The epidemiology, toxidromic classification, general management, and prevention of mushroom poisoning in the United States.

Since the 1950s, reports of severe and fatal mushroom poisonings have increased worldwide. Clinicians must consider mushroom poisoning in the evaluation of all patients who may be intoxicated by natural substances. Because information on natural exposures is often incorrect or insufficient, a new syndromic classification of mushroom poisoning is proposed to guide clinicians in making earlier diagnoses, especially in cases where only advanced critical care, including kidney or liver transplantation, may be life saving.

Cisapride poisoning.

A MEDLINE search from 1966-1996 revealed no reports of cisapride poisoning. An 8-mo-old, 8.9 kg girl received 8 mL of cisapride (Propulsid Suspension, 1 mg/mL, Janssen Pharmaceutica, Titusville, NJ) rather than the usual dose of 0.8 mL, resulting in an inadvertent, 10-fold, iatrogenic, dosing error. She developed emesis, hyperactive bowel sounds, abnormal behavior, mild hyperthermia, tachycardia, hypertension, and thrombocytosis. This is the first published report of poisoning with cisapride.

[Severe poisoning by 4-aminopyridine in a body builder]. / Ernstige intoxicatie met 4-aminopyridine bij een bodybuilder.

A 22-year-old man was admitted to hospital with severe, accidental intoxication with 4-aminopyridine, a medicine which increases the acetylcholine concentration in the synapses and has a limited application in the treatment of some neurological diseases. The patient acted on the assumption of body-building capacities of this 'amino'. Apart from the previously documented symptoms of intoxication such as an epileptic attack and confusion, he showed cardiac arrhythmias, conduction disorders and severe hypertension. The serum concentration of 4-aminopyridine was 335 mg/l, while the therapeutic level is 25-75 mg/l.

Neurotoxic mycotoxins: a review of fungal toxins that cause neurological disease in large animals.

Five mycotoxins found in concentrates or roughages have been shown to cause neurologic disease in livestock. Fumonisin B1 is produced by Fusarium moniliforme and causes leukoencephalomalacia in horses. Swainsonine and slaframine are produced by Rhizoctonia leguminicola and cause mannose accumulation and parasympathomimetic effects, respectively. Lolitrems from Acremonium lolii and paspalitrems from Claviceps paspali are tremorgens found in grasses.

[The value of artificial respiration for patients with myasthenia gravis (author's transl)]. / Die Bedeutung der Beatmung für den krisengefährdeten Myastheniker.

The value of artificial respiration for the bridging of crises in patients with myasthenia gravis is emphasized on some typical cases. Further use, beyond a life-saving indication, for limited periods is described. Such relative indications may exist, when there is not yet complete respiratory failure but when a worsening of myasthenic weakness or cholinergic intoxication may threaten a respiratory crisis. In order to prevent serious complications, early artificial respiration may be indicated in the following situations: deterioration of cardio-pulmonary complications, important changes in therapy, particularly at the start of immuno-suppressive treatment, following tracheobronchial aspiration, in chronic cholinergic intoxication, following operations under general anesthesia, particularly after thymectomy. The importance of careful psychotherapy of myasthenics threatened by respiratory crises and the well-timed information on the chances, intentions and goals of intensive care including artificial respiration is emphasized.