Fatal fulminant hepatitis associated with Ganoderma lucidum (Lingzhi) mushroom powder.

Hepatotoxic effect related to Ganoderma lucidum (Lingzhi) mushroom powder was first described in a patient from Hong Kong in 2004. In 2005, the authors experienced a case of fatal fulminant hepatitis associated with such a preparation. Both patients had taken other therapeutic agents and traditionally boiled Lingzhi without any toxic effect. After switching to taking Lingzhi in powder form for 1-2 months, the hepatotoxic episode occurred in both patients. The toxic role of Lingzhi powder needs close monitoring in the future, especially in combination with other drugs.

The "intermediate syndrome" as critical sequelae of organophosphate poisoning: the first report of two cases in Thailand.

The authors report 2 cases of organophosphate poisoning which developed intermediate syndrome. The first case was a man who took an organophosphate insecticide, monocrotophos, and developed severe organophosphate poisoning. Respiratory support was needed. He was treated with atropine and 2-PAM. Weakness of neck muscles, proximal limb and respiratory muscle developed in the 3rd day after ingestion. By supportive treatment and careful monitoring, however, he recovered after 11 days of the poisoning. The second case was a lady who took dicrotophos. She developed severe organophosphate poisoning for which respiratory support was also needed High dose of atropine, but without 2-PAM, was administered. She developed bulbar palsy, proximal muscle and respiratory weakness 3 day after the ingestion. Ventilation support was needed for 13 days before weaning was successful. This report did not support an efficacy of pralidoxime (2-PAM) in alleviation of the intermediate syndrome, but aims to alert physicians to recognize the intermediate syndrome for which adequate respiratory care is the crucial key for its management.

Non-occupational determinants of cadmium and lead in blood and urine among a general population in Thailand.

In this study the levels of cadmium and lead in blood and urine were measured by the method of graphite furnace atomic absorption spectrometry in 356 healthy, non-occupationally exposed individuals and the factors affecting the metal concentrations were investigated. The geometric means for cadmium in blood and urine were 0.98 microg/l (Cd-B) and 0.87 microg/gCr (Cd-U). The lead levels were 32.5 microg/l for blood (Pb-B) and 2.54 microg/gCr for urine (Pb-U). Men had significantly higher blood cadmium and lead levels than women whereas the urinary excretion rates of both metals were higher in women than men. Cigarette smoking was found to affect the levels of Cd-B, Cd-U, and Pb-B. Other factors like alcohol intake and place of residence also related to blood lead levels. Both blood and urine levels of cadmium and lead in this study group were within acceptable ranges for non-occupationally exposed populations and were decreased compared with the past. It is important to continue monitoring levels of these metals in order to prevent adverse health effects in the Thai population.