
Pub Date : 2026-01-01Epub Date: 2025-12-20DOI: 10.1007/s13181-025-01105-5
Leslie Rae Dye
{"title":"Introduction to the Donovan Memorial Lecture: 'Fentanyl Plus', A New Era of Fentanyl Polydrug Combinations in the North American Overdose Crisis.","authors":"Leslie Rae Dye","doi":"10.1007/s13181-025-01105-5","DOIUrl":"10.1007/s13181-025-01105-5","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"1"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800550","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}
Pub Date : 2026-01-01Epub Date: 2026-01-13DOI: 10.1007/s13181-025-01109-1
Joshua Trebach, Ali Graebner, Mark K Su
{"title":"Evidence-Based Toxicology-Hypothesis Testing in Randomized Clinical Trials: Part I-Superiority.","authors":"Joshua Trebach, Ali Graebner, Mark K Su","doi":"10.1007/s13181-025-01109-1","DOIUrl":"10.1007/s13181-025-01109-1","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"63-66"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145966257","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}
Pub Date : 2026-01-01Epub Date: 2026-01-07DOI: 10.1007/s13181-025-01099-0
Kim Aldy, Shao Li, Mari Costantini, Alyssa Falise, Rachel Culbreth, Paul M Wax, Jeffery Brent
Established in 2010, the American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (ToxIC) Core Registry has systematically captured data from in-hospital and clinic-based medical toxicology physician consultations across the United States (US) and internationally. The ToxIC Core Registry contains deidentified patient data, including patient demographics, reason for medical toxicology evaluation, exposure agents, clinical signs and symptoms, treatments and antidotes administered, and mortality outcomes. This fifteenth annual report provides data from 8,868 patients entered into the Core Registry in 2024, bringing the total number of cases to 111,276 between 2010 and 2024. These cases were submitted by 41 participating sites encompassing 67 distinct hospitals over 23 US states and 3 international countries. In 2024, ethanol was the most commonly reported exposure agent class (17.8%), followed by opioids (15.8%), non-opioid analgesics (10.5%), and sympathomimetic agents (7.6%). A total of 107 fatalities were reported, corresponding to a case fatality rate of 1.2%. Additional descriptive analyses in this annual report were conducted to describe trends for opioid and psychoactive exposures between 2010 and 2024.
{"title":"The Toxicology Investigators Consortium 2024 Annual Report.","authors":"Kim Aldy, Shao Li, Mari Costantini, Alyssa Falise, Rachel Culbreth, Paul M Wax, Jeffery Brent","doi":"10.1007/s13181-025-01099-0","DOIUrl":"10.1007/s13181-025-01099-0","url":null,"abstract":"<p><p>Established in 2010, the American College of Medical Toxicology (ACMT) Toxicology Investigators Consortium (ToxIC) Core Registry has systematically captured data from in-hospital and clinic-based medical toxicology physician consultations across the United States (US) and internationally. The ToxIC Core Registry contains deidentified patient data, including patient demographics, reason for medical toxicology evaluation, exposure agents, clinical signs and symptoms, treatments and antidotes administered, and mortality outcomes. This fifteenth annual report provides data from 8,868 patients entered into the Core Registry in 2024, bringing the total number of cases to 111,276 between 2010 and 2024. These cases were submitted by 41 participating sites encompassing 67 distinct hospitals over 23 US states and 3 international countries. In 2024, ethanol was the most commonly reported exposure agent class (17.8%), followed by opioids (15.8%), non-opioid analgesics (10.5%), and sympathomimetic agents (7.6%). A total of 107 fatalities were reported, corresponding to a case fatality rate of 1.2%. Additional descriptive analyses in this annual report were conducted to describe trends for opioid and psychoactive exposures between 2010 and 2024.</p>","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"2-28"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145917784","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}
Pub Date : 2026-01-01Epub Date: 2025-10-16DOI: 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
{"title":"ACMT and AACT Position Statement: Preventing Occupational Opioid Exposure to Emergency Responders.","authors":"Andrew Stolbach, Jon B Cole, Christopher Hoyte, Emily Kiernan, Maryann Mazer-Amirshahi, Charles McKay, Michael Moss, Lewis S Nelson, Brandon Warrick, Hannah Hays","doi":"10.1007/s13181-025-01101-9","DOIUrl":"10.1007/s13181-025-01101-9","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"94-102"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301418","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}
Pub Date : 2026-01-01Epub Date: 2025-12-29DOI: 10.1007/s13181-025-01111-7
Joshua Trebach, Ali Graebner, Mark K Su
{"title":"Evidence-Based Toxicology-Hypothesis Testing in Randomized Clinical Trials: Part III - Non-Inferiority.","authors":"Joshua Trebach, Ali Graebner, Mark K Su","doi":"10.1007/s13181-025-01111-7","DOIUrl":"10.1007/s13181-025-01111-7","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"70-72"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145856682","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}
Pub Date : 2025-12-02DOI: 10.1007/s13181-025-01107-3
Kevin Brandecker, Kayla Kendric, Christopher Raciti, Paul F Ehlers
{"title":"Articles You Might Have Missed.","authors":"Kevin Brandecker, Kayla Kendric, Christopher Raciti, Paul F Ehlers","doi":"10.1007/s13181-025-01107-3","DOIUrl":"https://doi.org/10.1007/s13181-025-01107-3","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654475","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}
Pub Date : 2025-10-02DOI: 10.1007/s13181-025-01095-4
Amar Chakraborty, Annika Strand, William Bleifuss, Nicholas Hoffmann
{"title":"Articles You Might Have Missed.","authors":"Amar Chakraborty, Annika Strand, William Bleifuss, Nicholas Hoffmann","doi":"10.1007/s13181-025-01095-4","DOIUrl":"https://doi.org/10.1007/s13181-025-01095-4","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206766","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}
Pub Date : 2025-10-01Epub Date: 2025-07-31DOI: 10.1007/s13181-025-01088-3
C James Watson, Michael C Monuteaux, Katherine B Tang, Michele M Burns
{"title":"Variable Toxicity by β-Blocker Class in Intentional Overdoses Reported To U.S. Poison Centers.","authors":"C James Watson, Michael C Monuteaux, Katherine B Tang, Michele M Burns","doi":"10.1007/s13181-025-01088-3","DOIUrl":"10.1007/s13181-025-01088-3","url":null,"abstract":"","PeriodicalId":16429,"journal":{"name":"Journal of Medical Toxicology","volume":" ","pages":"409-413"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760360","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}
Pub Date : 2025-10-01Epub Date: 2025-09-02DOI: 10.1007/s13181-025-01093-6
Taylor Sanders, Christine Murphy, Greggory Davis, Christina Aspinwall, Lauren Theriot, Christopher McVicker, Thomas Arnold
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.
{"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":"<p><strong>Introduction: </strong>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')<sub>2</sub> (Fab2AV) for Agkistrodon envenomations, data is limited comparing their efficacies for this indication.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","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}
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