Epidemiology and clinics of mushroom poisoning in Northern Italy: A 21-year retrospective analysis.

BACKGROUND: Limited information exists about epidemiology and management of mushroom poisoning. We analyzed and described epidemiology, clinical presentation, and clinical course of mushroom-poisoned patients admitted to emergency departments (EDs) of the Province of Parma, Italy. METHODS: Data from the database of mycological service were matched with clinical information retrieved from hospitals' database, from January 1, 1996 to December 31, 2016. RESULTS: Mycologist consultation was obtained in 379/443 identified mushroom poisonings. A remarkable seasonality was found, with significant peak in autumn. Thanks to the collaboration, the implicated species could be identified in 397 cases (89.6%); 108 cases (24.4%) were due to edible mushrooms, Boletus edulis being the most represented (63 cases). Overall, 408 (92%) cases presented with gastrointestinal toxicity. Twenty cases of amatoxin poisoning were recorded (11 Amanita phalloides and 9 Lepiota brunneoincarnata). One liver transplantation was needed. We observed 13 cases of cholinergic toxicity and 2 cases of hallucinogenic toxicity. Finally, 46 cases were due to "mixed" toxicities, and a total of 69 needed hospitalization. CONCLUSIONS: Early identification and management of potentially life-threatening cases is challenging in the ED, so that a mycologist service on call is highly advisable, especially during periods characterized by the highest incidence of poisoning.

Mean temperature and humidity variations, along with patient age, predict the number of visits for renal colic in a large urban Emergency Department: results of a 9-year survey.

BACKGROUND: A marked geographic variability has been reported in stone disease, partially attributed to the Mean Annual Temperature (MAT), as well as to the seasonal fluctuations of climatic conditions. Accordingly, peaks in Emergency Department (ED) visits for renal colic are commonplace during the summer. MATERIALS AND METHODS: The aim of this study was to assess the influence of day-by-day climate changes on the number of visits as a result of renal colic in the ED (City of Parma, northern Italy, temperate continental climate). A total of 10,802 colic episodes were retrieved from the database during a period of 3286days (January 2002 to December 2010). RESULTS: The analysis of the data confirms a peak of renal colic cases during the summer, especially in July (maximum number of 4.1 cases of renal colic per day), and a winter nadir (minimum number of 2.7 cases of renal colic per day, in February). The linear regression analysis shows a high and significant correlation between the mean number of cases of renal colic per day and both the mean daily temperature (positive association, R=0.93; p<0.0001) and the mean daily humidity (negative association, R=-0.82; p<0.0001). The influence of temperature and humidity on the incidence of renal colic cases varied widely among age groups, the highest incidence seen in patients aged between 30 and 40years, and the lowest seen for those aged <20 and >70years of age. CONCLUSION: The combined data suggest that the hot and dry climate would favor an acceleration of the process of stone formation, which seems more pronounced in the older population.